EMPATHY WITH LIKED AND DISLIKED PATIENTS

THOMAS LANGDON HEISKELL, Purdue University

Abstract

Therapists judge clients they like as having better prognoses and outcomes than patients they dislike. Some research suggests that therapists show more empathy with clients they like, as well as attending to the strengths of their liked clients. This study investigates the relationship between liking for a patient and empathy shown towards the patient. Two hypotheses were tested: (I) Subjects will bring forth higher levels of empathy when working with a patient they like than when working with a patient they dislike, and (II) Subjects will convey at least as much empathy towards a liked patient's positive self-references as to the patient's negative self-references, with any differential being in favor of their positive self-references. Subjects will convey higher levels of empathy towards a disliked patient's negative self-references than to a disliked patient's positive self-references. These hypotheses were tested in a therapy analogue study employing 23 male junior-year medical students as quasi-therapists, and 20 videotapes of male V.A. psychiatric outpatients as the clinical material to which the students were asked to relate. Students were asked to give meaningful formulations of the communications of both a patient they liked and a patient they disliked. Each patient "interview" consisted of the patient making two positive self-references (i.e., statements of strengths) and two negative self-references (i.e., statements of weaknesses). One of each patient's positive and negative self-references had previously been shown to the medical students as a basis for the students to arrive at their affective assessments of the patients. In the "interview" phase students were asked to communicate their understanding of what the patient said and felt after each positive or negative self-reference statement. Raters assessed the level of empathy each student response embraced. The study thus lent itself to a two (responding to a liked and disliked patient) by two (responding to patient positive and negative self-references) by two (responding to familiar and unfamiliar self-references) within-subjects analysis of variance, with empathy being the dependent variable. Hypothesis I was not supported. No differences emerged in the levels of empathy students brought forth with their liked and disliked patients. Hypothesis II was generally supported in the full sample. In conducting a priori comparisons within a predicted trend, it was found that students did not differ in the levels of empathy they offered in their formulations of the positive and negative self-references of patients they liked. Students did offer higher levels of empathy in their formulations of the negative self-references of patients they disliked than they offered in their formulations of these patients' positive self-references. An even clearer pattern, favoring the positive self-references of liked patients and the negative self-references of disliked patients, emerged when six subjects who showed indications of unreliability in their affective assessments in the final phase of the study were excluded in a secondary analysis. In both analyses liked patients were seen as having better prognoses and as being easier to empathize with than disliked patients. Students also were more satisfied with their replies to their liked patients.

Degree

Ph.D.

Subject Area

Psychotherapy

COinS