When Therapists Mistake Caretaking for Empathy
What many therapists call “empathy” isn’t empathy at all.
Therapists like to talk about “empathy.” Who doesn’t want empathy? The problem is that what many therapists mean by the word is not empathy at all.
Psychology’s deepest insight is that we are not of one mind. We are of many minds. We have multiple, often contradictory feelings. We have layers of experience, conscious and unconscious. What’s on the surface is never the whole story.
So we have to ask: given multiple layers of experience, which part of the patient is the therapist “empathizing” with?
Which part of the patient is the therapist “empathizing” with?
In practice, the answer is usually the same: the therapist “empathizes” with the patient’s hurt, needy parts. Then the therapist takes on the complementary role of comforting, nurturing, and caretaking.
The problem is that this excludes all the other parts of the patient that are also real: anger, envy, resentment, hate, spite, rivalry, destructiveness, aggression.
When the therapist doesn’t acknowledge these parts of the patient’s experience, the patient cannot acknowledge them either. The feelings go underground and the opportunities for self-awareness are lost. Therapist and patient collude with each other’s defenses, and each presents a false self. The acknowledged feelings become the acceptable version of the self while the rest is disowned.
What is not recognized cannot be worked with.
So we have to ask again: which part of the patient is the therapist empathizing with, and which parts are being erased?
What is called “empathy” can become a rationale for selectively attending to the feelings that are comfortable for the therapist, or that bolster the therapist’s self-image as caring and nurturing.
Genuine empathy is receptivity to the full range of a patient’s experience—not just the hurt parts that are easiest for therapists to identify with, but also their anger, envy, spite, and aggression.
Anything less is erasure, not empathy.
Related Essays
When Psychotherapy Works, Then What? (July 28, 2025)
Therapists Say the Relationship Heals. Few Know What It Means. (September 30, 2025)
Selling Bad Therapy to Trauma Victims (December 8, 2025)
Why Psychotherapy Gets Stuck (January 19, 2026)
Much of What Is Called Therapy Is Not Psychotherapy (February 23, 2026)
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I am not a professional, simply a person that’s been working on my own trauma recovery for several years now (with a therapist), the way I see people practice or consume therapy today almost feels contradictory to several of the key things I had to work through to actually heal and get to the other side.
It’s almost like patients are enabled to avoid discomfort even in the one setting where they should be able to explore WHY there’s discomfort in the first place.
I might call this "selective" empathy. Or maybe "easy" empathy if I'm being a bit cynical.
Certainly patients/clients seek someone who understands and honors their pain. This is necessary but not sufficient for change, and therefore for psychotherapy to occur. Whereas empathizing with their inner struggles, with the mixed and often conflicting feelings that swirl around any personally meaningful theme or topic... that's the harder kind of empathy that makes psychotherapy different from mere emotional support.