Empathy, Self-Other Differentiation, and Mindfulness Training

Empathy, self-other differentiation and mindfulness training Paul W.B. Atkins Australian National University Acton, ACT, 0200 Australia To appear as: Atkins, P. W. B. (in press 2013). Empathy, self-other differentiation and mindfulness. In K. Pavlovich & K. Krahnke (Eds.), Organizing Through Empathy: Routledge. Corresponding Author: Dr. Paul W.B. Atkins Crawford School of Economics and Government Australian National University Canberra, ACT 0200 AUSTRALIA Email: paul.atkins@anu.edu.au Tel: +61 2 6125 8979 ABSTRACT Decety and Lamm argued that empathy is “the ability to experience and understand what others feel without confusion between oneself and others” (italics added; 2006, p. 1146). Excessive identification with another who is suffering appears to lead to personal distress and avoidance rather than empathic concern. This is particularly a problem for roles involving helping or other forms of emotional labour. And yet there is a potential paradox here as empathy appears to be motivated by a felt sense of connection between self and other. How can we understand self-other differentiation in a way that allows us to improve it in organisations? In this chapter I present a contextual, behavioural approach that explains why mindfulness programs work to improve self-other differentiation. We can see self and other either in terms of a) conceptualisations, b) a flow of experiences or c) as awareness itself. Responding to conceptualisations of self and other can be helpful but can also impair empathy. Self-other differentiation at the level of content generally creates separation and judgement rather than empathy. Responding at the level of present-moment experience is the essence of responding to the others experience but it is here that differentiation of self and other is essential for mature, sustainable empathy. At the level of awareness itself, a stable sense of self beyond threat can be contacted in such a way to support empathy. Furthermore, in rare instances one can experience a sense of shared awareness that transcends difference. Mindfulness training appears to support the development of all three senses of perspective taking in a way that can enhance empathy, but also improve organisational outcomes in other areas such as authentic leadership. If organizations are to become more empathic, simple and effective interventions are required to improve individual empathy. Historically efforts to increase empathic responding in organizations have relied mainly upon either communication skills training or emotional intelligence training. Both of these approaches tacitly assume that improving empathy is a matter of improving skills. While both approaches can be extremely effective in organizations, in this chapter I argue that both ignore a deeper aspect of sustainable empathy, the capacity to balance a felt sense of connection with ongoing differentiation from another. Empathizing with others in the absence of a welldifferentiated sense of self can lead to secondary stress and burnout particularly in roles involving helping or other forms of emotional labor. This chapter presents an approach to understanding the basic psychological processes underpinning the construction of a sense of self and the capacity to take the perspective of others. I describe the interplay between thinking about the self and other that results in empathic concern, personal distress, or a range of other more or less helpful affective responses in the presence of another person (Atkins & Parker, 2012). In brief, I describe how we can see self and other either at the level of a) conceptualizations, b) a flow of experiences or c) as awareness itself; and how the nature and extent of differentiation needed at each of these three levels to support empathy is distinct. The chapter then reviews evidence that mindfulness training demonstrably improves empathy and suggests that this positive effect is at least in part the result of a changed relationship to the self and improved perspective taking. Empathy can be understood in its broadest sense as simply the responses of one person to the observed experiences of another (Davis, 1983). In the West at least, empathic responses are generally understood to consist of both cognitive and affective elements. Empathy involves both understanding the perspective of the other but it also involves caring, a bodily or emotional response to the other. For Davis (1983), perspective taking is the “tendency to spontaneously adopt the psychological point of view of others” (Davis, 1983, p. 114). Having understood another’s perspective, a range of possible affective responses are possible including empathic concern and personal distress. Empathic concern refers to the “other-oriented emotional response elicited by and congruent with the perceived welfare of a person in need” (Batson & Ahmad, 2009, p. 6). By contrast, personal distress is a “self-focused, aversive reaction to the vicarious experience of another’s emotion (e.g. as discomfort or anxiety)” (Eisenberg, 2010, p. 130). Perspective taking appears to be a primary process associated with noticing and appraising the experience of another, while empathic concern or personal distress are secondary processes that are the products of that noticing and appraising (Atkins & Parker, 2012). Perspective taking can also lead to other emotions. Atkins and Parker (2012) argued that a person may take the perspective of another in the sense that they understand the other is suffering but fail to respond if they appraise the person as irrelevant to their goals or selves in some way. This corresponds to a kind of ‘cold’ perspective taking of understanding the other without really caring about them. Similarly, if an appraisal is made that the other is deserving of their suffering, then other emotions such as anger or disgust may occur. And if a person appraises that they do not have the capacity to cope with a secondary experience of suffering they are likely to act defensively to avoid exposure to that suffering. This is what the literature refers to as a personal distress response. A key determinant of whether perspective taking is followed by personal distress and avoidance, or empathic concern and compassion appears to be the degree of self-other differentiation. Indeed Decety and Lamm argued that empathy is “the ability to experience and understand what others feel without confusion between oneself and others” (italics added; 2006, p. 1146). Empathizing with another can lead to personal distress when a person is unable to differentiate themselves adequately from the other. Professional helpers can experience secondary traumatic stress or ‘compassion fatigue’ (Figley, 2002) if they do not have sufficient self-other differentiation or emotional separation from others (Badger, Royse, & Craig, 2008; Decety & Lamm, 2006). Thomas and Otis demonstrated that emotional separation was negatively associated with burnout and compassion fatigue and concluded that risks arose when practitioners cared for clients “without the ability to keep themselves separate" (2010, p. 93). Carl Rogers, the psychologist most closely associated with empathic approaches to psychotherapy, saw empathy as sensing "the client's private world as if it were your own, but without ever losing the 'as if quality" (Rogers, 1992, p. 829; emphasis added). This latter quote beautifully illustrates the paradox of empathy. On the one hand, true empathy calls for a sense of the person’s situation ‘from the inside’ – a sense of oneness and connection. But effective helping requires a capacity to differentiate one’s own responding from the responding of the other. How can we think about the nature of “selfother differentiation” in a way that allows us to develop helpful interventions? And is it possible to foster self-other differentiation? These questions represent both a gap in the literature and a practical concern. Without addressing how a person defines themselves and takes the perspective of others, interventions to enhance empathy are simply dealing with the expression rather than the causes of empathy. To answer these questions we need to understand how a sense of self and other develops across the lifespan. It is to these questions that I now turn using a contextual behavioral account of language and cognition known as Relational Frame Theory (Hayes, Barnes-Holmes, & Roche, 2001). This will require some exposition of basic learning processes. The reader may be more familiar with attempts to understand perspective taking as “theory of mind” (BaronCohen & Wheelwright, 2004) and/or stages of epistemological development (Kegan, 1994; Piaget, 1969). I hope to provide enough of a technical framework to understand the core ideas of relational frame theory, and thereby provide a more precise understanding of the nature of perspective taking and relationships. The development of a sense of self and other and its implications for empathy From a behavioral perspective, self is a verb not a noun. The construction of sense of self is a process of self-discrimination. A prototypical form of this behavior can be found in pigeons who are able to ‘report’ on their previous behavior by differentially pecking one key if they have previously responded to a stimulus and another if they have not. With the advent of verbal capabilities, human self-discrimination becomes vastly more complex. As children we all receive multiple exemplar training in reporting our own behavior. We are continually reinforced for being able to appropriately report “I want …”, “I am …”, “I know …”, “you are”, “you want” and so on. From this perspective, the self is a “repertoire of behavior imparted by an organized set of contingencies” (Skinner, 1974, p. 149) . As a behavior, we might more appropriately use the word ‘selfing’ to indicate the activity of creating and recreating the self through verbal interaction with others in a community however here I use the noun form as it is more widely understood. We construct a sense of self in response to the functional demands of social interactions. This process is inherently social and linguistic – our ‘knowing’ is a function of environmental contingencies rather than any internal ‘force’ or ‘drive’. According to Skinner: “In arranging conditions under which a person describes the public or private world in which he lives, a community generates that very special form of behavior called knowing... Self-knowledge is of social origin. It is only when a person’s private world becomes important to others that it is made important to him” (Skinner, 1974, pp. 30-31). The development of self and cognition begins in interactions with others. The acquisition of human language begins with learning simple name-object pairings. Through exposure to many, many examples, the child learns to relate symbols to events and symbols to symbols. Initially a child might be reinforced by a smiling parent for looking towards the cat in the presence of the parent saying “where is the cat?” Gradually they are also reinforced for saying the word “cat” in the presence of an actual cat or a picture. With enough practice, they eventually learn to derive the reverse relationship automatically so that, for example, having seen a boat in a picture book and being told it is called a ‘boat’ (object name), the child is subsequently able to point to a boat when asked “where is the boat?” (name object). This pattern of exposure to relational responding continues over thousands of examples of increasingly complex relations including spatial, oppositional, hierarchical, temporal, evaluative and comparative. Such relational responding is called relational framing. Relational framing has three defining features. 1) Mutual entailment refers to the fact that a relation in one direction always corresponds to a second relation in the opposite direction. For example, if a child learns that coin A is worth more than coin B, they will derive that B is worth less than A. 2) Combinational entailment refers to derivation of combined relationships. For example, if the child now learns that coin B is worth more than coin C, they will derive that A is also worth more than C (as well as C < A and C < B). 3) Transformation of stimulus functions refers to the way in which words and symbols become meaningful. From a relational frame theory perspective, to change the meaning of an object or event is to change the way the organism responds to that object or event. For example, imagine a child has previously experienced buying sweets using coin B such that coin B is seen as desirable. If the child is now introduced to two new coins, A and C, and is told that A is “worth more” than B, she will choose A over both B and C even though only B has previously been directly reinforced. In other words, A acquires new stimulus functions through relating based upon arbitrary symbols rather than formal properties or direct exposure. The notion of transformation of stimulus functions is particularly important for understanding the difference between behavioral approaches to selfing and cognitive approaches. As we will see, self is not a thing or even a representation inside the person driving behavior, it is a response of the whole person to a context that calls for particular forms of behavior. Similarly, from this perspective, cognition and emotion, including perspective taking and empathy, are not hypothetical mental causes but a form of behavior - namely private relational responding. Next we describe how this capacity to relationally frame events both leads to the formation of a sense of self at the same time as making it possible for a person to take the perspective of others and experience empathy. The capacity to differentiate self from others, and therefore to empathize, takes years to develop in children (Kegan, 1994). Relational Frame Theory suggests this is because it involves repeated exposure to a language community making skilled use of a particular form of relational responding known as deictic framing (McHugh, Stewart, & Hooper, 2012). Deictic framing involves three main relational frames: I-YOU, HERE-THERE and NOW-THEN. Children struggle with learning these distinctions. For example, when asked “What did YOU have for breakfast?” a young child may respond with what the speaker had for breakfast. Or they may mistakenly believe an absent observer would know where a hidden doll is located because they know where the doll is located. In cognitive psychology, this “false belief task” (Wimmer & Perner, 1983) demonstrates whether or not a child is able to represent another’s perspective internally. In relational frame theory terms, the child’s behavior is interpreted as indicating whether or not the child has develop an appropriately complex repertoire of relational responding, specifically to contextual stimuli representing self and other. Deictic framing takes years to learn because it requires abstraction. Most forms of relating have physical analogues in the world. For example, the comparative relational frame ‘more than’ can be taught by comparing actual physical amounts of a liquid. But deictic relational frames have no physical analogue and depend entirely upon the point of view for experience. HERE is only HERE relative to my current point of view. If I move over THERE it becomes a new HERE, and what was previously HERE becomes THERE. The quality of “HERE” only exists relative to my perspective, not as a physical property of the world. Skillfully using deictic framing relies upon the child abstracting a point of view from which experience is witnessed. In summary, I have argued self is a behavior based upon a form of verbal relating that allows us to abstract a point of view upon the world, a sense of knowing distinct from others. From this perspective, self can only exist in reciprocal interaction with other. Self is born from interaction with a linguistic community. But there can be no “I” without a “YOU”. And thus it is also this process of deictic relational framing that allows us to take the perspective of others. McHugh, Barnes-Holmes and Barnes-Holmes (2004) demonstrated that older children were increasingly effective at answering questions ranging from “I have a red brick and you have a green brick. Which brick do you have?” through to such complex deictic framing as “Yesterday you were sitting there on the blue chair, today you are sitting here on the black chair. If here was there and there was here; and if now was then and then was now. Where would you be sitting now?” Over time children learn to correctly use deictic frames to take the perspective of others. If self and perspective taking is verbal relational behavior, then there are three functionally distinct senses of self: self as the content of verbal relations (the conceptualized self), self as the process of verbal relations (the knowing self) and self as the context of verbal relations (the transcendent self)(Hayes, 1984). And since I-YOU is one distinction not two, the establishment of these senses of self also establishes other-ascontent, other-as-process and other-as-context. These distinctions will allow a more precise specification of the particular form of self-other differentiation required to experience empathic concern rather than personal distress. Self-as-Content and Other-as-Content: The conceptualized self and the conceptualized other. As children, we learn very quickly that it is helpful to be able to describe ourselves to others. The social environment provides numerous reinforcers for being able to consistently describe characteristic preferences, capabilities and experiences. For example, if at one meal a child says they like broccoli and at the next they say they don’t, a parent will be quick to point out that the child’s descriptions of themselves are inconsistent and will reinforce more consistent self-descriptions. Self-as-content is our capacity to verbally relate applied to conceptualizing (i.e. abstracting) qualities of our own self-discriminated behavior. Such descriptions allow others to predict our behavior, and provide a concise and greatly simplified summary of our history of experience (e.g. “I am a psychologist”). Over time we learn to internalize our conceptualized self and form stable beliefs about our identity. In the workplace, selfas-content might refer to our job attitudes, the things we characteristically like and dislike, our perceived roles and responsibilities and our place in a network of social relationships. Other-as-content refers to such verbal relating regarding the stable features of others in the service of understanding and predicting others. A wide range of theories social perception and cognition describe how we continually evaluate and conceptualize others in terms of stable characteristics, histories and roles in order to predict their behavior (Dweck, Hong, & Chiu, 1993; Fiske & Taylor, 1991; Hogg, 2001). These theories demonstrate that conceptualizing about self and other is an essential aspect of social interaction. But verbal relating regarding self -as-content and other-as-content are a double edged sword in terms of empathic responding. On the one hand, self/other-as-content can provide useful summaries of learning histories that inform understanding of how the self and other might respond to a given situation. For example, the statement “I am a psychologist, you are an engineer and, as such, we are likely to have very different views of the world” might aid understanding. Similarly, characterizing one’s own stable personal values (e.g. “I value close relationship with my colleagues”) can also motivate more empathic responding (Atkins & Parker, 2012). Other-as-content can also be helpful. Imagining the other’s learning history, their personality, preferences, goals and values can inform appropriately targeted empathic responding. However, conceptualizations of self and other can also interfere with empathy because of the rigidity and context insensitivity of such conceptualizations. Atkins and Parker (2012) described in detail how appraisals of self and others can interfere with compassionate responding. For example, if we make an appraisal that a person is personally responsible for the situation in which they find themselves, we are less likely to experience empathic concern and more likely to experience other emotions such as anger. Similarly, appraisals that the other is in some way irrelevant to our lives and goals are likely to lead to apathy rather than empathic engagement. Finally appraisals that we are unable to cope with the aversive emotions likely to result from engagement with another who is suffering, we are more likely to avoid the situation than respond compassionately (Atkins & Parker, 2012). One can easily imagine how such self-as-content beliefs such as “I am not a good listener”, “I am supposed to be an expert with the answers” or “I am tougher than you are” can interfere with empathic responding. At the same time, judgments and projections regarding the other can also interfere with empathy. Imagining another’s learning history, personality, preferences and goals and values is a fallible process. For example, even after years of marriage, partners can seriously misjudge how a person is likely to respond to a given situation. Thus empathic responding from other-as-content must also be tempered by paying attention to the dynamic cues available in each moment from other-as-process. Self-as-Process: The knowing self Self-as-process refers to the reporting of an experience of self in the present moment. It is the continuous unfolding dynamic of thoughts, feelings, sensations, memories, images occurring HERE-NOW1. Self-as-process behavior also receives a great deal of social reinforcement. Statements like “I am happy”, “My stomach is hurting” or “I don’t understand what I am meant to do” provide useful and predictive information to others. Over time, such statements about the self also serve useful private functions. To say “I am happy” may be highly predictive of what will happen in the next instance or in a very similar context in the future whereas self-as-content descriptions such as “I am generally a happy person” provide broad predictability across contexts. Self-as-process descriptions are more flexible, dynamic and context-sensitive than self-as-content descriptions. Being able to flexibly monitor our own state is the basis of successful selfregulation. Other-as-process refers to one’s verbal relating regarding the ongoing experience of the other. Other-as-process is a central component of perspective taking and empathic responding: It is “based on a moment-to-moment construction of reactions of the other” (Barnes-Holmes, Hayes, & Dymond, 2001, p. 134). Batson (2009) distinguished between an “imagine-other” perspective that involves imagining how the other sees his or her situation and feels as a result, and an “imagine-self” perspective that involves imagining how you would see the situation were you in the other person's position. Verbal relating regarding other-as-process could involve either of these forms of constructing another’s experience, but only an “imagine-other” perspective would be likely to be experienced as empathic in the sense of “standing in the shoes of another”. Accurate other-as-process is the basis of a psychotherapist effectively engaging with a client, or a speaker successfully reading their audience. Self-other differentiation at the level of process appears to be particularly important for experiencing empathy without unhealthy personal distress. The verbal relating described here as self-as-process and other-as-process is the fundamental self-regulatory process 1 Kahneman and Ris (2005) refer to self-as-process as the ‘experiencing self’ and note that it has hardly been studied in psychology because almost all instruments call for retrospective report and thus invoke remembered abstractions regarding the self. associated with empathy. Decety and Lamm (2006) reviewed studies of the neural processes underpinning empathy and described how such verbal, self-regulatory processes are essential for self-other differentiation: “… one critical question debated among social psychologists is whether perspective-taking instructions induce empathic concern and/or personal distress, and to what extent prosocial motivation springs from self-other overlap… The recent work reviewed here demonstrates that adopting a self-perspective when observing others in pain results in stronger feelings of personal distress and activates the pain matrix to a larger extent, as well as the amygdala [involved in threat detection]. Such a complete self-other merging seems to be detrimental to empathic concern… Conversely, when participants take the other’s perspective, there is less overlap between the neural circuits involved in the processing of first-hand experience of pain, and they indeed report more feelings of empathic concern. From these studies, it can be concluded that empathy relies both on bottomup information processing (shared neural systems between first-hand emotional experience and the perception or imagination of the other’s experience), as well as top-down information processing that allows modulation and self-regulation.” (Decety & Lamm, 2006, p. 1160) In other words, we must notice our own experience, the other’s experience and the difference between the two. From a relational frame theory perspective, to notice is to respond, and specifically to make meaning of the cues provided by the other. That is, to “notice” is to verbally relate; to construct a relational network regarding the state of the other (other-as-process). The neural and behavioral evidence indicates that, unless one is also able to construct a discrete relational network regarding our own experience (self-asprocess) and hold both relational networks in a frame of distinction, our experience will mirror the other’s and we will experience personal distress rather than empathic concern. Knowing one’s own self-as-process allows one to self-regulate to avoid the detrimental effects of shared neural systems that do not differentiate between self and other. We are now in a position to better understand the precise nature of self-other differentiation required for empathic responding rather than personal distress. I have argued that self-other differentiation at the level of content can be helpful, but can also easily create disconnection from the other if one is not conscious of automatic appraisals and judgments regarding the other. By contrast, differentiation at the level of process is a key component of mature empathy. To illustrate, the sort of verbal relating I have in mind could be expressed privately or publicly as follows: “There is my process occurring here and now and there is your process occurring here and now. I can acknowledge your process and indeed care about it without having to have the same process myself. Conversely there is no reason why your process must be the same as my process. I can acknowledge your process, even deeply care about your process and want something that is more satisfying or enjoyable for you, without experiencing what you are experiencing.” One can easily recognize mature self-other differentiation in this statement and appreciate why such complex relational framing can take a lifetime to acquire. Self-as-Context: The transcendent self Self-as-context refers to the context within which verbal relational framing is occurring. In relational frame theory, self-as-context is understood as the point of view or locus from which events are experienced. Self-as-context is awareness, but it is awareness conditioned by the prior acquisition of deictic framing that allows a distinction between the I-HERE-NOW that perceives psychological content THERE-THEN (Hayes, 1984). That is, there is a sense of an I or ME that is doing the observing. Self-as-context is transcendent in the sense that we can never observe our point of view from outside our point of view. Torneke provides a vivid description of this aspect of self-as-context: “We cannot observe this perspective in itself… We can talk or write about it, just as I am doing now, and we can observe the consequences of being able to take this perspective. We can make observations from a specific perspective or locus, but we can never observe this locus or perspective as such. Of course, this is rather obvious, because from which perspective would we observe it? All we have is I-here-now. And whatever we observe, it simply cannot be this locus, as that is the vantage from which we observe it” (Torneke, 2010, p. 107). Other-as-context appears to be a relatively infrequent (and difficult to describe) form of verbal relating. Barnes-Holmes et al. describe other-as-context as: “when the speaker is psychologically connected to the listener as a purely conscious person. In this aspect, the speaker and the listener are one, since ‘HERE and NOW’ is imputed to be a singular event (i.e. one cannot be HERE and NOW, simultaneously, at different times and places). Perhaps for this reason, the level of self-as-context is associated with a sense of the transcendent other-the two go hand in hand” (Barnes-Holmes, et al., 2001, p. 135). To experience other-as-context is perhaps to experience the other as beyond time, location and, in a sense at least, separation. In this sense, self-as-context experience seems to foster a sense of oneness between self and other rather than differentiation. In summary, I have described three forms of ‘selfing’ behavior. Verbal relating allows us to describe to ourselves and others a) our abstracted qualities and experiences as content, b) our current here-and-now experience as process, and c) the continuity of a point of view from which we experience the world. From a contextual, behavioral perspective, such “selfing” behavior is a functional response to social contingencies. We learn to report our preferences, history and characteristics because the social world values predictability and coherence. Similarly, we learn to report on our current experience because it allows social communication and cooperation. And while most verbal environments (with the exception of meditation retreats and philosophy seminars) do not explicitly reinforce talking about ourselves as bare awareness or perspective, we are continuously reinforced for correctly discriminating our “own” experience (I/HERE) from that of others (YOU/THERE) and for having a stable perspective from which we view experience. Furthermore, the very same verbal relating that gives rise to these three senses of self also gives rise to three senses of other. We can relate to the other in terms of a) our conceptualizations of their stable characteristics over time, b) their ongoing process of knowing or c) (perhaps, rarely) at the level of bare awareness itself. From this perspective, deictic relating is perspective taking, and perspective taking can be developed throughout the lifespan through multiple exemplar training in shifting perspectives. In the remainder of this chapter I explore how these ideas can be used to shape thinking about interventions to improve empathy in organizations. Interventions to Enhance Empathy By far the oldest approach to improving empathy in organizations is through training in communication skills, most notably active listening (e.g. Jentz, 2007) and dialogue (Isaacs, 1999; Mazutis & Slawinski). This practical approach has been widely used in organizations for generations and yet there appears to have been no systematic research regarding the impacts of such training upon emotional self-regulation or empathic responding. In a sense, this is an ‘outside-in’ approach to increasing empathy. If done well, teaching a person how to behave more empathically can enhance their willingness and capacity to take the perspective of others (Coulehan et al., 2001). Although such training is widely used and effective for improving relationships, it is usually framed simply as a technique rather than as an opportunity for self-development. The reasons why such approaches might lead to changes in epistemology (Kegan, 1994) and identity have not been articulated. Another approach to developing empathy is through improving individual skills in emotional identification, emotional understanding and emotional management. Emotional intelligence (Goleman, 2006) has been variously defined and there are a correspondingly wide array of approaches to improving emotional intelligence (Ciarrochi & Mayer, 2007). While research on emotional intelligence in organizations has been much more extensive than that on active listening, most of it has been directed towards measuring emotional intelligence as a capability and research on improving emotional intelligence is still in its infancy. Both of these approaches tacitly assume that improving empathy is a matter of improving skills. While both approaches can be extremely effective in organizations, the account of perspective taking provided above makes it clear that both of these approaches ignore a deeper aspect of sustainable empathy, the capacity to balance a felt sense of connection with ongoing differentiation from another. More recently, many organizations have implemented mindfulness training to improve staff wellbeing, work engagement and performance (Glomb, Duffy, Bono, & Yang, 2011). Mindfulness is defined by Kabat-Zinn as: “paying attention on purpose, in the present moment, and nonjudgmentally” (2003, p. 145). Almost all definitions of mindfulness include at least an awareness component – attending to the present moment; and an attitudinal component - acceptance of experience whether it be positive, negative or neutral (Bishop et al., 2004). From a behavioral perspective, attending to present moment experience is functionally equivalent to self-as-process (Foody, Barnes-Holmes, & Barnes-Holmes, 2012) and amounts to responding under the control of stimuli available HERE-NOW rather than responding under the control of verbal relating regarding the past or future. Acceptance is behaviorally defined as “allowing of thoughts and feelings to be as they are without trying to change their content, form or frequency” (Fletcher, Schoendorff, & Hayes, 2010, p. 43). Acceptance and Commitment Therapy (Hayes, Strosahl, & Wilson, 2011) also adds two further concepts helpful for understanding the nature of awareness described as mindfulness: defusion and self-ascontext. Defusion is recognizing thoughts and feelings as passing mental events not literal truths while self-as-context has been described at length earlier and is the sense of self as an observer or perspective from which experience is observed (Hayes & Plumb, 2007). Defusion and self-as-context are two sides of the same coin with defusion referring to that which I am not (“I am not my thoughts and feelings”) and self-as-context referring to that which I am (“I am an observer of my experience”). The four processes of self-as-process, defusion, acceptance and self-as-context work interactively to undermine the dominance of verbal relating, thereby supporting behavior that is more sensitive and responsive to the environment, allowing a larger set of contingencies to be noticed and a broader behavioral repertoire to be available (Vilardaga, 2009). Changing the way individuals relate to their own verbal relating provides them with the capability to respond more adaptively in a wider range of contexts. In the next section I review evidence indicating that mindfulness training is associated with increases in perspective taking and empathic responding, and reductions in personal distress. I then discuss why these effects might occur from the perspective of the theory of perspective taking presented above. Mindfulness and Meditation are Associated with Enhanced Empathy There is now considerable evidence that mindfulness and meditation training are associated with increased levels of empathy. Since mindfulness programs are now being increasingly adopted in workplaces around the world (Glomb, et al., 2011), it is timely to explore their likely impacts upon empathy and relationships in the workplace. In this section, I review the evidence from cross-sectional, intervention, qualitative and neurological studies in turn. Mindfulness has been positively associated with empathy in a series of cross sectional studies. Tipsord (2009) explored the relationships between different facets of mindfulness as measured by the Five Facet Mindfulness Questionnaire (FFMQ; Baer, Smith, Hopkins, Krietemeyer, & Toney, 2006) and the Interpersonal Reactivity Index (IRI; Davis, 1983). Mindfulness was positively related to perspective taking and negatively related to personal distress. At the subscale level, higher observing scores were associated with increased perspective taking and empathic concern while higher non-reactivity scores were associated with less personal distress. Thomas and Otis (2010) found a similar pattern of results with mindfulness (FFMQ) being positively correlated with perspective taking, negatively correlated with personal distress and unrelated to empathic concern. Greason and Cashwell (2009) also showed that mindfulness (FFMQ) correlated positively with empathy (IRI) although they did not reports relationships at the subscale level for either measure. Overall, these cross sectional studies suggest that mindfulness improves perspective taking and self-regulation to reduce personal distress. Mindfulness training has also been linked to increases in empathy. Lesh (1970) showed that practicing Zazen meditation for 4 weeks, 30 minutes per day increased empathic accuracy relative to control participants. The empathic accuracy task involved watching a video of a counselling client and then choosing which feeling the participant believed the client was experiencing in the video. Shapiro, Schwartz, and Bonner (1998) showed increased empathy, measured using an adapted version of the self-report Empathy Construct Rating Scale (Monica, 1981), for medical and premedical students who completed an eight week Mindfulness Based Stress Reduction (MBSR) program. Just as in Lesh’s (1970) study, improvement in empathy was mediated by reduction in anxiety. Shapiro et al. speculated that “the intervention may have helped students cultivate listening skills and develop new, more compassionate perspectives and paradigms to approach their own lives as well as their future patients’ lives” (1998, p. 594). Krasner et al. (2009) also showed significant improvements in empathy among medical students as measured by the Jefferson Scale of Physician Empathy and that changes in mindfulness were correlated with changes in the perspective taking subscale of physician empathy. More recently, Shapiro, Brown, Thoresen and Plante (2011) showed significant increases in self-reported empathy 2 and 12 months after an MBSR course. Finally, to the extent that meditators engaged in a 3 month retreat improved in self-regulatory capability, they also improved in a measure of adaptive functioning that included empathy (Sahdra et al., 2011). However, the pattern of relationships between mindfulness training and empathy appears to be complex, and sensitive to the specific design of studies. For example, in a second study comparing an 8 week mindfulness intervention with a waitlist control group, Tipsord (2009) used a modified empathic accuracy task and showed that those trained in mindfulness a) made more inferences regarding the mental states of others in a video and b) were more likely to make inferences at times that corresponded to times when the subject of the video actually reported having a thought or feeling. However, those trained in mindfulness were no more accurate than the control group in their inferences regarding the mental states of others. This pattern of results suggests that mindfulness training enhanced noticing of another but did not improve the quality of inferences regarding the experience of the other. There are also studies that have not shown a link between mindfulness, meditation and empathy. For example, Beddoe and Murphy (2004) conducted an uncontrolled pretestposttest study with only 16 participants and failed to find any effects of an MBSR course on empathy in nurses. They conclude this effect may have arisen because the nurses were very high in empathy initially. Other studies using eight week meditation courses have also not found impacts upon measures of empathy (Galantino, Baime, Maguire, Szapary, & Farrar, 2005; Pearl & Carlozzi, 1994) but have made use of relatively weak designs. Finally, Plummer (2008) collected data from therapists and their clients and found that those who meditated were less likely to be perceived as empathic by their clients and this effect was larger for those who spent more time meditating. Another study used an innovative qualitative approach to show that even very brief mindfulness interventions may increase the degree to which people take the perspective of others. Block-Lerner (2007) reported a study in which participants were randomly assigned to receive either a brief mindfulness intervention, a positive thinking intervention or a relaxation control condition. The mindfulness intervention involved instructions to be aware of, and accepting toward, whatever thoughts and feeling arose. The positive thinking intervention involved instructions encouraging the evaluation and control of thoughts and feelings. Participants watched an emotionally evocative film clip and wrote about their reactions which were then coded using the Linguistic Inquiry Word Count program (Pennebaker, Booth, & Francis, 2007). Participants in the mindful awareness condition wrote more about other people, and used the first person singular tense less than participants in the positive thinking group. Overall, these results suggest that even a brief mindfulness intervention can increase the degree to which participants consider others. This pattern of results was also obtained in a qualitative study of trainee therapists. McCollum and Gehart (2010) reported that daily meditation increased the degree to which students felt compassion and acceptance towards both themselves and their clients. Most of the quotes they report in their paper emphasize the importance of being less judgmental towards self and others. For example, one participant reported: “At my fieldwork site, the clients are struggling to function on a very basic level. What they don’t need are heavy judgments about material wealth and success. The meditation is helping to guide me toward a non-judgmental acceptance of them and myself” (McCollum & Gehart, 2010, p. 356). While another stated: “… to be an effective therapist, one must be comfortable with the positive and negative traits that encompass oneself. How else can we convey to clients that their tears, anger and feelings are OK to have in session, if we don’t accept these qualities in ourselves?” (McCollum & Gehart, 2010, p. 356). In a similar vein, Aiken (2006) reported that therapists who were also experienced meditators believed that their practices enhanced their capacity to achieve a felt sense of the client’s inner experience and be more present to any pain and suffering of the client. Mindfulness training enhances empathy in part because it helps people take judgments of others (selfas-content) less seriously and instead attend more closely to their moment-to-moment process (self-as-process). Finally, studies of brain function and structure have also suggested links between meditation practice and empathy or perspective taking. For example, Leung et al. (2012) conducted a study of long-term practitioners of loving-kindness meditation and reported increases in the grey-matter volume of the right angular gyrus, an area previously associated with empathy and perspective taking (Decety & Lamm, 2007). This finding appears to confirm earlier research showing experts in loving-kindness meditation had more activity than novices in the right angular gyrus when listening to emotional vocalizations during loving-kindness meditation (Lutz, Brefczynski-Lewis, Johnstone, & Davidson, 2008). In summary, the weight of evidence suggests that mindfulness and meditation training are associated with increased empathy. In particular, there is consistent evidence that mindfulness is associated with lower levels of personal distress and higher levels of perspective taking. There appears to be little evidence that mindfulness increases empathic concern, at least as measured by the Interpersonal Reactivity Index (Davis, 1983). This result makes sense when one examines the items in the IRI associated with empathic concern, all of which refer to changes in the frequency or intensity of feelings. Changing the frequency or intensity of feelings is not an explicit aim of mindfulness training, rather such training is directed towards reducing automatic reactivity to unhelpful feelings. Why does mindfulness training improve empathy? Mindfulness training might increase empathic responding via many pathways including improvements in emotional self-regulation and changes in relationship goals and values (see Atkins & Parker, 2012). Here I wish to focus on the effects of mindfulness training on self-other differentiation. I argue that mindfulness and meditation training have effects at the levels of content, process and context. Specifically, mindfulness training helps create a more flexible relationship to verbal content, enhances noticing of process and creates a stable sense of self as an awareness that is beyond threat, and these effects all support more empathic responding rather than personal distress. Mindfulness Creates a More Flexible Relationship to Content One key facet of mindfulness training is learning to see thoughts and emotions as passing mental events rather than as literal truths regulating behavior. Typically participants are instructed to witness their thoughts without judgment or elaboration. Contrast the statements “I am angry” with “I notice I am angry”. In the former statement, “I” is in a frame of coordination with the experience whereas in the latter it is in a frame of distinction. This process of discriminating between self and private content is referred to as “defusion” and it is a particularly important part of mindfulness based therapies such as Acceptance and Commitment Therapy. If a thought is perceived to be ‘bad’ and if the client is fused with that negative thought, then the functions of the self are transformed to also be “bad”. Mindfulness training in therapy teaches clients to discover a place from which they can “have” rather than “be” their thoughts and feelings. It “temporarily puts the literal, temporal, and evaluative functions of language on extinction” (Hayes & Shenk, 2004, p. 252). Defusion enables redirecting attention away from labeling of self and other, towards more flexibly engaging with one’s own and the other’s process. To give some feel for how this might work in the workplace, imagine a manager who is fused with the belief that they are an expert who is supposed to provide solutions (self-as-content) or that their subordinate is incapable of finding solutions for themselves (other-as-content). Faced with the subordinate expressing a difficulty, they are unlikely to empathize with the subordinate, and instead will seek to provide solutions in line with their perception of what is going on for the other. By contrast, empathically listening to the other would be engaging at the level of process. There is evidence to suggest that promoting defusion from thoughts and feelings reduces reactivity to automatic evaluations regarding ourselves and others. Hayes, Bissett, et al. (2004) showed that, relative to a control group that received multicultural training, a mindfulness-based intervention for a group of alcohol and drug counselors reduced stigmatizing attitudes toward clients and burnout at three-month follow-up. Thus, the intervention appeared to work to assist in both self-care and also caring for others. Masuda et al. (2007) reported similar results but also showed their intervention was most effective in reducing stigmatization for those participants who were experientially avoidant or fused with their judgmental thoughts. Such a process appears to be implicated in the lack of empathic responding arising from stereotyping. To the extent that a person is fused with his or her categorizations and evaluations of other human beings (other-ascontent), they lose contact with the individual, unique, and dynamic qualities of the other available in the present moment and see them instead in terms of generalizations. This process appears to be similar to the depersonalization of others described by selfcategorization theory (Hogg, 2001). Empathy doesn’t require defusion from all thoughts and beliefs regarding self and others. For example, behaving in response to personal preferences and capacities might provide a basis for authentic expression in the presence of another and helpful self-other differentiation. For example, Lesh (1970) found that empathy was supported by a high self-regard and self-awareness of personal characteristics. Mindfulness Enhances Noticing and Self-Regulation of Process One pathway whereby mindfulness seems likely to improve empathy, and particularly perspective taking, is simply through responding to more cues provided by others. Mindfulness training courses create a context for learning to bring behavior more under the control of internal or environmental cues available in the present moment, and less under the control of verbal stimuli (thoughts and feelings) regarding the past or possible futures. Atkins and Parker (2012) reviewed evidence regarding the effects of mindfulness training and proposed that this aspect of mindfulness training improves noticing of another’s emotional state by directing attention to the immediate social and emotional cues regarding that state. In other words, self-as-process and other-as-process are privileged in mindfulness training over experience at the level of content. Over time, this can lead to enhanced awareness of one’s own and other’s emotions, and thus can aid empathic responding in the workplace. According to Glomb et al. “a growing body of social neurobiology research indicates that our capacity to be attuned to others depends, in part, on our knowledge of our own mind and internal state” (2011, p. 132). Of course, mindfulness training does not necessarily result in long-term increases in noticing of others. To be sustainable, responding to the socio-emotional cues of others must then be reinforced by the experience of improving relationships in this way. A key aspect of self-as-process and other-as-process is developing a willingness to be in the presence of thoughts, feelings and sensations without seeking to change their form or frequency. This is particularly important if one is empathizing with someone who is experiencing aversive emotion because of the potential effects of secondary stress upon burnout and professional impairment (Badger, et al., 2008; Figley, 2002). To the extent that a person is able to accept their unpleasant thoughts and feelings arising in the present moment, they are more able to be empathic towards others. McCracken and Yang (2008), found that rehabilitation workers with higher levels of acceptance were less likely to avoid situations in which they might encounter the suffering of their clients. Vilardaga et al. (2012) similarly found that mindfulness predicted levels of burnout among addiction counselors. When fused with negative appraisals concerning their clients, and when unable to accept difficult thoughts and feelings, counselors believed they were less able to cope, less sensitive toward their clients, and less able to effectively help their clients (Vilardaga, et al., 2012). Mindfulness Creates a Sense of Self Beyond Threat The effects of mindfulness training in terms of the context of verbal relations can be understood at both a mundane level and a transcendent level. At the mundane level, self- as-context is unaffected by psychological content and mindfulness training may therefore enhance a sense of self as relatively beyond threat. Self-as-context is constant despite changing experiential content: Although the content of experience changes, the point-ofview from which experience is witnessed is the same at 60 as it was at age five. Even when experiencing distress, the practitioner realizes that some part of them (namely awareness itself) remains unchanged, is not distressed and is beyond threat (Hayes, et al., 2011). This awareness of a stable sense of self beyond threat can support responding with empathic concern rather than personal distress (Atkins & Parker, 2012). At a more transcendent level, mindfulness and intensive meditation training can provide experiences of oneness that appear to be beyond psychological content. Such states may embody the very deepest forms of empathy. CONCLUSION Decety and Lamm argued that empathy is “the ability to experience and understand what others feel without confusion between oneself and others” (italics added; 2006, p. 1146) . In this paper I have explored what it means to be without confusion between oneself and others. One reason why a technical account of self and perspective taking is important is because it helps bridge the gap between bottom-up, automatic and top-down, selfregulatory aspects of empathy (Decety & Lamm, 2006). I have argued that verbal relational responding is the process whereby bottom-up affective signals are interpreted, evaluated and, potentially, regulated. Excessive identification with another who is suffering appears to lead to personal distress and avoidance rather than empathic concern. This is particularly a problem for roles involving helping or other forms of emotional labor. And yet there is a potential paradox here as empathy appears to be motivated by a felt sense of connection between self and other. How can we understand self-other differentiation in a way that allows us to improve it in organisations? I have argued that responding to conceptualisations of self and other can be helpful but can also impair empathy. Self-other differentiation at the level of content generally creates separation and judgement rather than empathy. Responding at the level of present-moment experience is the essence of responding to the others experience but it is here that differentiation of self and other is essential to avoid personal distress. At the level of awareness itself, a stable sense of self beyond threat can be contacted in such a way to support empathy. Furthermore, in rare instances one can experience a sense of shared awareness that transcends difference. Mindfulness training appears to support the development of all three senses of perspective taking in a way that can enhance empathy. To this point, my analysis has been focused upon verbal relating from the perspective of one person. But this analysis might also be applied to understanding empathy in dyads. Many, perhaps most, social relationships in the workplace might be characterized by both parties perceiving the other in terms of verbal content. Such relationships will be somewhat disconnected as each relies upon their conceptualizations regarding the other rather than their observations of what the other might actually be experiencing in the present moment. The most effective dialogue arises when all parties operate at the level of other-as-process. And a relationship where both parties are operating at the level of other-as-context might conceivably characterize the deepest form of unconditional love. 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