The inconsistent definition of empathy has had a negative impact on both research and practice. The aim of this article is to review and critically appraise a range of definitions of empathy and, through considered analysis, to develop a new conceptualisation. From the examination of 43 discrete definitions, 8 themes relating to the nature of empathy emerged: “distinguishing empathy from other concepts”; “cognitive or affective?”; “congruent or incongruent?”; “subject to other stimuli?”; “self/other distinction or merging?”; “trait or state influences?”; “has (...) a behavioural outcome?”; and “automatic or controlled?” The relevance and validity of each theme is assessed and a new conceptualisation of empathy is offered. The benefits of employing a more consistent and complete definition of empathy are discussed. (shrink)

We use Homer and Sun Tzu as a background to better understand and reformulate confrontation, anger and violence in medicine, contrasting an unproductive ‘love of war’ with a productive ‘art of war’ or ‘art of strategy’. At first glance, it is a paradox that the healing art is not pacific, but riddled with militaristic language and practices. On closer inspection, we find good reasons for this cultural paradox yet regret its presence. Drawing on insights from Homer's The Iliad and The (...) Odyssey, we argue for better understanding of confrontation, anger, bullying, intimidation and violence in medicine in order to change the culture. For example, equating medicine with war is not a given condition of medicine but a convenient metaphor with historical origins and a historical trajectory. Other, non-martial metaphors, such as medicine as collaboration, may be more appropriate in an age of team-based care. Taking lessons from Homer, we suggest three key ways in which cold-hearted confrontation and anger in medicine can be transformed into productive, warm-hearted engagement: the transformation of angry impulse into reflection, moral courage and empathy. Thinking with Homer can offer an aesthetically and morally charged alternative to the current body of literature on topics, such as anger in doctors, and how this may be ‘managed’, without recourse to an instrumental economy where emotions are viewed as commodities, and emotional responses can be ‘trained’ through communication skills courses. (shrink)

Written in the 1960s, TRUTH AND METHOD is Gadamer's magnum opus.

During the last three decades there has been a wave of interest in narrative and narrativity in the humanistic and the social sciences. This “narrative turn” has spilled over to medicine, where narrative medicine has gained a considerable influence.However, there have also appeared second thoughts on the role of narratives in our lives, as well as on what narratives may mean in relation to clinical medicine.This article presents some influential voices in this debate and scrutinizes the assumptions of narrative medicine (...) in the light of these. It is concluded that there are sound reasons to tread this path with some caution and avoid the too far reaching ambitions on behalf of narrativity in relation to clinical medicine. However, narrative medicine should still be seen as a promising attempt within the broader scope of medical humanities to emphasize the importance of human subjectivity in clinical medicine. (shrink)

During the last three decades there has been a wave of interest in narrative and narrativity in the humanistic and the social sciences. This “narrative turn” has spilled over to medicine, where narrative medicine has gained a considerable influence. However, there have also appeared second thoughts on the role of narratives in our lives, as well as on what narratives may mean in relation to clinical medicine. This article presents some influential voices in this debate and scrutinizes the assumptions of (...) narrative medicine in the light of these. It is concluded that there are sound reasons to tread this path with some caution and avoid the too far reaching ambitions on behalf of narrativity in relation to clinical medicine. However, narrative medicine should still be seen as a promising attempt within the broader scope of medical humanities to emphasize the importance of human subjectivity in clinical medicine. (shrink)

A comprehensive reassessment of the concept of mimesis in the history of ancient Greek aesthetics and philosophy of art, with particular attention to Plato, Aristotle, Hellenistic philosophy, and neoplatonism. There is also a wide-ranging review of arguments pro and contra the idea of artistic mimesis from the Renaissance to modern literar theory. The book challenges standard accounts in numerous respects and builds a new dialectical model with which to make sense of the entire history of mimeticist thinking in aesthetics.

Mimesis is one of the oldest, most fundamental concepts in Western aesthetics. This book offers a new, searching treatment of its long history at the center of theories of representational art: above all, in the highly influential writings of Plato and Aristotle, but also in later Greco-Roman philosophy and criticism, and subsequently in many areas of aesthetic controversy from the Renaissance to the twentieth century. Combining classical scholarship, philosophical analysis, and the history of ideas--and ranging across discussion of poetry, painting, (...) and music--Stephen Halliwell shows with a wealth of detail how mimesis, at all stages of its evolution, has been a more complex, variable concept than its conventional translation of "imitation" can now convey. Far from providing a static model of artistic representation, mimesis has generated many different models of art, encompassing a spectrum of positions from realism to idealism. Under the influence of Platonist and Aristotelian paradigms, mimesis has been a crux of debate between proponents of what Halliwell calls "world-reflecting" and "world-simulating" theories of representation in both the visual and musico-poetic arts. This debate is about not only the fraught relationship between art and reality but also the psychology and ethics of how we experience and are affected by mimetic art. Moving expertly between ancient and modern traditions, Halliwell contends that the history of mimesis hinges on problems that continue to be of urgent concern for contemporary aesthetics. (shrink)

In this paper we (1) define and describe the practice of narrative medicine, (2) reveal the need for narrative medicine by exposing the presuppositions that give rise to its discounting, including a reductive empiricism and a strict dichotomy between scientific fact and narrative value, (3) show evidence of the effects of education in narrative competence in the medical clinic, and (4) present Peircean realism as the proper conceptual model for our argument that the medical school curriculum committees should give space (...) to the employment of the scientific and literary knowledge in medical practice. On account of our argument, we contend that the medical community should tend to latitude and openness with regard to the tools we use to resolve medical problems. These tools include both biomedical and narrative knowledge. (shrink)

Summary The term empathy has become a linguistic commonplace in everyday communication as well as in interdisciplinary research. The results of the research questions, raised in the last hundred (and more) years, coming from different areas, such as aesthetics, psychology, neurosciences and literary theory, lack in fact a clear concept of empathy. Not surprisingly, a recent paper has identified up to 43 distinct definitions of empathy in academic publications. By reconstructing the main research lines on empathy, our paper highlights the (...) reasons for this conceptual inadequacy and the deficiencies in the theorization of empathy that create misleading interpretations thereof. Along the line connecting Plato’s insights on empathic experiences to the present neuroscientific experiments, a broad spectrum of issues is deployed for which “empathy” functions as an umbrella term covering a net of categorical relationships – projection, transfer, association, expression, animation, anthropomorphization, vivification, fusion, and sympathy – that only partially overlap. Our paper therefore recommends that “empathy” should not be assumed as a self-evident notion but instead preliminarily clarified in its definition every time we decide to have recourse to it. (shrink)

The aim of this paper is to give a new interpretation of Aristotle's account of the emotions evoked in the course of engaging with tragic narratives that would give rise to a coherent account of catharsis. Very briefly, the proposal is that tragedy triggers vicarious emotions and catharsis is the purgation of such emotions. I argue that this interpretation of “fear and pity” as vicarious emotions is consistent with both Aristotle's account of emotions and his account of catharsis and also (...) with his choice of examples for tragedies that trigger catharsis. (shrink)

It seems to be a fundamental feature of being human to make meaning out of experiences and events by telling stories. We are born into a web of narratives‐to become a self is, it can seem, to hear others' stories about you and, eventually, to insert yourself into those webs and assert your own story. When we teach ethics illustrated by cases, we tell stories. When children and parents talk about how they came to hospital, what they hoped, how things (...) have gone, what worries them about the decisions we ask them to face, we hear stories. Stories often reveal best the meaning a person attaches to his or her experiences, and stories shape the meaning those experiences will come to have for that person or family as the story is told, retold, and refined. I share the belief of narratologists that most of us are, at our core, storytellers. And I can't help but notice that many of those stories contain moral evaluations, explicitly or implicitly. (shrink)

This paper progresses the original argument of Richard Ratzan that formal presentation of the medical case history follows a Homeric oral-formulaic tradition. The everyday work routines of doctors involve a ritual poetics, where the language of recounting the patient's ‘history’ offers an explicitly aesthetic enactment or performance that can be appreciated and given meaning within the historical tradition of Homeric oral poetry and the modernist aesthetic of Minimalism. This ritual poetics shows a reliance on traditional word usages that crucially act (...) as tools for memorisation and performance and can be linked to forms of clinical reasoning; both contain a tension between the oral and the written record, questioning the priority of the latter; and the performance of both helps to create the Janus-faced identity of the doctor as a ‘performance artist’ or ‘medical bard’ in identifying with medical culture and maintaining a positive difference from the patient as audience, offering a valid form of patient-centredness. (shrink)

Next SectionIn a series of previous articles, we have considered how we might reconceptualise central themes in medicine and medical education through ‘thinking with Homer’. This has involved using textual approaches, scenes and characters from the Iliad and Odyssey for rethinking what is a ‘communication skill’, and what do we mean by ‘empathy’ in medical practice; in what sense is medical practice formulaic, like a Homeric ‘song’; and what is lyrical about medical practice. Our approach is not to historicise medicine (...) and medical education, but to use thinking with Homer as a medium and metaphor for questioning the habitual and the taken-for-granted in contemporary practice. In this article, we tackle the complex theme of ‘translation’. We use the lens of translation studies to examine the process of turning the patient's story into medical language. We address the questions: what makes a ‘good’ translation? What are the consequences of mistranslation and poor translation? And, while things are inevitably lost in translation, does this matter? (shrink)

One of the major tasks of medical educators is to help maintain and increase trainee empathy for patients. Yet research suggests that during the course of medical training, empathy in medical students and residents decreases. Various exercises and more comprehensive paradigms have been introduced to promote empathy and other humanistic values, but with inadequate success. This paper argues that the potential for medical education to promote empathy is not easy for two reasons: a) Medical students and residents have complex and (...) mostly unresolved emotional responses to the universal human vulnerability to illness, disability, decay, and ultimately death that they must confront in the process of rendering patient care b) Modernist assumptions about the capacity to protect, control, and restore run deep in institutional cultures of mainstream biomedicine and can create barriers to empathic relationships. In the absence of appropriate discourses about how to emotionally manage distressing aspects of the human condition, it is likely that trainees will resort to coping mechanisms that result in distance and detachment. This paper suggests the need for an epistemological paradigm that helps trainees develop a tolerance for imperfection in self and others; and acceptance of shared emotional vulnerability and suffering while simultaneously honoring the existence of difference. Reducing the sense of anxiety and threat that are now reinforced by the dominant medical discourse in the presence of illness will enable trainees to learn to emotionally contain the suffering of their patients and themselves, thus providing a psychologically sound foundation for the development of true empathy. (shrink)

James Highland; Transformative Katharsis: The Significance of Theophrastus's Botanical Works for Interpretations of Dramatic Catharsis, The Journal of Aesthetic.

As empathy gains importance within academia, we propose this review as an attempt to bring clarity upon the diverse and widely debated definitions and conceptions of empathy within the medical field. In this paper, we first evaluate the limits of the Western mainstream medical culture and discuss the origins of phenomena such asdehumanizationanddetached concernas well as their impacts on patient care. We then pass on to a structured overview of the debate surrounding the notion of clinical empathy and its taxonomy (...) in the medical setting. In particular, we present the dichotomous conception of clinical empathy that is articulated in the debate aroundcognitive empathyandaffective empathy. We thus consider the negative impacts that this categorization brings about. Finally, we advocate for a more encompassing, holistic conception of clinical empathy; one that gives value to a genuine interest in welcoming, acknowledging and responding to the emotions of those suffering. Following this line of reasoning, we advance the notion of ‘empathic concern’, a re-conceptualization of clinical empathy that finds its source in Halpern in Med Health Care Philos (2014) 17:301–311engaged curiosity. We ultimately advance Narrative Medicine as an approach to introduce, teach and promote such an attitude among medical trainees and practitioners. (shrink)

Machine generated contents note: Introduction; Part I. Theoretical Views about Pity and Fear as Aesthetic Emotions: 1. Drama and the emotions: an Indo-European connection? 2. Gorgias: a strange trio, the poetic emotions; 3. Plato: from reality to tragedy and back; 4. Aristotle: the first 'theorist' of the aesthetic emotions; Part II. Pity and Fear within Tragedies: 5. An introduction; 6. Aeschylus: Persians; 7. Prometheus Bound; 8. Sophocles: Ajax; 9. Euripides: Orestes; Appendix: catharsis and the emotions in the definition of tragedy (...) in the Poetics. (shrink)

This book examines the later work of Paul Ricoeur, particularly his major work, Time and Narrative. The essays, including three pieces by Ricoeur himself, consider this important study, extending and developing the debate it has inspired. Time and Narrative is the finest example of contemporary philosophical hermeneutics and is one of the most significant works of philosophy published in the late twentieth century. Paul Ricoeur's study of the intertwining of time and narrative proposes and examines the possibility that narrative could (...) remedy a fatal deficiency in any purely phenomenological approach. He analysed both literary and historical writing, from Proust to Braudel, as well as key figures in the history of philosophy: Aristotle, Augustine, Kant, Hegel, Husserl and Heidegger. His own recognition of his limited success in expunging aporia opens onto the positive discovery of the importance of narrative identity, on which Ricoeur writes here. Other contributors take up a range of different topics: Tracing Ricoeur's own philosophical trajectory; reflexively applying the narrative approach to philosophy, or to his own text; reconstructing his dialectic of sedimentati and tradition. An essential companion to Time and Narrative, this collection also provides an excellent introduction to Ricoeur's later work and to contemporary works in philosophical hermeneutics. (shrink)