Hi, my name is Piper Harris, and welcome to the Untangled Mind Podcast, where I help you untangle your mind to untangle your life's challenges. I'm a data-driven mental health therapist in the suburbs of Atlanta, Georgia, and an expert in third-wave CBT for individuals dealing with trauma and anxiety. On today's episode, I'm unpacking the neuroscience of empathy, why so many professionals confuse empathic distress with compassion, and how our culture has turned burnout into a badge of honor. I'll share some real life examples, including what happens when a clinician becomes so overwhelmed by empathy that they literally disassociate in the middle of session. This is episode two of the empathy series when empathy hurts the brain. If you haven't listened to that, go ahead and listen to that one that's episode 63. But we're jumping into this empathy series just because I'm seeing so much chatter about it, both negative and positive. And I thought, well, let's do a series on this and really talk about it. So today we're really talking about how empathy really impacts our brain and our body. And that empathy is not just an emotional posture. It's actually a physiological event as well. And if you stay stuck in empathy, the cost is not just psychological, it's actually physical as well. So let's talk about the neuroscience of empathy. When researchers put people in the fMRI machines, this shows the brain, it and they show them images of other people in pain. What we see on this imaging is the anterior insula and the anterior cingulate cortex light up. So these are the same regions of the brain that activate when you are actually in pain, which is fascinating. So, in other words, when we empathize with someone, our brain treats someone else's suffering as though it were our own. That's why empathy can be really dangerous if it's unchanneled. So, although that sounds super noble, right, that we're gonna feel somebody else's pain, there is a catch. So the constant stimulation of pain, it's not neutral. You can't feel someone's pain and see it light up in the brain regions that show it as if you're going through it and it not create an issue. It creates something that we call empathic distress. So it really primes our nervous system for suffering. And here's the key the more that you stay in this area, the more you live there, the more um stress you feel physiologically, and it's activated. Like the whole physiology is activated if you just sit there in empathy. So, what we have to understand is that empathy pulls on the same circuits that keep you, say, in um hypervigilance, um, exhaustion, tension, all of that. So when our brain perceives pain, like with when we empathize with somebody else's pain, the amygdala activates. So the amygdala, that's the brain's kind of alarm bell, that's the most primitive part of our brain. Our brain actually forms bottom up. And so the amygdala is very important. It keeps us safe, but it's really not intelligent. It just is constantly scanning the environment for danger. So, what happens when we perceive pain through this empathized pain, it the amygdala turns on and then it signals to the hypothalamus to activate the HPA access. So, if you know a lot about the HPA access, it's the hypothalamus, pituitary gland, and adrenals. So this whole system preps our body for stress, to regulate stress, to manage stress, to get through stress. So, what happens is our cortisol is released and that really prepares our body for threat. So, this is the fight or flight system that we hear about, the sympathetic system of our autonomic system. So if you are to stay in that empathic distress, basically you're essentially living in this very low grade threat state. But low grade, it doesn't always just stay there. Um, so what happens is that cortisol it remains elevated and the nervous system never downshifts, right? And so over time, this really does lead to massive burnout. Um, you'll see this in like immune suppression, poor sleep, maybe anxiety or depression. You might see some GI issues. So again, this goes back to if empathy is not channeled, it's just simply going to keep firing and exhausting you. It's biologically unsustainable. It really is. So we have to understand empathy is a wonderful, beautiful thing, but the whole premise of this series is that we can't sit in empathy. Sitting in empathy is really uh not a good place to stay. So here's also where some of the science gets really, really fascinating. So we're talking about, we already see on brain imaging with individuals that are shown images of somebody that's under distress that the brain regions light up as if you're having the pain, right? Well, there was this other research team led by Tanya Singer, um, and she compared empathy with compassion. So what happened was when people experienced that empathic distress, of course, those pain centers lit up, right? The anterior insula, anterior cingulate cortex. But she taught people how to shift into compassion. And that's a totally different system that lit up on that fMNRI, which is fabulous. So, what lit up on there was the ventral striatum and the medial orbitofrontal cortex. Say that three times fast. All that to mean these regions actually are tied to reward, motivation, and positive affect. So when we teach people to not sit in that empathic distress, empathy, if unchanneled, turns into empathic distress. It signals to the body, the brain, our physiology that we are literally hurting. But if we teach people to go to compassion, it lights up those same systems in the brain, same regions in the brain that are tied to all of the good stuff. So the real key here that you need to understand is that empathy does drain and compassion energizes. So that's why staying in empathy really does lead to collapse. But moving into compassion will actually sustain us. And the neuroscience actually confirms what clinical practice shows. Empathy is not enough. It's just not enough. Now, here's where it gets a little sticky. There's something called mirror neurons, and these were found in an Italian research lab, I think in the 90s, and I've talked about this on other podcasts. So, mirror neurons are these specialized little brain cells, and they fire both when we act and we observe somebody else's acting. So they kind of underlie this imitation and learning and yes, emotional resonance. So, for example, and I talk about actually mirror neurons in my untangling workbook series because it's so key in the therapy room. So, for example, when a client cries, my mirror neurons will resonate with them. So I'll feel my pain, their pain in my body. That's what empathy is, because that mirror neuron is firing. But this is why it is so important for the skill. If we remain in that resonance, like I'm resonating with this client's pain the whole time, then that means both me and the client stay in that pain and in that distress. So I have to regulate myself. So I'm slowing my breathing, maybe I'm doing some grounding, I'm steadying my voice, I'm watching eye contact. What I'm doing is I'm offering the client a new state to mirror or new mirror neurons. So it's very important for me in session with clients, especially with trauma anxiety. These are highly elevated sessions. But if I don't regulate, if I am not aware of what's taking place with the mirror neurons, we're both off to the races, and I'm gonna do nothing to help them. Nothing. So it's so important that we learn co-regulation. Empathy is a doorway, but regulation is the thing that transform it, that transforms it, okay? So we we move from simply feeling something into modeling resilience. So again, if all we do is feel, no one would feel better, let alone have the wherewithal to learn any of my tools, right? So what's the point of therapy? This is where I hear these stories all the time from clients coming in saying, I've tried seven other therapists, and all I do is I sit there and I cry and I leave and I feel worse. That's not co-regulation. We're not, as a clinician, it is absolutely incumbent on us to help them regulate. But if we just sit there and we're just like a blank canvas, which we've heard that a lot in the counseling field, was I think is a blank slate. I think it's ridiculous. You can't be blank when you're dealing with people's pain. But you also can't bring in the pain and sit in it, if that makes sense. So co-regulation is so important. This is important in marriages, this is important in business relationships, this is important with our kiddos. If you're dysregulated, your kid is going to be more dysregulated. If you're still, you know, dysregulated after an argument with your partner, you're going to increase the severity of the fight. This is why mirror neurons are beautiful, wonderful things, but we can't sit in it. We cannot sit in it. It's why the empathy has to move towards compassion. So for example, um I had a healthcare worker, um, she came to me last year, and she um kept saying to me that she was just utterly depleted. And it was really causing issues within her marriage. She was having a hard time really engaging with her young um son, I believe she had a son, um and she was just really having a hard time. And basically she was like, you know, I'm I'm taking on all my clients' pain. And so I go home and I cry, I can't sleep, um, I can't think about each stop thinking about each case. So she was really in the suffering. And here's the thing: she she saw this as proof of her compassion, but what we discussed was what was actually happening was that empathic distress. Her brain just was on this constant loop of pain resonance, right? Her her uh system, her nervous system was stuck in this threat mode because she just kept pinging the snot out of that sympathetic system, the fight or flight system, because she told herself that if I don't feel the patient's pain, therefore I am not um a compassionate human being. So when we worked together, I really had to help her practice that mirror to strength sequence, right? So that's really first she had acknowledged that her resonant she that she resonated with her patient's pain. That's wonderful. There's nothing wrong with it. But then she needed to learn to regulate her own nervous system. So we came up with our toolbox for her to regulate her system. We regulated the system, then we went into more of the cognitive and reframed what her perspective was. And then from there, she was able to model more calm strength outwardly. So it took time. This doesn't happen over, you know, one session. I mean, if you're constantly practicing this empathic distress, and that's really what you're practicing, if you're choosing to only feel people's pain, it is very difficult to shift out of it. Because again, this is a physiological response. This isn't just, you know, a psychological response. So it does take time to practice new tools and to um really devise an understanding of what's taking place in the mind and the body. Oftentimes it's called a bottom-up approach, is saying, okay, we have to regulate the nervous system, but then where does my body tell me um that I'm getting into this fight or flight state? Is it shallow breathing? Is it a sick stomach? Is it tight shoulders? Is it tight throat? So we understand what's happening in the body because the body whispers far before our our brain is off to the races. And so we really create this kind of timeline of how we understand that we go from empathy to absolute full-on distress. So as she and I worked through it, it was really profound. I mean, it really was. She was able to reframe that she did care deeply, but she didn't have to collapse under the weight of empathy. She could operate in compassion, right? Which energized and um energized her and she was much more effective, not just at work, but at home too. And it's super sustainable. So I want to take just a brief little kind of pause and ask you to kind of ask yourself a couple of questions just to think about this as we're going through this empathy series. Number one, um, where in your life do you take on someone else's pain as though it were your own? This is very, very common. I see this a lot with um people that are transitioning in life, maybe out of um working full-time into retirement, maybe it's saying goodbye to kids in the home. Um, I see this a lot where there's this kind of clinging on to somebody else's pain. So really think about that. Identify where in your life you're taking someone else's pain on as if it were your own. It is very hard for us to distinguish this when it comes to our loved ones, those that are closest in our life. But you really do have to honestly assess, am I taking on, say, um, you know, my son's poor choices as my own, like seeing his distress and his pain, right? You really need to be honest with yourself. Um, then I want you to ask, how does your body feel when you do this? So are you paying, feeling tense, restless, exhausted? Are you crying just as much along with them? Really identify, am I mirroring their reactions? Now keep in mind if you recognize, ooh, shoot, I'm mirroring their reactions with those little mirror neurons, what are you doing? You're actually increasing distress. You're dysregulating the other person even more. So, what would it look like to mirror strength instead of distress? So, this isn't for people have a hard time with this when we start learning this. This is not about denying the distress that the person is in. That is not it at all. But it is not sitting in the distress with them. So, for example, um, I talk a lot with individuals that have lost loved ones, and they say to me all the time, you know, people can't even just like sit with me. So people have a very hard time. Either they don't want to feel any of your pain or they're like too amped up by your pain. Does that make sense? But if we can mirror strength, so sometimes mirroring strength is again just like I regulate myself in session when it's a really tough session that I'm listening to. Maybe it's my breathing patterns or I'm doing my own grounding exercises. I have a large chair in here that I sit in and they're stitching. And so a lot of times when I can feel dysregulation, when I'm like, ooh, I'm stepping into this client's story too much. I don't want to become dysregulated. And I recognize this by my heart rate increasing. I always notice it when I my heart rate increases. Um, what I do is I ground by rubbing the stitching on my chair. And I know that sounds silly, but it it grounds me to the here and now, like, hey Piper, this is not your story. You're sitting in this space with this human that really needs your strength. So we can mirror strength instead of distress. So, where in your life do you take someone else's pain as though it were your own? How does your body feel when you do this? And what would it look like to mirror strength instead of distress? So these questions really do matter because, again, they help us shift from empathy, from this like path, you know, um, excuse me, passive flood of emotion into an active choice. And that's really important. So, one thing that I have a bone to pick about shocking, I know, is something called compassion fatigue. And I really think this is a misnomer. So you hear compassion fatigue all the time. You hear it in the counseling field, medical fields, and even ministry. And so the truth is I think it's a misnomer. Compassion does not fatigue, right? Compassion motivates us to action. Compassion energizes, compassion lights up those brain reward centers and motivation centers. What I actually think they're they're experiencing is empathic distress fatigue. It's not compassion fatigue. Compassion is totally different from empathy. So they're not fatigued from caring too much. That's that's kind of what you think about with compassion fatigue. They're actually fatigued from being stuck in that resonance with the pain without moving through from empathy to sympathy to compassion. That's what I think is the actual problem. And so when I hear about compassion fatigue, I I take a little umbrage with it because it's not um, it's not defined enough. And words matter, they just matter. So I think compassion, and here's the thing too, people say, well, but I am compassionate and it leads me to do so, so much. Well, because then what we have to talk about is especially we see this in a lot of like ministry where they're doing so, so much for the community, which is beautiful and wonderful, and but then they're totally burned out. Okay, well, then that's in a totally different realm. That's where we need to communicate boundaries, we need to communicate effective, um, you know, leadership, whatever it is within the ministry that you're burning people out because you're asking them to do too much. Is that compassion fatigue or are you just using people? Does that make sense? They're totally different. And so I really do think this matters because when we mislabel it, we misdiagnose it. Does that make sense? Like when you mislabel compassion fatigue, when actually what I think it is is empathic distress fatigue, then what we do is we tell professionals that their problem is caring too much, when in reality the problem is they're channeling it too little. That's the problem. So I do take a little uh I get annoyed with the compassion fatigue thing. They talk about it a lot in counseling school during my master's, and it always bothered me then because I'm like, well, compassion's not the bad thing. Compassion is what led me to come to school. The problem is you're just simp sitting there and just resonating with pain. That that does nothing. So I think too, um, I've touched on this just a little bit. We'll talk about this more and more as the series goes on, is there's like this badge of honor. So in my field, this mislabeling has become a badge of honor. So you'll hear clinicians say, clinicians say, like, oh, I'm so burnt out because I care so much. Or you'll hear medical professionals, like I shared with that one client, who wear exhaustion as this proof of their dedication. So this is the issue. We are purposefully um dregulating our system. We're purposefully, I'm I'm calling it what it is. This you chose to sit in empathy. So this is a dysfunction that's paraded as a virtue. So instead of modeling resilience, we model collapse. So we reinforce this myth that the best therapists are the most depleted ones, and the best doctors are the most exhausted, and the best nurses are the most drained. This is wrong. And again, this is a bigger conversation just than just empathy, you know, empathic distress fatigue. This is uh talking about leadership. This is talking about so much more. But again, we have to be aware that there is a dysfunction in this mislabeling of it, and it really gets paraded around like this this virtue, and it's not. You're burning out your brain, you're burning out your body. This is not strength, this is empathy unchanneled, and it's broadcasted as like um an odd identity or characteristic, and it's not sustainable, it's super harmful both to the professional and those that they serve. It's it's it's really unsustainable and harmful. So, um years ago, when I was in, I think it was my first internship, it was my first internship. You can see some real severe reactions with individuals that have believed the hype about empathy. And all they should do is feel, and all they should do is resonate with the pain in the office. So during my internship, we had to do um group supervision, and so there were some of the of us in there with like different levels. So some of us were still students, some of us were APCs, um, waiting for full licensure. It just kind of was different, but we'd sit in group supervision, and I was working a Alongside this woman, I don't know if she got her APC or LPC. She must have been APC because she was in supervision. But anyway, we're sitting in there, and I think it was three or four of us were sitting in there, and she starts talking about that she became so flooded with her client's story that she disassociated, like full on, bleeped out. She's not in the room at all. And that her system literally shut down. Just like shut down. Now, listen, disassociation is this amazing thing that our brain does, but y'all, your therapist shouldn't be disassociating on you. They shouldn't be a therapist if they can't stay grounded. Period. Now there's some upsetting things that happen in session. I don't disassociate. I get to the dysregulation. I'm like, whoo, gotta pull back, or I'll say to them. Thanks for spending this time with me today on the Untangled Minds podcast. My hope is that what you heard today helps you think differently, question deeply and real steps towards change that. So remember, empathy isn't the end if you feel the trip you're putting in. And the real work is really moving beyond the feeling and into action. If you're finding this series helpful, I'd love for you to share it with someone who could benefit system. So be sure to join me next time as we continue to untangle the myth around empathy and explore that. Number one, this is extreme. This is at the extreme end of empathic distress fatigue. Um, that her system, her nervous system, couldn't even hold that level of resonance that it checked out. Yet it was framed in the middle of this group's group supervision as proof of how much she cared. And again, this goes into all the crap in the counseling profession and maybe other professions where there's this real lack of gatekeeping that the director of this group wanted just to make more money and just totally ignored the fact that her clinician's disassociating, which is gross. So this is how far the myth has gone that empathy is the only way to go. We've normalized trauma responses and professionals as an evidence of virtue instead of naming them for what they are. Sign of poor boundaries and unsustainable practice. And by the way, go to therapy, get your stuff figured out before you think you can be a therapist for real, because you're causing harm to that client. This is, I mean, we hear funny stories and not really funny where, you know, physics or clinicians fall asleep in session or whatever. But can you imagine as a client that comes in, say you have a horrible, horror, horrible trauma? Maybe you're a rape victim and you're reiterating, you're saying out part of your memory with this, whatever. And your therapist also has a rape history and is not able to manage your story that they just blink out and disassociate on you. And disassociation looks different for everyone. Sometimes you get like this hazed overlook. I've seen people they can rock every once in a while with me. Sometimes they'll just say, mm-hmm, uh-huh. And there's like, there's just they're not blinking. Disassociation looks different on everyone. But can you imagine your therapist doing that to you in the middle of you working through your own trauma? That's insane. That's insane. So again, this is where this idea that empathy is the only way to go, this myth is really normalizing traumatic response responses in professionals as like they're so virtuous. It's disgusting. It's disgusting. Now, sometimes the cost of empathy only shows up in the individual nervous system, like I shared, right? But what about if their system is so overwhelmed by this empathic distress that it literally shuts down? And then all of a sudden it's collective. What if people surround themselves with communities where everyone is living in their feels, where empathy becomes contagious? So remember, mirror neurons are firing not just between two people but across groups. So this emotional resonance spreads. Stress and distress echo. So a lot of times we can see this in grief groups, divorce groups, where you can go into a divorce group and you it's like a processing group, and pretty soon everybody's so angry and they walk away and they're so mad. Or you can see this in grief groups where you go to get over the loss of a loved one, and all you feel is the depth of everybody's grief. So psychologically, right, this can morph into what we call like collective hysteria or um like a mass psychogenic illness. Okay. So where groups of people they start to share these same heightened states of emotionality and even physical symptoms without any external cause. Those mirror neurons are incredible, but they can be dangerous. So neuroscience shows us why empathic resonance activates the insula in the anterior cingulate cortex, right? Our prey, our pain and threat circuits, and then it mirrors across a group, and these regions keep firing. So it's reinforced by like this social validation. It's not even, you're not even aware of it. So then you add in the amygdala's threat response and HPA access, it's just like pumping cortisol and adrenaline. All of a sudden, you've got individuals turning into a whole group. So the physiology of the whole group becomes dysregulated. So the result of this group is either hyperousal, it's exaggerated perception of threat, it's impaired cognitive control. So that means the front part of our brain, the prefrontal cortex, that part of our brain that's responsible for critical thinking, um, it goes offline. So in its place, the limbic system just completely dominates. So the group becomes less rational, more reactive, and increasingly paralyzed in shared distress. That is why compute communities that glorify empathy without channeling it often spiral into cycles of despair or outrage or performative suffering. The brain isn't just sharing feelings, it's amplifying them. So once the group's nervous system s synchronizes in distress, it becomes like nearly impossible to pull out of it. That's again why we need co-regulation. We need intentional leadership and reframing. It is so key. Empathy is wonderful, but we cannot stop there. So, you know, whether we call it compassion fatigue, which you know, I think that's a misnomer, um, burnout or collapse, the root issue is the same. Empathy without channeling is not good because it misfires everything in our nervous system and our brain. So for clinicians, like I've said, this leads to exhaustion and attrition. For parents, it leads to enmeshment, for leaders, it's paralysis, maybe, and for individuals, it can lead to anxiety and an identity built around suffering. So in each case, empathy, you know, looks like this proof of virtue rather than a pathway to change. And that's what I want to say. Empathy can be a pathway to change, but we have to learn to channel it. And again, if all you do is sit in empathy because you're telling yourself it's proof of the beautiful part of who you are, then your nervous system pays the price. Your brain pays the price. So what do we do with this? First, we have to acknowledge that empathy is absolutely necessary. I am not demonizing empathy at all, but it's not sufficient. It's the doorway. Second, when I talked about the ladder, we gotta climb the ladder. So from empathy to sympathy, from sympathy to compassion, empathy resonates, sympathy recognizes, compassion acts. And third, we gotta co-regulate. We have got to learn to um regulate. We have to learn to model strength. And that's really that is where therapy changes people. It's not by drowning them with their own emotions because I'm feeling them so much, but it's by offering them a stronger state to join, right? That's that's what therapy is. And fourth, we've got to stop glorifying distress. Y'all, I'm tired. I've been going through some kind of scary, not even kind of, some scary health stuff that we're trying to get to the bottom of. And I am telling you, I'm not talking about it, I'm not glorifying it. I'm letting my clients know because I feel bad. I've been moving sessions around because of all these stupid doctor appointments, but I am not glorifying the distress. I'm not glorifying that I'm scared to death. I'm not glorifying any of the things that I'm going through because all that does is heighten the nervous system that I need to calm. So we've got to stop calling collapse proof of virtue. You know, we we gotta do that. We gotta stop doing that in these professions. The helping professions, I get it, we are all exhausted and we've got our own crap that we're dealing with. But you gotta stop holding on to it as if it's proof of who you are, like that you're a good person. We have to start teaching our industries and ourselves, right? Um, that resilience and not exhaustion is the evidence of care. We have to, we have to stay change that. So empathy is powerful, but what we've learned today is if it's left unchanneled, it really does hurt the brain and the body. And listen, the soul, it does. Compassion, by contrast, sustains and energizes. We can see it on brain imaging. This is not just Piper spouting out just some of her opinions. No, this is proven. So, again, as you kind of reflect on what we've talked about today, ask yourself am I living in empathic distress? Is it actually empathic distress fatigue, not compassion fatigue? Stop calling it that. Or, or am I trying to learn to regulate and move into compassion? Are you doing that? So, in our next episode, we're going to take um on empathy as a cognitive trap and how empathy um functions as a heuristic. So, these are those shortcuts in our brain that again feel virtuous, but they actually reinforce oftentimes avoidance and false beliefs. So be sure to check out uh the third podcast coming out in our empathy series. Thanks so much for joining me. That brings us to the end of this episode. Thanks so much for joining me. Hyperheron to the Untangled Mind Podcast. I hope you learned some tools that can equip you to untangle your mind and untangle your life. If you're curious about working with me for your anxiety or trauma, head on over to my website at untangledmind.net to connect with me. If you enjoyed the show, please rate and review me on your podcast listening platform and share it with your friends and family. As always, thanks so much for listening to me. Piper Harris with the Untangled Mind Podcast. I'll talk with you next time.