Alan Alda, Helen Riess Urge Pandemic-Era Empathy

August 11, 2020

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

Empathy is needed now more than ever in the chaotic era of COVID-19.

That's the message actor Alan Alda and Helen Riess, MD, Mass General Hospital, Boston, are trying to spread. In the midst of another rising wave of COVID-19 diagnoses, personal protective equipment shortages, renewed calls for wearing masks, and continued uncertainty about a condition that is still relatively unknown, clinicians need empathy when dealing with patients, colleagues, friends and family, and even themselves, Alda and Riess stress.

Alda has been helping to train scientists and physicians to communicate better through the Alan Alda Center for Communicating Science founded at Stonybrook University, New York, in 2009. Riess is associate professor of psychiatry at Harvard Medical School, director of the Mass General Empathy and Relational Science Program, and has published several studies on this topic.

Recently, the two came together for a Medscape Medical News video to interview each other with a focus on empathy, a subject they both deeply care about.

"Teams work better in the lab or in the clinic. People get together and collaborate more effectively the better they communicate," Alda said in the video.

"One of the things we've found is that if you want to communicate with another person, you have to do more listening than they do. You have to be aware of what they are going through," he added.

Riess noted that her team has done substantial research showing that empathy is linked to better healthcare outcomes in areas such as obesity, asthma, hypertension, and diabetes.

"When we're in a pandemic like this, the topic of empathy is front and center," Riess said, adding that it's especially important today to be "a leader with empathy."

A First Step

Alda noted that although some people think empathy is synonymous with wishing another person well and being sympathetic and compassionate, he "sees it in a more fundamental way."

"It's a first step toward taking positive action in aid of the other person, but it doesn't automatically lead to that. You have to decide to use your empathic understanding of their point of view to do something to help them," he said.

Riess agreed. "Empathy gets us to the motivation stage. We see pain and suffering and, if it's working, we are motivated to help. But you're right, not everybody takes that course of action," she said.

She noted that, for her, empathy has both cognitive and emotional components. It's an ability to resonate emotionally with another person, as well as to take their perspectives and understand the contexts in which they are living, she said.

A systematic review of 16 studies by Riess and colleagues published in 2016 in Patient Education and Counseling showed that nonverbal expressions of empathy varied across cultural groups and affected the quality of patient care.

In addition, a randomized controlled trial conducted by Riess and her team showed that, among 99 residents and fellows, those who received postgraduate medical education augmented with empathy-training modules had greater changes in patient-rated CARE scores than those who received standard medical education alone.

Empathy During COVID

Alda pointed out that, currently, healthcare workers are being exposed to "the most harrowing, tension-producing experiences; and the empathy that we want them to have to effectively deal with patients can overload them.

He said it's important to teach physicians to "get in with empathy; and then before they get overwhelmed, get out."

"Empathy is not a limitless supply," Riess agreed. That's why self-empathy and self-care should also be recommended.

"We need to spread the empathy interprofessionally. It also starts at the top and the way healthcare organizations are communicating with their work teams to recognize the sacrifices they are making, the risks they're taking," she said.

"No one goes into healthcare taking an oath that they are going to risk their lives. They take an oath to do no harm," Riess added.

That said, "many people are risking their lives because it's in them to care."

She pointed out that noted psychologist Heinz Kohut called empathy "psychological oxygen."

"We have to remember that it's not just oxygen prongs that people need but it's also psychological oxygen. They need to feel the support, the appreciation, and the outpouring of gratitude for all the work they're doing," Riess said.

"When it comes to leaders, that should be one of the loudest messages we're hearing: gratitude and thanks. And it should really be about the people that are making this pandemic turn toward the better," Alda added.

Click on the player to watch the entire interview between Alda and Riess.

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