Empathy and Mental Health: Enhancing Well-being Through Understanding

Empathy is the ability to take in what another person feels and to see how things look from where they stand. Sympathy is different: it means feeling sorry for someone from the outside. Empathy means understanding the situation as the other person experiences it. It does not require you to agree with the person, and it does not require you to carry their distress as your own.

What empathy is, and how it differs from sympathy

Two forms of empathy are usually described, and the difference matters for anyone trying to work out what they are short of. Affective empathy is the felt part: your own body reacts to another person's fear, anger or grief. Cognitive empathy is the worked-out part, where you can name what someone is probably feeling and why, even when you feel little yourself. Most people have more of one than the other, and the two do not always move together.

The distinction is not only an empathy idea. When researchers who study well-being draw their own distinction between affective and cognitive well-being,¹ they are separating the same two things. One is what a person feels. The other is what a person judges to be true about their life.

Why empathy matters for mental health

Being understood is not a soft extra. It is part of what keeps people well, and its absence carries measurable risk. The WHO's 2025 report on social connection links loneliness and social isolation to higher risk of stroke, heart disease, diabetes, cognitive decline and early death. The same WHO report on loneliness and social isolation finds that people who are lonely are twice as likely to become depressed.⁷

Connection is not simply company. What people describe as support is largely made of empathic acts, and Christen's 1986 review of social support networks describes socioemotional aid as acceptance, affection, emotional understanding, empathy and esteem.⁶ Advice and practical help sit in a separate category, which is why a well-meant solution can land badly when someone wanted to be understood first.

One route from support to health runs through stress. A 2024 study in Frontiers in Psychology reports that social support is associated with better mental health outcomes partly through reduced perceived stress.⁸ Feeling that someone has grasped your situation changes how threatening the situation seems, before anything about it has changed.

Empathy also does not depend on someone being well before it can reach them. Goodman and colleagues note in the Handbook of Well-Being that the presence of negative emotions in psychological disorders does not rule out positive emotions.² If a person you care about is depressed, warmth and humour can still get through.

Empathy in the therapy room

In therapy, empathy is part of the method rather than a matter of good manners. Your therapist listens for what you mean as well as what you say, offers their reading of it back to you, and adjusts when the reading is wrong. The repair of that misunderstanding is often where the useful work happens, because it shows you that being misread is survivable and correctable.

More empathy is not automatically better. A careful clinician parts company with the popular version here. Elliott and colleagues have argued that therapists sometimes need to fit their response to the individual client, and to judge when empathy is called for and when it is not.⁴ Some people open up when their feelings are named for them. Others, at a fragile point, find it intrusive and pull back. A therapist who is paying attention will notice which one is happening in front of them.

That attention is trainable in the clinician too. In psychotherapy research on routine process monitoring, one pilot study of routine process monitoring points to the value of patient engagement and therapist self-reflection in the therapeutic process.⁵

The same principle carries into work with couples and families, where integrative behavioural couple therapy works in part by building understanding of, empathy for and acceptance of each partner's preferences, goals and emotional vulnerabilities.⁹ The aim there is not that partners agree. It is that each stops treating the other's reaction as inexplicable.

One honest limit belongs here. Well-being and mental illness are not the same axis, and a British Journal of Psychiatry review states that the evidence base linking mental well-being and mental illness remains poorly developed.¹⁰ Feeling understood is worth having on its own terms, and claims that it cures a diagnosis go past what anyone can show.

Can empathy be built, and why it runs short

Empathy is not a fixed personal trait handed out at birth. It develops late and unevenly. One reason is biological: the brain regions involved in social cognition, empathy and emotional regulation are still developing through adolescence.³ That is why a fifteen-year-old can be both sharply perceptive and startlingly careless in the same afternoon.

In adults, empathy usually runs short for ordinary reasons rather than character ones. Exhaustion narrows it. So does sustained stress, fear of being taken advantage of, and any situation where you are already braced against threat. Reading a person accurately takes attention, and attention is the first thing that goes when you are stretched.

What helps is unglamorous and specific:

• Listen for the feeling underneath the account, and say what you think you heard rather than assuming you have it right.
• Ask instead of guessing. "What was the worst part of it?" gets further than "That must have been awful."
• Stay with the difficulty for a few sentences longer before moving to solutions.
• Check your reading against the other person's correction, and treat the correction as information rather than rejection.

None of this requires special training, and Louis Agosta makes the case that you do not need an expert to practise empathy. Where it is harder is when empathy has been switched off for a long time, often for good reason. If closeness has cost you before, therapy is a reasonable place to work on it, because it lets you practise being understood in a setting built for the purpose.

When empathy costs too much

The opposite problem is more common than the shortage, and it is rarely named. Some people absorb what others feel rather than recognising it. The distress becomes theirs, and they are left flat, resentful or avoidant after contact with someone they love. This is empathic distress, and it is a different difficulty from a lack of empathy, with a different remedy.

If you are a carer, a partner of someone unwell, a nurse or a therapist, the risk is structural rather than personal. Sustained exposure to other people's suffering, without recovery time or support, wears down the capacity itself. Withdrawal is often the first sign, and it is usually read as coldness by everyone including the person doing it.

What helps here is close to the reverse of what helps the first problem. Notice whose feeling you are holding. Keep the difference between understanding a person's pain and taking custody of it. Limit exposure where you can, and treat rest as part of the work rather than a reward for finishing it. If you take on other people's states unusually easily, our article on managing the overwhelm of high sensitivity goes further into practical strategies. Depletion is not a moral failing, and it does not mean you care too little.

Getting help with either problem

The two problems on this page pull in opposite directions. Work out which one you have before deciding what to do about it. If people repeatedly tell you that you miss what they are feeling, the work is in reading and responding, and it can be practised. If contact with someone in difficulty leaves you drained for days, the work is in boundaries, recovery and support, and pushing yourself to feel more will make it worse.

A therapist can work with either one. No one can promise how it will turn out, and progress in this area tends to be gradual rather than dramatic. If you want a starting point, our guide on how to find the right therapist covers what to look for and what to ask.

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References

1. [1] Diener, Oishi & Tay - Handbook of Well-Being (2018, DEF): Diener, Oishi & Tay - Handbook of Well-Being (2018, DEF), The Work Context- The Organization (pp 44-45).
2. [2] Diener, Oishi & Tay - Handbook of Well-Being (2018, DEF): Diener, Oishi & Tay - Handbook of Well-Being (2018, DEF), Environmental (pt 44) (pp 471-478).
3. [3] PubMed Central. pmc.ncbi.nlm.nih.gov/articles/PMC10741468.
4. [4] PubMed Central. pmc.ncbi.nlm.nih.gov/articles/PMC7042173.
5. [5] PubMed Central. pmc.ncbi.nlm.nih.gov/articles/PMC11700981.
6. [6] PubMed, National Library of Medicine. pubmed.ncbi.nlm.nih.gov/3465643.
7. [7] World Health Organization. who.int/news/item/30-06-2025-social-connection-linked-to-....
8. [8] Frontiers. frontiersin.org/journals/psychology/articles/10.3389/fpsy....
9. [9] DOI record. doi.org/10.1111/1467-6427.12481.
10. [10] Source hosted at www.cambridge.org. cambridge.org/core/journals/the-british-journal-of-psychi....