Empathic understanding and immersion in a patient’s pathological experiences by a psychiatrist have their limits and do not allow for the subjective experience of the other to be lived through, and thus, the difference in the Other’s lived world must be respected to avoid causing epistemic harm to the patient, concluded Lucien Spencer in her lecture titled “The Epistemic Harms of Empathy in Phenomenological Psychopathology.”
In the lecture held on October 4th in the Grand Hall of the Institute of Social Sciences (via Zoom and in front of a live audience), a postdoctoral researcher from the University of Birmingham’s Institute of Mental Health, Lucienne Spencer, critically examined Jaspers’ concept of empathic understanding. Starting from this traditional perspective on the meaning and significance of empathy when attempting to understand the pathological experiences of psychiatric patients and moving through modern approaches in phenomenological psychopathology, the author attempted to show that empathy has its limits that will prevent the psychiatrist from truly empathizing with the patient’s experiences. If clinicians rely too heavily on Jaspers’ empathic understanding, this can lead to the opposite effect – misinterpretation and misdiagnosis. This also applies to modern viewpoints that build upon Jaspers’ theory, and they suggest that through “radical empathy” or “second-order empathy,” severe psychiatric disorders like schizophrenia can be understood at an experiential level.
Spencer argues that the difference that must exist in the pathological subjective experience of the patient must be respected, and only the patient can contribute their experiential knowledge. Experiential and clinical knowledge should not be conflated; the latter belongs to the psychiatrist, who brings methodological and therapeutic expertise as well as an understanding of the causal processes of psychiatric disorders. The author emphasizes that the clinician cannot have an equal lived experience and understanding compared to the patient unless the clinician themselves has the same disorder. When a clinician believes they have such an understanding of the patient’s experience, they cause a specific form of epistemic harm to the patient by marginalizing the experiential knowledge that they can convey about their illness. In a lively discussion on these controversial topics, alongside psychiatrists and philosophers, a person with lived experience of bipolar disorder also participated.
Lucien Spencer’s lecture is the sixth in the series of seminars on “Philosophy and Psychiatry” organized by the Center for Philosophy at the Institute of Social Sciences. The seminar aims to provide young colleagues and doctoral students with an opportunity to present their work and enhance it through the discussions that follow each lecture.