A Healthy Dose
of Empathy
Gabriela Clayton
Loyola
University Chicago
December 11, 2012
A
recent Huffington Post article outlined the results of a 2012 research study
done by Michigan State University of doctor-patient empathy and the effects
that are correlated with the conditions of an empathic doctor as opposed to a
non-empathic doctor. The results of the study conclude that patients who
experienced empathic doctors also experienced a higher tolerance of pain.
Though this study is a primary one in which the underlying mechanisms were not
discovered, it opens doors to new research into the effects of doctor-patient
relationships upon the patients’ health status and how it develops. To begin to understand the effects of
receiving empathy, one must first consider the importance of empathy evolutionarily,
and its development from infancy into adulthood. Jean Decety and Margarita Svetlova in their
2011 empathy empirical research, “Putting together phylogenetic and ontogenetic
perspectives on empathy”, outlined many of the underlying roots of empathy
evolutionarily, biochemically, and neurologically. They argue that it is
essential to consider empathy within these frameworks because empathy is
“grounded in multiple interacting systems and processes” (Decety et al). By deciphering where empathy is learned, and
how it is developed and displayed, would bring important insights into the
responses of being shown empathy.
Decety et al. root empathy in the attachment and
interaction between a mother and her offspring. They cite that the evolutionary
roots of empathy are an important component of mammalian evolutionary fitness.
Decety et al. claim that the root of empathy is a mechanism for reproductive
fitness and survival, so it basically evolved as a survival mechanism for the infant,
the mother feels empathic toward the needs of the infant and thus responds
accordingly. Empathic arousal and concern are common traits in most all
mammalian species. Empathic concern evolved during the evolution of fetal
gestation; internalizing reproduction gave rise to new behaviors including
parenting, and attachment (MacLean, 1985). Once mammals began to parent their
offspring they were given increased exposure to emotional signals of others and
thus were able to form adaptations to deal with this new environmental stimulus
(Decety et al.). The ability to perceive and respond to distress, fear, pain
and hunger are important in ensuring the survival of the genetic legacy of
mammalian species.
Empathy is first imparted upon the young from the mother.
The mother is neurologically and biochemically programmed to attend to and take
pleasure from attending to the needs of her young. Numan and Sheehan’s 1997
study about the neuroanatomy of mammalian maternal behavior indicates that
during late stages of pregnancy rising estrogen and prolactin levels and waning
progesterone levels act on mechanisms in the brain to either decrease fear and
aversion, or increase attraction and approach behaviors in response to infant
related stimuli. In addition, oxytocin (an amino acid peptide) is known to facilitate
attachment behaviors by decreasing natural avoidance behavior (by decreasing
fear and anxiety, and increasing tolerance to stressful stimuli) and thus
facilitating approach behavior (Carter, 1998). Carter et al. in their 2008
study has also demonstrated that oxytocin facilitates maternal behavior in that
the levels of oxytocin increase within the mother while she is near her infant,
decrease when she is separated from her infant (in fact cortisol, the stress
hormone, levels increases during separation) and oxytocin increases again once
she is reunited with her infant. This is congruent with the research indicating
that brain processes parental care is a rewarding experience. The evidence for this comes from a 2005 study
where it was observed that in fMRI scans of during the process of mother rats feeding her pups the addiction
and reward brain centers showed greater activation than when given the stimulus
of cocaine (Ferris et al., 2005). So mothers are preprogrammed to attend to the
needs of her young to increase evolutionary fitness, but what is more is that
in attending to the needs of her young she receives greater reward and
addiction than when given highly addictive and rewarding stimulants; thus the
act of empathy is evolutionarily rewarding in more ways than one.
From the beginning of life the infant observes the
behavior of the mother and through this observation the infant begins to build
schemas about the world and about behavior.
It has been demonstrated that infants as young as 8 months can display
empathic responses to signs of distress (Roth-Hanania et al., 2011). Roth-Hanania
et al. in their study conclude that “young
infants’ understanding of the internal states of others also includes their
ability to comprehend others’ emotional states – at least that of distress –
and to respond to them with emotional attunement”. This may be due to the
mother granting the infant the same emotional attunement when they display
signs of distress. Empathic behavior in humans develops more in the second year
of life when the child is better attune to awareness of the experiences and
emotions of others and the regulatory abilities of their own emotions (Decety
et al.) The empathy shown by the mother is passed along into the behavior of
the child, whom is already predisposed to the ability of empathy through
evolutionary progress, as the child gains cognitive awareness the empathic
reasoning, understanding, and responses increases.
From an early age humans are exposed to empathic responses to
their distressing needs, this may elicit a positive reaction to empathic
responses during times of vulnerability during later years in life. Humans are
predisposed evolutionarily to altruistically aid their kin, but also humans
have the unique ability to act altruistically in the favor of non-kin (Decety
et al.). This altruistic act in the favor of non-kin has proven to a degree to
be necessary in the hospital environment. During the time of vulnerability
where a patient’s health is degrading the patient may feel as helpless as they
had as an infant or child, albeit unconsciously. The inability to maintain
equilibrium with their health is positively correlated with high stress levels,
which by nature is positively correlated with elevated levels of cortisol
(Marmot et al., 2005). Empathy has shown to enhance oxytocin levels, which reduce
the secretion of hormones like cortisol (Decety et al.). By reducing cortical
levels and increasing oxytocin levels stress, fear, and anxiety is reduced.
However, there is little to none research done on the effects of empathic
responses have upon the person that they are aimed at, it could be hypothesized
that is induces increased oxytocin levels. This can be inferred from the
response of patients from the empathic actions of the doctors in the Michigan
State University doctor-patient empathy study. In all, empathy displayed by the
doctor may help to ease the pain of patients because all humans are
evolutionarily exposed to empathy from the beginning of life and this exposure
may predispose us to positive reactions later in life from experiencing empathic
responses from others.
References
Decety,
Jean, and Maragrita Svetlova. "Putting Together Phylogenetic and
Ontogenetic
Perspectives on Empathy." Developmental
Cognitive Neuroscience 2 (2011): 1-24. Print.
Carter,
C.S., 1998. Neuroendocrine perspective on social attachment and love.
Psychoneuroendocrinology 23, 779–818.
Carter,
C.S., Grippo, A.J., Pournajaļ¬-Nazarloo, H., Ruscio,M.G., Porges, S.W., 2008.
Oxytocin,
vasopressin and sociality. Progress
Brain Research 170, 331–336.
Chan, Amanda L. "Doctor Empathy Could
Decrease Stress, Pain Sensitivity In Patients:
Study." Huffington Post. AOL Lifestyle,
4 Dec. 2012. Web.
MacLean,
P.D., 1985. Brain evolution relating to family, play, and the separation call.
Archives
of General Psychiatry 42, 405–417
Marmot, M. G., and Richard G. Wilkinson. Social Determinants of Health.
Oxford: Oxford UP,
2006.
Print.
Numan,
M., Sheehan, T.P., 1997. Neuroanatomical circuit for mammalian maternal
behavior.
Annals of the New York Academy of
Sciences 807, 101–125
Ronit Roth-Hanania,
Maayan Davidov, Carolyn Zahn-Waxler, Empathy development from 8 to
16 months: Early signs of concern for others, Infant Behavior and Development,
Volume 34, Issue 3, June 2011, Pages 447-458.
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