When Good Feels Like Bad: Empathy Intolerance Due to Trauma

By Dr Alan Bowman, Clinical Psychologist & Clinical Director, Trust Psychology Ltd.

Content advice: This blog post touches on themes of trauma and abuse

Empathy and the Therapeutic Relationship

Whilst the range of psychological therapies available now outnumbers the days in a year, most will emphasise the importance of the therapeutic relationship in one way or another. Therapy is often sensitive and challenging, and without a sturdy, trusting, and supportive connection between client and therapist, any attempts at therapeutic growth may be limited.

To cultivate a good therapeutic relationship, psychologists and other therapists (e.g., counsellors) are trained to listen to their clients attentively, ask thoughtful questions, and ultimately, express empathy towards them. Empathy is, in essence, the ability to take the perspective of the other, to understand what they are thinking and feeling, and appreciate how they see things from their point of view.

Empathy is a wonderful thing. It connects people, making them feel heard, seen, and understood. If we are drowning in a sea of fear, sadness, and loneliness, empathy can be a life raft that pulls us out of the depths and onto the calmer shores of dry land.

Why Does Empathy Feel Revolting for Some People?

Upon qualifying as a psychologist, I left my professional doctorate equipped with a mind full of theories and practices, a stable framework for interacting with people in distress, and a keenness to roll up my sleeves and get on with the work of helping people.

Regularly, I would see in practice the importance of the therapeutic relationship, and the role of empathy was clear. If I could sincerely express an attuned and accurate understanding of my client’s distress, this would pave the way for change and progress to unfold.

But every so often, this did not work. In fact, some individuals responded in the opposite way to what I expected when trying to build a therapeutic relationship, and the work would get stuck. When empathy showed up, the client would recoil, grimace, or look down at the floor. It was as if empathy was a radioactive substance that I had just pulled out of my bag. In those moments, expressing empathy felt awkward and prohibited.

As my knowledge and skills in working with trauma developed over time, I realised that this pattern of interaction speaks to some of the core difficulties that some clients carry with them due to complex, frightening, and isolating experiences of a life lived with trauma.

For some individuals who have endured traumatic experiences, empathy does not (at least initially) feel soothing and connecting. It can feel revolting, terrifying, and unwanted. Here is why:

1. Empathy requires vulnerability: To be properly understood by another person is quite a vulnerable act. It involves someone seeing past our defences, peering through the “masks” we may put on when we are with others. Having our emotions understood by another means that emotions we may rather not experience come to the surface. When we are not used to this, it can feel like too much.
2. Expressions of empathy can trigger trauma: If an individual has had (or is still having) experiences of interpersonal trauma (e.g., being harmed by another person), then expressions of empathy can inadvertently re-trigger some traumatic experiences. For example, an abuser may have used pseudo-empathic behaviour to control and manipulate others. In such cases, even genuine expressions of empathy from safe people are experienced as terrifying and may plunge us into survival mode.
3. If our trust has been violated, empathy can make us suspicious: Traumatic experiences often involve betrayal, such as being harmed by people who were supposed to keep us safe or being ignored by those who were supposed to nurture us. Such experiences can erode our sense of trust in others. Not trusting becomes a baseline survival strategy. Even well-intentioned empathic expressions can be met with suspicion and withdrawal.
4. We may feel unworthy of empathy: After living through major trauma, abuse, or neglect, we can develop a significant sense of shame. Guilt is related to behaviour – “I have done something bad,” whereas shame is related to the self – “I am bad.” When surrounded by unsafe, unpredictable, and even dangerous others, our sense of who we are can break down, producing shame and making us feel unworthy of empathy.
5. Numbness may block empathy: Significant trauma can lead to dissociative survival reactions, such as depersonalisation (feeling disconnected from oneself, out of body) or derealisation (feeling disconnected from the world, dream-like or fuzzy). These processes are common in the face of severe trauma, designed to take us “offline” so that we can survive the un-survivable. Whilst vital in the face of danger, when we are out of harm’s way, being in a continued state of dissociation can disconnect us from others and make it very hard to accept empathy.
6. We may perceive empathy as having “strings attached”: In abusive relationships, pseudo-empathic treatment may have been used as a form of currency – “I will listen to you and take care of you if you do XYZ.” If this has been our experience, we may mistake genuine empathy as dangerous, expecting a “cost” for kind treatment, and therefore reject it.

How to Move Towards Greater Tolerance of Empathy

It’s clear that for some people, empathy is not the safe, warm, nice thing that many people automatically assume it is. Due to complex, frightening, traumatic experiences, empathy can become something that feels unsafe and not okay to receive.

This is somewhat of a paradox, because sometimes the people most in need of sincere empathy are those who are the most afraid of it. So how do we break this paradox? Whilst there is no “one size fits all” approach, the following ideas can give us some starting points to think about:

1. Recognise this pattern as a survival response: Finding empathy hard to tolerate is not a reflection of who you are, your strength of character, or how “good” or “bad” you are. In the face of traumatic and unpredictable experiences, being suspicious of empathy can be protective, fulfilling an important survival function. While we may feel confused or judgmental towards our reactions to empathy, we need to remember why these patterns exist – they are attempts by our incredible nervous system to keep us safe and alive.

2. Do not write-off empathy: Developing an intolerance of empathy does not mean it is out of reach. In fact, empathy is one of the ingredients to help move through trauma and thrive. Working on growing empathy tolerance is important and may set the scene for your growth goals, self-reflection, or personal therapy. You are not doomed to a life without empathy.

3. The importance of safe relationships: If we struggle to tolerate empathy due to lack of trust, working on our ability to trust others can be very useful. Having connections with safe, sincere, kind people provides opportunities to experience empathy without strings attached. This may take the form of a friend, family member, or a psychologist/therapist. You can read more about developing mindful, considered trust of others, in my previous blog post.

4. Start low, go slow: Like anything initially frightening or uncomfortable, if we want to develop a tolerance for empathy, we need to practice experiencing it in small, manageable steps so that we can get used to it over time. Depending on how tricky we find empathy, we might need to start very small (e.g., a single empathic comment from a therapist) and go very slowly to maintain a strong sense of safety. Over time, tolerance will grow, and empathy may start to feel less revolting and even pleasant.

5. Remember why you are doing this: When tackling something challenging that brings up unpleasant thoughts, feelings, or memories, it is important to have a reason for doing it (other than because a man in a blog once suggested it might be helpful!). Empathy connects people and is an antidote to loneliness. It can help to melt away shame, and make us feel safe, understood, and connected to others in beautiful ways. Before you embark on any work to improve your empathy tolerance, ask yourself, “If I were better able to let empathy into my life, what would be different, and why is this worth my effort?”

6. Building skills: As we practice receiving empathy, difficult thoughts and feelings may arise, as well as long-held beliefs about what empathy means. Our inner “protectors” may put defensive walls up to try and keep us stay safe from the trauma that has come before. Growing our skills to manage these challenges helps us respond to automatic thoughts, beliefs, emotions, and bodily reactions in a healthy and flexible way that can help us move closer to letting empathy into our life. This is a common focus of psychological therapy for many individuals.

7. We are what we make: If we have had a hand in producing something, we are better at doing it. You may have heard the phrase “the best way to learn something, is to teach it”. We can borrow this logic for expanding our tolerance for empathy. Practising giving empathy to others by trying to understand their perspective helps train our “empathy muscles,” making it less alien when we are on the receiving end.

8. Working on trauma: Despite our best efforts, trauma can keep our terror, suspicion, and doubt alive. Trauma is not a very good timekeeper (the past still feels like the present) and so sends us messages that we are still in danger, even if we are not. It does this by reminding us of what has happened to us (e.g., via flashbacks or intrusive memories), keeps us on edge (so we are ready for action all of the time and can’t relax), and shapes the perspective we see the world through (“it’s not safe out there, trust no one”). All these things can make growing a tolerance for empathy a real challenge. If this applies to you, consider whether trauma-focussed therapy (such as Eye Movement Desensitisation and Reprocessing – EMDR) is something to take up. These therapies are geared towards processing traumatic experiences so that they are stored in a more organised, less distressing way in the mind. A good psychologist/therapist with expertise in trauma will work at your pace to help you navigate trauma and develop your tolerance for empathy in a gradual, sensitive way.

You Are Not Alone

I have worked with many people who experience intolerance of empathy for some, or all of the reasons explored above. Nearly every single one of them at some point felt they were the only person on earth who experienced empathy as revolting and intolerable, leaving them to wonder, “Am I broken?” Rest assured, you are not broken, and you are not alone. Having a low empathy tolerance often tells a story about the kind of life we have had leading up to this moment. The ink is not dry, and the story can change.