Too much emotional empathy can lead to feeling overcome with the pain experienced by the other person, argues cognitive behavioural therapist and author Michael O'Sullivan.

Arguing against empathy in the world of mental health is almost taboo. The ability to understand and respond to the unique experiences of another person is essential in the work of any therapist.

"Compassion is ultimately about ethical action."

Certainly, I cannot imagine doing my work without some ability to empathise. If I cannot help the person feel understood and accepted through empathising with them, then I am of no help. Equally, if I cannot help that person recognise how others might experience them through showing them how to empathise with others, then I am of no help.

There is evidence that empathy is hard wired within us. We now know we have empathy neurones, called mirror neurones. Mirror neurones send messages to the brain, which says that if “I cut myself then I know that whoever is observing it will flinch”. Empathy therefore seems an unquestionably good thing. However, it is an idea we can begin to question.

Challenging assumed truths

In his book “Against Empathy - The Case for Rational Compassion” Stephen Bloom invites us to challenge our preconceived ideas about empathy. He starts by outlining the two types of empathy.

Cognitive empathy is when one person has an “idea” of how the other person is thinking. However, whether this is a good or bad thing depends on the person. People who torture have every idea about “how” their victims think.

Emotional empathy is about the mirror neurones, when one person “feels” what the other is “feeling”. However, this can also be problematic.

Too much emotional empathy can lead to feeling overcome with the pain experienced by the other person, which can then lead to exhaustion.


Empathy can also be biased. We will often be more empathic to people who are “like” us and less empathic to those who are “unlike” us. Indeed, this type of empathy could support racism.

If you do not believe you are biased, then try the implicit association test: IAT. This test is free and is offered by Harvard University on their web page. It reveals the unconscious biases we hold about people who are different to us.

The results of an IAT are always surprising. My empathy may even stop me from being a good therapist. I may hold back from helping people come out of their comfort zone because I am too empathic to the short-term distress that this may cause them.

The Compassion in the title of Bloom’s book is offered as a solution to some of these dilemmas. Implicit within the idea of compassion is a motivation to help.

Helping does not require empathy. If I see a child drowning in a river I cannot empathise with what they feel like to drown but I jump in. I am motivated to help.

Compassion is ultimately about ethical action. We act because it is the "right thing" to do. For me, I am a therapist because I think it is the "right thing" to help people overcome depression. I also act because we know it will do the most good.

Helping someone with depression is not only good in its own right but is likely to help others, friends, family and society as a whole. Clearly empathy is important, but it is clearly not enough.