VARIETIES OF

EMPATHIC RESPONDING
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LESLIE S. GREENBERG AND ROBERT ELLIOTT

The revival of interest in the importance of empathy in psychotherapy

calls for the specification of what is being referred to in clinical practice by
both clinicians and theorists when using the term empathy. We will argue
that empathy is not a unitary construct and thus clarification and differentia-
tion of the phenomena referred to by the concept are needed. We will
initially discuss the nature of empathy and contrast it with interpretation
to clarify the essential nature of empathy. Then we will suggest that a more
componential view of empathic responding is required-one that is more
differentiated than for example the dichotomy proposed between empathy
and interpretation. Following this, we will discuss a variety of different types
of empathic responses, empathic tasks, and principles, from the viewpoint
of a process-experiential approach to treatment (Greenberg, Rice, & Elliott,
1993).

What is Empathy?

Empathy first and foremost is an attitude and is implemented by the

taking of a specific type of vantage point or stance toward another. This
means that the empathic therapist attempts to operate within the internal
frame of reference of the client and to remain in empathic contact with
the client’s inner world. Empathy involves listening from the inside as if “I

167
http://dx.doi.org/10.1037/10226-007
Empathy Reconsidered: New Directions in Psychotherapy, edited by A. C. Bohart
and L. S. Greenberg
Copyright © 1997 American Psychological Association. All rights reserved.
 am the other,” as opposed to occupying an outside vantage point. Empathy is
not simply friendly rapport, sympathetic encouraging, listening, or being
warm and supportive. Conflation of empathy with these common social
responses, essentially forms of rapport, has resulted in one of the major
persistant misunderstandings of the nature of empathy in some approaches
that claim to be empathic. Empathy is the process of deeply contacting the
inner world of another, being attuned to the nuances of feeling and meaning
as well as the essence of another’s current experience.
In understanding what empathy is, it is also important to distinguish
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between experiencing empathy and communicating empathic understand-

ing (Barrett-Lennard, 1981). As we have said, being empathic involves
entering the psychological world of the other and in some way experiencing
what it is like to be that person in this moment. Communicating this under-
standing is a separate component of empathy, which must flow from em-
pathic attunement but may be communicated in a variety of ways. In addi-
tion, one could be empathic (i.e., enter the other’s frame of reference) but
then use one’s sense of the other’s experience to manipulate the person.
Thus, empathic communication differs from empathic contact or attune-
ment, and, as we will discuss later, the communication of empathy can
take a variety of forms.

The Function of Empathy

A variety of different functions have been outlined in the literature

(Bohart, 1991). In client-centered therapy empathy has been viewed essen-
tially as providing two different kinds of learning experiences. First, the
therapist’s communication of empathic understanding is viewed as helping
clients come to trust and accept themselves. T o facilitate this, the therapist’s
process goal is to follow the client, to be an accepting companion who helps
break the psychological isolation experienced by the client. Here empathy
is viewed as helping clients to be self-accepting and to find their own voice.
In this view clients’ increased trust in themselves then leads, among other
things, to increased awareness.
The second type of learning occurs through exploration and discovery.
In this view clients are seen as explorers who come to relate to their internal
experience differently, to see things freshly and experience things more
deeply. By paying attention to what they experience, they expand their
awareness. The therapist’s process goal here is to be a facilitator of explora-
tion and a companion in the search, a co-explorer. The therapist does not
lead the client but encourages the client to look carefully and to keep going
where he or she might have feared to go. In this view discovery then leads
to internal reorganization.
In our view, empathy involves the more or less immediate apprehen-
sion of the client’s subjective world through imaginative entry into the

168 GREENBERG A N D ELLIOTT

 experience of the other. This is an affective form of understanding that
does not depend on labored reasoning and differs from conceptual under-
standing. In our view empathy does not entail actually feeling the feeling
of the other “as if one were the other.” Rather, it entails a complex process
of emotional understanding of the other. This involves a felt apprehension
of the other’s situation as well as one’s own affective response to this. All
of this is then synthesised into a felt understanding. Thus, when a client
feels pain or sadness, in being empathic the therapist does not necessarily
feel pain or sadness. It is more complex than this. Often, the therapist may
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feel a reciprocal responsive feeling, such as compassion or concern. As

opposed to feeling a “little” of what a client is feeling, a therapist often
experiences a complex felt sense, a complex sense of understanding the felt
meaning of the situation to the client. What is important is that it is some-
thing the therapist feels rather than just understands intellectually. Empathy
is thus a feeling, or experiential process of understanding.
In terms of the communication of empathic understanding, we believe
that the moment-by-moment communication of empathic understanding
is important in providing a safe facilitative environment and promoting
exploration. Another form of empathic communication, practised more
consistently by self psychologists, involves offering at more spread-out inter-
vals a more holistic understanding of a person’s experience. This form of
empathy is offered more as a summary or integrative understanding of what
the client has been saying. This may even be offered only a few times a
session. Thus, the therapist’s activity level can vary quite dramatically in the
empathic process, and we view a sustained active effort at communicating
understanding as most helpful. In addition, in our view this form of sustained
empathy serves the important function of enhancing affect regulation, in
that symbolization of affect by an empathic response aids in its assimilation
into meaning structures (Greenberg & Paivio, in press; Pennebaker, 1990;
Pennebaker & Susman, 1988). Once symbolized, the emotion becomes
more able to yield its meaning and is more amenable to reorganization
(Greenberg & Paivio, in press).

DYNAMIC INTERPRETATION

Empathic responding will be contrasted with dynamic interpretation

below to clarify some of their differences. First, however, we need to clarify
the nature of dynamic interpretation.

What is Interpretation?

As defined by the Therapist Intervention Rating System (Piper, Azim,

Joyce, 6r McCallum, 1991), for example, a dynamic interpretation is a

VARIETlES OF EMPATHIC RESPONDING 169

 therapist statement that (a) refers to a dynamic component (i.e., a wish,
fear, defensive process, or dynamic expression), and (b) provides links be-
tween affect, thought, or behavior (e.g., “You felt guilty so you bought her
a gift”). More broadly, interpretation in general has been defined as a thera-
pist response mode that intends to give clients new information about self
through offering connections, labels, or patterns (Hill, 1986).
In our view a key distinction between empathic and interpretive re-
sponding lies in the intention of the therapist when delivering the interven-
tion rather than the behavior. The intention in interpretation is to point
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out something to the client or to “give news,” to have the client see some-
thing he or she did not see before. This intention can be contrasted with the
intention in empathic responding of conveying understanding or promoting
exploration. Thus, it may be that the same words (e.g., “You’re feeling
angry because therapy is ending”) could be either an interpretation or an
empathic response, depending on the therapist’s intention.
An additional feature of interest in distinguishing empathy and inter-
pretation, and especially dynamic interpretations, is that the content of
interpretations is more often theory derived, whereas the content of empa-
thy is derived from the client’s experience and is always checked back against
the client’s experience.

Comparison of Empathy and Interpretation

In our view empathic and interpretive responding can be compared

profitably on the dimensions of (a) aim or intention, (b) function,
(c) degree of inference, (d) target or focus, and (e) the created role rela-
tionship.

Aim or Intention
Three aims can be delineated that help distinguish empathic from
interpretative responding: (a) to convey that one understands, (b) to pro-
mote exploration of the client’s experience, and (c) to give news to clients
about themselves. The first two intentions are compatible with empathy,
whereas the third is not.

Function
The functions associated with these three intentions are: (a) Convey-
ing understanding leads to reduction of isolation to improved affect regula-
tion, to the experience of being confirmed, to greater trust in the self, and
to a strengthening of the self. (b) Exploring leads to discovery and new
awareness within a particular situation. This results in a new perceptual-ex-
periential awareness of self and other, rather than a conceptual understand-
ing (Greenberg et al. , 1993). (c) Giving news involves explanation, results

I 70 GREENBERG A N D ELLIOTT
 in insight, and generally leads to the client recognizing patterns of behaviors
across situations. The result is that clients understand patterns or connec-
tions they did not see before.

Degree of Inference
Empathic responses are low on inference and focus on explicit and
implicit meanings. They focus not only on what is in awareness but also
on what is currently not attended to or is implicit. What is currently out
of awareness is, however, regarded as being available to awareness by a shift
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in attentional focus. It is not repressed from consciousness by a barrier

that can be broken only by interpretation. Empathic responding requires
listening for what is being said or expressed and focuses on what is explicitly
or implicitly meant. By contrast, interpretation is higher in inference. It
brings what is not available to awareness into awareness. Interpretation
listens more for what is not being said or is being defended against or avoided
and focuses on what is hidden. It should be recognized that degree of infer-
ence is a continuum that ranges from very explicit on to low-level inference
on to high-level inference on to totally unconscious client material.

Target or Focus
Three major targets of empathy have been delineated: (a) Feelings,
with the focus on emotional experience; (b) self-concept, with people’s
views of themselves and their self-evaluations as the focus; and (c) dynamic
elements and their connections, with the focus on underlying motivations
and defenses, wishes, and fears.

Role Relationship
Three views of the therapist’s expertise and directiveness can be deline-
ated: (a) The client is treated as an expert on his or her own experience
with the therapist following the lead of the client; (b) a coconstructive,
collaborative form of interaction occurs between client and therapist. Nei-
ther leads or follows but both contribute to an evolving shared understand-
ing; (c) the therapist is seen as the expert, sensitive to unconscious cues,
who understands clients better than they understand themselves and ex-
plains them to themselves.
Clearly, empathic responding lends itself to certain of the above ele-
ments more than to others. It is best characterized as involving a more
egalitarian or nonexpert role-relationship stance, lower level inference
statements that focus on feeling, conveying of understanding to facilitate
healthier affect regulation, trust in the self, and promotion of exploration.
Ultimately, however, the false dichotomy between empathic responding
and interpretation needs to be overcome, as does the view that empathic

VARIETIES OF EMPATHIC RESPONDING 171

 responding is solely client-centered and interpretation is solely psychodyn-
amic. More differentiated analyses of therapist responding are needed. For
example, what is the intention, the function, degree of inference, and the
focus or target of the response, and what is the role relationship created by
the response?

Differentiation and Specification of Empathy

A much more differentiated understanding of the many facilitative

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processes that therapists engage in in therapy is needed. Attempts to clearly

label many therapist actions as either exclusively empathic or interpretive
is fraught with difficulty. Although there are prototypic differences between
empathic and interpretive interventions, in general the picture is more
fuzzy.
The first author tested this view by asking 12 therapists to rate a set
of responses as predominantly empathic or interpretive according to their
own view of these constructs. This was done to test the hypothesis that a
response would be categorized as either empathic or interpretive, as a func-
tion of the therapist’s theoretical orientation (i.e., that the same responses
that dynamic therapists would tend to label as interpretations would be viewed
as empathic by experiential therapists). This would reveal how fuzzy the
distinction is in defining the nature of many real therapeutic interactions.
This hypothesis, however, was not borne out. Rather, no consistent pattern
of response labelling within or across orientation was found. Particular re-
sponses were labelled by some as interpretation and by others as empathic,
regardless of orientation. Many actual instances are, therefore, combina-
tions of features that were difficult to label clearly as either empathic or
interpretive. What is called empathic by one therapist may be called inter-
pretation by another.

A Process-Experiential View of Empathy

O n the basis of the above views, we have begun in our experiential

approach to empathy (Greenberg et al. , 1993) to make a number of distinc-
tions about therapeutic actions that help specify what we actually do in our
practice of empathy. First, we view each therapist statement as a momentary
process facilitation or a processing proposal (cf. Sachse, 1992) that poten-
tially has an effect on the client’s next processing step. Each therapist state-
ment has the potential to influence the form and content of the client’s
internal processing.
In conveying empathic understanding, we therefore view ourselves
as engaging in both selection and reflection of client experience. Clients’
communications are complex and everchanging, requiring the therapist to
select what to listen for. A selective response focuses on specific parts of

I 72 G R E E N B E R G A N D ELLIOTT
 the message. One of the most important things to listen for is the client’s
current feelings and strong attitudes. The therapist listens particularly for
what is live and most poignant and what is central in these messages. A
second important element to listen for is what can be thought of as the
client’s growth possibilities (Greenberg et al., 1993). This type of growth-
oriented response often has a future orientation (Bohart et al., 1993) and
focuses on organismic needs and internal strengths or resources, whenever
these emerge-even if only momentarily. What is possible, desired, or
wanted by the client is constantly being picked up and confirmed by the
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therapist. Thus, it is the seeing by the therapist of the client’s growth possi-
bilities that is critical, and it is this that helps confirm the person’s possibili-
ties. Responses based on this type of empathic selection are process directive
and are intended both to convey understanding and to promote exploration
and growth. This can be contrasted with the purely nondirective attitude
involved in classical client-centered reflection with its singular intention
of conveying understanding of what is most alive or central. We believe
that both types of responses are important but are useful at different times.
Below we will discuss different process-experiential principles of empa-
thy, followed by a variety of different types of empathic responses, and
empathic tasks that we have delineated.

Principles

In addition to specifying and attempting to measure different actions,

we have delineated two higher-level principles governing empathic func-
tioning (Greenberg et al., 1993). We distinguish between an empathic
attunement principle, in which the therapist makes empathic contact with
the client, and an empathic communication principle, in which the thera-
pist communicates understanding and forms a warm supportive bond.

Empathic Attunement
The first principle of process-experiential therapy is empathic attune-
ment. Empathic attunement begins with the therapist attempting to “step
into the client’s shoes” and continues as the therapist tries to follow closely
in the client’s “footsteps,” “tracking” what is most important to the client
as it evolves through the session. Making contact with and tracking the
person’s moment-by-moment experience is the fundamental activity. In
empathic attunement, the therapist then directs his or her focal attention
toward the client’s current, immediate experiencing and attempts to “join”
with the client in understanding what the client is currently experiencing.
T o do this, the therapist listens deeply to both what is said (content) and
how it is said (manner), as this evolves from moment to moment. As we
have said, empathy involves a complex process of apprehension and thera-

VARIETIES O F EMPATHZC RESPONDING I73

 pist experiencing but is not primarily feeling the client’s feeling “as if’ one
were the client.
From the therapist’s point of view, empathic attunement is an unmis-
takeable but difficult-to-describe experience. For this reason, a wide range
of language has been used, with a number of basic metaphors seeming to
capture different aspects of the experience: letting go, moving toward or
into, resonating, sorting out or selecting, and grasping or taking hold. Each
of these metaphors provides a variety of potentially useful ways of under-
standing and developing this crucial attitude.
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Letting go involves setting aside preformed ideas, beliefs, expectations,

or previous understandings of the other (cf. Vanaerschot, 1990). The thera-
pist tries to let go of or “bracket” preconceptions of the client to make
himself or herself more open to what the client is saying or revealing. To
enter deeply into the client’s world and pursue his or her evolving experienc-
ing, the therapist must alternate between grasping and letting go of under-
standing (Vanaerschot). Moving into involves actively entering the other’s
world, becoming immersed in, dwelling in, or feeling into the client’s expe-
rience. In empathizing with the client, the therapist experiences an active
reaching out to enter into the client’s world. Resonating with the other
involves tuning into, being “on the same wavelength,” feeling with (i.e.,
compassion), feeling similar to, or tasting the client’s experiencing. Sorting
out or selecting is another aspect of the therapist’s experience, as he or she
is often faced with a host of client’s experiences to respond to empathically.
A final image or component experience is that of actively grasping or
taking hold of what is important in the client’s world (cf. Vanaerschot,
1990), as suggested by words such as apprehending, comprehending, getting
(the point), assimilating, or perceiving. In other words, having entered
into the client’s world, the therapist then latches onto what is central,
critical, alive, or poignant, sometimes with a sudden sense of insight into
the other’s experience.
Attunement also involves tracking the client’s evolving moment-by-
moment experiencing. As client experiencing develops and changes from
moment to moment in the therapy session, the therapist listens carefully
and responds to these small changes. Attunement to affect involves not
only tracking the client’s experiencing but also conveying an appreciation
of the quality of the affect state, without imitating the exact behavioral
expression of a person’s inner state. This involves the manner in which one
responds and is best explained in dynamic, kinetic terms. Thus, the thera-
pist’s tone or facial expression may catch the surging, fleeting, fading, or
exploding quality of the client’s affect. The response matches not only
content but also intensity, time course, and shape or contour of the client’s
emotional experience, as when, for instance, the therapist speeds up a re-
sponse and in a fast tempo and with an anxious look responds, “It’s like
they’re gonna get me, they’re gonna get me.”

I 74 GREENBERG AND ELLIOTT

 Not only is being empathically attuned to affect important but em-
pathic understanding of empathic failure is also important. The therapist
is at times bound to misunderstand or not grasp the client’s experience.
When the therapist is attuned to the possibility of misunderstanding and
tries to grasp empathically how he or she has failed to grasp the client’s
world, the client realizes the therapist is with him or her. Thus, the creation
of an empathic bond and its continual repair by empathic understanding
of empathic failures is in our view an important curative agent.
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Empathic Communication
The second principle of our approach is that the therapist’s empathic
attunement should be verbally communicated to clients. The varieties of
forms in which this can be done will be discussed below. At the core of
empathic communication is communicated accurate understanding. Under-
standing implies acceptance as well as confirmation of experience. Clients
typically experience communicated therapist empathy as a supportive rela-
tionship message, indicating that the therapist is “on my side” (Elliott,
1985). In fact, in many instances clients are quite satisfied simply with the
sense that their therapist is trying to understand, perceiving inaccurate but
tentative reflections as empathic because of their intent.

Types of Therapist Empathic Responses

For purposes of specification and measurement, we have conceptual-

ized empathy as consisting of qualitatively different types of empathic re-
sponses, of which empathic understanding is only one. Earlier conceptuali-
zaticins of empathy measurement adhered to a unitary additive-subtractive
model wherein empathic responses were rated according to their ability to
access feelings at various depths of awareness (Truax, 1967). Instead we
would rather define a number of different types of empathic responses and
see them as guided by the two dimensions of (a) specific intentions directed
selectively toward (b) different classes of targets, including different types
of emotions and cognitions, rather than simply toward different levels of
feeling (Campbell, 1988; Goldman, 1991; Greenberg et al., 1993).
We have delineated and attempted to measure five distinct forms of
empathic responding: understanding, evocation, exploration, conjecture,
and interpretation. These empathic forms of responding vary on whose
frame of reference is being used in making the response and on the degree
of new information that is added. The continuum of frame of reference (or
degree or depth of inference) ranges from the client’s frame of reference,
through a shared frame of reference, to the therapist’s frame of reference.
The degree of new information increases from reflective empathic under-
standing, where no new information is added, to empathic interpretation,
where the relatively highest degree of information is added.

VARIETIES OF EMPATHIC RESPONDING I 75

 In our view two major intentions serve to guide the choice of empathic
form, either the intention to create an accepting, supportive environment,
through conveying nonjudgmental understanding or the promotion of ex-
ploration and current growth possibilities by searching for newness. In both
cases, manner of communication, especially vocal quality and facial fea-
tures, are as important as content in achieving these aims. Finally, each of
the empathic forms is directed toward a target of either different types of
emotional process (primary or other emotions) or toward a target of different
types of meaning (idiosyncratic meaning or core organizing belief). Using
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this system, it is therefore possible to code a response as, say, an empathic

understanding of a primary emotion, or perhaps an empathic exploration
of a nonprimary emotion, or an empathic conjecture about an idiosyncratic
personal meaning. The forms of empathic responding and the targets shown
in Table 1 are described briefly below.

Empathic Understanding

The therapist communicates understanding of explicit felt experience

or of what is just implied but not yet stated. The therapist’s communication
is from within the client’s frame of reference. The intention is to communi-
cate an understanding of experience. The function is to strengthen and
affirm the self and help build trust in the self.

Empathic Evocation

The therapist brings the client’s experience to life through the use of
metaphor, expressive language, evocative imagery, or speaking as the client.
The therapist’s communication is from within the client’s frame of reference.
The intention is to elicit, arouse, or evoke experience so that it is re-
experienced in the moment. The function is to access new experiential
information. There is no new information added by the therapist, but evoca-
tion enhances the possibility of accessing new information from the client’s
own experience. The therapist selectively attends to poignant information
that seems suitable to evoke.

Empathic Exploration

The therapist encourages the client to search around the “edges” of his
or her experience to symbolize it in a differentiated fashion. The therapist’s
communication is from within the client’s frame of reference. The intention
is to promote an experiential search for new internal information. The
function is to promote discovery of some new aspect of experience, to see
something in a new way. There is no addition of new information by the
therapist, but the client is encouraged to search for new information. The

176 G R E E N B E R G A N D ELLlOTT
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TABLE 1
Empathic Forms and Targets

Emotion Cognition

Idiosyncratic
Target form Adaptive Maladaptive Secondary Instrumental meaning Core be1ief

Empathic I hear how sad Just so shaky Feeling really Crying, saying Unsure whether Just feeling
understanding you feel inside frustrated "you've you can do it "I'm bad"
hurt me"
Empathic Just wanting Feeling wretched -a - Like this means Like whatever
evocation to cry out, like a I'm fighting I touch will
but no one motherless her ghost be cursed
will hear child
Empathic Feeling so hurt So rotten inside - Does it mean You say "I'm
exploration you just like you might something bad" and
want t o . . . never feel like I'll never then what's
what? good again be able to be it like
me inside?
Empathic My hunch is I guess it feels - Maybe it seems Maybe you
conjecture you're like, "I'll like "no one believe you
feeling sad shatter" believes in don't
me" deserve to
be happy
Empathic Your sadness Your need to be Your anger The tears may This present Your belief
interpretation seems to loved also protects be an threat seems that you're
belong to seems to drive you from attempt to so similar to bad
what you your ambition your get his the past prevents
missed in sadness comfort defeat your anger
the past

a These empathic forms are not used for secondary and instrumental emotion targets
 therapist focuses on the expansion and differentiation of the client’s current
experience by either using reflections to focus the client’s attention on the
unclear edges of experiences or through open-ended questioning or even
direct requests for more information about what is implicit or not yet explic-
itly stated. The therapist selectively attends to what is most poignant, un-
clear, idiosyncratic, or implicit in what the client is saying.

Empathic Conjecture

The therapist attempts to clarify the client’s experience by tentatively

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offering information from his or her own perspective about what might be
the client’s current experience in the form of a hunch or a guess. The
therapist encourages the development of a shared frame of reference by
taking a nonauthoritarian and nondogmatic stance, thereby making it easy
for the client to disagree if necessary. The therapist does not leave the
client’s frame of reference but rather is operating synergistically, neither
leading nor following. The intention is to offer the client a possible symbol
to capture an aspect of his or her current experience. The therapist creates
the possibility of the addition of new information through focusing on an
unstated aspect of the client’s current experience. The conjecture functions
to give form to an unstated but significant aspect of the experience, which,
once clarified in this manner, serves to bring about acknowledgement of
the experience.

Empathy-Based Interpretation

Here empathy is used to help the therapist build an internal model of

the client to help understand unconscious dynamics. From this model the
therapist then infers the nature of the client’s experience and states aspects
of the experience that are not available to the client’s awareness. This
response builds on empathy but goes beyond it by moving outside the client’s
frame of reference. The therapist’s communication is now from within the
therapist’s frame of reference. The intention is to tell the client something
new about himself or herself or to offer information to the client about his
or her experience that is not already known by the client. The function is
to promote links between aspects of experience. There is an explicit attempt
to add new information about the client’s experience. In addition, timing
is important: The therapist interprets the client’s experience in a sensitive
and nonjudgemental fashion when the client seems ready to accept and
assimilate this new information.

Targets of Empathic Responding

The second dimension of empathic responding is the empathic target,

defined in categories drawn from our work on emotion and cognition
(Greenberg 6r Safran, 1986; Greenberg et al., 1993).

178 GREENBERG A N D ELLIOTT

 Primary Emotional Processes
1. Primary &ptive emotional processes. The focus is on the basic feelings
and needs and the associated adaptive responses to environment such as
feelings of fear and sadness and the needs for protection or closeness and
the associated action tendencies.
2. Primary maladaptive emotional processes. The focus is on core mal-
adaptive feelings such as fear of abandonment, basic insecurity, or shame.
These emotional experiences may have been adaptive in certain situations
at one time but are now problematic.
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Nonprimary Emotional Processes

(1) Secondary emotional processes. The focus is on feelings that are
expressed in response to some more primary experience, such as when anger
is expressed when fear is the primary feeling, when frustration or rage is
experienced in response to disappointment, or when depressive feelings
occur in response to self-criticism.
(2) Instrumental emotional processes. The focus is on emotional expres-
sions used with the intention to influence others, such as crying to evoke
sympathy.

Cognitive Processes
(1) Idiosyncratic meanings. The focus is on the client’s subjective
construal of the impact of a given situation or experience and on what an
experience means to the client.
(2) Core organizing belief. The focus is on basic assumptions that orga-
nize meaning. These represents basic guiding values, standards, or beliefs
about self and others.
O n the basis of this reconceptualization, an empathy-measurement
system was created that consists of operationalized definitions of the compo-
nents of the empathic response forms and targets plus examples (Campbell,
1988; Goldman, 1991). In a test of this measure, two raters rated 26 samples
of therapeutic empathy (Campbell). The overall agreement between the
raters on forms was a Cohen’s kappa of .4521. This indicates only fair
agreement on empathic forms. Categories of empathic understanding
(k = .6119) and empathic conjecture (k = .5667) showed stronger and mod-
erate agreement respectively, but it was difficult to distinguish evocation
from exploration. The overall agreement between raters on targets was
k = .3158, indicating a less than fair agreement. The category of primary
emotion (k = .7417), however, showed strong agreement. Results indicate
that the different components of empathic responding show promise and
that collapsing into the three broader categories of understanding, explora-
tion, and conjecture would be useful. The targets need further refinement.

VARIETIES OF EMPATHIC RESPONDING 179

 Empathic Tasks

In addition to specifying higher-level principles and lower-level con-

crete actions, we have, at a level intermediate to these, delineated different
types of empathic tasks. We have distinguished between the baseline task
of empathic exploration and a specific task of interpersonal affirmation at
a vulnerability marker (Greenberg et al., 1993). These are discussed briefly
below.
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Empathic Exploration of Experience

The key task in the process-experiential approach is the exploration
and elaboration of client’s experiences. In this task, the therapist attempts
to facilitate client experiencing by helping the client focus on and explore
the bodily felt sense of a particular domain of experience. While staying
within a particular domain of client experiencing (e.g., memories of father),
the therapist helps the client to re-experience, explore the edges of, and
differentiate his or her experience. Here, the therapist listens for what is
most important or poignant in what the client says. In addition, if the client
is telling an external narrative, the therapist listens for “doors” into the
client’s internal experience, indicators of what the client is actually experi-
encing. Thus, the therapist looks for nonverbal signs of unspoken feelings
or perhaps may stop the client to inquire, “I wonder, as you’re telling me
this, what you’re feeling inside about it?” or, when the client continues to
speak externally, the therapist may try to capture the sense of the client’s
stance in what is being narrated, perhaps one of watching with absorbed
interest or even mild horror.
The therapist also attempts to help thz client engage in various forms
of exploration, including reexperiencing, attending to, and differentiating
experience. In facilitating reexperiencing, the therapist attempts to evoke
the past experience by having the client re-enter the original situations and
relive it in the present, as when the therapist says, “Can you go back there,
picking up the phone and dialing. What’s it like? What happens for you
as you begin to dial?” The therapist also encourages the client to explore
the “edges” of experience by attending to what the client is groping toward.
The therapist listens for what is sensed at the periphery of awareness but
not yet said and for the direction in which the client is headed, but in
which he or she may not yet know quite how to proceed. These edges may
be variously sensed as unclear, troubling, or puzzling; fresh, incipient, or
emerging; poignant, primary, or authentic, future- or possibility-oriented,
or idiosyncratic or special (Rice, 1974). The therapist encourages the client
to examine these experiences because they are likely sources of new experi-
encing, discovery, and growth.

180 GREENBERG AND ELLIOTT

 An example of baseline empathic exploration task follows. At the
level of action a variety of empathic forms are used, and these are indicated
on the transcript.
The client in the following excerpt is a 30-year-old woman with some
high-school education. She is the mother of two preschoolers, and her
husband has a gambling problem. Her family believes she should stick by
her husband whom she has unsuccessfully attempted to leave twice. The
treatment of depression has focused, to this point, on her feelings of depen-
dence on her husband and her parents and on her lack of self-worth. She
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has decided to become more independent of her husband by giving up on

trying to save him from his gambling addiction. From her newly gained
sense of independence, strong feelings of loneliness have emerged. This
segment starts a few minutes into session nine and involves entry into her
feelings of unsureness and difficulty “being herself.”

T: So what’s happening with you this week?

C: (Sigh) um-(crying) I’m sad today (T. mm hm), sad-I
mean it’s loneliness I find um this week I’ve been, eating a
lot and I don’t know if it’s just-filling in an emptiness.
T: Uh huh, feeling empty [empathic understanding-reflection].
C: (Sniff) yeah as much as you know, my surrounding lately has
been really good (T. uh huh)’ like having the support group
(T. yeah), that’s really good, I feel good about that but I still
feel. . .
T: Still it’s when you’re (C: yeah [crying]) by yourself there’s a
real sense of just being alone [evocation].
C: Yeah like “why not, I’m important,” and I can’t because I
have to be there for the kids (T. mm hm).
T: So it keeps you relating to something [understanding].
C: Yeah, um, I find it hard like I’m taking care of everybody,
well you know, the kids and you know, and myself that’s a
that’s a must, that comes with it-maybe I’m expecting some-
thing back.
T: So it feels like you’re kind of giving and giving and (C: yeah)
and sort of like, well “What about me?” or . . . [exploration]
C: Yeah that’s right even though, you know, I feel content be-
cause um I do have friends now that I’ll just sooner or later
talk to (T. mm hm), but then that loneliness um creeps up
when I’m alone.
T: There’s just something about being alone right now that just
really hard [exploration].
C: Yeah, I guess it’s lonely no matter how much I understand
you know I’m needed or I am wanted and I do count?

VARZETIES OF EMPATHZC RESPONDING 181

 C: Yeah it’s like, well it’s not hard, it’s the loneliness is there,
and I guess what I’m looking for is comfort (T: uh huh), um
being told that I matter (T: yeah, that’s what you’d like),
reassurance I guess.
T: Yeah, somebody to say “Yeah, it’s okay, Cindy.” [evocative]
C: Yeah (crying), I’m just I guess to just hear from somebody else,
and (T: uh huh) and um I mean just repeating to myself. . .
T: Uh huh, it’s like hard to keep doing it on your own [explo-
ration].
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C: Yeah yeah, it is, that’s right, it’s like always there.

T: Sort of a constant feeling of wanting something [exploration].
C: Yeah yeah, that’s always there (T: uh huh)-I guess I just
need to reassure myself that you know it’s going to be okay,
(T: mm mm hm hm) you know that-you do have friends
that care and um family and yeah I guess just reassurance (T:
mm hm).
T: But just something there’s there’s something you want out
there-some kind of reassurance [exploration].
C: Mm hm, yeah I guess I’m the type of person that needs to
hear that or again because I’ve always been, always been giving
and um not I guess I didn’t get it back to me um that make
makes me feel maybe like um you know I’ve been ripped off
o r . . . (T: mm hm)
T: So there’s a feeling of being cheated, too (C: cheated, yeah).
What’s that like? “I’ve given and given and given and what
have I got for this?” kind of thing [understanding/exploration].
C: Right yeah, “Why isn’t it coming back to me?” or (T: mm
hm) it’s prolonging like it’s been a very long time.
T: So you’re getting a bit fed up with it like, “It’s been a long
time since I’ve been giving and putting out” [evocative].
C: Yeah, “When is it going to be my turn to?” not that I want
to receive as in gifts stuff but just (T: yeah) to mean that I
count that I’m there for a reason (T: yeah), to be told that
(snifl .
T: Yeah like you’ve sort of become more aware now of what you
need-right ? [exploration]
C: Yeah, um and maybe this is why um I give because I guess
the emptiness-it makes me feel good like when I do that but
then inside um well it seems like a hole.
T: Yeah so you’re saying you sort of would try to fill it before
by giving and now that you’re not doing it you’re kind of left
with this big open gap [understanding and evocation].

I82 GREENBERG A N D ELLIOTT

 C: That creeps up on me and you know I will think when you
know um I’ve given and given “When is it my turn to receive?”
T: Yeah so it sounds like a little bit of almost anger or like (C:
uh) it’s like “What about me?” [empathic conjecture]
T: So you sort of (C: cut myself up) and tell yourself like--“No
that wasn’t nice (C: yeah), you’re mean C.” [understanding]
C: (Crying) so it’s actually-I guess being myself you know why
can’t I just (crying) do that, why do I have to feel this, you
know it’s just common sense it’s something that is minor.
T: So it’s like just being yourself and saying what you want to
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say is difficult? [understanding & exploration]

C: Yeah (crying)(sniff)(T: try to take a breath) (crying) (T: yeah
just breathe) I guess you just you just hit the spot like when
you said (crying) um be myself (T: uh huh) (sigh).
T: There’s something about being yourself that’s difficult [under-
standing].
C: Yeah, it’s like um I feel restrained (T: uh huh) um . . .
T: Is there some feeling of uh you’re clamping down? [conjecture]
C: No (crying), you know it’s bad to say what I think that or
(T: uh huh) (sniff), but then it worries me because then I
say to myself, you know, “Don’t you have any respect for
yourself?”
T: Uh huh, that’s the other side of it, but there’s something
about it like it’s bad to be yourself or . . . [exploration]
C: Yeah yeah, that’s it, it’s bad to speak your mind (T: uh huh)
um again because (sniff) it’s um getting it from my parents
saying you know, don’t and then getting it from V. (T: mm
hm) I just have a hard time (sigh)-you know even though
it’s in my mind I want to express it but it’s, I hold back (T:
mm hm).

Empathic Affirmation of Intense Vulnerability

Some of the most powerful moments in therapy occur when therapists
are able to convey genuine acceptance of client’s expressions of strong,
vulnerable, self-relevant emotions. Here, the task involves affirmation as
opposed to the exploration of the previous task. Such emotions as deep
hurt, intense shame, bitterness, despair about the future, or a sense of total
isolation from others or an extreme sense of fragility are all felt as intensely
personally defining. People feel extremely vulnerable about having these
feelings. Clients often fear that if they reveal themselves and fully express
these painful emotions, or other seemingly unacceptable aspects of them-
selves, that the therapist will not understand, will judge them, feel alienated
from them, or even reject them. They fear that they will be viewed by the

VARlETIES OF EMPATHIC RESPONDING 183

 therapist as unacceptable, abnormal, defective, or even frightening. There
is, thus, often an attempt to close down, or hold off, dreaded feelings or
aspects of self and to avoid dealing with them. For some clients there is
also the fear that, if they fully acknowledge these dreaded negative feelings,
these emotions will be bottomless and engulfing, and they will lose control
and will, themselves, be overwhelmed by them. They, therefore, feel ex-
tremely fragile.
A client’s statement of intense vulnerability presents an important
opportunity for an empathic and highly validating intervention by the thera-
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pist. This provides an affirming interpersonal experience with the therapist.

If a client can fully express a feared, dreaded, unacceptable aspect of experi-
ence, such as intense despair or shame, and have it fully received by a
therapist who is sensing the feeling in full intensity and is clearly valuing
the client with no reservations, this can be a powerful experience that
promotes change. The product of this event is the crucial interpersonal
learning that one’s experience is acceptable to another, and this validation
leads to a stronger sense of self.
In this whole process, vulnerable clients are confirmed by making
contact and being accepted as they are. They are helped to become unique
selves by the therapist’s confirming them in their uniqueness. I t is the exis-
tence of the self as a separate centre of experience and agency that is con-
firmed by the therapist’s empathic affirmation of the client’s unique inner
experience, however fragile. Accepting clients as they are in their vulnera-
bility or despair does not imply accepting them as forever stuck; nor does
it imply that the therapist has given up hope for their change. Instead,
the continuing empathic affirmation of the whole person while they are
experiencing and revealing these painful, fragile aspects of themselves helps
them to differentiate this aspect of self from the total self. They cease to
feel as overwhelmed by the vulnerability and can see the feared aspect as
a part, rather than as all, of themselves. The person feels stronger and more
able to cope. This strengthened sense of self makes possible further changes
and growth. (For more on the task, see Greenberg et al., 1993).

CONCLUSION

The self speaks in a language of feeling, and empathy is the channel

for understanding affect. The self is always in a constructive process of
becoming, involving a dialectical process of symbolizing and constructing
experience from internal complexity (Greenberg 6r Pascual-Leone, 1995,
in press). People simultaneously discover and create themselves anew each
moment (Greenberg et al., 1993). Self-organization is created in the mo-
ment from person and situation interactions, by integrating information
from both inside and outside. Meaning arises in the moment out of the

184 GREENBERG A N D ELLlOTT

 constituting activity of inwardly attending to and symbolizing one’s internal
complexity (Greenberg et al., 1993; Grcenberg & Pascual-Leone, 1995).
Empathic attunement to affect is one of the core ways of being therapeutic
because empathic attunement and its communication are key aids in the
construction of self experience. They help the client to symbolize inchoate
emotional meaning, and this aids affect regulation and strengthening of the
self as well as exploration and discovery.
In our view, to better understand empathy and its communication
in therapy, empathy needs to be differentiated into a variety of different
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components, including both acts with different intentions and targets and
different, more molar tasks with different processes and effects, as well as
different higher-level principles that describe its functioning. Empathy, as
therapist experience of attunement, needs to be differentiated from the
communications that flow from the attunement. Communication can take
many forms, of which empathic understanding is only one. Empathic explo-
ration to promote discovery and conjecture to offer new symbols are other
important forms of responding from an empathically attuned base. Future
efforts at investigating empathy in psychotherapy need to be guided by
differentiated questions such as what type of empathic communication, with
what intent, at what target, in what specific context, with what interper-
sonal style and manner, has what type of effect? In addition, new attempts
are needed to measure therapists’ attunement to clients’ changing states and
their ability to track their clients’ moment-by-moment experience and to
design their interventions to fit the client’s current experience. I t is this
skill that is probably at the core of effective therapeutic intervention.

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