Empathetic Abiding Presence and Listening

Research suggests that a nurturing clinical context characterized by safety is crucial to allow information processing to unfold fully and organically with minimum risk of harm (van der Kolk, 1994; Murphy, 2022).

Demonstrable components of empathetic abiding presence include evenly suspended attention, mindfulness, empathetic listening, “doing by non-doing,” and responding to distress with calmness and equanimity (Phelps, 2017).

Video: What is Interoception?

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Empathetic presence is aided by strongly developed interoception in the health professional, along with an ability to self-monitor, self-reflect, and identify one’s own contributions to the therapeutic dynamics unfolding. Watch this video to learn more about interoception.

As a health professional, you can provide an empathetic presence by quieting the mind and observing when action is being asked of you and when not. Dual awareness allows the health professional to track both the client’s and their own experience, and they unfold in dynamic relationship, creating what has been called relational alchemy (Ogden, 2021).

Empathetic listeners are relaxed but engaged, ask questions, and explore without prying. The listener maintains appropriate eye contact and offers reassuring, appropriate touch, if culturally and personally acceptable. Empathetic listeners may be required to admit that they don’t have answers. Important components of empathetic listening and active listening include:

  • Minimal encouragement (verbal and non-verbal)

  • Invitation rather than direction

  • Paraphrasing

  • Reflecting

  • Emotional labelling

  • Validating

  • Reassurance and waiting

  • Allowing participants to come to conclusions themselves

References

Murphy, R., Kettner, H., Zeifman, R., Giribaldi, B., Kartner, L., Martell, J., Read, T., Murphy-Beiner, A., Baker-Jones, M., Nutt, D., Erritzoel, D., Watts, R., and Carhart-Harris, R. (2022). Therapeutic Alliance and Rapport Modulate Responses to Psilocybin Assisted Therapy for Depression. Frontiers in Pharmacology, 12(788155). https://doi.org/10.3389/fphar.2021.788155

Ogden, P. (2021). A Healing Context: Philosophical-Spiritual Principles of Sensorimotor Psychotherapy. In D. J. Siegel, A. N. Schore, & L. Cozolino (Eds.), Interpersonal Neurobiology and Clinical Practice. WW Norton.

Phelps, J. (2017). Developing Guidelines and Competencies for the Training of Psychedelic Therapists. Journal of Humanistic Psychology, 57(5), 450-487. https://doi.org/10.1177/0022167817711304

van der Kolk, B. A. (1994). The body keeps the score: memory and the evolving psychobiology of posttraumatic stress. Harv Rev Psychiatry, 1(5), 253-265.