How to Combat Empathetic Distress, the Shadow Side of Empathy

If you’re wondering “What is empathetic distress?” or “How does a therapist’s empathetic concern become empathetic distress?” read on for tips on recognizing empathetic distress and combatting it.
I get approached by strangers a lot.

Whether it’s someone asking for directions, wondering what time it is, or small talk in line at a store, I seem to be a popular target. It’s something that has become a transferable skill in my work as a psychotherapist.

People tend to open up to me pretty quickly. 

My husband, a fellow psychotherapist, gets similar reception.

It’s pretty common that we’ll be out for a meal together and the server comes over and asks us how we’re doing. When we ask the question back to them, we often learn a lot about how they’re really doing.

We’re both naturally interested in the lives of other people. And if you’re a helping professional, I wouldn’t be surprised if you have similar stories too.

This empathetic concern that we have as clinicians doesn’t turn off when we’re not at work—it’s how we move through the world all the time.

I consider this both a positive quality and a skill to be honed. 

Empathetic concern vs. empathetic distress

Like every quality, there can be a shadow side to empathy. In this case, the shadow side of empathic concern is empathic distress. As much as I hate to admit it, my capacity for empathy is part of what led me to a severe episode of burnout a few years ago.

So, how do we as clinicians distinguish empathic concern from empathic distress, and recognize the signs to ensure we’re not on the road to burnout? Let’s start with defining some terms.

C. Daniel Batson, an American social psychologist and researcher, defines empathic concern as an “other-oriented emotion elicited by and congruent with the perceived welfare of someone in need.”   

Empathetic distress, on the other hand, has been defined by Canadian veterinary professor Trisha Dowling as “the strong aversive and self-oriented response to the suffering of others, accompanied by the desire to withdraw from a situation in order to protect oneself from excessive negative feelings.”

Empathetic concern is what comes to mind for most helping professionals when we think about empathy in general. It’s recognizing that someone is going through something difficult, and our focus remains on that person in need and how we can help.

In contrast, empathetic distress is an internalized response to what other people are going through.

While empathetic concern often leads to positive action, empathetic distress can lead to self-protective measures like avoidance, cynicism, and reduced motivation.

Over time, empathetic distress can lead to dopamine depletion and burnout. 

Questions to help recognize empathetic distress

Of course, we can’t expect to move through the world and never experience empathic distress. However, it’s also important to be mindful of how this shadow side of empathy is impacting us as clinicians.

It’s not always so simple to recognize if what you’re feeling is concern or distress, especially if you’re already feeling the effects of burnout.

To help you determine if your empathy has moved from concern to distress, here are four questions to ask yourself. 

1. How full is my cup?

There are a lot of metaphors we can use here—how full is my gas tank or how charged is my battery. What this question boils down to is how much energy you have at a given time. When we’re pulling from our personal energy surplus, it’s easier to approach situations from a place of empathetic concern. When we start pulling from our energy reserve, or when we’re in an energy deficit, that’s when our empathy has moved into distress territory.  

2. How connected do I feel to the things that are important to me?

Disconnection is a key marker of burnout. When we feel in tune with both our core values and the people that are important to us, it tends to allow the space for empathetic concern and more positive action. However, if you start noticing a sense of disconnection or like you’re shutting down, then your ability to respond to the concerns of others is compromised. 

3.  Does my discomfort feel self-focused, or other-focused?

By nature, empathetic concern is focused on our response to the needs of others, while distress is focused on our own responses. If you observe that your empathy has moved away from the well-being of someone else and is instead turned inward, what you’re feeling is empathetic distress. 

4.  Am I feeling the need to avoid parts of my life?

Empathetic concern can often be recharging and activating for helping professionals. It can move us toward using our skills to offer support to a person in need, even outside of sessions.

Empathetic distress has the opposite effect, and can result in us wanting to avoid the negative feelings that have shown up for us. This can present as taking extra sick days, cancelling appointments without cause, or increased isolation in your personal life.   

How to combat empathetic distress

Once you recognize what you’re feeling as empathetic distress, there are many ways you can address it and move forward. I have four ways here that can act as a starting point for coping with empathetic distress.

If you incorporate these strategies into your daily routine and mindset, they can also serve as a proactive way to ward off empathic distress before it happens. 

1. Shift to compassion

This probably isn’t a tough sell to helping professionals. At the same time though, it’s an active choice we have to make.

If you’ve noticed another person’s situation has left you feeling self-focused and drained, can you use your natural and developed skills of compassion to shift the attention back to their needs?

If you can do so, you’ll start to move back towards concern and the positive actions you can take there. 

2. Focus on self-compassion

This might be harder for helping professionals to prioritize.

I’ve noticed anecdotally that people who are the best at showing other people compassion have a harder time turning it inward for themselves.

That means you have to make a conscious choice to speak to yourself the same way you would to a friend, or a client. If you’d like help showing yourself compassion, I recommend the work of Dr. Kirsten Neff. 

3. Consider mindfulness practices

There’s a reason mindfulness is so highly recommended for so many concerns—it works!

If you don’t feel like you’re in a space to take on a meditation practice, see how you can work mindfulness into other activities you’re already doing, like walking, eating, cleaning, or spending time with your loved ones.

Bonus points if you’re able to turn off your phone and step away from the news during these activities. 

4. Assess your own health and well-being 

If you’ve been managing empathetic distress for a long time, chances are your health and well-being have paid the price.

Get into a regular habit of assessing all aspects of your health—physical, mental, emotional, spiritual, and social.

Then choose one area that you can make a change to improve how you care for yourself. Once that becomes a habit, add another one for another aspect of your health.

Slowly, you’ll build a routine that allows you to care for all aspects of your well-being in a way that feels sustainable. 

Our capacity for empathy is what drew many of us to the work we do.

Don’t let it become the thing that pulls you away from that work.

When you make it a priority to take care of yourself, you’ll be able to lead a more balanced life, and show up with your best self in everything you do.

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