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	<title>Comments on: I Don&#8217;t Feel Your Pain</title>
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		<title>By: locutusbrg</title>
		<link>http://theness.com/neurologicablog/index.php/i-dont-feel-your-pain/comment-page-1/#comment-21034</link>
		<dc:creator>locutusbrg</dc:creator>
		<pubDate>Wed, 19 May 2010 17:07:34 +0000</pubDate>
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		<description>Billy Joe:
I have provided two Webster&#039;s definitions for your perusal below.
 It is subjective but I think the empathy over sympathy statement does have validity. I have no wish to argue semantics or list 20 definitions. To clarify for you simplistically. It is my opinion that sympathy conveys a indication that I am &quot;feeling sorry for you&quot; whereas empathy is more a intellectual understanding of a patients pain without the actual experience. To be empathetic is to acknowledge a persons discomfort without the &quot;fake&quot; impression that you know what they are going through. It was my understanding that Steve was indicating the opposite and sympathy is more detached than empathy. I missed the fact that I repeated empathy twice in my last statement making my point confusing. I don&#039;t think &quot;actions&quot; have a direct association with either word used in this context.
At least that is my impression.
 
 Sympathy: an affinity, association, or relationship between persons or things wherein whatever affects one similarly affects the other b : mutual or parallel susceptibility or a condition brought about by it c : unity or harmony in action or effect 
2 a : inclination to think or feel alike : emotional or intellectual accord  b : feeling of loyalty : tendency to favor or support 
3 a : the act or capacity of entering into or sharing the feelings or interests of another b : the feeling or mental state brought about by such sensitivity 
4 : the correlation existing between bodies capable of communicating their vibrational energy to one another through some medium
Empathy:
Etymology: Greek empatheia, literally, passion, from empathēs emotional, from em- + pathos feelings, emotion — more at pathos
Date: 1850
1 : the imaginative projection of a subjective state into an object so that the object appears to be infused with it
2 : the action of understanding, being aware of, being sensitive to, and vicariously experiencing the feelings, thoughts, and experience of another of either the past or present without having the feelings, thoughts, and experience fully communicated in an objectively explicit manner; also : the capacity for this</description>
		<content:encoded><![CDATA[<p>Billy Joe:<br />
I have provided two Webster&#8217;s definitions for your perusal below.<br />
 It is subjective but I think the empathy over sympathy statement does have validity. I have no wish to argue semantics or list 20 definitions. To clarify for you simplistically. It is my opinion that sympathy conveys a indication that I am &#8220;feeling sorry for you&#8221; whereas empathy is more a intellectual understanding of a patients pain without the actual experience. To be empathetic is to acknowledge a persons discomfort without the &#8220;fake&#8221; impression that you know what they are going through. It was my understanding that Steve was indicating the opposite and sympathy is more detached than empathy. I missed the fact that I repeated empathy twice in my last statement making my point confusing. I don&#8217;t think &#8220;actions&#8221; have a direct association with either word used in this context.<br />
At least that is my impression.</p>
<p> Sympathy: an affinity, association, or relationship between persons or things wherein whatever affects one similarly affects the other b : mutual or parallel susceptibility or a condition brought about by it c : unity or harmony in action or effect<br />
2 a : inclination to think or feel alike : emotional or intellectual accord  b : feeling of loyalty : tendency to favor or support<br />
3 a : the act or capacity of entering into or sharing the feelings or interests of another b : the feeling or mental state brought about by such sensitivity<br />
4 : the correlation existing between bodies capable of communicating their vibrational energy to one another through some medium<br />
Empathy:<br />
Etymology: Greek empatheia, literally, passion, from empathēs emotional, from em- + pathos feelings, emotion — more at pathos<br />
Date: 1850<br />
1 : the imaginative projection of a subjective state into an object so that the object appears to be infused with it<br />
2 : the action of understanding, being aware of, being sensitive to, and vicariously experiencing the feelings, thoughts, and experience of another of either the past or present without having the feelings, thoughts, and experience fully communicated in an objectively explicit manner; also : the capacity for this</p>
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		<title>By: Brian The Coyote</title>
		<link>http://theness.com/neurologicablog/index.php/i-dont-feel-your-pain/comment-page-1/#comment-20866</link>
		<dc:creator>Brian The Coyote</dc:creator>
		<pubDate>Fri, 14 May 2010 16:30:18 +0000</pubDate>
		<guid isPermaLink="false">http://www.theness.com/neurologicablog/?p=1939#comment-20866</guid>
		<description>When I was being trained as a paramedic it was drilled into us over and over that we had to keep dispassionate while maintaining some sympathy.  When I think about it, it is really using a science-based approach to emergency interventions.  What the patient reports you pretty much take on the level of anecdotal evidence.  Your findings on examination are given much more weight.  The classic example almost always given is that a broken finger will hurt much more than a femoral bleed but only the bleed is life-threatening.</description>
		<content:encoded><![CDATA[<p>When I was being trained as a paramedic it was drilled into us over and over that we had to keep dispassionate while maintaining some sympathy.  When I think about it, it is really using a science-based approach to emergency interventions.  What the patient reports you pretty much take on the level of anecdotal evidence.  Your findings on examination are given much more weight.  The classic example almost always given is that a broken finger will hurt much more than a femoral bleed but only the bleed is life-threatening.</p>
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		<title>By: BillyJoe7</title>
		<link>http://theness.com/neurologicablog/index.php/i-dont-feel-your-pain/comment-page-1/#comment-20850</link>
		<dc:creator>BillyJoe7</dc:creator>
		<pubDate>Fri, 14 May 2010 12:48:28 +0000</pubDate>
		<guid isPermaLink="false">http://www.theness.com/neurologicablog/?p=1939#comment-20850</guid>
		<description>lotusbrg,

&quot;I agree with some of the other bloggers. You have it backwards between empathy and sympathy. I referenced several sources and empathy and my understanding of the definitions is more detached than empathy. The way you used them is the opposite of their respective relative definitions. It is most often taught empathy not sympathy.&quot;

I can&#039;t quite make sense of what you&#039;ve written above so I don&#039;t know exactly what you&#039;re trying to say, but you&#039;re wrong if you&#039;re saying Steve has it wrong because his version is actually quite correct.

Sympathy is a shallow version of empathy. It&#039;s about actions rather than feelings. Whereas, empathy is all about feelings.</description>
		<content:encoded><![CDATA[<p>lotusbrg,</p>
<p>&#8220;I agree with some of the other bloggers. You have it backwards between empathy and sympathy. I referenced several sources and empathy and my understanding of the definitions is more detached than empathy. The way you used them is the opposite of their respective relative definitions. It is most often taught empathy not sympathy.&#8221;</p>
<p>I can&#8217;t quite make sense of what you&#8217;ve written above so I don&#8217;t know exactly what you&#8217;re trying to say, but you&#8217;re wrong if you&#8217;re saying Steve has it wrong because his version is actually quite correct.</p>
<p>Sympathy is a shallow version of empathy. It&#8217;s about actions rather than feelings. Whereas, empathy is all about feelings.</p>
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		<title>By: rmgw</title>
		<link>http://theness.com/neurologicablog/index.php/i-dont-feel-your-pain/comment-page-1/#comment-20847</link>
		<dc:creator>rmgw</dc:creator>
		<pubDate>Fri, 14 May 2010 08:01:35 +0000</pubDate>
		<guid isPermaLink="false">http://www.theness.com/neurologicablog/?p=1939#comment-20847</guid>
		<description>Surely a similar mechanism explains how Stanley Milgrams subjects (they weren&#039;t &quot;participants&quot; back then) overrode their sympathy for the apparent shockee?  Or, indeed, how humans can  disregard suffering in other species when they have managed to convince themselves that it is necessary and all for a good cause?
Manipulating our own feelings of sympathy/empathy for a good end or simply habituating to overriding an impulse not to cause pain is a handy ability in all sorts of situations, (perhaps submission postures in other species trigger this impulse?) but it seems pregnant with possibilities on both sides......therapeutic and quite the reverse.</description>
		<content:encoded><![CDATA[<p>Surely a similar mechanism explains how Stanley Milgrams subjects (they weren&#8217;t &#8220;participants&#8221; back then) overrode their sympathy for the apparent shockee?  Or, indeed, how humans can  disregard suffering in other species when they have managed to convince themselves that it is necessary and all for a good cause?<br />
Manipulating our own feelings of sympathy/empathy for a good end or simply habituating to overriding an impulse not to cause pain is a handy ability in all sorts of situations, (perhaps submission postures in other species trigger this impulse?) but it seems pregnant with possibilities on both sides&#8230;&#8230;therapeutic and quite the reverse.</p>
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		<title>By: locutusbrg</title>
		<link>http://theness.com/neurologicablog/index.php/i-dont-feel-your-pain/comment-page-1/#comment-20823</link>
		<dc:creator>locutusbrg</dc:creator>
		<pubDate>Thu, 13 May 2010 16:34:22 +0000</pubDate>
		<guid isPermaLink="false">http://www.theness.com/neurologicablog/?p=1939#comment-20823</guid>
		<description>two points I will try to be brief.
Steve 
I agree with some of the other bloggers. You have it backwards between empathy and sympathy. I referenced several sources and empathy and my understanding of the definitions is more detached than empathy. The way you used them is the opposite of their respective relative definitions. It is most often taught empathy not sympathy.


Starting with Jim.. there are several issue with some statements I have read here about nurses. My biases are obvious. I have been a RN for 20 years. Emergency medicine for 10. I have been an Nurse Practitioner for 10 years. I was trained and I practiced science based medicine. I took the same undergrad science courses that the pre-med students took at my university. I never took homeopathy 101 nor was I required to learn some woo to graduate. 
In my particular case my graduate school of nursing was at a medical school and I received my graduate education from the same physicians that the medical students did. I was in the cadaver lab every day with a medical student next to me. There is a wide variation in nursing training and I cannot speak for all. Still characterizing nurses as the only source of medical psuedoscience is unfair and incorrect. I do not see a &quot;Nurse OZ&quot; show on the TV everyday do I?
Secondly despite popular perception registered nurses are not indentured servants to doctors whims. I will not even try to explain what I do or what my qualifications are as a NP. As a RN I had my scope of practice, I did things (Horror) without checking with a doctor. Often in a progressive university environment I was treated as a peer by the attending physician.  
Doctors are the ultimate arbitors of medical decisions and treatments. They would not tell me where or how the want an IV placed. They know that it is my decision. The need for an IV and the type of IV treatment is their decision.  Nurses are ethically and legally responsible to refuse a doctors order when they feel it is detrimental or in error.
Please do not generalize or characterize My profession, when you do not practice in it, and do not understand what we do.
As an aside, it is my opinion that RN&#039;s are wrongfully encouraged to pursue alternative medicine practice in certain education situations. I have had students and could do a whole blog on the problems with the nursing education system. 

Still anecdotally everyone I associate with does science based nursing practice. I hold my Practice as a NP to rigorous scientific based medical practice. It is more than my Philosophy it is the way I was trained at the graduate and undergraduate level.

Steve P</description>
		<content:encoded><![CDATA[<p>two points I will try to be brief.<br />
Steve<br />
I agree with some of the other bloggers. You have it backwards between empathy and sympathy. I referenced several sources and empathy and my understanding of the definitions is more detached than empathy. The way you used them is the opposite of their respective relative definitions. It is most often taught empathy not sympathy.</p>
<p>Starting with Jim.. there are several issue with some statements I have read here about nurses. My biases are obvious. I have been a RN for 20 years. Emergency medicine for 10. I have been an Nurse Practitioner for 10 years. I was trained and I practiced science based medicine. I took the same undergrad science courses that the pre-med students took at my university. I never took homeopathy 101 nor was I required to learn some woo to graduate.<br />
In my particular case my graduate school of nursing was at a medical school and I received my graduate education from the same physicians that the medical students did. I was in the cadaver lab every day with a medical student next to me. There is a wide variation in nursing training and I cannot speak for all. Still characterizing nurses as the only source of medical psuedoscience is unfair and incorrect. I do not see a &#8220;Nurse OZ&#8221; show on the TV everyday do I?<br />
Secondly despite popular perception registered nurses are not indentured servants to doctors whims. I will not even try to explain what I do or what my qualifications are as a NP. As a RN I had my scope of practice, I did things (Horror) without checking with a doctor. Often in a progressive university environment I was treated as a peer by the attending physician.<br />
Doctors are the ultimate arbitors of medical decisions and treatments. They would not tell me where or how the want an IV placed. They know that it is my decision. The need for an IV and the type of IV treatment is their decision.  Nurses are ethically and legally responsible to refuse a doctors order when they feel it is detrimental or in error.<br />
Please do not generalize or characterize My profession, when you do not practice in it, and do not understand what we do.<br />
As an aside, it is my opinion that RN&#8217;s are wrongfully encouraged to pursue alternative medicine practice in certain education situations. I have had students and could do a whole blog on the problems with the nursing education system. </p>
<p>Still anecdotally everyone I associate with does science based nursing practice. I hold my Practice as a NP to rigorous scientific based medical practice. It is more than my Philosophy it is the way I was trained at the graduate and undergraduate level.</p>
<p>Steve P</p>
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		<title>By: The Dicklomat</title>
		<link>http://theness.com/neurologicablog/index.php/i-dont-feel-your-pain/comment-page-1/#comment-20794</link>
		<dc:creator>The Dicklomat</dc:creator>
		<pubDate>Thu, 13 May 2010 04:51:42 +0000</pubDate>
		<guid isPermaLink="false">http://www.theness.com/neurologicablog/?p=1939#comment-20794</guid>
		<description>Steve&#039;s article focuses on the benifits of desensitization but not the mechanism for it.  This is of course not what the article was about, but this is the &quot;Neurological&quot; blog, so Steve could you perhaps expand on this to include what is happening behind the scenes?

When you learn to drive, you are hyper aware of everything that you are doing.  Your actions are all disjointed, you hesitate, overthing and the other drivers probably think you&#039;ve been drinking, iuntil they see the &quot;trainer&quot; sign on the back and they happily stay clear of you.

Once you get better at it, you no longer think about it.  The car becomes an extension of you and instread of thinking &quot;see turn, signal, watch your back, freak out, merge out, slow down, freak out again, wave at the honker, turn the wheel, not that much, straighten out, park, cry&quot; and spend the next year feeling guilty about the kitten that you tried and failed to avoid, you think, &quot;hey, I&#039;m hungry and these&#039;s a McDonalds over there&quot; and next thing you know you&#039;ve ordered a cheeseburger without much recollection of what happened in between.

From what I recall, &quot;learning&quot; behaviors and &quot;learned&quot; behaviors operate from different parts of the brain.  I expect  there is some correlation between the source or triggering of our empathic senses and the locations of the brain where we operate at concious and unconcious levels?</description>
		<content:encoded><![CDATA[<p>Steve&#8217;s article focuses on the benifits of desensitization but not the mechanism for it.  This is of course not what the article was about, but this is the &#8220;Neurological&#8221; blog, so Steve could you perhaps expand on this to include what is happening behind the scenes?</p>
<p>When you learn to drive, you are hyper aware of everything that you are doing.  Your actions are all disjointed, you hesitate, overthing and the other drivers probably think you&#8217;ve been drinking, iuntil they see the &#8220;trainer&#8221; sign on the back and they happily stay clear of you.</p>
<p>Once you get better at it, you no longer think about it.  The car becomes an extension of you and instread of thinking &#8220;see turn, signal, watch your back, freak out, merge out, slow down, freak out again, wave at the honker, turn the wheel, not that much, straighten out, park, cry&#8221; and spend the next year feeling guilty about the kitten that you tried and failed to avoid, you think, &#8220;hey, I&#8217;m hungry and these&#8217;s a McDonalds over there&#8221; and next thing you know you&#8217;ve ordered a cheeseburger without much recollection of what happened in between.</p>
<p>From what I recall, &#8220;learning&#8221; behaviors and &#8220;learned&#8221; behaviors operate from different parts of the brain.  I expect  there is some correlation between the source or triggering of our empathic senses and the locations of the brain where we operate at concious and unconcious levels?</p>
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		<title>By: Trey</title>
		<link>http://theness.com/neurologicablog/index.php/i-dont-feel-your-pain/comment-page-1/#comment-20791</link>
		<dc:creator>Trey</dc:creator>
		<pubDate>Thu, 13 May 2010 01:20:53 +0000</pubDate>
		<guid isPermaLink="false">http://www.theness.com/neurologicablog/?p=1939#comment-20791</guid>
		<description>I work in medical labs, and have, in the past, been an instructor for students learning phlebotomy (drawing blood).  I&#039;ve taught everyone from high school students to resident doctors, and I agree.  Everyone flinches at causing pain at first, but it goes away with practice.

I&#039;ve always had a decreased empathetic response, I&#039;ve noticed.  I never flinch when the tetherball smacks the dad in the groin during America&#039;s Funniest Home Videos, or when another person is in pain.  This seems to just be a part of my personality, from childhood on.

This makes me a very good phlebotomist.  Only a certain type of person can stick a newborn baby or an infant, and have the stability of hand to hit a tiny vein, and even a little flinch is going to miss.  Even though I don&#039;t work in that part of the lab anymore, I still get called over regularly to get a difficult patient.

I&#039;ve never really correlated the two, but it makes good sense.</description>
		<content:encoded><![CDATA[<p>I work in medical labs, and have, in the past, been an instructor for students learning phlebotomy (drawing blood).  I&#8217;ve taught everyone from high school students to resident doctors, and I agree.  Everyone flinches at causing pain at first, but it goes away with practice.</p>
<p>I&#8217;ve always had a decreased empathetic response, I&#8217;ve noticed.  I never flinch when the tetherball smacks the dad in the groin during America&#8217;s Funniest Home Videos, or when another person is in pain.  This seems to just be a part of my personality, from childhood on.</p>
<p>This makes me a very good phlebotomist.  Only a certain type of person can stick a newborn baby or an infant, and have the stability of hand to hit a tiny vein, and even a little flinch is going to miss.  Even though I don&#8217;t work in that part of the lab anymore, I still get called over regularly to get a difficult patient.</p>
<p>I&#8217;ve never really correlated the two, but it makes good sense.</p>
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		<title>By: hippiehunter</title>
		<link>http://theness.com/neurologicablog/index.php/i-dont-feel-your-pain/comment-page-1/#comment-20787</link>
		<dc:creator>hippiehunter</dc:creator>
		<pubDate>Wed, 12 May 2010 23:33:48 +0000</pubDate>
		<guid isPermaLink="false">http://www.theness.com/neurologicablog/?p=1939#comment-20787</guid>
		<description>I have been a Registered Nurse for 25 years and live down the road from the university i trained in. That University recieved a bent spoon award from the Australian Skeptics for offering a degree in naturopathy but that&#039;s another story.

We were taught about empathy v sympathy too along with numerous postmodern feminist tripe and a good dose of woo ( louis hay et al ).

I believe that nurses eventually succumb to the mentioned desensitisation but , in my experience , to a lessor degree to , say surgeons. 
Its role dependent , an experienced emergency department or ICU nurse will be much less emotional about an invasive procedure than a nurse who works in admin only.

I wonder how this study would apply to ambulance officers and nurses working in resus bays in the E.D.

Thanks for another great article, again I feel myself a little embarressed by the amount of woo associated with my job.</description>
		<content:encoded><![CDATA[<p>I have been a Registered Nurse for 25 years and live down the road from the university i trained in. That University recieved a bent spoon award from the Australian Skeptics for offering a degree in naturopathy but that&#8217;s another story.</p>
<p>We were taught about empathy v sympathy too along with numerous postmodern feminist tripe and a good dose of woo ( louis hay et al ).</p>
<p>I believe that nurses eventually succumb to the mentioned desensitisation but , in my experience , to a lessor degree to , say surgeons.<br />
Its role dependent , an experienced emergency department or ICU nurse will be much less emotional about an invasive procedure than a nurse who works in admin only.</p>
<p>I wonder how this study would apply to ambulance officers and nurses working in resus bays in the E.D.</p>
<p>Thanks for another great article, again I feel myself a little embarressed by the amount of woo associated with my job.</p>
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		<title>By: tmac57</title>
		<link>http://theness.com/neurologicablog/index.php/i-dont-feel-your-pain/comment-page-1/#comment-20785</link>
		<dc:creator>tmac57</dc:creator>
		<pubDate>Wed, 12 May 2010 23:14:14 +0000</pubDate>
		<guid isPermaLink="false">http://www.theness.com/neurologicablog/?p=1939#comment-20785</guid>
		<description>daedalus2u- The probable reason that they don&#039;t like you to watch while they insert the needle,is that they are wary about subjects that might have a vasovagal  syncope (fainting) episode due to needle phobia. This can affect something like 10% of people, and is more likely if you are watching the procedure. It is  not necessarily about the pain, but more about an instinctive fear of invasive medical procedures, and it can even be occasionally dangerous. Not watching, and having your head lower to maintain blood flow to the brain can help avoid an episode.</description>
		<content:encoded><![CDATA[<p>daedalus2u- The probable reason that they don&#8217;t like you to watch while they insert the needle,is that they are wary about subjects that might have a vasovagal  syncope (fainting) episode due to needle phobia. This can affect something like 10% of people, and is more likely if you are watching the procedure. It is  not necessarily about the pain, but more about an instinctive fear of invasive medical procedures, and it can even be occasionally dangerous. Not watching, and having your head lower to maintain blood flow to the brain can help avoid an episode.</p>
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		<title>By: SARA</title>
		<link>http://theness.com/neurologicablog/index.php/i-dont-feel-your-pain/comment-page-1/#comment-20782</link>
		<dc:creator>SARA</dc:creator>
		<pubDate>Wed, 12 May 2010 22:05:01 +0000</pubDate>
		<guid isPermaLink="false">http://www.theness.com/neurologicablog/?p=1939#comment-20782</guid>
		<description>To me there are implications in this study confirming what was already intuitively known = that humans can control their emotional responses.  Apparently in this case by forcing repetitive confrontation with the trigger.  

Does it not suggest that this should work in other cases of excessive emotional response such as phobias?  

But I think those types of &quot;confrontation&quot; treatments are not always successful.  I wonder why.</description>
		<content:encoded><![CDATA[<p>To me there are implications in this study confirming what was already intuitively known = that humans can control their emotional responses.  Apparently in this case by forcing repetitive confrontation with the trigger.  </p>
<p>Does it not suggest that this should work in other cases of excessive emotional response such as phobias?  </p>
<p>But I think those types of &#8220;confrontation&#8221; treatments are not always successful.  I wonder why.</p>
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