Psychiatrist and Empathy Expert: Can Empathy Help Overcome Anger Toward the Unvaccinated?

It is critical that we understand why the golden rule of caring about our neighbor as ourselves has eroded.

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As an empathy researcher, educator and a clinical psychiatrist, I've recently become aware of my own limited empathy as I've attempted to understand vaccine refusal, grappling with my own secret feelings of disgust — bordering on disdain, as the stakes are so high — that have tested the limits of what I not only practice, but also teach.

Studies show that empathy has been linked to greater trust in the patient-clinician relationship, greater adherence to medical recommendations and better health outcomes. Despite these benefits, even the most well-meaning healthcare providers are being challenged right now.

My own feelings hit a new high when I learned about a 15-year-old who asked someone to pose as his father so he could get vaccinated because his own parents refused. Weeks later, both parents were hospitalized with COVID. The father died while his mother eventually agreed to be vaccinated.

Why does it take death to convince others to get vaccinated? How can physicians and others maintain empathy when people make decisions that flout medical wisdom and basic science?

For doctors, this is not new. We work with patients every day who refuse to quit smoking, lose weight, or stop drinking — behaviors that can also affect the health and well-being of others. Empathy education is often needed to help move doctors beyond judgment and into a curiosity mode, enabling us to uncover more about patient perspectives and build trust.

We already know a few reasons why people refuse vaccinations, including fear and uncertainty of side effects, need for autonomy, education disparities, lack of medical literacy, widespread misinformation, polarized political rhetoric and distrust of governments.

But we're also seeing a big departure from one of the most powerful past drivers of vaccine adherence: a strong belief in social responsibility for the common good.

We're moving quickly away from a society that was once ideologically grounded in principles of cooperation, collaboration and reciprocity to one focused on the self. And that profound shift may be the most fundamental reason why appeals to get vaccinated to protect fellow humans aren't working.

This is certainly not the only reason for vaccine refusal, but it is critical that we understand why the golden rule of caring about our neighbor as ourselves has eroded. Why have people lost faith in participating in the public good?

It all leads back to empathy. When there is empathy, people feel seen, understood and helped. Our brains are wired to care for others, which is why we flinch when we witness someone fall or get hit by a ball. We also feel motivated to help in these scenarios because the human brain maps others' pain onto our own pain matrixes, producing concern and helping behaviors that involve reward networks and moral reasoning.

These crucial brain networks have been preserved throughout millennia to protect and ensure the survival of our species because when others hurt, we hurt. We need one another to survive as a species, and nowhere is that more evident than when fighting a global pandemic.

Studies show that well-educated, more affluent people are likelier to be vaccinated because they trust the government to do right by them because they reap many benefits. One of the root problems of vaccine refusal occurs when people experience a lack of empathy from the government and live the consequences of a broken social contract. Because many people living in poverty don't benefit from the public good, and are denied safe housing and decent schools, this lack of government empathy is mirrored externally: If no one cares about me, why should I care about you?

A failure of empathy toward the poor, disenfranchised, wrongfully imprisoned, and those with insecure food and housing can result in no desire to "give back" because the fundamental empathy loop that motivates positive reciprocity is broken. There is no reservoir of goodwill to tap into when people live in dire straits, distrust the legal system and watch billionaires get rich while paying zero taxes.

Frustrating to many leaders and doctors is the fact that meaningful change in people who lack trust in authorities happens slowly, one caring relationship at a time. But our society is not structured that way.

In the medical world, patients make changes when their unwillingness to change is viewed through the lens of empathy and met with curiosity and genuine interest. Respecting the autonomy of individuals to make their own choices while helping them build confidence in making small changes results from many conversations, not from bombarding them with information and public service announcements about why smoking leads to cancer.

The government and its institutions must tap into the power of empathy to learn more about how to make vaccines feel safer. However difficult to do, both doctors and citizens must also tap into their own empathy to offer understanding to those who feel they don't need to care about others, knowing that they may indeed have reasons not to care.

We also need self-empathy when we find ourselves judging others, recognizing that we've all fallen into the same trap of blaming rather than working on solutions. While this blame trap can lead us to feel powerful in our outrage — no matter what side we're on — we need to work together in our conversations to bridge our divides by seeking opportunities to understand and connect.

Waiting for the federal government to convince vaccine refusers to change may be waiting much too long. Our collective health is not an individual matter, yet we run the risk of individual choices undermining the health of our country and the world.

As a collective solution, we need to empathize and understand the predicaments that many people live with, including a lack of basic housing, food, education and medical access, all of which can cause people to give up — not only on their own health, but also on the health of society.

Empathy can get us through this pandemic, and we must find ways to harness it. Our lives depend on it.

The information provided here is not intended as medical advice, diagnosis or treatment. You should consult with a qualified healthcare provider for advice concerning your specific situation.

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