Panel I:
Neuroscientific Advances in Understanding Empathy

In his presentation entitled "Emotion, Intuition, and Empathy," Professor Oliver Turnbull, Ph.D., a psychologist from the Centre of Cognitive Neuroscience at the University of Wales, addressed the growing interest in the biological basis of emotional and cognitive capacities. Basing his discussion on empirical research, he examined the ways in which empathy plays a crucial role in complex decision-making and learning. He defines empathy as the "indirect experience of the emotions of another," and regards it as an "unconscious and natural manner of sharing another's emotional life." Taking care not to equate the concepts of "brain" and "mind," he described multiple memory/learning systems and the specific areas of the brain in which they seem to be rooted.

Empathy, he suggests, positively influences complex decision-making when there is a shared alignment, advantage and/or cooperation between player and observer. However, when schadenfreude (a sadistic form of empathy derived from pleasure in the vicarious experience of the other's pain) is operative, then the relational learning process is "undercut" and is "worse than learning alone."

What implications can be applied to the training and practice of psychoanalysts and psychotherapists? Essentially, according to Dr. Turnbull, collaboration and (emotional) "investment" offset the reflexive activation of aggression and hostility and enhance the learning in mentor-student, supervisor-training analyst, and analyst-patient interactions. He cautioned that we must avoid inferentially leaping from findings of research conducted on simple tasks to the epistemological hermeneutics of psychoanalysis defined by a Kohutian understanding of empathy (sustained and conscious empathic listening and data-gathering in an extremely complex configuration of biological, cognitive, emotional, and interpersonal dynamics).

Dr. Turnbull expressed excitement about the future of neuro-psychoanalysis, noting that much is to be gained at the crossroads of research and the clinical exchange. He spoke of being especially intrigued with the possibility of future explorations of the therapeutic dialogue, insofar as patient self-expression is "open and honest" and therefore heuristically rich.

Drs. Lucyann Carlton and Estelle Shane then discussed Dr. Turnbull's ideas and epistemological concepts from their self-psychological perspective. They began with a comparison of Turnbull's research and Kohut's clinical understanding of empathy - a sustained and conscious listening perspective utilized to enter the patient's inner world to gather psychoanalytic data. Questioning the generalizability of Turnbull's unexpected finding regarding schadenfreude, they asked if schadenfreude is a ubiquitous phenomenon. They also questioned whether neuro-psychoanalysis is the future of self psychology and referred to Edelman's writings to make the point that "the focus is not on structure, but on interactions among structures, that is, elements of the system" where body, mind, and brain are contextually embedded in a nonlinear dynamic system. "Psychoanalytic theory," they insisted, "must recognize and articulate interactive relations among elements in the system, relations that change the elements themselves. It is only with such a theory," they suggested, "that the unpredictable, at times unimaginable, nature of the mind and brain can be understood, and that the unpredictable, at times unimaginable, nature of change can be embraced."

In answer to the questions: "So why talk about the brain at all?" and "Should there be a place for brain research in our field?" Drs. Carlton and Shane provided a number of "justifications" for assuming that the study of the brain enhances psychoanalytic understanding. They observed that current brain research exposes limitations in extant clinical theories; that it affords "a different order of generalization," one that is formulated on an abstract, process-based level of brain-based epistemology; and that the brain, with its ever-present and heretofore under-appreciated capacity for development and change, informs the analyst's clinical sensibility. They noted that the cross-pollination of brain research and psychoanalysis offers a unique opportunity to address "at one and the same time, both levels of understanding, the idiographic, or individual level, and the nomothetic, or universal level."

Dr. David Terman began his discussion of Dr. Turnbull's presentation by reviewing "what self psychology has said about empathy." He quoted Basch (1983, p.114) as follows: "Empathic perception is never a matter of somehow getting a direct look at what goes on inside another mind; rather it is considered judgment that there is a correspondence between what we are feeling and what, in the case of the analytic situation, the analysand is experiencing, consciously or unconsciously." Dr. Terman discussed the idea that empathy, as a mode of observation, can be used for good or ill, depending upon the motivations of the empathizer. He reminded us that since the discovery of the importance and centrality of empathy was done in a clinical setting, we must be careful not to dissect empathy into component parts just as we must avoid the fragmentation of human experience in order to not lose the gestalt.

Dr. Terman went on to say that we need to heed and understand neuroscience insofar as "there seems to be a clear correspondence between neuronal event and the varieties of psychological processes we have called empathy. He added that definitions of empathy by many neuroscientists' are compatible with our own. He noted that Decety & Jackson (2004) in "The Functional Architecture of Human Empathy", propose "three major functional components that dynamically interact to produce the experience of empathy in humans: 1. Affective sharing between the self and the other based on perceptual-action coupling that lead to shared representations; 2. Self-other awareness. Even when there is some temporary identification, there is no confusion between self and other; and 3. The presence of mental flexibility to adopt the subjective perspective of the other and also regulatory processes. In other words, for Decety and Jackson, empathy is not simply the sharing or similarity of affect or any other state, it must have the components of awareness of the difference between self and other and the complex cognitive operations that involve the capacity to take the perspective of another."

Dr. Terman concluded his discussion by pointing out that psychoanalysis is still "ahead" of neuroscience in that clinicians look at the whole self and self-other psychological experiences while experiments breakdown this gestalt into parts or elements of the isolated mind. "But," he noted, "both approaches are informative and can inform each other.

This first panel stimulated some lively theoretical and clinical discussions in the small group discussions and throughout the conference. It appears that conference attendees are interested in finding a collaborative scientific vernacular. Dr. Turnbull took us to Hollywood to illustrate empathy and complex decision-making by means of the film, "Casablanca." He observed that Rick solved his conundrum with Ilsa and Victor by altruistically choosing world welfare. Regarding the future of self psychology and neuroscience, it seems that, as Humphrey Bogart said to Claude Rains at the end of the film, "This could be the start of a beautiful friendship!"