Empathy embodied: An integrative literature review of the history, philosophy, psychology, clinical science, neuroscience, and phenomenology of the construct of empathy with clinical recommendations

The notion of "empathy" has had a history marked by ambiguity, discrepancy, and controversy among philosophers, psychologists, and behavioral, social, and medical scholars. Despite the conceptual ambiguity, empathy is among the most frequently mentioned humanistic dimensions of patient care and is one of the main requirements for successful therapeutic outcomes regardless of theoretical orientation;The relevant psychotherapeutic literature consists primarily of studies examining the cognitive, affective and communicative aspects of empathy. Until recently, there was clearly a deficiency of the embodied and/or physiological correlates of empathy. The early theorists of the construct proposed that the mechanism responsible for the shared feelings of empathy was afferent feedback from the body's conscious or unconscious motoric imitations of the other's posture, gesture, and expression.;In the last couple of decades there has been a renewed interest in the physiological aspects of empathy, emerging mainly from the fields of cognitive science and neuropsychology. These perspectives are somewhat reductionistic in that they consider the brain to be the substrate of the psyche and see the empathic process as a necessary processing capacity or neural network. This ignores the somatic, lived bodily experience of the empathizer.;In reconceptualizing the empathic process that includes the cognitive, affective, communicatory, physiological, and somatic dimensions of empathy---which will have implications for both practice and training---the present study will utilize an integrative literature review. This type of review not only facilitates an integration of research from diverse fields, but also addresses the need for a review, critique, and reconceptualization of the expanding, diverse knowledge base related to the concept of empathy. The review will pay particular attention to two issues, thus circumscribing the literature that is relevant: the inherent dualism of mind and body in contemporary science and psychology; and the embodied aspects of the empathic process.