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Empathy is a broad concept that refers to the cognitive as well as the emotional reactions of one individual to the observed experiences of another. Questions regarding how we understand others have intrigued psychologists and philosophers for centuries. In order to answer these questions, two major theories have been proposed, known as Theory Theory and Simulation Theory. In the past two decades, these questions have been re-examined by neuropsychologists and neuroscientists. This chapter reviews the different aspects of emotional and cognitive empathy in light of converging evidence from lesion patients, electrophysiology and neuroimaging studies. Neuropsychiatric disorders, such as Autism or Schizophrenia, although heterogeneous and difficult to study, have also been examined in relation to their deficits in cognitive and emotional empathy, and some of these new findings are discussed in this chapter. Lastly, we propose a model which relates brain mechanisms such as simulation or cognitive and affective ToM, to psychological processes, the empathic responses they lead to, and deficits which may occur when these mechanisms are disrupted.

This chapter focuses on clinical empathy substituting emotional empathy in medical care. It discusses the reasons for avoiding emotional sympathy, including interference with the doctor’s objective mindset, effective care of the patient in trying circumstances, and burnout risk. The chapter explores the importance of developing trust through empathy, along with the challenges that physicians face while trying to be empathic toward patients, including emotional distress and compassion fatigue. It presents the arguments against the reasons for the avoidance of emotions in clinical sympathy, along with the methods through which physicians can engage with their patients on an emotional level in a very subtle manner, and explores the importance of curiosity for physicians to understand empathic accuracy.

This chapter describes the multiple traumatic events encountered by emergency responders, drawing directly on interviews with emergency responders. While most discussed horrific events which contained much blood and gore, they were quick to add that these were not the events that “have left me sleepless.” The events that were most troubling for paramedics, firefighters, and police officers did not involve multiple deaths in a dramatic incident, but rather involved the death or injury of someone that the worker contextualized in relationship to others. These events connected personally with the emergency responder and often caused them to re-evaluate their own relationships, priorities, and achievements. These findings require a rethink of intervention models that focus on high profile, dramatic incidents and ensure that services are available to allow workers to discuss personal reflections of tragic, yet unsung events.