Chapter three reviewed the reasons why empathy is sometimes lacking. Levels or degrees of empathy were presented first ranging from a complete lack of empathy to very empathetic behaviour. It was then pointed out that, although empathy is located in the human gene code, the development and sustained experience of empathy requires a lifelong process of relational interaction that begins with early infancy. The evidence from orphanage studies revealed that the experience of empathy is often necessary for basic survival. The following circumstances were presented as hindering the development of empathy in children: lack of healthy emotions in primary caregiver; neglect and/or abuse; the de-emphasis of close family and/or social relationships in modern Western society; as well as various forms of stress. Bullying and evil were compared to empathy followed by the proposed notion of viewing evil, not as a permanent personality trait, but as a form of severe lack of empathy. Evil acts were presumed to occur as a result of complete empathy erosion and turning people into objects. Similarly, narcissistic behaviour was sometimes deemed to be due to a fear of being vulnerable. Specific reasons why some helping professionals lack skill in applying empathy in the clinical setting was also investigated, followed by suggested strategies for incorporating empathy training into educational programs. In the case in point a new nurse shares her story of not knowing how to be when confronted with a patient’s sadness. A simulation role play exercise is suggested to practice using nonverbal communication techniques to convey empathy.
Keywords: Attunement, bullying, compassion fatigue, Developmental psychology, emotional intelligence, empathy, evil, failure to thrive, intelligence quotient, misattunement, narcissism, neural circuits, psychopaths, safety plan, socio-paths, suicide risk assessment, unconditional positive regard.