Empathy: From the Individual to Society

During the transition from the psychoanalytic to self-help era, empathy is one of those words that has seeped into the general lexicon. For many, empathy and sympathy are false synonyms with the new vocabulary word intended to impress others rather than convey new information. In other circles, using the word, still not necessarily correctly, in casual conversation serves as a hidden signal to search out like-minded emotional souls. If received by one in the cohort, the missive opens the door to commiserate about the burden of carrying others' emotional pain--an unappreciated service to society. Otherwise, the message easily slips by those not afflicted.

In short, empathy means identifying with and feeling the pain of others. A complete lack of empathy, a rare and terrifying aberration in emotional development, is a crucial element to become a sociopath. People with a low empathy quotient tend to be self-absorbed and, although not particularly harmful to society, devastating to any intimates. In some ways, the single-mindedness of the self-involved can propel them to high achievement while limiting the ability for any close relationships. An overwhelming majority experience empathy for others in pain but can emotionally protect themselves from being overwhelmed by these feelings. Without this unique social construct, humans would not have developed the complex, social civilizations we have today.

For a few, empathy feels like a sixth sense, at times a gift and others a gaping wound. Feeling other people's pain is not a choice but a part of how one experiences the world. Deep personal connections, friends in need and even sad films or documentaries are all entrées into a powerful emotional abyss that allows for a vivid, invigorating world experience but, with no way to turn off the intensity, can at times turn into its own prison.

Many women with eating disorders have this level of empathy and describe the relentless feelings as unbearable. The illness numbs all emotion and pushes away any closeness in relationships, thereby significantly diminishing the intensity of any empathic response but simultaneously leaving innately interconnected women painfully alone. As a consequence, reconnecting emotions during recovery--a raw, exposing process--means not only re-engaging with the world but re-living empathy for others. This can leave people gasping for air at the overwhelming emotional intensity. Others' feelings come crashing down on them in a burst of psychological and emotional torment that can be hard for a person in recovery to identify, let alone tolerate.

The process of recovery can no more cure the hyper-empathic person than therapy changes one's personality. The goal is to learn to live with this ability and find a way to manage and cope with the vulnerability of daily life. What was a confusing and overwhelming realization as an adolescent can  in time become a facet of life as an adult. Our success and maturity depends as much on the ability to accept and hopefully harness our personality and interactive style as it does on the sheer luck of our life station. Empathic people can use their ability to identify and clearly express the collective emotions of those around us. But my optimism can hide the immediate reality in recovery. After a protracted illness, the road through treatment to acceptance is a long and arduous one.

Based on the last post, silencing people with eating disorders has significant meaning for our society. It's a short step to intuit the hidden meaning: people who harness their own empathy can be very powerful indeed. Individuals with a facile empathic response tend, on an individual basis, to harbor and reflect the emotions of those around them. For instance, in a relatively inexpressive family, the empathic member is usually seen as the "sensitive" one. On the surface, this moniker implies the person most emotionally connected but effectively means the ridiculed one attacked for not repressing her feelings sufficiently. Particularly unemotional families often accuse the empathic member of being fully responsible for everyone's feelings. When no one accepts their own emotions, it's convenient to blame the one incapable of repression for all of the emotions in the family. As absurd as this dynamic looks from the outside, scapegoating is an age-old method of maintaining stability in chaos.

However, by definition, the empathic family member actually reflects the emotions around her. She is a mirror for the family to see what's truly inside them. And if the reflection is too painful, why not blame the mirror itself. On a larger scale, a group of empathic people can reflect and even amplify the emotions of the society around them. Silencing those emotions dampens the impact of certain social forces. In a society ripe for change, the empathic set can galvanize a group to open new avenues for communal growth. The non-violence of the civil rights movement reflected the pain and patent prejudice to rally effective support and long-lasting effects.

What would the group of suppressed, empathic women--many trapped in the internal hell of eating disorders--reflect to society today? What social forces can be ignored by covering the mirrors around us? Injustice? Intolerance? Callousness? A stagnant, polarized world? I think the answers lie in what these silenced people might finally say when given the podium. Look out for the next post. 

The Meaning of Silence

The emergence of eating disorders as a new group of psychiatric illnesses in only a generation opens the door to a host of inquiries. The changes in food supply, the homogeneity of modern life and the cultural focus on weight and thinness are the explicit pressures encouraging disordered eating and, for those susceptible, eating disorders. But the more profound questions remain unanswered as to why the public remains so uneducated about eating disorders and why those afflicted are never heard.

From a sociological perspective, the increased incidence of eating disorders coincided with the impact of the feminist movement. Protesting the oppression and limits of women's lives brought about substantive change and opportunity. Today's girls feel confident that their goals and dreams need not be different from the boys. Simultaneously, the pressure to look thin, to harshly critique their bodies and to become a sexual object encroach on younger and younger girls. Disturbingly, the current ideal woman's body is that of a fifteen year old, not a grown woman. The academic, intellectual and professional achievements possible because of Betty Friedan and many others seem to have come at a steep cost. Why has this external equality among the sexes forced women and girls collectively to feel enslaved to an internal source of inequality?

Much of what I have written explores the hidden side of these diseases as opposed to the DSM-IV-TR--the psychiatric Bible--which lists a series of relatively concrete symptoms that comprise an eating disorder. Although an accepted diagnosis is necessary to create consensus among clinicians, the absence of an emotional and psychological guideline only propagates the deeply rooted misunderstanding. It is too easy for the public to equate Anorexia Nervosa solely with starvation, for example, without any awareness of the psychological torment at the root of the illness.

Perhaps the most suffering is caused by the feeling that someone is at fault for their entire illness, that they are solely to blame. One goal of therapy is to see the self-blame as part of the illness--how can you blame yourself for something you never could control? Relinquishing the personal responsibility makes room for healing and subsequently the painful, personal growth necessary for recovery. However, misunderstood by family, the media and even ignorant clinicians, patients remain alone and often spend years sure that blaming themselves is completely accurate. It is curious to me that the general public response to these horrific diseases is to corner the patient into feeling fully responsible. Why is the needed compassion replaced by ridicule or contempt? How did eating disorders turn into a media spectacle? It is hard not to interpret these circumstances as a covert societal force intended to silence this subset of women.

Interestingly, this is one similarity between eating disorders and disordered eating. The self-reproach of disordered eating can be a modified version of the self-blame of eating disorders. Both serve to tamp down any burgeoning confidence  fostered by the equality among the sexes today. Just as girls might be finding their rhythm in school, their attention shifts to body and self-image. Often, pressures to be attractive, including sexually appealing, entraps younger and younger girls. Considering the personality traits that increase the risk of eating disorders--motivation, perfectionism, drive and powerful empathy--it is hard not to connect the dots: many of the most successful girls are lost to the preoccupation with food and weight. The full implication of this statement is profound. Equality exists in this country no matter one's sex, but the covert societal forces now seem to generate enough internal turmoil in girls to severely limit their potential. By hiding the truth about eating disorders, society ignores and silences voices no one wants to hear. Now the inequality exists but can't be seen.

The next post will focus on the experience of empathy in people with eating disorders and the concomitant emotional pain of outpatient recovery, both on an individual basis and on the contribution to what remains concealed behind the public ignorance of eating disorders.