How do Therapists Become Empathic? Another Question You were Afraid to Ask Your Therapist


Several weeks back, Spacefreedomlove sparked my interest by posting questions she’d been afraid to ask her therapist. Though not her counselor, I answered those queries here. I also requested her readers to offer their own. I’ll respond to one such today and more in the future. I don’t promise any other retired therapist would answer as I do.

This question comes from Possibly Penny, with my thanks:

“What is your story? What helps you to appear empathetic toward what can seem like trivial external triggers?”

Several things. I was a sensitive little boy, both sensitive in the way most children are (to their own injuries) and sensitive to the many moods I encountered in my home. As the first born and first grandchild of my mother’s parents, I received lots of attention, especially for the four-plus years before my brother Eddie (and later Jack) arrived. So, I knew love and loving at the start.

I think my family was happier in my first few years than at any other time. No, it wasn’t due to being wonderful, but because a first child who fits the household’s expectations creates parental bliss. A progeny of three active boys (my brothers only one year apart) demands more than a solo flyer. Moreover, Milton Stein and Jeanette Fabian married in 1940 and, not long after, the future-dad found himself in a European war zone. I was conceived in the joyous heat of his return from the defeat of the Nazis. The intensity of their desire to be together is reflected in his Love Letters. Their world was new with promise. The hardship of the time apart got repaid in a metaphorical second honeymoon upon dad’s return. I doubtless benefited.

I think my identification with the underdog derives from several roots. While the extended family held mild prejudices in private, they gave everyone respect in the world of lived public experience. I listened to many stories from my folks about their lives prior to marriage (during the Great Depression). Mom was malnourished and humiliated by her family’s poverty and her father’s alcoholism. I identified with her pain because I loved her.

Both sets of grandparents were secular Jews. Outside I received the occasional anti-Semitic slur, but nothing more. Nonetheless, I intuitively understood discrimination, not only against Jews, could lead to horrors beyond imagining. From dad’s mother came eye-witness stories of Russian pogroms. By high school I’d made friends whose parents had numbered tattoos on their arms, casting indelible shadows on all of their lives.

Uncle Sam, mom’s brother, owned a business in which he employed both black men and women. This was prior to civil rights legislation, a period when lynchings still occurred in the South. During high school — in summers and after class — I worked with them side-by-side.  Experience confirmed my expectations having to do with their basic decency, intelligence, and kindness — neither inferior nor superior to whites. They deserved better than to be “other.” One of my two best friends in first year college was a bright, funny black young man named Lou Sterling. We did things out of school (including at my house) at a time when blacks and whites socializing in public still was uncommon.

I grew from an uninhibited small boy to a smart, but introverted teen with interests I thought few others cared for (like classical music). The sweet child who worshiped my mom was replaced by a stranger (still me) who saw enough of her flaws and unresolved anger to judge her and struggle with her. In other words, I knew the role of the outsider even within the family. Time passed before I understood what was required to work through the psychological after effects. Fortunately, I found a terrific group of high school buddies who reconnected many years after graduation to give college scholarships to disadvantaged teens of varied races and religions. We still maintain contact.

My wife, the finest person ever, is a model of kindness and consideration. I’ve had the boundless good fortune of having two female children of whom I am immensely proud. More pertinent to Possibly Penny’s question, I learned from them, experiencing by osmosis the big and little hurts each suffered when they were small. These three women showed me a side of life I didn’t experience growing up in a home of one female and four males.


I’ve had a lucky life, but one (from an early time) that permitted me to peer into what it could have been had I been a young man in the Great Depression or a malnourished, ashamed teenaged girl or a Jew caught in the Holocaust or a black person before civil rights reforms. My empathy, to the extent it exists, is due to this and all the lives I’ve been permitted to enter. Whatever compassion I have works to counteract my judgmental tendencies, with less or more success, depending…

One other element of Possibly Penny’s question: she wonders how empathy is possible in response to “what can seem like trivial external triggers.” She is, I believe, referring to a patient’s overreaction to an event that appears small to an outsider, but reminds the client of something associated with trauma.

My answer is simple. It consists in knowing a triggering stimulus, however trivial, can be psychologically powerful. The capacity to be empathic follows from understanding how you (the therapist) overreact in your own life, even if you never were as traumatized as the patient. You must look through your client’s eyes back at yourself to understand his viewpoint.

Therapists are people. Patients often put them on a pedestal and sometimes underneath one! In both spots are flawed human beings. We mental health professionals strive to rise above our limitations, for ourselves and our clients. And we do care about our patients, although not in the same way we relate to spouses, children, siblings, parents, and friends. We endeavor to find whatever is best in them all. We don’t always succeed.

Every one of us in a clinic office is swimming upstream, some with more success. My job in therapy was occasionally to give my patients just a little push against the current. Looking back, I think I got the better of the deal. As I said, call me lucky.

The first image is the Compassion Logo of Projekts der Schulstiftung der Erdiözere by Schulstiftung. The photo is called Taking Care of the Heart by Enver Rahmanov.



18 thoughts on “How do Therapists Become Empathic? Another Question You were Afraid to Ask Your Therapist

  1. Somewhat similar to empathy in nursing. We can care long term for patients that appear distasteful to others. But when we put ourselves on their shoes, especially if we not only are at the bedside and not in it, but healthy, it is not hard to feel their plight and be empathic. Thanks for putting this into words!


  2. You explain such complex things in such a clear way. Such a beautiful post about the art of the therapeutic process and relationship.
    Thank you.


  3. Thanks for your openness and honesty, Dr. Stein. How interesting that you grew up in a family of males and gained a family of your own of females!


    • Thank you, Rosaliene. Yes, the atmosphere was entirely different (and needed to be). While I never had a gender preference, it did work out wonderfully well. Interestingly, my brothers also have only female children. Yet, our father was the oldest of three boys and I was also the oldest of three boys.


  4. The more glimpses into your parents’ love story you dish out, the more smitten I am with it 🙂


  5. Gee, I learned so much about your family’s past, Dr. S! I am always surprised how much of history I was never exposed to in my ’60s suburbia bubble (where, when a divorced woman moved onto the street, it was the talk of the neighborhood, and I never went to school with a black person till bussing started in the ’70s). I was also interested in reading how therapists empathize with a client talking about an irrational fear, because with PTSD, I have many. As I may have said before, your essays are always a thought-provoking and a moment to ponder. They’re my intellectual respite. All my best, as always. 🙂


    • Thanks, Harry. In my early life there were many things to see and learn, although no one called attention to them. The Holocaust, for example, didn’t even have a name until some time after my boyhood and the survivors tended not to talk about it. Also, I think many (if not most children) define “normal” by what surrounds them every day. For me, I identified a number of things as “abnormal” at some internal and external cost, but profited in terms of insight and empathy. It also opened the door to my profession. Be well, Harry!


  6. Could it be? A selfie hidden within a post?

    Thank you again for linking back to my original post. Penny’s question is a thoughtful one. I am grateful she asked it and that you obliged to answer. Your unique personal history is fascinating – the stuff of memoirs, literature, film. Have you considered writing an autobiography?


    • A lovely metaphor! I never would have considered the visual translation you’ve provided, but I agree entirely. It is something I never would have or could have written while in practice. I don’t think of my early life as especially remarkable, but there were certain scenes that might have fit into a movie. I suspect we all have them. In response to you last question, I wrote a thinly disguised novel about 35 years ago, which was never published. I suspect the best I will do is to write these posts and, since I have little ambition, this form of writing is enough.

      Liked by 1 person

  7. Loved learning your story Doc. -Especially enjoyed the paragraph where you spoke of your wife and daughters. Lovely.


  8. Dr. Stein, thank you for sharing your story. I am grateful for your help to swim against the current! I still swim, and at times the current seems stronger than me, but yet I still swim!!! I’d like to say my swimming, with your help, and the many people that touch my life, has resulted in reaching interesting destinations. In one week, I will be marrying my fiance, Brian! (who is a mental health counselor at a small university) We have chosen to swim together against life’s currents. (sometimes I want to drown him and vice versa) I think I have met someone who brings out the best in me. I’m myself unapologetically, we laugh together and enjoy traveling and family, I’m more decisive, I face challenges with more resolve, and the future looks bright, with him! So thank you, for your stories, your help, your empathy, and the great smile that accompanies all of the above. Kindly yours, Michelle


    • What wonderful news, Michelle! I’m so happy for you. I appreciate your thanks, but it sounds like you’ve come a long way since we last met. I’m not only happy for you, I’m proud of you. Tell Brian I think he is a lucky man.


  9. Here’s a question for the therapist, something I really do wonder about: what’s it like to be a vault for other people’s secrets and a person who spends the work day absorbing other people’s pain? I know as a teacher, it’s not so easy to separate emotionally when a kid is suffering. I thought of this on Saturday when I went in for my own session, which I learned was his birthday. It was the day after my pregnancy test, and I know he was prepared for the distinct possibility that I would be a wreck. I thought driving home – what a bummer that would have been…


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