The Importance of Empathy

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Empathy varies across individuals but can be strengthened through structured reflection and practice.

Mentalization—the ability to understand minds—can be taught and is linked to better mental health.

Early attachment experiences shape how people interpret others’ intentions and respond emotionally.

Recognizing one’s reactive patterns creates opportunities to respond more thoughtfully in relationships.

Some people are more readily attuned to other people's feelings and perspectives, while others are more limited in this ability. Despite this variability, we are all prone to empathic disruptions, which can cause significant emotional and relationship difficulties. However, like many psychological abilities, empathy can be developed and refined with proper interventions and exercises. Thus, some people can undergo what might be called an “empathy makeover,” a process in which they gradually learn to understand others’ experiences more fully, recognize areas that disrupt their capacities, and respond more thoughtfully and constructively.

Empathy is closely related to mentalization (Fonagy and Target, 1997), the capacity to conceive of and interpret mental states (beliefs, desires) as explanations of behavior in oneself and others. Mentalizing includes recognizing that people’s minds work differently, that they can reach different conclusions from the same data, and that they can hold false beliefs about the world. The capacity for mentalization is correlated with many positive measures of mental health, including the mental health of children (Steele and Steele, 2008). Many studies indicate that mentalization skills can be taught (Bateman et al., 2023; Busch, 2008), and such interventions are an important aspect of problem-focused psychodynamic psychotherapy (Busch, 2022).

Empathic and mentalizing capacities are enhanced by secure attachment in one’s childhood milieu (Fonagy & Target, 1997). Children in more secure environments develop a greater freedom to consider others’ states of mind and anticipate more supportive responses from others. People who grow up in more insecure or traumatic circumstances are generally more prone to assuming others in their adult life have malevolent intentions. They may have never learned empathic or mentalization skills or may “hypermentalize” (Bo et al., 2017), on the lookout for anticipated harsh attacks by others. As a result, they tend to respond defensively to what they perceive to be others’ negative judgments and have difficulty appreciating others’ points of view. They may feel that being empathic puts them in a weakened position, allowing them to be taken advantage of by others.

Notably, empathic failures are most likely to occur with those with whom we are closest. We’re most vulnerable to being hurt by them and tend to have our most intense emotional reactions to them. We’re also prone to directly transferring our problematic feelings and expectations from our childhood relationships (particularly with caregivers) to our current family members. Our attention is often drawn inward when feeling criticized, misunderstood, or threatened, limiting our efforts to understand others’ experiences. Life stresses also exacerbate problems being empathic with others, as they typically heighten anxiety, irritability, and self-focus.

There are several strategies for developing the ability to recognize other people’s perspectives, emotional experiences, and expectations, and to take these into account when interacting with them.

Step One: Building a Staging Area

One of the first steps in increasing empathy is learning to consider one’s own and the other person’s reactions before responding. In problem-focused psychodynamic psychotherapy, this is referred to as building a staging area. Journaling or keeping a log of one’s feelings, thoughts, and circumstances that cause empathic disruptions provides clues about one’s own triggers and reactions, creating space to respond differently. An empathy makeover, therefore, requires helping someone become less dominated by automatic reactions and more able to reflect on their own and others’ experiences.

Step Two: Cultivate Curiosity

Empathy and mentalization capacities grow when people become genuinely curious about other minds. Although I don’t treat patients with mentalization-based therapy per se, I often have them consider what the other person may be experiencing. Instead of assuming they already know why someone behaved in a certain way, empathic individuals tend to ask questions such as:

What might others be feeling right now?

What is happening for others at this moment?

What might they be worrying or frustrated about?

What expectations might they have?

What factors might others be responding to in their history, such as trauma or adverse events?

Helping people adopt this stance of curiosity can help modulate their responses and transform interactions. For instance, someone who is unexpectedly attacked by a colleague, friend, or boss may suddenly feel bad or guilty about what they presumably did wrong or become angry or defensive. Considering what is going on with the other person may help to ease these responses. For instance, a patient who was abruptly (and apparently unfairly) reprimanded by her boss was able to recognize that the boss was under pressure from his superiors to complete a project.

The Importance of Empathy

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Step Three: Recognize Patterns in Reactions

Empathy difficulties often follow recognizable patterns. For example, some people offer advice rather than acknowledging others’ feelings. Still others become withdrawn and/or enraged when conflict arises. Helping someone notice these patterns can be a powerful step toward change.

Once individuals recognize their typical responses, they can begin experimenting with alternatives. Instead of offering advice, they might ask a question. Instead of defending themselves immediately, they might first acknowledge the other person’s experience. Over time, these small adjustments can produce significant changes in how interactions unfold.

A brief example demonstrates this process of building empathy. A physician in therapy for anxiety about marital difficulties routinely complained about his wife attacking him for being too withdrawn. He agreed he withdrew, but felt it was the only way to protect himself from her criticisms. He also believed that his work simply did not allow him time to be more available, which his wife did not understand. The therapist began encouraging him to step back, build a staging area, and consider what led him to pull away so quickly from his wife. It emerged that withdrawal had been his defensive stance since childhood to protect himself from an abusive father.

The therapist also encouraged him to consider what his wife was experiencing, and after entering couples therapy, he learned important new details about her background. Her history included a greater severity of neglect and abandonment by her alcoholic mother than he realized. He began to understand the pattern in which his withdrawal would exacerbate his wife’s attacks. He would keep his wife’s history in mind when she criticized him and made active efforts to be emotionally and physically present, including reducing his workload. Although flare-ups would occur, his efforts ultimately eased her frustration, reducing her attacks, creating a more positive cycle between them.

A Skill That Develops Over Time

Like any meaningful change, an empathy makeover rarely happens overnight. It usually develops through repeated experiences of reflection, curiosity, and addressing problematic patterns. Small shifts in how someone approaches a partner or child can gradually reshape their interactions. With practice, most people can expand their ability to understand others’ experiences and respond with greater sensitivity and insight. When that happens, conversations become less about defending positions and more about discovering what each person is actually trying to express—a shift that benefits everyone involved.

Bateman, A. W., Fonagy, P., Campbell, C., Luyten, P., & Debbané, M. (2023). Cambridge guide to mentalization-based treatment (MBT). Cambridge University Press.

Bo, S., Sharp, C., Fonagy, P., & Kongerslev, M. (2017). Hypermentalizing, attachment, and epistemic trust in adolescent borderline personality disorder: Clinical illustrations. Personality Disorders: Theory, Research, and Treatment, 8(2), 172–182.

Busch, F.N., editor. Mentalization: Theoretical Considerations, Research Findings, and Clinical Implications. Hillsdale, NJ: The Analytic Press, 2008.

Busch, F.N. Problem-Focused Psychodynamic Psychotherapy. Arlington, VA, American Psychiatric Press, 2022.

Fonagy P, Target M: Attachment and reflective function: their role in self-organization. Dev Psychopathol 9(4):679–700, 1997

Steele, H., & Steele, M. (2008). On the origins of reflective functioning. In F. N. Busch (Ed.), Mentalization: Theoretical considerations, research findings, and clinical implications (pp. 133–158). Analytic Press.

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