IS THE CAPACITY FOR EMPATHY THE KEY QUALITY IN OUR WORK WITH TRAUMATIZED CHILDREN? – PATRICK TOMLINSON (2014)

Date added: 08/10/20

One of the first things I learnt in work with traumatized children, is that the Capacity to Empathize marks a critical stage in a child’s development. The children and young people, who were placed with us often had no or little capacity for empathy. However, this didn't mean they didn't have the potential to develop it. The development of empathy was one of the key aims of our therapeutic work, as it is for many of us that work with and look after children.

We carried out a needs assessment on each child to determine his stage of development, how it had been disrupted by trauma, and how his developmental needs could be met. Dockar-Drysdale’s (1970, p.98) Need Assessment, described empathy, 

…as being the capacity to imagine what it must feel like to be in someone else’s shoes, while remaining in one’s own.

From infancy onwards, the consequence of not being able to recognize another person, as a separate being with their own emotions, thoughts and needs, causes havoc in daily living.  It can also be dangerous as the child has no conscious sense of hurting others and has little if any remorse. More recently, Cameron and Maginn (2008, p.1158) claimed, 

Increasingly, too, it is the development of empathy which is now being viewed as the antidote to both childhood and adult violence—an argument which is well evidenced in the ‘Worldwide Alternatives to Violence’ report (2005). Children who do not experience attunement with a caregiver may fail to develop empathy altogether. Secure attachment is therefore fundamental to children’s socialisation and wellbeing.

To develop empathy a child needs to experience empathy. That sounds straightforward on paper.  However, it can be extremely difficult to achieve, when working with children and young people who have long passed the age at which empathy would normally develop. For example, it is not easy to ‘empathize’ with a 10-year old’s ruthless lack of concern towards others, especially when this is lived with 24 hours a day. On top of this, a traumatized child often actively rejects any attempts to show empathy towards him. This is partly because empathy might connect him with his traumatic experiences, which he is desperate to keep out of mind. It might also cause him to feel vulnerable as empathy normally connects people, and mistrustful children are resistant to being connected.

As well as showing empathy, another key factor in helping a child develop empathy is creating a safe, reliable and nurturing relationship where the child may begin to feel attached. Attachment usually leads a young child to develop the capacity for feeling concern towards the attachment figure. This makes sense from an evolutionary survival point of view - the vulnerable dependent infant, benefits from being able to understand the protective carer. When the infant is completely dependent on the carer she must develop a level of understanding that helps reciprocate and grow the attachment relationship, which is critical for survival.

Young infants can be observed making efforts of contributing something positive towards their attachment figure. For example, beginning with facial expressions, such as smiling. For this to work well the infant needs to understand something about how the other feels. Normally by the end of the first year, an infant has some ability for understanding what thoughts and feelings are in another’s mind. When empathy begins to develop it may be rudimentary, but it is very important. It may be a gesture like an infant, wanting to feed the parent a spoon of her food. Though she hasn't quite worked out that the parent might not like baby food, she is moving in the direction of wanting to give something good to the other. By 18 months an infant might be able to show sympathy to another distressed infant. A securely attached infant, who has had more attuned experiences with his caregivers, is more likely than an insecurely attached infant to develop empathy.

Graham Music (2010, p.50), in his excellent book ‘Nurturing Natures: Attachment and Children's Emotional, Sociocultural and Brain Development’ states, 

Children who suffer neglect and receive little attuned attention can be less able to make sense of another's mental states. Others who experience more abusive rather than neglectful parenting can develop a skewed understanding of others.

Empathy is different from sympathy, which can be shown without necessarily understanding much about how the other feels. It is also different from projection, where one’s feelings are projected onto the other. Various clinicians have emphasized how empathic understanding is helpful in the process of therapy. According to Nelson et al. (2014, p.140), 

Research has shown that therapists trained in mindfulness have better patient outcomes, and even a patient’s visit to a physician for a common cold can be made more effective when the clinician is open and empathic.

Shame is often a theme involved with trauma, and especially that caused by abuse. Dr Brené Brown (2007) talks about Empathy and Shame being on a spectrum with both being at the opposite ends.  

If children need to experience being empathically understood to develop empathy, those working with and caring for them will also benefit from receiving empathic support. This can help make what feels intolerable, tolerable. The capacity to feel empathy towards another isn't static, it changes according to circumstances. For example, if someone is feeling anxious, it isn't so easy to feel empathy.

If care workers are expected to show qualities such as empathy, reliability, and dependability in their work then these qualities also need to be reflected in all aspects of the organization’s culture and the way it operates. In the case of parenting, the same could be said of the support provided by the extended family and community.

Not long into my career and after a period of relentless testing out by the young people I worked with, I felt exhausted and demoralized. There were many times when I felt like I’d had enough. One day I was telling our consultant Barbara Dockar-Drysdale how I felt. She told me that sometimes the most important thing you can do is just survive and be there the next morning. This seemed manageable to me and by saying this she was empathizing with exactly how difficult it was for me. I found this immensely helpful and I did survive!

I try to share a few useful links in my blogs

This book by Maia Szalavitz and Bruce Perry is a fascinating and very accessible read about empathy – exploring it from many different perspectives.

Below are a couple of good blogs on empathy from the Daily Good. 

“If you think you’re hearing the word “empathy” everywhere, you’re right. It’s now on the lips of scientists and business leaders, education experts and political activists. But there is a vital question that few people ask: How can I expand my own empathic potential? Empathy is not just a way to extend the boundaries of your moral universe. According to new research, it’s a habit we can cultivate to improve the quality of our own lives.”  (Krznaric, 2013)

Krznaric, R. (2013) Six Habits of Highly Empathic People, in The Daily Good
http://www.dailygood.org/story/518/six-habits-of-highly-empathic-people-roman-krznaric/

What Is Empathy? 
http://www.dailygood.org/story/625/what-is-empathy-http-greatergood-berkeley-edu/

 

References
Brené Brown (2007) Shame and Empathy, https://www.youtube.com/watch?v=qQiFfA7KfF0

Cameron, R.J. and Maginn, C. (2008) The Authentic Warmth Dimension of Professional Childcare, British Journal of Social Work, Vol. 38 No. 6 p.1151-1172

Dockar-Drysdale, B. (1953) Some Aspects of Damage and Restitution, in Therapy and Consultation in Child Care Problem (1993) London: Free Association Books

Dockar-Drysdale, B. (1970) Need Assessment – 11 Making an Assessment, in Therapy and Consultation in Child Care Problem (1993) London: Free Association Books

Music, G. (2010) Nurturing Natures: Attachment and Children's Emotional, Sociocultural and Brain Development, Hove and New York: Psychology Press

Nelson, B.W., Parker, S.C. and Siegel, D.J. (2014) Interpersonal Neurobiology, Mindsight, and Integration: The Mind Relationships, and the Brain, in Brandt, K., Perry, B.D., Seligman, S. and Tronick, E. (Eds) Infant and Early Childhood Mental Health: Core Concepts and Clinical Practice, Washington DC, London: American Psychiatric Publishing

Worldwide Alternatives to Violence (2005) The WAVE Report 2005: Violence and What to Do About It, www.wavetrust.org/

Comments made in response to this article. 
Such a great article Patrick. When infants are "held" by their mother’s arms and psyche for the really important first year and beyond, they develop the neurological functioning that is biologically mapped out. Deficits in this magical process, impact on young person’s view of the world and capacity to interact with others, amongst many other aspects of their well-being. Empathy is such an important aspect to this, and this article has summarised the importance of it. Also, if the organizational culture is non-congruent to the overall task of the therapeutic work, the environment can become chaotic for all, and this, in turn, can be detrimental rather than healing.
Joanne Prendergast - Social Care Worker at St Bernard Group Homes, Ireland

Many thanks for sharing this enhancing article indeed. All true to me and I think empathy is the key quality of a social worker, actually it is a quality which makes us human of high consciousness. Bravo!
Gulchekhra Nigmadjanova - Advocacy Advisor at SOS Children's Villages, Uzbekistan

Just survive and be there the next morning. Sounds like our organization every start of a new school term. Never know where you are going to be placed or what your hours will be. Whew, I will remember that comment. 
Janet Eades - Teacher at Capitol area community action agency, USA

Empathy is teachable and core to humans' mandatory curriculum of communing with others. Imagine how every avenue of human interaction will improve when we embrace proactive education for emotional literacy as passionately as we do for academics, sports and music. Much appreciate your advocacy, Patrick!
Marlaine Cover - Transforming the Life Skills educational process for the benefit of humanity present and future, USA

Thank you Marlaine - I tend to think of empathy as something that can be facilitated and develops through experience.  Patrick Tomlinson

I remember feeling worthless, angry, emotional and then finally understanding that they were not my feelings at all, but the feelings of a child I am working with. It takes time and understanding to be able to recognize this and lots of good supervision, which is extremely important in childcare organizations.
Lynda Noble - Senior Recovery Practitioner FDA at SACCS, England

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