Sympathy vs Empathy vs Compassion

I wrote this title at the start of the year and couldn't really remember what I was thinking or writing about at the time. The concept of empathy, sympathy and compassion came up again recently though when I was reading through some of the material for the RACDS final examinations. At first glance, the differences between these terms are quite subtle but what they mean for us as practitioners has quite a profound difference.

Sympathy is the act of understanding what the other person is feeling i.e recognising their emotions and motivations. Recognition of other's feelings is the basis of our human interaction and is essential in a practitioner's skill-set to get a read for the patient's desires, goals and reasons for seeking treatment. It is really the first step in gaining meaningful information that underpins the whole treatment plan. It is not enough simply to gather objective data about probing depths, carious lesions and restorations. In the end, percieved pathologies are connected to a human being and the same treatment plan and care that satisfies one patient may be grossly inadequate for another if we don't consider their needs in the context of their emotions and motivations.

Empathy takes this further and involves feeling the emotions of others. Some aspects of empathy are important as a clinician in allowing one to build on sympathy and gain a deeper understanding of the patient's perspective but too much empathy can be counterproductive. I was recalling just this week the first time I ever felt out of my depth in a clinical setting. It was third year uni and there was a young woman in the student clinics who had obviously had a troubled past. She was probably only just a few years older than me at the time and all but three of her teeth had been extracted. The remaining teeth were heavily carious and unrestorable and she was in constant pain. The examination was painful for her and she was very understandably emotional about the whole situation. She was a woman in her 20s, in pain and was looking at the close prospect of having no teeth. I was essentially a boy, not far out of high school. I had never seen anyone in proper pain and I had never dealt with that level of despair before. I was stuck still listening to her story and had no idea what to do. I escorted her over for xrays and the supervisor transferred her over to the senior students for management. I recall being quite upset afterwards but can't remember the reason why. Perhaps it was the feeling of helplessness and knowing my inexperience had been brought to the fore or maybe it was my version of empathy where I not only listened to that patient's words but also felt her pain. 

Empathy is good in small doses and we can't be compassionate professionals without some level of empathy but if utilised excessively, empathy can be a tiring and counterproductive experience. To some extent we have to remain impartial and strive to see those objective facts that hide behind the red herring of emotion. The supervisor that day told me that we can't take patient's problems on board or they will become our problems too. He showed me that we need to actively separate ourselves from the situation and do what needs to be done for the betterment of our patients. If we let empathy take over ourselves then we are placed in the same position of helplessness as out patients are.

Then comes compassion. Compassion is the willingness to help relieve the suffering of others. A philosophy of compassion underpins our role as a professional. Without it we are just mechanics of the mouth. Compassion is what we want to attain and it involves healthy levels of sympathy to recognise the patient's emotions and empathy to provide us with the drive to help. Elements of altruism and morality come into the mix as well.

As we proceed in life I think there is a general sentiment that we want to improve ourselves. Some people feel this drive more than others but I don't think that anyone wishes to become worse. Elements of EQ such as sympathy, empathy and compassion don't come naturally to someone like myself. But I think that sympathy is a skill that can be trained up like any other, empathy is harder but the right amount can be gained once you can show sympathy and compassion is what we can all strive towards achieving. Accepting that the gifts that you are blessed with and the knowledge that you have attained can be used for the betterment of others, and accepting that carrying this philosophy will improve not only their lives but yours will put you on the right path to developing a strong sense of compassion. Compassion is what patients will feel before the will see and it will lead to the development of trust which is integral to all we do in dentistry.