For anyone working in the ‘Front-Facing’ sector of the mental health professions, empathy and the therapeutic alliance are considered to be vital components of successful treatment (Nienhuis, 2018).

However, there seems to be a general confusion on what exactly ‘empathy’ is. Political figures and pundits have recently concluded that, under certain circumstances, empathy can be toxic.

Hillary Clinton recently published her thoughts on the subject in the Atlantic and Allie Beth Stuckey wrote the book, ‘Toxic Empathy’ in 2024, in which she noted how the left is exploiting Christian compassion for their own ends. Having read both publications, as a mental health professional, I felt that is was a shame that both ladies didn’t just use the word ‘sympathy’ instead of ‘empathy’ as it would have saved them, and us, a lot of confusion.

Unfortunately, the confusion surrounding the word ‘empathy’ is not limited to the political debate. The mental health professions suffer from a similar confusion and double-think. From a clinical point of view, they describe ‘empathy’ in two conflicting ways:

1. The capacity of human beings to sense or perceive “the private world’ of another person’s thoughts or feelings, which implicitly suggests that the mind is not confined to the physical brain.
2. The ability to closely observe physical cues and to use the imagination to guess what the client is thinking or feeling, which suggests that the mind is limited to the physical brain and five senses.

In this series of articles, I will discuss the modern concept of empathy, specifically its role in the mental health professions, and its importance to our clients. I will discuss the history of the concept and the etymology of the word. More importantly, I will suggest the cause of this confusion in the context of the changing face of science.

In this first article, I will suggest an answer to the question ‘does empathy even exist’?

In 1956, Carl Rogers, the father of ‘person-centred’ therapy, wrote in the Journal of Consulting Psychology ‘The Necessary and Sufficient Conditions of Therapeutic Personality Change’ in which paper he said:

“The fifth condition is that the therapist is experiencing an accurate, empathic understanding of the client's awareness of his own experience. To sense the client's private world as if it were your own, but without ever losing the “as if” quality—this is empathy, and this seems essential to therapy.”

And again, later in 1961, he stressed the importance of ‘empathy’ in the therapeutic relationship in his book ‘On Becoming a Person’ 1961:

“To sense the client’s private world as if it were your own, but without ever losing the ‘as if’ quality; to perceive the feelings and meanings which the client experiences, and to communicate this understanding to him or her. This is what I mean by empathy: perceiving the internal frame of reference of another with accuracy, and with the emotional components and meanings which pertain thereto.”

Obviously, the term ‘as if’ implicitly suggests that the therapist use his imagination to guess what the client is thinking or feeling whilst, in the same sentence, Rogers suggests that the therapist should, sense and perceive the client’s ‘private world’, which implies extrasensory perception.

Such conflicting advice does not help mental health professionals learn to be genuinely empathic, rather it implicitly compels them to ‘guess’ and to repeat their conjecture back to the client, ad nasuem. This often leads to the break-down of the therapeutic relationship and disengagement of the client. So what is ‘empathy’?

Contrary to popular belief, ‘empathy’, is a modern word (20th century) based on an old German idea (Einfühlung), translated (badly) into Greek to give it a clinical veneer. Originally this made-up term meant ‘prejudice, malevolence, or hatred’. Somewhat ironically, over time it has come to be defined as ‘the ability to share someone else's feelings or experiences by imagining what it would be like to be in that person's situation’.

Interestingly, in 1956, J.T. McIntosh used the word ‘empath’ in his science fiction writing to describe someone with extrasensory perception (the ability to know what a person is really experiencing without resort to inference or context). However, the fact that the term seemed to immediately gain global usage did not happen in a vacuum.

This was a time when science was beginning to adopt the neurocentric view of the mind – that the mind and consciousness was a product of the brain – and any suggestion that there was more to the mind than meat was frowned on.

However, people still needed a term to describe sensing a person’s thoughts, feelings or mood - a phenomena, with which they had always been familiar. The public enthusiastically adopted the word ‘empath’.

Prior to the Second World War, in almost every culture and time, humans had a word to describe sensing a person’s thoughts and feelings remotely.

In old English the term ‘innseon’ had meant ‘to see within’.

In old Norse the term was ‘Samúö’ which literally meant ‘same feeling’.

In Italian, ‘immedesimazione’ means to identify with another’s inner experience.

In Greek, the word ‘Noos’, means the intuitive apprehension of another’s mind.

In Japanese, ‘Sassuru’ means the same as in the Greek.

It is evident that the concept of ‘intuitively connecting with someone else’s thoughts and feelings’ has been ubiquitous throughout human history.

The problem for Carl Rogers and anyone else who might want to describe the ability to ‘intuitively connect with someone else’s thoughts and feelings’ was that, by the end of 1950s, science had come to see humans as meat robots, totally separate and totally dependent on the five senses. Neo-Darwinism had come to see consciousness as a product of evolution and a product of the brain.

Obviously, if this neurocentric view of the mind is true, then the Greek term ‘Vóoç’ or Noos (direct apprehension of mind) must be impossible.

So it is logical and understandable that Carl Rogers uses double think when he writes his papers. He used terms like ‘sense’ and ‘perceive’ to describe what he does but uses terms like ‘imagination’ and ‘observation’ to explain how he does what he does; to have done otherwise, would have been professional suicide.

I would posit that any academic, working at that time, would have been very shy of applying terms that suggested extrasensory perception.

And this would be where the story ends if it were not for the fact – ever true – that science moves on!

Now in 2026, the weight of decades of contrary evidence can no longer be ignored. Scientists such as Professor Wilder Penfield, wrote in the ‘Mystery of the Mind’ (1975) that the observing Self was not a product of the brain.

Professor Michael Egnor, Professor of Neurosurgery and Pediatrics, in his book ‘The Immortal Mind’ goes further and details the case of Pam Reynolds.

In 1991, Pam felt dizzy and had trouble speaking, after a series of tests, it was discovered that she had an aneurysm the size of a walnut in her brain. She was sent to Dr Robert Spetzler to have it removed. The only way Spetzler could save her life was to kill her for half an hour, drain the blood from her head so that he could repair the aneurism and, hopefully, revive her again.

After the operation, Pam said “It was brighter and more focused and clearer than normal vision… There was so much in the operating room that I didn’t recognize, and so many people... You’re very focused and you have a place to go. The feeling was like going up in an elevator real fast.”

Pam saw things in the operating theatre, heard things that she couldn’t have possibly seen or heard. Her head had no blood, no brain activity and her eyes were covered and her ears blocked and yet she heard and she saw with extraordinary clarity. It is evident that we have access to information about this world not supplied via our five senses (Greyson, et al. 2025)

This case is not rare; a lot of people have had the experience of life beyond the brain and I mention it in order to suggest to you that there is a reason that people have always believed that it is possible to ‘intuitively connect with someone else’s thoughts and feelings’: the mind is not confined to the brain.

If I were to list all of the evidence to support my hypothesis I would need to write another book and it would still not be enough to convince some people.

I will therefore call another witness instead! You!

Nearly everyone has had the experience of thinking of a person just before the phone rings or in a conversation, saying something that the other person was thinking.

I, myself, many years ago had the experience of driving home – not really thinking anything – when I was struck by a sense of dread and fear, I knew that something terrible had happened to an old girlfriend of mine that, at the time, I had loved very much. I had not thought of her in decades as we parted on bad terms – hers was not a memory I liked to dwell on. I called her mother to see if she was alright and she said “How did you know? Diane has just had a late miscarriage due to a boating accident.”

Most people have experiences of true empathy but we have been conditioned to ignore the evidence of our own experience.

As the weight of evidence builds up for true empathy (the ability to sense another person’s feelings and thoughts) devotees of the neurocentric paradigm have suggested physical mechanisms to account for the anomalies:

• Micro-sound leakage
• Air pressure changes
• Subtle vibration
• Temporal expectation
• Context priming
• Prior probability bias
• Confirmation bias
• Retrospective reinterpretation

What is the truth? I’ve looked at the evidence and I am sceptical but I will let you decide.

Carl Rogers in the end, in his famous session with ‘Gloria’, said “well all I can do is what I am feeling - that is – I feel close to you in this moment.”

Real empathy demands that the therapist open his heart to another person, to give them unconditional positive regard, when that happens, when there is a true need, maybe it is possible for a true connection between two people to be created.

What do you think? Have you had the experience during therapy of knowing what another person thinks or feels?

In my next article of the series, I will examine the question:

“Does empathy make me a better therapist?”