The inspiration for today’s article comes from a keynote address that was delivered at my sisters medical school Hippocratic oath ceremony by Brian Goldman, a well known Toronto area ER doctor and author.

He spoke about the importance of  kindness and empathy as a fundamental component of healthcare practice and I want to share a little bit about what I learned as a result of his pretty powerful address.

He obviously spoke about the doctor’s perspective but for the sake of today’s article I am going to extrapolate his points to the dietetic profession, which I believe is  quite reasonable.

To preface this whole article, the man has written a book called The Power Of Kindness.

He knows what he’s talking about!

Kindness Vs Expertise

Before we move on we have to accept that to be a truly great dietitian, or healthcare practitioner of any variety, it is not enough to be JUST an expert or to be JUST kind.

You need to have both.

Being an expert who is unkind, or a very nice person who doesn’t know what they are talking about, is insufficient.

Kindness & Empathy

Empathy is formally described as follows:

The psychological identification with or vicarious experiencing of the feelings, thoughts, or attitudes of another.

Kindness is formally described as follows:

The act of being  good or of benevolent nature or disposition, as a person

In short: Kindness is truly wanting to help,  empathy enables you to understand how to help in the best way possible.

The Importance Of Empathy & Kindness In Dietetics And Healthcare In General

Dr Goldman’s story starts with a recollection of the first ever instance when he was told by a patient’s family that he was unkind.

He said this was an especially painful revelation for him because he believes that if a patient says  ” you don’t know what you’re doing”, there is every possibly that they are wrong, but if they say you are unkind, they’re probably right.

It was not until several months later when his own family was treated coldly  by a physician in the events leading up to the death of his father that he realized just how important kindness and empathy are in medical practice.

At that point, he essentially set out on a journey of self-discovery  (which culminated in the writing of his book) where he learned that both kindness, and empathy, are absolute essential characteristics of a good doctor ( and, by association, a good dietitian too!) and that patient-doctor interactions that are rich with empathy and kindness tend to result in better patient outcomes.

There’s research to support that notion as well!

One of the really important conclusions he came to, which brought him back to his experience with his father’s attending doctor at the time of his death, is that the challenges and pain you’ve felt as an individual throughout your life are actually some of the best feelings you can channel to help you become more  empathetic.

Take-Away Message #1: The more in-tune you are with your own life’s pain and struggles, the more likely you can empathize with any given individual, because you’ve been there.

There’s more to empathy than that however!

Emotional Vs Cognitive Empathy

Did you know that there are AT LEAST two, very different, types of empathy?

I honestly had no idea until Dr Goldman dropped some of this knowledge on me.

Let me break it down for you to the best of my recollection:

Emotional (or affective) Empathy: Emotional empathy, also called affective empathy, is basically an automatic and unconscious response that we have when other people share their feelings ( good or bad) with us.

If I understood the presentation correctly, this type of empathy is not necessarily something we can really manipulate.

Cognitive Empathy:  The second type of empathy that Goldman discussed,  cognitive empathy, appeared to be something he considered to be more important and , in fact, something that could be improved with attentiveness, experience and intention.

Upon exploring the concept further ( because my memory of the day could only take me so far) it appears that cognitive empathy is, in fact, also known as perspective taking, which is what I believe most people think of when they think about empathy in general.

As you may already know, perspective taking is akin to “putting yourself in someone else’s shoes” with the goal being to better understand their emotional state.

It appears to be generally understood that ,  yes, this type of empathy is much more of a skill and how accurately and effectively you are able to “take” someone’s perspective requires nurturing and a truly deep understanding of the individual.

Here are some important considerations about Cognitive Empathy:

1. It’s about genuinely comprehending someone’s mind and their feelings and it’s not enough to just ” try to do it”, there are varying degrees of accuracy with which it can be done.

2. It’s not based on having feelings ( like emotional empathy) it is based on THINKING about feelings deeply , hence why it is called cognitive empathy .

3. In order to be effective at this you must be able to adopt a person’s perspective in order to learn what drives them, what excites them, what scares them and what holds them back.  If you are able to truly understand those things, you can offer that much better guidance as a practitioner.

4. Perspective taking, as per point #3, is more complicated than you think because, guess what, there are TWO types of that too.

Self Vs Other-Oriented Perspective Taking

This is yet another facet to empathy that I’ve come across, and something that is probably widely misunderstood.

I was introduced to the different types of perspective taking upon reviewing a journal article on empathy by David Jeffrey.

Many of us think that empathy is all about “putting ourselves in someone else’ shoes”, but there is more than one way to do this.

Self-orientated perspective taking is actually more like sympathy ( which is kind of like empathy’s evil cousin) than it is  empathy because we imagine ourselves in someone else’s situation.

The mistake we make in doing this is assuming that we will think and feel as they do in that situation and we make decisions based on this feeling, when in fact they may perceive their own situation very differently than we would if we were in that situation.

I know this is something that I need to keep in mind because I’ve certainly been guilty of this in both personal and professional life.

Have you?

Contrarily, Other-orientated perspective taking is centered around both putting yourself in someone else’s shoes AND their mind, meaning you put your thoughts, emotions and feelings COMPLETELY to the side and attempt to adopt someone else’s way of thinking.

Easier said than done.

This is something that requires practice and probably a skill that many young practitioners don’t even really think about it.

I encourage you to keep this very point in mind, regardless of where you are at in your training or career.

Final Thoughts 

I hope you’ve learned something new about empathy and kindness that will push you to become a kinder, more empathetic practitioner and thus greatly improve your effectiveness and your patient’s success.

Thank you to Dr Goldman for an exceptional keynote address and I hope I’ve been able to accurately convey your story and message with today’s article.

I will close today’s post with Theresa Wiseman’s four attributes of empathy:

• To be able to see the world as others see it—This requires putting your own “stuff” aside to see the situation through your loved one’s eyes.

• To be nonjudgmental—Judgement of another person’s situation discounts the experience and is an attempt to protect ourselves from the pain of the situation.

• To understand another person’s feelings—We have to be in touch with our own feelings in order to understand someone else’s. Again, this requires putting your own “stuff” aside to focus on your loved one.

• To communicate your understanding of that person’s feelings—Rather than saying, “At least you…” or “It could be worse…” try, “I’ve been there, and that really hurts,” or (to quote an example from Brown) “It sounds like you are in a hard place now. Tell me more about it.”

Before leaving make sure to take a moment to ask yourself.. Do you  catch yourself doing all of the above? Do you check each of these four boxes?

Something to think about.

Until next time,

Andy De Santis RD MPH