Empathy as an interactionally achieved phenomenon in psychotherapy: Characteristics of some conversational resources

Empathy is a central notion in psychotherapy and has been the attention of much research, focusing on its importance for the provider–patient alliance and for the success of psychotherapy. Despite its importance, little effort has previously been made in order to study the details of actual sequences through which empathy is achieved. In this study drawing on the method of conversation analysis, actual interactions between therapists and their patients have been video taped and analysed in detail. The present study describes and analyses three types of empathy that can be identified in actual sequences of talk; cognitive empathy, affective empathy, and sharing empathy. These types of empathy are higher level conversational resources that build on the more basic resources, such as questions, assertions, and other types of utterances and non-verbal behaviour. When empathy is expressed, the patient should receive by responding appropriately to the therapist's prior utterance. This receipt may involve answering questions, agreeing with assertions, demonstrating understanding, and appropriate showing of feelings. A lack of proper receipt by the patient is oriented to by the interactants and may result in signs of conversational failure, such as reformulations, pausing, and an abrupt change of topic.