Journal of Family Therapy (1992) 14: 193-205 01634445 $3.00

How do we understand empathy systemically?

Mary Wilkinson*

This paper considers what a systemic understanding of empathy might be in the context of recent developments in systemic approaches. Clinical work is the basis for an exploration of which systemic ideas might be useful in thinking about ‘systemic empathy’. The question of whether empathy is inherent in the systemic approach is considered.

Introduction

In some models of therapy, empathy is considered essential to the therapeutic relationship. Rogers (1957; pp. 219-235) described the ‘conditions’ he considered necessary for therapeutic change. Three of these related specifically to the therapist’s own behaviour: congruence, unconditional positive regard, and ‘empathic understanding of the client’s internal frame of reference’. The therapist should be able to communicate ‘accurate empathy’ successfully to the client, through ‘reflecting feelings’.

Writing thirty years later (1986a, 1987; pp. 127-129), Rogers expressed concern that ‘reflection of feelings’ had become a ‘wooden technique’. He suggested that the therapist responses he envisaged might be more accurately described as ‘testing understandings’ or ‘checking perceptions’. The therapist’s intention is not merely to reflect feelings, but to determine whether his or her ‘understanding of the client’s inner world is correct’, setting aside personal judgements and values. Ideally ‘the therapist senses accurately the feelings and personal meanings’ of the client, and is ‘so much inside the private world of the other that he or she can clarify not only the meanings of which the client is aware but even those just below the level of awareness’ (1986b; pp. 135-1 36).

The concept of empathy, however, has not been given particular attention in systemic therapy. In this paper I am interested in exploring what language might be appropriate to describe empathy,

* Social Worker, Norfolk Social Services Department, Woodlands, 381 Dereham Road, Norwich NR2 4DJ, UK.

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in relation to systems as well as individuals. Which systemic principles might be useful in conceptualizing empathy, and how might they relate to practice? I shall focus on those ideas which my own clinical practice has led me to reflect on recently. I shall not attempt to define systemic empathy, as writing this paper will be a process of redefining, rethinking and reconceptualizing as I consider how far empathy is embodied in, and created through, systemic principles.

Connecting

Bateson’s concepts of pattern and connection (1979; pp. 8-9) may be useful in considering how we understand empathy systemically. A way of thinking about empathy might be in terms of how family members, for instance, connect with each other; how therapist and team connect; how therapist, team and family members connect; the connections they make together between action and meaning.

Therapy occurs in the context of relationships, between individuals, between systems; if we locate empathy ‘in’ the therapist, in only one part of the therapeutic system, we are ignoring the process, the patterns of interaction between therapist and client(s). Bateson’s principle of ‘double description’ (1979; pp. 132-1 33), which is helpful in conceptualizing relationships between family members, is equally helpful in viewing the therapist-therapy team-client(s) relationship (Bateson, 1979; p. 133; Keeney, 1983; pp. 37-38), so that we begin to notice patterns of interaction and connections between people.

The D f a m i b

I shall consider a session with this family, in terms of how I connected with family members, how family members connected with each other, and how I and the team connected.

A worried GP referred the family because of concerns about James, aged 15, the second of three sons. He was lying, stealing, truanting, and ‘sniffing’. James came to the session with his mother, a single parent, and younger brother, Luke. After the first session, the observing team commented on my way of questioning, and the intonation of my voice: ‘Social-worker-like, very caring, empathic, losing neutrality. What’, they wondered, ‘was it about the family that brought this forth?’ Apparently, this had been particularly evident at the beginning of the interview.

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In the session, whenever I talked to Mrs D, James withdrew; when I talked to James, Mrs D withdrew. I attempted to engage each by ‘showing empathy’ towards himlher. I demonstrated an individualized ‘selective’ empathy, rather than ‘systemic’ empathy. Perhaps each time I talked to James he felt more ‘understood’, his mother felt less ‘understood’; when I talked to her the reverse happened. This is one hypothesis about what we co-created at the beginning of the session. So I went from one to the other, with a particular questioning intonation in my voice. One of the team commented that it was as if I were saying: ‘Please talk to me, I am interested in you as well, and not just your sonlyour mother’.

I recognize that as part of my ‘professional life-script’ (Cronen and Pearce, 1985) there has been a belief that I should show my empathic understanding through expressions of concern, warmth, sympathy. At the level of ‘agency script’ there has perhaps been a social work ethos that empathy is crucial in the helping relationship. During my social work training ( 1976-8) I was impressed by the findings of Truax and Carkhuff (1967). They identified the essential characteristics of the effective counsellor as genuineness, non-possessive warmth, and accurate empathy. It seemed that these qualities were also essential for any effective social worker; one of the major themes of social work literature has been the centrality of the therapeutic relationship between worker and client (e.g. Davies, 1981).

I am aware that this set of beliefs from my social work training can be activated with some individuals, or families, and can organize my behaviour. When ‘showing empathy’ in that particular way has become my higher context marker (Cronen and Pearce, 1985; p. 72), I have lost neutrality, circularity and curiosity (Cecchin, 1987). When I have been trying hardest to demonstrate empathy I have probably been least systemically empathic; the purposeful effort has been counter-productive and non-therapeutic (cf. Keeney and Sprenkle, 1982; p. 14).

As our team discussion proceeded, it seemed that beliefs had been triggered about engaging people, especially people in opposition to each other, as Mrs D and James appeared to be. My belief seemed to be that if you are empathic you engage people, you engage people through empathy.

If I had been aware, at the time, of how my beliefs were organizing my behaviour, instead of relating to mother and son in an individualized way, I might have moved into a stance of curiosity, hypothesized about the process, and asked more circular questions

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about their relationship (Palazzoli et al., 1980; Cecchin, 1987). I might have asked Luke for his comments on the pattern of interaction between his mother, brother and myself. I might have observed the isomorphism between my interactions with family members, and between Mrs D and her sons. Maybe in my efforts to be ‘fair’, I was picking up the importancc of fairness in this family. If I had been aware of these processes at the time I might have been more empathic to the system, and used my awareness to focus on process, rather than content, and to make connections with the family’s belief system.

The observing team noted that as the interview progressed my intonation changed, I asked more circular questions, and the conversation became more animated; it seemed that each member of the system was engaged. I reframed their disagreements about how James started ‘sniffing’ as being loyal and protective. My interest in their beliefs led me to ask more circular questions about the different meanings for them of ‘punishing’ and ‘rewarding’ and ‘getting attention’. Through questioning, distinctions were drawn; for Luke, attention was a reward, for James, a punishment. Mrs D was confused about whether James was punishing her. My curiosity about the meanings attributed by each family member to specific behaviours drew out the differences between them, and perhaps enabled each to reflect on her/his own assumptions, and the assumptions of other family members.

In our final message to the family we were able to address their relationships systemically by identifying their dilemmas. I wonder if this encouraged systemic empathy between mother and son by offering them an alternative version of the story they brought. Supposing each felt I understood him/her; would that in itself have been enough to lead to a shift in perceptions? I rather doubt it. It might have made some difference to Mrs D if she thought James had some understanding of her dilemma, and for James if he thought his mother had some understanding of his. Again I wonder, though, if that would have been sufficient to create a context for change. In describing their dilemmas we did not just reflect them but made new connections, and gave a positive connotation to the behaviour of both mother and son (Palazzoli et al., 1978). In identifying a pattern that connected them our intervention might be described, in Bateson’s terms, as having an ‘aesthetic’ quality, a systemic empathy perhaps?

Mrs D’s behaviour, which James framed as ‘punishment’, we reframed as ‘protective’. His behaviour, perceived by his mother as evidence of the ‘wrong attitude to life’ and ‘deliberate disobedience’,

Understanding empathy systemically 197

we reframed as ‘confusion’ about what kind of man he might become, compounded by divided loyalties. This alternative explanation incorporated information they had given us, but with a different perspective of their relationship, a double description. From their responses to the message it seems that there had been enough of a ‘fit’ for them (Von Glasersfeld, 1984; pp. 20-21). The explanations we had offered for the behaviours of Mrs D and James may not have ‘matched’ exactly, that is, been the same as the descriptions each might have given of her/his behaviour, but they were close enough to make sense; they ‘fitted’ well enough, so that like the key which is a good enough fit to open the lock, they had the potential to unlock some reciprocal understanding. Perhaps ‘fit’ is what we might understand as systemic empathy.

At our second and final session, two months later, they reported a great improvement. James said he had found the sessions helpful because ‘everyone discussed what they felt’; it was different from what happened at home. It seemed significant that James had valued being interviewed by someone who, he assumed, had no assumptions about him. I wondered if my lack of assumptions and my curiosity had aroused his own curiosity about himself and family relationships; and if my neutrality, once I had regained it, had led to his feeling that he was not being blamed, and so was freer to consider alternative views.

In my work with the D family, certain systemic principles seemed to embody in action the concept of systemic empathy: neutrality, circular questioning and positive connotation created a process where there was sufficient ‘fit’ for mother and son, and therapy team.

Fit

Pearce (1989) suggests: ‘If our stories are compatible, all will be well, and we will understand each other.’ I like the idea of ‘compatibility’. The ‘story’ the therapist offers needs to be new, but not too new; it needs to be suffkiently different to offer a new perspective, but not too different or it will not make sense to the client. T o be with people who are in the process of change requires that the therapist has the capacity to change too, and the ability to enter imaginatively not just one person’s ‘world’, but many; to entertain many different stories, meanings, perceptions. A therapist may be more able to maintain a stance of systemic empathy if she or he can put ‘objectivity-in- parenthesis’ and think in terms of ‘multiversa’ where all views are equally legitimate, if not equally desirable (Efran and Lukens, 1985;

198 Mary Wilkinson

p. 25; Maturana, 1988; p. 31; Mendez et al., 1988; pp. 146-154). Then the therapist respects each person’s view as equally valid, so everyone feels respected, and no-one feels unheard, or discounted. As we found with Mrs D and James, ‘fit’ is about compatibility - the compatibility, or complementarity, of the key and the lock; they do not need to ‘match’ each other perfectly. Many keys shaped differently will have a good enough fit to open the same lock (Von Glasersfeld, 1984; pp. 20-21). Systemic empathy then is inherent in the concept of fit.

Structural coupling

Maturana’s concept of ‘structural coupling’ is helpful when consider- ing the relationships between therapist-and-team, therapist-and- family and therapist-team-family, and the way they ‘shape’ each other’s responses. In creating a therapeutic context it is helpful for the therapist to become ‘coupled’ to the family system in a way that is not constrained by family rules, or a particular perspective. Being ‘coupled’ to the team through the process of hypothesizing and team discussions may enable the therapist to maintain almost a free- floating position between the two systems, family and team (Leyland, 1988; pp. 366-368; Varela, 1989, p. 24). The therapist is then free to enter many worlds, and free to leave them.

Hypothesizing

Dilemmas raised for therapists by their subjective responses to clients can be addressed very usefully by a team perspective. Because of differences in gender, class, culture and life experiences, personal and professional, of the various team members, a team has a greater potential than the individual therapist to offer a wide range of different perspectives and different punctuations (Selvini and Selvini Palazzoli, 1991).

Pre-session hypothesizing may free up the team and may facilitate the process of entering into different people’s worlds, appreciating different, sometimes alien, perspectives, and gaining a systemic understanding of problem behaviours. Inherent in this freeing-up kind of hypothesizing may be the capacity for systemic empathy. Hypothesizing may facilitate understanding, which is not a fixed state, owned by the therapist, but a recursive evolving process involving all members of the therapeutic team. Hypothesizing may enable teams to avoid premature conclusions based on their own

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assumptions as long as they remember the old adage, ‘Don’t fall in love with your hypothesis!’ Teams need to be constantly alert to the danger of having favourite hypotheses, and of converging in their thinking.

Neutrality and curiosity

The concept of neutrality (Palazzoli et al., 1980) is a basic principle of systemic therapy, and possibly the most misunderstood. Neutrality is not about the therapist being an observer who maintains a cold, aloof, distant manner (Boscolo et al., 1985; pp. 275-282; Cecchin, 1987; pp. 405417; Cornwell, 1989; pp. 102-103; Varela, 1989; p. 22). Rather, neutrality is a state of curiosity, of non-blaming, of ‘multipartiality, taking all sides and working within all views simultaneously’ (Anderson and Goolishian, 1988; pp. 372-385). Neutrality and empathy are not mutually exclusive; multipartiality is not the same as impartiality.

Curiosity enables the therapist to maintain neutrality, to continue to look for other descriptions, rather than being satisfied with one; to look for the patterns that connect; to be ‘aesthetic’ (Bateson, 1979; pp. 8-9). If we listen to different family members’ explanations, we can maintain neutrality and curiosity and avoid agreeing or disagree- ing which may ‘block’ further exploration; agreement with one person’s explanation may imply disagreement with, and invalidation of, another’s (Furman and Ahola, 1988). A neutral stance enables the therapist to co-create with all the family members a new story where both/all explanations fit.

If we become acquainted with the causal explanations, the different constructs and beliefs of each person involved, their attempted solutions become more understandable as they are consistent with each person’s causal explanation. The therapist may begin to understand the connection between the way someone thinks and the way she or he acts. The process of looking at explanations which tend to be causal may facilitate understanding which is about meaning (Sadler and Huigus, 1989; p. 259); curiosity and neutrality combine to facilitate the creation of systemic empathy.

Circularity

Thinking about how we understand empathy systemically led me to consider again Tomm’s description of circularity (1987; p. 8). He

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points out that circular questioning can be used mechanically, and in a way that could be abusive, when the therapist is mainly concerned in searching for openings to use. Circular questioning used in this way not only fails to provide space for clients to create their own solutions, but also stifles empathy. It is notjust what the therapist does, i.e. ask circular questions, but how it is done.

Positive connotation

The concept of positive connotation (Palazzoli et al., 1978; pp. 55-66) is central to a systemic understanding of empathy. Palazzoli et al. found that positively connoting the symptom of one person had the effect of negatively connoting the behaviours of other family members; this process might be described as selective empathy. They found it was more helpful to positively connote the behaviours of all members of the system, recognizing that the system cannot be otherwise than it is at present.

The therapist needs to be attentive to the whole system, and to how individuals within the system perceive their difficulties, and their own explanations for those difficulties - to recognize the struggle. Otherwise, positive connotation is likely to be experienced by clients as glib and dismissive, a slick technique, and it will not fit for them. If the therapist, however, has been attentive then the positive connotation is more likely to fit, and clients are more likely to experience a sense of the therapist having some understanding of their struggles, and some appreciation of their good intentions. They are more likely to be open to consider alternative views of their situation, if they feel ‘witnessed and accepted’ (Real, 1990; pp. 265-267), and if they are positively rather than negatively connoted (Hoffman, 1985; p. 391). What we offered the R family was a positive connotation of their current difficulties.

The R farnib

Another example of a situation where two family members were in opposition occurred in my work with the R family. Simon, privately fostered by Mr and Mrs R, had told his social worker he wanted to live elsewhere after two recent family rows. Mr R said Simon could leave; he did not care.

During our discussion, Mrs R told us that Mr R had ‘lost’ his own son from his first marriage; this new information enabled us to offer

Understanding empathy systemically 20 1

the family an alternative story ab0u.t the relationship between Mr R and Simon. The prevailing story was that they did not care about each other; Simon wanted to leave, and that was fine by Mr R.

Through questioning and maintaining a neutral stance, it was possible to gain a different perspective of their apparently uncaring attitudes towards each other, and we offered this in our final message. We made a link between Mr R and his foster son and reframed their apparent rejection of each other in terms of how difficult it was for each of them to be close to the other because of previous losses. Mr R had lost his son and Simon had lost his mother; both feared another loss if they got too close. In a way, each of them, by not getting close, was protecting the other from further hurt. We hoped that our acknowledging their discomfort was affirming, and that the connection we made between their experiences would ‘seed’ some understanding between them.

There was no verbal response to our message, but the atmosphere in the room became noticeably less tense. The systemic principles of neutrality and curiosity seemed to create empathy systemically, not only between myself, the team and fkmily members, but also between Mr R and Simon.

The N f a m i b

In this family, mother and daughter were closely connected; Sadie, aged 14, the middle and brightest daughter of three, had been refusing to go to school for the past few months. She had always been caring and protective towards her mother, and had taken/been given the dominant role in the family since her father’s departure, four years previously.

At the beginning of the first session, attended by Mrs N and Sadie, I asked Mrs N to describe what happened when Sadie refused to go to school. I was interested in their own explanations for Sadie’s school refusal.

Mrs N’s explanation for not making Sadie go to school was that Sadie was unhappy there. That belief made it difficult for Mrs N, who had always had a very close relationship with Sadie, to make her daughter go to school and cause her to be unhappy. Sadie, who had always been protective towards her mother, was upset by her mother’s distress when she refused to go to school. Both spoke of feeling guilty about making the other unhappy.

Exploring their belief systems and their explanations of their

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problem enabled me to gain some systemic understanding of the experience of each of them, and the meaning of their actions. I t seems that each felt responsible for the other’s happiness and unhappiness; this was their highest context marker. Exploring further their relationship by asking questions about Mrs N’s relationship with her own mother, and with her other two daughters, highlighted the importance to both Mrs N and Sadie of this mother-daughter relationship, for support and companionship. The process of question- ing, from a neutral stance, brought out the strength of the beliefs which informed their actions. Our positive connotation of their closeness, mutual caring and concern was very affirming for them. From that position we were able to move on to challenge gently Sadie’s ideas that she needed to look after her mother by staying at home.

In relation to this family, the issue of how we understand empathy systemically involved exploring their explanations and their beliefs, the meaning in their system of mother-daughter relationships, and what the fit was between Sadie’s school refusal and their belief system.

Some conclusions

At the beginning of my exploration of how we might understand empathy systemically I had wondered why the term ‘empathy’ was not often used in the context of systemic therapy. Was empathy not considered important, or were different words used to describe it, or was its existence taken for granted, and so not commented upon? What differences were there between being empathic to an individual, and being empathic to a system, and its individual members? How might professional beliefs about empathy affect a therapist’s behaviour? Did empathy always facilitate therapy? What meaning did ‘being understood’ have for clients? Might it seem reassuring, affirming, liberating, or controlling and intrusive? What beliefs informed the choices therapists made about how they used their ‘understanding’ of clients? Was empathy a useful concept to be incorporated into systemic therapy, or was it already inherent in the systemic approach?

Certain ideas and concepts seemed useful in thinking about empathy systemically, and also seemed to be helpful in practice. These included the concepts of fit, structural coupling, hypothesizing, neutrality, curiosity, circularity, and positive connotation. There were times when one of these ideas might become less useful if relentlessly pursued, in a linear way and in isolation; for example, positive

Understanding empathy systemically 203

connotation or a particular hypothesis. When that happened, other systemic ideas about self-reflexivity, about multiversa, could redress the balance. A team could be particularly helpful in offering different perspectives. Systemic empathy does not describe a process which occurs within the dyadic relationship of a therapist and a client; rather it describes a multi-dimensional process operating on many levels of meaning between therapist, team members and family members.

The main difference between Rogers’ definition of empathy and a systemic understanding of the process seems to be a matter of emphasis. Rogers’ main interest wa,s in the process of the therapist’s entering into an individual’s inner, private world, with the relationship between therapist and client providing the context for change.

The systemic therapist’s stance of neutrality and curiosity seems very similar to the person-centred therapist’s unconditional positive regard. The emphasis for the systemic therapist, however, is not so much on the therapeutic relationship, or the therapist’s entry into the individual’s private world, but on the connections between people, and between their different belief-systems. I t is this wider system, or network of relationships, which is tlhe focus, and which provides the context for change. That is so whether the therapist is working with an individual, a couple, or a family group.

The process of circular questioning enables connections to be made, whether or not all members of the system are present. Rogers, working mainly with individuals, was most interested in the communi- cation to the client of the therapist’s empathic understanding, and the effect of this on the client. I suggest that the systemic therapist would see the creation of empathic understanding between members of a system as equally important, and would engage them through circular questioning, through maintaining a stance of neutrality, and through positive connotation, in a process whereby they would become involved in reaching understandings of others, as well as of themselves.

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