Empathic Communities

Educating for Justice

Johanna M. Selles

• Publisher: Wipf and Stock
• Year: 2011
• Print ISBN: 9781608998616, 9781498258166
• eBook ISBN: 9781498274012
• Topic: Social Sciences
• Subtopic: Religion
• Index: Social Sciences

Empathy is generally considered a useful skill for professional students in the helping professions, such as medicine, nursing, teaching, and clergy. This book examines the pedagogical and curricular implications of educating for empathy. Empathy is described as consisting of both cognitive and affective elements. Students may demonstrate empathic abilities on a continuum from an empathic deficit to empathic overload. Mentoring, reflection, journaling, and an understanding of spiritual formation can be helpful to professional students in learning how to engage empathy. For both the professional and the client, empathy can enhance the encounter and the professional relationship. Building on the inherent potential for relationality, professionals engaging empathy bring respectful humility into their encounters that can facilitate intercultural understanding in a diversifying and complex world.

1

Professional Relationships

Applying to be a student at a professional school is a challenging experience involving transcripts, reference letters, resumes, statements of interest, application fees, and often evidence of volunteer work or research. The application process is only the first test—the second one involves surviving the demands of the program. This book serves as a guide to reflection on one aspect of professional formation, namely the ability to be empathic and to sustain empathic engagement in professional relationships. To begin, we will look at the following questions: What is a profession? What is involved in the history of a profession? What is a professional relationship? What is empathy, and how does it affect the professional relationship?

Observing a Profession

After she experienced some disabling headaches, Jill’s friends convinced her that she needed to see a doctor. She made an appointment for a physical since she had never had a thorough check. On the day of her appointment, she leafed through magazines in the waiting room and watched the patients come and go in the office. She was eventually called into a small office and invited to take a seat. Her eyes wandered over the doctor’s diploma from a nearby medical school, and then she noticed the examining table with a variety of instruments lined up. A blue gown was folded neatly on the table.

When Dr. Jones entered, she introduced herself and sat at the desk. While completing the history, the doctor asked Jill about the particular complaint that had led to the office visit, as well as her overall medical history. She left the room while Jill changed into the patient gown. During the physical assessment, Dr. Jones systematically checked and recorded data from her observations and continued to ask Jill questions related to her presenting complaint. Once Dr. Jones had completed the history and assessment, she wrote a prescription for medication and sent Jill to the laboratory for further blood work and urinalysis.

Although neither Jill nor Dr. Jones stopped to acknowledge the fact, their meeting was the beginning of a patient-practitioner relationship guided by unspoken rules and expectations. Jill quickly felt at ease with the professional setting of the clinic and with Dr. Jones’s style, both of which balanced a caring attitude with a professional purpose. Dr. Jones recorded information in the patient chart. Jill was not worried that this information would be shared with others or used for inappropriate purposes. She assumed her chart would be filed and any subsequent lab results or notes would be added to that file.

During the appointment, Jill undressed and put on a patient gown. In any other setting, she would have felt very uncomfortable talking to a stranger in a state of relative undress. The setting and the doctor’s professional attitude eased the awkwardness that Jill had initially felt while perched on the examining table with a small sheet and the blue gown for cover.

Both Jill and Dr. Jones operated in this encounter according to expectations that shape professional relationships. Each brought to the consultation a personal history and web of relationships that defined their expectations of health and illness. Primarily, though, their encounter was governed by unspoken expectations associated with a professional-client relationship involving respect, trust, safety, and confidentiality.

What Is a Profession?

The term “profession” was traditionally applied to law, medicine, and divinity—professions that traditionally excluded women until the late nineteenth and twentieth centuries. Arguments related to women’s essential nature or social propriety were used to exclude women from professions and from science.1 The story of women’s entry and the entry of visible minorities into these professions is well documented elsewhere.2 The entrance of women or visible minorities into professions did not, however, guarantee their full equality in the profession; many restrictions and limitations continued to be applied. Alternate forms of practice outside of the professional certification programs provided routes to practice for those still excluded from professional schools; discrimination against those alternative tracks continues to this day. In the nineteenth century, male doctors responded by using “science” to disqualify female lay healers and midwives.3

Entry into the historical learned professions assumed that a student had acquired a liberal education, including instruction in Latin or Greek. According to Gidney and Millar’s study of professionals in nineteenth-century Upper Canada, professional status derived from social standing, liberal education, and membership in respectable classes, rather than from specific technical skills or knowledge.4

In modern times, professional status generally means that a person has completed postsecondary training including specialized skills, passed a certification test, and submitted to a degree of regulation by other practitioners.5 Each profession tends to hold monopolistic control over its own work based on the specialized knowledge that distinguishes it from other forms of work.6

Professions change and adapt to the internal demands of their own professional associations, as well to external demands from society or government. Educational changes in a professional school can include higher admission standards, increased practical experience or required clinical hours, or a shift in the form of curriculum evaluation, such as outcomes-based assessment. An example of one such potential shift can be found in a recent report on nursing that recommends that nurses obtain a master’s degree within ten years of graduation from a baccalaureate.7 Resistance to such changes may derive from the institutions, faculty, or students.

The reality gap between professional education and the practice setting can sometimes become uncomfortably large in two opposite ways: teachers who were trained in another era may continue to teach as they were taught, or teachers may introduce innovations that are too advanced for the daily realities of the practice setting. Some professional schools attempt to overcome these gaps by requiring that faculty retain one foot in the clinical/practice setting. The rate of change in those settings, accelerated by the use of technology, creates uncertainty for students as they struggle to master knowledge that will likely be outdated before they graduate. Although attempts have been made in a variety of disciplines to disseminate research findings or transfer knowledge more rapidly, the lag between new knowledge and teaching remains difficult to overcome. Demands for research dissemination are now increasingly heard in the humanities; individuals and institutions seek to adopt models of relevance and change to a body of knowledge that once had been considered to be essential and unchanging.

Science versus Humanities

The growing and virtually unquestioned predominance of science as the exclusive basis for knowledge and method in modern times has created a separation among professional education programs. Although doctors and clergy shared a classical liberal curriculum in the nineteenth century, the rise of specialized professional training programs without a humanities core resulted in a fracture between the sciences and the humanities. The educated gentleman doctor had less and less in common with educated clergy—a rationalized division of labor made one a specialist in the body and the other in the soul. In this way, the science-based curriculum made exclusive claims on its adherents that gradually devalued other types of knowledge and other ways of knowing. Current attempts to overcome the fracture through programs in Humanities in Medicine provide a creative challenge to an otherwise dominant scientific paradigm.

Nineteenth-century students of nursing and teaching were educated i...

Table of contents

• Title Page
• Foreword
• Acknowledgments
• Introduction
• Chapter 1: Professional Relationships
• Chapter 2: The Health-Care Relationship
• Chapter 3: Regarding Suffering
• Chapter 4: Bearing Witness
• Chapter 5: Improving the Empathic Ability
• Chapter 6: Empathic Communities
• Conclusion
• Bibliography