Exploring the communicative dynamics of empathic learning

With much of the focus on empathy coming from the professional contexts of psychology and the medical field, this study moves the scope of empathy research towards understanding how empathic communication is experienced in the personal lives of individuals. A constructivist's approach to grounded theory is used to explore the way a group of students experienced and learned communicative empathy over the course of a semester. Using symbolic interaction as a theoretical lens, this research project centers on two aspects of empathy. First, using empathy journals as a means to access students' personal experiences, it calls attention to the communicative behaviors that the students perceived as paramount to creating an empathic interaction. Second, it highlights how the students' working models of empathy changed over the course of the semester. Drawing on message design logic, the analysis shows that at the outset of the course, the students drew on linear models of communication and a predominantly expressive design logic to conceptualize empathy. By the end of the semester, the majority of the students developed more sophisticated design logics and articulated a view of empathy that was rooted in a transactional model of communication. The limitations and implications of this research are discussed in the final chapter.

EXPLORING THE COMMUNICATIVE DYNAMICS OF EMPATHIC LEARNING by Paul Hyde Parkin A dissertation submitted to the faculty of The University of Utah in partial fulfillment of the requirements for the degree of Doctor of Philosophy Department of Communication The University of Utah December 2015Copyright © Paul Hyde Parkin 2015 All Rights Reserved ii The University of Utah Graduate School STATEMENT OF DISSERTATION APPROVAL The dissertation of Paul Hyde Parkin___________ has been approved by the following supervisory committee members: Ann Darling ___________________ , Chair _04/13/2015_ Date Approved Suhi Choi ____________________ , Member _04/13/2015_ Date Approved Norm Elliott ____________________ , Member _04/13/2015_ Date Approved Patricia Henrie-Barrus , Member _04/13/2015_ Date Approved Carolyn Hollingshead , Member _04/13/2015_ Date Approved and by Kent Ono , Chair/Dean of the Department/College/School of _____________Communication_____________ and by David B Kieda, Dean of The Graduate School iii ABSTRACT With much of the focus on empathy coming from the professional contexts of psychology and the medical field, this study moves the scope of empathy research towards understanding how empathic communication is experienced in the personal lives of individuals. A constructivist's approach to grounded theory is used to explore the way a group of students experienced and learned communicative empathy over the course of a semester. Using symbolic interaction as a theoretical lens, this research project centers on two aspects of empathy. First, using empathy journals as a means to access students' personal experiences, it calls attention to the communicative behaviors that the students perceived as paramount to creating an empathic interaction. Second, it highlights how the students' working models of empathy changed over the course of the semester. Drawing on message design logic, the analysis shows that at the outset of the course, the students drew on linear models of communication and a predominantly expressive design logic to conceptualize empathy. By the end of the semester, the majority of the students developed more sophisticated design logics and articulated a view of empathy that was rooted in a transactional model of communication. The limitations and implications of this research are discussed in the final chapter. iv TABLE OF CONTENTS ABSTRACT........................................................................................................................... iii ACKNOWLEDGEMENTS .................................................................................................. vii Chapter 1. A PERSONAL INTRODUCTION OF EMPATHIC COMMUNICATION ................... 1 An Introduction to Empathy ........................................................................................ 5 Overview of the Research Project .............................................................................. 9 2. EMPATHIC COMMUNICATION: A REVIEW OF THE LITERATURE ................. 13 Empathy Research ..................................................................................................... 14 Empathy and Education ............................................................................................. 46 Summary..................................................................................................................... 60 3. RESEARCH METHODS: USING GROUNDED THEORY TO EXPLORE EMPATHIC COMMUNICATION ....................................................................................... 63 A Constructivist Approach to Grounded Theory ..................................................... 65 Theoretical Perspective: Symbolic Interactionism .................................................. 67 Research Design ......................................................................................................... 72 Data Collection........................................................................................................... 93 Data Analysis ............................................................................................................. 95 4. THE COMMUNICATIVE DANCE OF EMPATHY ...................................................101 Turn-Points and Nexting .........................................................................................103 Empathy Codes ........................................................................................................111 Conclusions ..............................................................................................................161 5. EXPLORATIONS OF EMPATHIC LEARNING FROM A COMMUNICATIVE STANDPOINT .....................................................................................................................163 Message Design Logic .............................................................................................165 v Data Exploration and Analysis: Week 1 Definitions .............................................169 Data Exploration and Analysis: Week 15 Definitions ...........................................178 Transformative Reciprocal Communication ..........................................................184 Empathic Listening ..................................................................................................186 Contextualized Design Logic ..................................................................................190 Equifinality ...............................................................................................................195 Person-Centeredness ................................................................................................198 Valuing Narrowly Focused and Specific Person-Centered Concepts ..................199 Valuing the Personhood of Both Participants ........................................................206 Conclusions ..............................................................................................................211 6. CONCLUSIONS, CONTRIBUTIONS, AND IMPLICATIONS .................................213 Revisiting the Communicative Dance of Empathy ................................................214 Turning-Points and Nexting ....................................................................................216 Empathy Codes ........................................................................................................219 Final Thoughts About Research Question One ......................................................240 Redefining Empathic Communication ...................................................................243 Limitations and Recommendations ........................................................................253 The Transformative Power of Empathic Communication.....................................260 Appendices A. SYLLABUS OF THE COURSE USED FOR THIS STUDY .........................263 B. EXAMPLE OF OPEN CODING OF RESEARCH QUESTION ONE ..........269 C. EXAMPLE OF FOCUSED CODING OF RESEARCH QUESTION ONE .271 D. EXAMPLE OF AXIAL CODING OF RESEARCH QUESTION ONE .......272 E. FINAL LIST OF CODES FOR RESEARCH QUESTION ONE ...................273 F. EXAMPLE OF OPEN CODING FOR RESEARCH QUESTION TWO: WEEK 1 DEFINITIONS .........................................................................................274 G. EXAMPLE OF FOCUSED CODING FOR RESEARCH QUESTION TWO: WEEK 1 DEFINITIONS .........................................................................................276 H. FINAL LIST OF CODES FOR RESEARCH QUESTION TWO: WEEK 1 DEFINITIONS .........................................................................................................277 I. EXAMPLE OF OPEN CODING FOR RESEARCH QUESTION TWO: WEEK 15 DEFINITIONS ....................................................................................................278 vi J. EXAMPLE OF FOCUSED CODING FOR RESEARCH QUESTION TWO: WEEK 15 DEFINITIONS.......................................................................................280 K. FINAL LIST OF CODES FOR RESEARCH QUESTION TWO: WEEK 15 DEFINITIONS .........................................................................................................282 L. SAMPLE OF ENTRY OF MY RESEARCH/TEACHING JOURNAL .........283 M. SAMPLE OF MY ANALYTIC MEMOS ........................................................285 REFERENCES .....................................................................................................................286ACKNOWLEDGEMENTS This accomplishment is truly a team effort and I've been lucky enough to have the best team possible sustaining me through the journey. First and foremost, Jennifer, who has been my constant support throughout the many challenging times particularly these last few years. Your support, encouragement, and cake got me through many late nights when I wanted to throw my laptop through the window. You know how much you mean to me and rather than expressing it all here, I shall do it through interpretative dance at my graduation. I'd also like to thank my children for their understanding as it seemed like dad was always writing. I've probably learned more about empathy and unconditional love from you than I could have ever learned from any research project. Thank you, Robin and Clay, for your support, encouragement, and patience. We have the most incredible and uniquely positive blended family and I'm grateful to have you as friends in my life. I cannot forget the parents that have influenced my journey. First, my parents who always encouraged me to work hard and never give up. Second, I'd like to thank the Hills (who are alive with the sound of music). The greatest gift you ever gave me was your daughter but the second was your love and acceptance. Thank you for accepting me as I am and always being there for us. Finally, the Weidmers, who have graciously invested in me and shown me kindness through the years. In so many ways, this dissertation have been a joint family effort.viii I wouldn't be here if it weren't for some amazing mentors and teachers who have helped me along the way. Ann Darling, I can't imagine having a better supportive chair to take me through this journey and if I had to do it again, I'd get down on one knee with a cake in my hands and ask you to be my chair all over again. I'd also like to thank my committee members, Suhi Choi, Carolyn Hollingshead, Trish Henrie, and Norm Elliott. Without your guidance and assistance, this would not be possible. I would be remiss if I didn't thank Jennifer Peeples, Mark Williams, and Mark Stoner for putting me on a path that has led me here. You inspired me more than you realize through words and example. I would like to thank all of the students that I've had over the years, particularly those who participated in this research project. John Dewey said, "We do not learn from experience, we learn from reflecting on experience." I cannot thank you enough for giving me access into your personal lives and for your deep reflections on your empathy experiences. Your vulnerability and trust in me cannot be underscored enough and my admiration and respect for you goes beyond what I can articulate here. It is you who drive my passion for teaching every day and truth be told, more often than not, you are the teachers and I am the student. Lastly, I'd like to dedicate this labor of love to my brother, Emerson. viii 1 CHAPTER 1 A PERSONAL INTRODUCTION OF EMPATHIC COMMUNICATION I walked out of the room completely deflated. It only took 2 hours to change my emotions from excitement, relief, and confidence to those of discouragement, embarrassment, and confusion. "What just happened?" I kept asking myself. "I was so prepared. I was ready. I put in the work!" For the 6 months prior, I had spent hours a week preparing to take my comprehensive exams, eager to move past them to work on my dissertation and to put myself one step closer to graduating with my Ph.D. It had taken me years of work, intellectual and emotional blood, sweat, and tears to reach this point. I knew I wasn't the best test taker and although I had many strengths that had helped me reach this point in my academic journey, performing well under pressure was never one of them. Perhaps this is why I doubled down on my preparation to take the essays. I spent that 6 months reviewing the content and what I had learned from each of my graduate classes. I read more books and articles in those months than during any other time period of my life and I practiced writing essays on possible topics that my five committee members might ask. When the day arrived to write my first essay, I felt ready. I just needed to remember everything I had crammed into my head, connect the dots, and dig deep to put it all together on paper in a coherent and insightful manner. After a week and 2 half of writing essays, I was exhausted but even more than that, I was proud of what I had done. I thought it was pretty good, no better than that. After a small break (and some sushi) I began preparing for my defense only 2 weeks away. By the time I walked into the room holding each of my five essays, I felt excited to talk about what I had done, relief to finally be at this point, and confident that I would be able to withstand all of the questions my committee would throw at me, and perhaps even impress them in the process. Two hours later, I felt like I had been a part of a blood bath and I was the carnage. The people in the room I thought would be the most supportive and pleased with my answers weren't satisfied at all with what I had written or with my answers to their questions. I had taken a different theoretical approach in my essays than they had wanted. Only a few minutes into the defense, I became flustered, unorganized, and weakened. Superman had turned back into Clark Kent (without the glasses and much better looking). Barbara Fredrickson (2009) has conducted many studies on emotions and posits the theory that when we experience dark emotions, we get tunnel vision, which can greatly decrease our ability to think clearly and critically. In that moment she felt like a prophet. When it was over, the professors I had looked up to after years of working with them shuffled out of the room. It hurt. I hurt. They told me I needed to rewrite some of the essays (only answering new questions this time). On the way out, my committee chair tried to console me (to be honest I saw her mouth moving but nothing registered). I think she could tell as she ended the exchange by saying, "When you're ready to talk, come see me and let's talk." On the drive home, I began to question myself. Perhaps the Ph.D. thing wasn't for me. Perhaps I had hit my intellectual ceiling and needed to accept that. Perhaps I needed 3 to look for a new line of work. I heard that McDonald's was hiring. For the next few days these, and even darker thoughts came crashing over me in waves. I couldn't take it any longer and I went to see my chair. I had taken several classes from this professor, respected her knowledge, her experience and track record as a researcher and teacher. However, little did I know in that moment, she was about to teach me the greatest lesson I would receive at her hands, the one I have no doubt will last with me the longest: a lesson on the power of empathic communication. As I sat in her office with my heart in my hand, she came out from behind her desk and positioned herself closer, across from me. The look on her face was one of concern, concentration, and compassion. She asked me how I felt, letting me vocalize the melting pot, or stew, of emotions I had swirling inside of me. I surprised myself as I began talking and expressing ideas and feelings I hadn't fully processed until they came out of my mouth in that moment. She listened. Leaning forward, with a compassionate look in her eyes, I felt safe to talk honestly, openly, and vulnerably. I could tell she was there with me, in that moment. Rather than running from my pain, she had courage to lean into it and embrace my vulnerability. Periodically, she would ask me questions, probing further. I could tell she was trying to understand and I began to feel understood. When I was finished and had articulated what I felt like I needed to say, she asked me what I wanted to do. I replied, "I don't know. Maybe I need to reconsider this Ph.D. thing." Pausing, searching for what to say next, she finally responded, "Can I tell you a story about when I was sitting in your spot, facing down the comprehensive exams, anxious to move on to my dissertation?" Now I was the one listening intently. I'm not sure if the story she shared with me 4 was meant to be shared in confidence, so I will not repeat it here (or to anyone). What I will say is that as she spoke, she articulated feeling emotions similar to what I was feeling, expressing concerns similar to the ones I had, and acknowledging that she knew from her experience how hard and difficult this hurdle was. When she was finished, she told me she would support whatever decision I made, although she encouraged me to not let discouragement or fear keep me from continuing to try. With encouragement and kindness in her voice, she expressed her confidence in me, telling me she knew I could do it, that she had no doubt I was intellectually capable of moving forward and getting a Ph.D. Her words were reassuring and provided me with a flicker of hope and restoring some confidence in myself. Honestly, even without her words, the feeling I got from being with her in that moment was hard to describe. Her very presence, her body, her face, her sincerity, in many ways spoke louder than her words. This time I asked her some questions, probing for more answers, clarity, and reassurance. Our dialogue created something uniquely "ours" in that space, something that could not have been created had I been speaking with any other person at that time. I'm not sure how long we spoke, it might have been 15 minutes or it might have been 2 hours. All I know is that when I walked out of her office, I felt something that is hard to describe. Something had happened between us during our time together. An authentic and intimate connection was formed and I was confident she experienced it too. In an almost magical way, I had entered her office, lost, confused, hurt, carrying a bag full of emotions that felt almost too heavy to carry, but when our talk was over, I walked out of her office feeling nourished. The cluster of dark emotions I brought with me had somehow been transformed into a larger cluster of light ones. Sure I still had my bag, it 5 just wasn't so heavy anymore and I felt a new sense of confidence and hope that I would eventually be able to drop the bag and move forward with greater determination than ever before. As I drove home this time, I asked myself the same question I had asked just days earlier, "What just happened?" The answer came - empathy. An Introduction to Empathy People enjoy rich emotional lives colored by ups and downs, sweeping highs and abject lows. The situations and circumstances that give rise to these moments are both unique to each individual and yet patterned and universal to the life cycles of the human condition. However, when life throws something at us that is thick and heavy, producing a conglomeration of dark emotions, these can often be critical moments in our lives, leaving us with decisions that have real consequences. What's more, such moments are generally not only ours to bear but have a ripple effect that influence other relationships in our lives for good or for bad. The experience I just described was one of those moments in my life. It was a turning point, where I had to decide what to do with my future, all while being submerged in a bevy of strong emotions. But emotions are not the enemy; indeed, they serve a powerful purpose in our lives. As Planalp (1999), one of the prominent scholars on emotion, has stated, "feelings are not so much a sign of trouble as a way of keeping up the pressure to understand an emotionally charged experience and reconcile it with other beliefs about the world and ways of living" (p. 5). Thus, emotions are often invitations to reconstruct and realign our experiences with our values, and guide us toward deeper levels or understanding or toward taking positive actions. The key then, becomes sifting through these emotions to find the meaning and the course of action that 6 propels us in a constructive direction. Ultimately, it was empathy that helped me through the dark tunnel that I found myself in following my comprehensive exams, it was empathy that provided some light and clarity, and it was empathy that kept me pursuing the goal I set for myself years before. My experience is not unique. Anyone who has experienced empathy within a relationship knows how meaningful and important it can be during challenging or difficult times. It is a visceral experience that can often be difficult to describe but its production can also be unmistakably powerful. The power of empathy does not only manifest itself when major crises arrive, but rather its subtle presence often goes unnoticed as it connects us to those around us and to the human race in general. In his landmark book, Jeremy Rifkin (2009) draws on a vast amount of research to demonstrate how our growing knowledge of empathy has slowly begun to change our understanding of the human narrative. He points out that throughout history, philosophers, scientists, psychologists, historians, and theologians have often characterized mankind has being carnal, selfish, compulsive creatures motivated by greed and self-interest. The likes of Darwin and Freud have had a profound influence on the academic community, positing that humans are by nature driven by primal urges and will often act in egocentric ways at the expense of other humans. Looking at history, and the wars and violence enacted by people and groups, it is easy to see how some could arrive at these conclusions. However, Rifkin goes on to point out that there is another interpretation of the human narrative, one that is now being augmented by neuroscience. This new narrative posits that as a species, our baser instincts have not ruled the day but rather it is our ability to empathically work with each other that has created the nations we see and the continued striving for peace in the world. We have not destroyed each 7 other but over time, the world has become more communal as we have learned and continue to learn how to co-exist and help each other. In the last 2 decades, scientists have discovered that our brains have mirror neurons that literally wire us to care about the state of those around us (Braten & Trevarthen, 2007). In essence, we are programed from birth to care about each other in an empathic way and when we cultivate this side of our natures, we engage with others in prosocial ways and strengthen our relationships and our communities. Thus, empathy serves multiple functions. As I learned while talking to my graduate advisor, empathy has the power to transform our difficult and emotional experiences towards positive ends, and empathy also has the power to connect us to others in ways that foster productive action that works to improve our collective well-being. Based on this growing body of research, scholars and practitioners have argued that there is a great need to aggressively pursue a deeper understanding of empathy, particularly how it is learned and taught so that relationships and society can reap the benefits of cultivating its power. From helping marriages and families, to helping communities and countries, the need for empathy education and empathy nurturing is immanent. Intercultural scholar Carolyn Calloway-Thomas (2010) has emphasized this point by arguing that, "Empathy is the moral glue that holds civil society together; unless humans have robust habits of mind and reciprocal behaviors that lead to empathy, society as we know it will crumble" (p. 7). Furthermore, psychologists and researchers Miller and Striver (1997) advocate for embracing empathy in these terms: The phenomenon of empathy is basic to all our relationships. Either we deal with the feelings that are inevitability present in our interactions by turning to each other, or we turn away. If we turn away from others without conveying recognition of the existences of their feelings, we inevitably leave the other 8 person diminished in some degree. We also are inevitably turning away from engaging fully with our own experience, dealing with it in a less than optimal way - that is, in isolation. (as cited in Brown, 2007, p. 57) However, while the importance of empathy has been substantiated in many ways and its import is no longer in question, there is still considerable debate on how empathy should be defined, researched and taught. The following chapter will highlight several of the key issues and dynamics related to this debate. Consequently, at this point, it is necessary to say that my research project is meant to engage in this debate. In particular, I set out to participate in the conversation from a communicative perspective. As Preston and de Waal (2002) have noted, "Much of the empathy literature focuses on whether empathy is an emotional or cognitive process and distinguishes empathy from emotional contagion, sympathy, and perspective taking" (p. 2). This focus has only become more entrenched in the last decade as scientists have furthered our understanding of mirror neurons and the role they play in the production of cognitive and affective empathy. As a result of this debate, there is one aspect of empathy that has been left understudied and largely underappreciated, and that is the role that communication plays in the creation of empathy. As a connective force, empathy is more than an internal phenomenon, it is also a communicative one. Some scholars have recognized this, positing that "empathy exists where the journeys of two unique individuals converge. Empathy exists where realities meet, serves as a guide to the truth of the other person, and furnishes insight and understanding to where one's reality ends and the other's begins (Ciaramicoli & Ketcham, 2000)" (in Hickson & Beck, 2008, p. 378). It is this communicative convergent aspect of empathy that propelled both my desire and direction as a researcher. Thus, when I was contemplating what I wanted to do for my dissertation, I knew 9 two things were important. First, I wanted to do something meaningful that would make a contribution to the academic community and its understanding of relationships and communication. Second, I knew that I wanted my research to be such that I could use it to help people improve their personal lives and their relationships. With these as my guiding concerns, I asked myself this question: If I want to help people in a meaningful way, what is one thing that has made a significant difference in my life? The more I considered this question, the more moments of empathic connection surfaced out of my memory. As I reflected on these moments, I realized that without them, I most likely would not be where I am today, doing what I am doing. Truly, it has been the people in my life who have gotten down in the dirt with me, each time I tripped on an obstacle (either of my own doing or because of things that were beyond my control), and co-created deep and meaning empathic conversations or empathic relationships with me that have made a major difference in my life. Based on this realization, I knew I wanted to study empathy, and this is how I chose to do it. Overview of the Research Project In what follows, I provide a brief preview of this project and outline the structure and focus of each chapter. As noted above, Chapter 2 will provide an in-depth review of the current state of empathy research, particularly as it relates to empathy and communication. In addition, this chapter will make explicit the body of research that serves as the backing for my project, namely the way empathy is both taught and learned. Drawing on these bodies of research, the argument will be formed that there is still a great need to study empathy from a communicative perspective. This argument will focus 10 on exploring the way a group of students experienced communicative empathy in their personal lives, moving the scope of inquiry outside of the professional contexts of psychology and the medical field which have dominated the research on empathic communication. Furthermore, given the need to develop a greater understanding of empathic communication and how it can be learned and taught, the argument will be made that there is merit in conducting research on how communication instruction can longitudinal shape the way a group of students understand empathy. Based on the review of this literature, Chapter 3 will delineate the way in which the study was conducted and explain the epistemological and methodological approaches that guided the study. Adopting the perspective that meanings are socially constructed in and through interaction, I chose to use a constructivist approach to grounded theory to explore the empathic experiences and understanding of a group of students. In order to do this, I designed an upper division communication course that provided the students with a variety of readings on communication and empathy and afforded them various experiential learning activities both in and out of the classroom. Over the course of the semester, the students journaled about their experiences and wrote about their changing understanding of empathic communication. At the end of the semester, the majority of the students signed consent forms and allowed me to use their experiential empathy journals as data for my study. The depth and breadth of the journals was beyond the scope of one study, even one as large and rigorous as a dissertation, thus, I focused narrowly on a two elements of the journals and qualitatively analyzed their contents for insight and meaning. Chapter 4 and Chapter 5 provide the analysis of these portions of the journals. 11 Using symbolic interactionism as a theoretical lens, the research question that guided the analysis presented in Chapter 4 was: What are the communicative behaviors and patterns that facilitate feelings of empathy in the lived experiences of a group of students? Based on this, the students journaled about an empathic experience they participated in where they felt empathy from the person they were with. Specifically, they focused on making explicit the communication actions and words of their empathy partner, describing in detail what they did or said that helped them feel empathy with this person. Thus, this chapter highlights the various communicative actions and expressions that the journal keepers identified and codifies the significance of their role in producing empathy. Chapter 5 moves beyond analyzing the experiential journal entries of the students and instead focuses on identifying the specific ways the students' understanding of empathy and empathic communication changed over the course of the semester. Specifically, this chapter will answer the research question: In what way can empathy instruction shape students' understanding of empathic processes from a communication standpoint? To explore this process, the students wrote out their initial connotative understanding of empathy on the first day of class. After 15 weeks of instruction, experiential learning, and journaling, the students once again were asked to write out their personal definitions of empathy on the last day of the semester. These two data sets were then analyzed from a communicative perspective, exploring the way their working models of communication changed their understanding of the empathy process. After providing the analysis of the researcher questions, Chapter 6 details the way in which the insights generated by my study either extend our current understanding of empathy or enlarge the collective discourse surrounding it. Specifically, this chapter will 12 connect back to the literature reviewed in the Chapter 2, by focusing on the ways in which my research moves the academic focus toward developing a greater appreciation and understanding of the role that communication plays in the production of empathy. This chapter will conclude by outlining the limitations of the study and by making suggestions for further research. Hence, I will now turn my attention to the providing a review of the relevant research that grounds this project. 13 CHAPTER 2 EMPATHIC COMMUNICATION: A REVIEW OF THE LITERATURE The intent of this project is to add to the collective body of research on empathy. This is an exciting time for empathy research, as the last few decades have seen an increased interest in the topic from scholars in a variety of fields. As this review of the empathy literature will highlight, the vast majority of empathy research situates empathy as either a cognitive or affective phenomenon. Broadly stated, my purpose is to join the growing number of scholars who are inviting the academic community to consider that empathy is also, at a very foundational level, a communicative phenomenon. Based on this, my research project is designed to highlight the importance of understanding the way communication processes create empathy. In addition, the scope of the study is meant to provide insight into the way empathy is both taught and learned by individuals, from a communicative standpoint. To highlight the need for this research, the following literature review will do the following things. First, it will broadly delineate how the concept of empathy has become a serious line of research in a variety of fields. This overview of empathy research will demonstrate that scholars still struggle to define empathy and situate its role in the social world. Following this, I will review the research on empathy that account for its communicative dynamics, specifically how verbal and 14 nonverbal communication work to create it in interpersonal interactions. I will also show that there is a need in the research on empathic communication to explore it as a collaborative activity that gets co-created through transactional process of communication. Lastly, because my project was developed as a way to provide insight into how empathy can be learned by students, the final sections of the chapter will review the literature in empathy education, particularly through the lens of student development and experiential learning. The chapter will conclude by providing the two research questions that guided this study. Empathy Research The concept of empathy dates as far back as the Jin Dynasty in China, when the Confucian Mencius posited that mankind had an innate sense of compassion towards the suffering of others (De Waal, 2009). For the next two millennia, philosophers, scholars, theologians, poets, and thinkers spoke to the concept of empathy often couching it in the language of compassion (Nowak, 2011). Interestingly, it wasn't until the first part of 20th century that the English word "empathy" first appeared when American psychologist Edward Titchener (1909) translated the word "einfühlung" from Lipps (1903), a German psychologist, who used the term to describe the process that an artist or a writer goes through when they imaginatively project themselves into one of their subjects whether that be a person or an inanimate object. The word then began to be used to describe the process a consumer of art or literature goes through as they attempt to understand the thoughts and feelings of the artist or author, a concept that was later termed "aesthetic empathy" (Wispe, 1968). From this beginning, the concept of empathy has been used to 15 describe many phenomena related to one person attempting to understand or identify with someone else's thoughts and feelings. Consequently, after a century of use, the meaning and use of the word has expanded in both its application and conceptual framework. What follows is a summary of those branches of research. After the term empathy had been introduced into academic circles, it was briefly adopted by sociologists. However, it quickly fell out of favor because of the hermeneutic influence in that field, which believed that understanding is always mediated by culture and no singular perspective could provide definitive knowledge of a thing or person (Morrison, 1988). Following this brief flash of empathic attention, the vast majority of research about empathy prior to the 1980s came from the field of psychology. Carl Rogers, in particular, gave the word prominence in his developmental writings about "client-centered" therapy dating back to the 1950s (Raskin, 2001). This approach to therapy focused on having "unconditional positive regard" towards clients, a concept Rogers' defined as "to value the person, irrespective of the differential values which one might put on his specific behaviors" (Rogers, 1957, p. 208). In addition, Rogers believed that a therapist would have more influence to help a client if they were able to break down the power differential and communicate in a way that made the client feel that their feelings and thoughts were understood by the therapist. Within the framework of this concept, empathy was central in both listening and responding to clients. Rogers' client-centered therapy generated a great deal of attention in the field of psychology and propelled the concept of empathy forward. Marshal Rosenberg and Charles Truax, two research assistants of Rogers, have demonstrated this in their own work. Truax extended Rogers' perspective of empathy by positing that empathy was 16 more than just an attitudinal mindset that a therapist could have when working with clients, but rather, he argued that empathy was a set of communicative skills that could be taught and learned (Truax & Carkuff, 1967). While Rogers was uncomfortable reducing empathy to a set of responsive reactions (this felt too mechanistic for him), he agreed that communication was paramount to empathic interactions between a therapist and a client, thus he asserted that having an empathic perspective would bring empathic communication skill (Rogers, 1980). This exchange between Truax and Rogers helped shape the empathy construct as having both cognitive and skill components. Rosenberg (2003) picked up on this and created an empathic approach to resolving conflicts and working through disputes peacefully, an approach he named "nonviolent communication." His approach centers on teaching individuals to cognitively identify their emotions and then skillfully manage those with empathy for one's self and others. As the concept of empathy became more prominent in psychology, other fields began to study it in various ways and in the last 3 decades there has been a considerable amount of research done in fields such as medicine, social work, family studies, child development, neuroscience, philosophy, education, psychology, and communication (Arnett & Nakagawa, 1983; Broome, 1991; Cliffordson, 2002; Gallese, 2003; Lamm, Batson, & Decety, 2007; Stephan & Finlay, 1999; Stewart, 1983). In an attempt to codify this vast body of research, Miaskiewicz and Monarchi (2008) conducted an extensive literature review on empathy from 40 of the top journals in the fields of medicine, education, social work, and psychology. Using Information System software to search the digital collection of each of the 40 journals, more than 1700 peer reviewed journal articles on empathy were identified in a cluster analysis. The results of this extensive 17 investigation produced six themes (i.e., clusters) that were the most prominent in empathy research. These thematic clusters are as follows: Cluster 1. (effect, response, relationships): Research about how empathy is related to factors and/or constructs, and how other factors and/or constructs affect empathy. Cluster 2. (man, woman, gender): Research about measuring and distinguishing between empathy in men and women in a certain setting. Cluster 3. (child, behavior, measure): Research about the relationship between levels of empathy and social behavior. In particular, research describing the negative behavioral aspects of a lack of empathy such as child abuse, aggressiveness, and lack of moral reasoning. Cluster 4. (program, skill, group): Research about programs that train a particular group of individuals (e.g., social workers) to develop more empathy or train the group of individuals on the importance of empathy. Cluster 5. (concept, process, understanding): Research about the understanding of the concept of empathy, empathy's dimensions, and the process involved in exhibiting empathy towards others. Cluster 6. (rating, measure, scale): Research about developing, validating, and applying scales that measure empathy. The cluster analysis used in Miaskiewicz and Monarchi (2008) highlights the wide range of meanings and applications the concept of empathy has achieved within the academic community. In fact, Batson (2009), after conducting his own review of the literature on empathy, argued that there are at least eight empathy-related concepts that make up the differing definitions of empathy and that need to be better distinguished in 18 empathy research. These eight concepts are: knowing another's internal state, assuming the posture of another, coming to feel as another person feels, projecting oneself into another's situation, imagining how another is feeling, imagining how one would think and feel in the other's place, being upset by another person's suffering, and feeling for another who is suffering (Batson, 2009). In addition to Batson's (2009) invitation for perspicuity in defining empathy, Decety and Jackson (2004) conducted a review of much of the literature on empathy and concluded that three separate skills sit at the core of empathy: the ability to share the other person's feelings, the cognitive ability to intuit what another person is feeling, and a socially beneficial intention to respond compassionately to that person's distress. Looking at both Batson's (2009) list of eight empathy-related concepts and Decety and Jackson's (2004) three empathy skills, it becomes clear that empathy seems to have both psychological and skill based components. However, moving beyond how researchers have appropriated the concept of empathy in their research, to how scholars have actually defined the term, reveals additional layers of empathic meaning and conceptual tensions. Empathy Definition Empathy is a difficult concept to define. This is largely because of the incredibly broad application that scholars from a variety of fields have given it over the last several decades. It has been noted that researchers have defined empathy as an ability, an attitude, a feeling, an interpersonal process, a trait, a state, a sensitivity, and a perceptiveness (Sutherland, 1993). Perhaps one of the reasons for this stems from the 19 way empathy is often confused or conflated with many other concepts that have similar connotations, concepts such as perspective-taking, sympathy, emotional contagion, affective resonance, empathic accuracy, and compassion (Bates & Samp, 2011; Batson, Fultz, & Schoenrade, 1987; Eisenberg, 2002; Preston & Hofelich, 2012; White, 1997). There is a divide amongst empathy scholars on where to draw the boundaries between these and other related concepts in relation to phenomena we have come to identify as empathy. To complicate matters further, the concept of empathy continues to morph with advances in both the hard and soft sciences. Even 20 years ago, concepts such as "online-empathy" and "mirror neurons" did not exist (Hollan, 2012; Preece, 2004). Thus, as the world changes, so does our understanding of empathy and its important application in the social world. But, more importantly, as this literature review will show, it can be argued that the strongest need we have as an academic community is to develop a greater understanding of how empathy actually occurs, as a communicative process. It is to this end that this project has been conducted. The purpose of this project is to add to the expanding discourse on empathy by providing a new invitation to consider empathy production from a communicative perspective. To frame the way this project will add to the collective discussion on empathy, it is necessary to understand the empathy definition landscape. One of the primary features of this landscape centers on the way scholars interested in empathy have aligned themselves into camps distinguished by the differing conceptualizations of empathy to which they cling. Some of these researchers adopt a narrow view of empathy (Hoffman, 2000; Ickes, 1993; Schafer, 1959; Wispe, 1986). Ignatieff (1999) provides one such definition in which empathy is conceptualized as "the human capability of imagining the 20 pain and degradation done to other human beings as if it were our own" (p. 313). Other scholars posit that empathy is best understood in a broad sense that encompasses many other concepts (Arnold, 2003; Eslinger, 1998; Goleman, 2006; Preston & de Waal, 2002). For example, Baron-Cohen (2003) argues that "empathy is about spontaneously and naturally tuning into the other person's thoughts and feelings, whatever these might be" (p. 21). The differences in these positions are vast, leaving room for multiple conceptualizations and applications of the term empathy. Consequently, the crux of these debates often stem from scholars who see empathy as a cognitive function versus those who view empathy as an emotive process. This debate has only intensified in recent years based on advances in science and new theorizing in sociology and anthropology. Over the last decade, social cognitive neuroscience has shown that there are two distinct empathic functions in the brain, one cognitive and the other affective. While there is a link between the two empathic systems by the ventromedial prefrontal cortex, the operational function of each has caused some to invite the academic community to consider adopting two different notions of empathy, rather than conflating them both into one (Englen & Rottger-Rossler, 2012). Those who subscribe to the cognitive side of empathy most commonly define empathy as the mental activity of perspective taking or imagining the life of the other (Kohn, 1990). This requires the capacity for "positional thinking" where one can visualize the viewpoint of someone else (Nussbaum, 2010). Consequently, on the other side of the spectrum are those who believe empathy is primarily an emotional process, one that is produced when a person identifies with the experiences of another on an emotional level, often adopting the emotions of the other (Slote, 2009). Of course, many researchers have attempted to breach the two binaries by 21 advocating for definitions that make room for both. For example, Deitch Feshbach (1987) defines empathy as "a shared emotional response that is contingent upon cognitive factors" (p. 271) and Toranzo (1996) views it as "A multidimensional construct that involves the dynamic interplay of perception, social cognition, and affect" (p. 107). As was stated earlier, this dichotomy has been further heightened with increasing publications that invite those in the academic community to reconsider the role of nature verse nurture, as it relates to empathy. Historically, many in the academic community have operated from the assumption that human beings are hard-wired with aggressive, competitive, self-serving impulses (Freud, 1958). The works of Charles Darwin and Adam Smith, an evolutionist and economist, respectively, advanced this belief by positing that in order to survive and thrive, humans were motivated to act out of self-interest and consume or destroy competition to resources. However, developments in biological, neurological, and socio-psychological research have begun to redraft the human narrative. Two seminal works on this topic have recently been published by Frans de Waal, a renowned French primatologist and ethologist, and Jeremy Rifkin, a distinguished American social theorist and economist. In de Waal's book, The Age of Empathy (2009), he uses decades of research studying animals to draw the conclusion that it is through empathic behaviors such as sharing, herding, and communal protection that animals survive and adapt to their environment. Rifkin's book, The Empathic Civilization (2010), furthers this argument by noting that throughout history, societies have survived and thrived in much the same way. "A radical new view of human nature has been slowly emerging," writes Rifkin, "with revolutionary implications for the way we understand and organize our economic, social, 22 and environmental relations… We have discovered Homo empathicus" (p. 43). This emerging view that Rifkin refers to, i.e., that empathy sits at the very fiber or our human nature, is a belief that is augmented by research on human development. Early developmental theorists perpetuated the idea that young children were too egocentric or cognitively incapable of experiencing empathy (Freud 1958; Piaget 1965). Since then, this theorizing has been debunked as many studies have demonstrated that even young children are capable of behaviors that show a degree of empathic sophistication (Zahn-Waxler et al., 1992). Martin Hoffman (2000), a developmental psychologist, advocates that empathy development happens in stages, coterminous with the maturity process of an individual. The first stage he identifies as "mimicry" and manifests itself when a child responds to the distress of another child. It has been noted that this process often happens between 18 to 72 hours following birth, a process labeled reflexive crying or rudimentary empathic distress (Braten & Trevarthen, 2007; Martin & Clark, 1982). The second stage is "classical conditioning" and this happens when a child recognizes that other people experience emotional moments similar to their own emotional moments. This generally develops when a child becomes a toddler and often will compel a child to engage in helping and prosocial behaviors, such as hugs or verbalizations of concern (Zahn-Waxler et al., 1992). The next stage is "direct association" which involves a child's ability to view someone having an emotional experience and then recall a time when they had a similar experience, thus helping them take the perspective of the other. As a child matures they move into Hoffman's (2000) fourth and fifth stages of empathy development. The fourth stage, "mediated association," is when a child shows 23 the ability to empathically project themselves into emotional situations represented in stories or depictions, such as movies or television. The final stage has been named "perspective taking" or "role taking" and is the most sophisticated type of empathizing because it demonstrates the ability to cognitively imagine what it is like to be another person, experiencing what they are experiencing, and feeling what they are feeling. However, recent research has challenged Hoffman's stages by arguing that children can engage in a type of perspective taking much earlier than originally thought (Knafo, Zahn-Waxler, Hulle, Robinson, & Rhee, 2008). Regardless, the body of research on empathy development illustrates that it is a process that has both genetic and environmental factors (Zahn-Waxler, Robison, & Emde, 1992). Childhood has been shown to be critical to a child's empathy development because of the plasticity of their neural and synaptic connections (Verducci, 2000). When children are immersed in a culture of empathy by their caregivers, they show greater empathic capacities as teens and adults (Mikulincer et al., 2001). This realization that communicating empathically (i.e., participating in a cultural milieu) is essential to building empathy has helped researchers value the importance of the communicative components of empathy. As a result of the work in neuroscience, human development, and a new understanding of the human narrative, the academic community has been invited to reconsider their belief that empathy is an internal phenomenon. Rather, a community of scholars are advocating for updated definitions of empathy that recognize and explore the communicative and relational components of empathy, and that acknowledge that there are empathic behavior attributes that manifest the cognitive and affective workings that have become the cornerstones of empathy research. However, this community of 24 academics and clinicians still sit in the minority. Nowak (2011) conducted a recent study on empathy and compiled a list of 52 of the most notable definitions of empathy. To avoid being academically ethnocentric, she compiled the list from a diverse group of fields and authors writing from a variety of contexts. While the point of her study was not to illustrate the communication components of these definitions, engaging in such an exercise was insightful for this literature review. After looking closely at all 52 definitions, the vast majority of the models focus on empathy as either a cognitive or affective phenomenon, and as such, the only communicative elements these definitions acknowledge are those of an empathy giver interpreting the communicative messages (usually distress) of an empathy target. In fact, only 7 of the 52 definitions provide components that could even be construed as nonlinear in their communicative underpinnings, and by that I mean they acknowledge that empathy involves a "response" by one person to the situation of another. Most surprisingly, however, is the observation that there is only one definition on the list that identifies empathy as a complex communicative process that would warrant a transactional model of communication. That definition identifies empathy as "the mediation of emotional information involving systemic communicative processes operating between relational subjects" (Schertz, 2007, in Nowak, 2011, p. 16). Not surprisingly, some of the strongest advocates for updating the current definitions of empathy to include communicative aspects of it have come from contexts where expressed empathy has proven important. Thus, in order to understand the nature of empathic communicative research, it is essential to understand its birth and trajectory. It is to this topic the focus of this literature review now shifts. 25 Empathy and Communication In order to understand how my study will expand the current discourse on empathy and communication, it is important to understand the academic interest in human nature following World War II. At that time, the concept of empathy was beginning to make its way into the social sciences, particularly psychology (as was noted earlier in the literature review), as scholars saw the importance of doing research that looked specifically at the cognitive and, at times, the communicative components of empathy (Dymond, 1948). While the majority of these researchers were not communication scholars and their work didn't blatantly focus on communication, their research helped pave the way for the empathic communication research that would follow, picking up the theoretical breadcrumbs they left behind. Some of these early studies focused on empathy in terms of its importance and significance in interpersonal communication in a variety of contexts. For example, in 1946, Lowery argued that nonverbal communicative gestures have an empathic quality that allows a receiver to visually see what a speaker is feeling and experiencing. Building on the idea that empathic communication could influence people, researchers looked at the importance of empathy in leadership (Bell & Hall, 1954). One of these studies, conducted by Speroff (1953), observed the interpersonal communication breakdowns between labor and management leaders and advocated the use of communicative role-reversal strategies to increase the empathy each side had for the other, thus affording leaders with an empathic tactic to help influence their followers. Basic to these early studies was the idea that empathic communication could be used as a tool or technique to achieve clarity (Frank & Sweetland, 1962). Speroff (1953) framed it in this way, "it behooves each of us, whether 26 we are the sender or receiver of a communication, to be fully satisfied that the other person understand the meaning and intent of the communication" (p. 163). In the 1950s and 60s, the majority of the research on empathy came from the field of psychology and much of this research focused on empathy development and empathy as a cognitive state that needed to be assessed and measured in clients in order to help individuals develop healthy relationships and avoid maladaptive behavior (Bell, Hall, & Stolper, 1955; Dymond et al., 1952; Hastorf & Bender, 1952; Remmers, 1950; Worringer, 1953). However, when Carl Rogers (1957) appropriated empathy as a foundational component of his approach to therapy, his research and theorizing propelled scholars and clinicians to rethink empathy as a way of being as a therapist. This shift in empathic focus generated communicative research on interpersonal empathic messages in therapeutic contexts and beyond (Argyris, 1965; Berlo, 1966; Keefe, 1976). Suddenly, empathy was seen as a skill that could be fostered and developed to respond to the messages of others (Whiting, 1971). Psychologists were now being taught to communicate empathically when dealing with clients. Hill and Courtright (1981) summed up the communicative foci of this type of research by noting that this approach stresses that "for behavior to change individuals must perceive that they are being understood. It is not enough for a counselor to merely make understanding statements, rather these statements need to be perceived by clients as indicating understanding" (p. 215). It is clear that from this perspective, researchers were viewing empathy as a skill that psychologists could develop and use to change their clients' behaviors if they responded in a way that hit the empathic bulls eye of a client. During this same time frame, communicative empathy research moved into the 27 field of marriage and family development. Researchers began to consider the way empathy influenced the communicative aspects of intimacy (Katz, 1963; Kirkpatrick & Hobart, 1954; Shantz, 1981). Goodman and Ofshe (1968) furthered this line of research by having three sets of couples perform activities that required them to guess what their partner was thinking based on their communicative words and gestures, much like in the game Charades. The three sets of couples were divided based on their familiarity and commitment to each other, i.e., married couples, dating couples, and strangers. Based on the performance of each grouping, the researchers concluded that "the more empathic two people are vis-à-vis each other, the more short circuited their communication becomes" (Goodman & Ofshe, 1968, p. 603). This ability to use "fewer units of information" when exchanging messages and "transmitting meaning" denotes the concept of communication efficiency (Weinstein, Feldman, Goodman, & Markowitz, 1972). Based on their study, the researchers concluded that: Increasing commitment of two people to each other in courtship typically leads to increased communication between them… This intense and intimate communication ordinarily results in heightened possibilities for each to observe and understand the perspective of the other, i.e., to empathize with the other. This increase in mutual empathy leads to greater communication efficiency, since meaning can be transmitted in gestures as well as complete behavior acts and the former is more efficient than the latter. (Goodman & Ofshe, 1968, p. 603) Each of these early studies helped forge the path between empathy and communication as an area of serious research and demonstrated the value of conducting such research. However, it is interesting to note that each of these studies uses linear models of communication in talking about empathy, i.e., senders sending messages to receivers. In addition, reviews of this research have shown that the vast majority of these empathic communication studies were one dimensional studies built on quantitative 28 scales and questionnaires (Bachrach, 1975; Bylund & Makoul, 2005; Duan & Hill, 1996; Grief & Hogan, 1973; Hogan, 1969; La Monica, 1981; Lachter & Mosek, 1995; Mehrabian & Epstein, 1972; Neumann at al., 2009). After conducting a review of this research, Pedersen (2009) commented on the state of empathy research by noting that, "Qualitative approaches are rarely used and the predominant quantitative instruments have a relatively narrow or peripheral scope" (p. 307). Looking at the landscape of empathic research over the last 30 years has shown that narrow theorizing about empathy continued to dominate empathy research about communication (Nowak, 2011). Consequently, while these early empathic communication studies situated the importance of communication to empathy as an activity that is accomplished interpersonally, there were a few voices that invited empathy researchers to extend their thinking about the role that communication plays in empathy. Two of the primary ways these voices have attempted to push empathic communication research forward is to, first, explore the way specific empathic behaviors influenced individuals' subjective experiences of empathy, and second, to explore the collaborative nature of empathic communication. Each of these will be explored next. Empathy and Communication Behaviors As research about empathy expanded, it was the lived experiences and struggles born from clinical work that began to drive certain avenues of research. One such example was the need for greater understanding into identifying precise communication behaviors that created feelings of empathy in people. This line of inquiry was specifically driven by the fields of psychology, social work, and medicine (i.e., healthcare). In each of 29 these settings, research has increasingly demonstrated the benefits that come when counselors, therapists, and healthcare providers communicate empathically with clients or patients (Hall, 2009; Mast, 2007). These findings prompted a constellation of studies that sought to isolate specific behaviors that counselors and medical workers could enact to help their clients/patients feel empathy. What follows is brief summary of this line of research and some examples to highlight how it has been studied. Verbal communication. The field of psychology has a rich history of identifying types of verbal messages that have been identified as empathic in a therapeutic context. Carl Rogers (1957) is credited with being the first to advocate for a specific type of verbal communication that used empathy as a way to connect with a client's inner-world. This communicative approach was labeled "reflection of feelings" and centered on a counselor focusing on the feelings of a client and then verbally commenting on what they observed and probing to see if they correctly understood the feelings and perspective of the client. Thus, probing emotional questions and verbal messages about the emotional state of a client were identified as two types of verbal empathic communication. Similar observations have been made in the field of healthcare where much of the research done on empathy has focused on the way physicians verbally respond to patients. For example, multiple studies have identified the importance of asking questions as a form of empathy (Halpern, 2001; Norfolk, Birdi, & Walsh, 2007). These studies note that patients feel empathy when a physician is attentive to a patient's verbal or nonverbal expressions of emotion and discomfort and asks questions for clarification about how the patient is actually feeling. Unfortunately, there seems to be doubt as to how effectively physicians use this form of verbal communication. Easter and Beach (2004) found that physicians 30 missed 70% of the empathic opportunities of patient-initiated messages soliciting empathy. Other studies have shown that physicians often do not respond to any of the emotional cues they receive from patients (Butow, Brown, Cogar, Tattersall, & Dunn, 2002; Epstein & Street, 2007). In addition to noting the importance of probing questions into a patient's or client's emotional state, scholars have identified specific types of verbal statements that carry empathic weight. Anspach (1998) studied how physicians communicated medical cases to patients and found that physicians were viewed as more empathic when they used patients' names, crafted personalized rather than depersonalized messages, used an active rather than passive voice, and commented in a way that showed value for the patient's account of what they were experiencing. Wittenberg-Lyle et al. (2012) added to this type of research by analyzing video recorded sessions of biweekly web-based videoconferences between interdisciplinary hospice team members and family caregivers and acknowledged specific types of verbal messages that the team members used to show empathy to the caregivers. They identified three types of empathic messages used. The first of these came in the form of comments that showed acknowledgement for the caregivers situation, comments such as, "Well, I'm glad she is sleeping a little bit better for you" (p. 34). Another form of empathic messages came with verbal expressions that legitimized and confirmed the thoughts of the caregiver. For example, messages such as, "Bless your heart, that puts you in a real spot," and "It's not an easy decision [turning off the defibrillator], but you've got our support" (p. 34). In addition, they noted another type of verbal expression of empathy came in the form of comments that acknowledged a shared experience between the hospice team member and the family caregiver. Examples 31 of these types of comments were, "[I had a patient] just like that. Your situation is the reverse. The quality of life just isn't what it was before. I think it's a good decision" (p. 34). Out of the three types of empathic statements, shared feelings were the least prevalent and acknowledgement the most prevalent. Statements that show validation have been another focus of empathic communicative research. Validating communication has been conceptualized as communicating to an individual that their responses, either emotional or behavioral, are understandable and make sense given the current life situation (Linehan, 1993). Thus, researchers have identified that any such verbal statements that express this type of belief provide an empathic response to someone in distress (Clark, 2004; 2007). Central to this form of empathic communication is the ability of an empathy giver to recognize the emotional state of another, accurately reflect that through words, and then convey acceptance of the feelings, thoughts, or behaviors of the person in distress (Lynch, Chapman, Rosenthal, Kuo, & Linehan, 2006). Recently, a group of researchers conducted an experiment to test the empathic impact that verbal statements of validation can have in comparison to statements of reflection (Eunha & Changdai, 2013). The researchers had participants engage in a computer game that was set up to make them feel excluded from the gaming community participating in the game. Following the exercise, the participants were put into one of the three groups that helped them debrief their experience in the game. The control group debriefing simply focused on the mechanics of the game. The second group provided comments that might have reflected the player's feelings of exclusion. The third debriefing group provided comments that validated the players that not only reflected what they were feeling but acknowledged those feelings as acceptable 32 to the experience they had while playing the game. The results revealed that both the reflective and validating comments increased the participants' sense of belonging; however, the validation responses played a more significant role in increasing the participants' self-esteem and lowering "both the negative mood and aggression toward the people who excluded the participants" (p. 442). The research conducted by these scholars invites the academic community to consider that while reflective comments can show empathy, it is perhaps validating comments that carry more empathic weight. Suchman, Markakis, Beckman, and Frankel (1997), wanting to further our understanding of verbal communication behaviors and empathy, conducted a qualitative analysis of 23 video recordings and transcripts of patient-physician interactions. Their research team coded "all of the instances in which patients expressed emotions verbally and noted the nature and apparent consequences of the physicians spoken response" (p. 679). Because their goal was to identify empathic patterns of interaction, they conceptualized an empathic encounter as a communicative exchange that leaves a patient with the subjective experience of feeling known and understood. However, because they could not determine this without speaking to the patients, they developed an operationalized definition based on observable behaviors in the video, namely, "that in the presence of a verbalized emotion on the patient's part, the clinician communicates back to the patient some explicit recognition of the expressed emotion" (p. 681). Following their analysis, they noted that the patients rarely verbalized their emotions directly but rather that they offered clues or "statements about situations or concerns that might plausibly be associated with an emotion" (p. 681). These statements were identified as potential empathic opportunities that would either turn into direct empathic 33 opportunities, if the physician invited the patient to elaborate on the statement, or a missed opportunity, if the patient's statement went unacknowledged or was ignored completely by the physician. Consequently, if the physician's request for elaboration was accepted and the patient explicitly commented on their emotional life, then the physician had the opportunity to respond in an empathic way, completing the empathic exchange. The empathic responses were supportive statements by the physician that acknowledged the patient's feelings in an accurate and explicit way. The sequential empathic communicative model that was developed as a result of the study for Suchman et al. (1997) built on prior research on empathic responses by emphasizing the importance of paying attention to empathic opportunity statements, rather than looking for direct statements of emotion. Furthermore, it invites others in the helping role (in this case physicians) to pay attention to the responses they provide to those opportunities, namely, it is critical to ask people in distress to elaborate on their emotions, thus setting up the potential for an empathic exchange. Lastly, it identifies the importance of validation in empathic communication and the significance of reassuring a person in distress that it is okay to feel the way they do. Consequently, in the limitations of their study the authors acknowledge that additional research needs to account for the subjective experience of those receiving empathy as it relates to all specific communicative behaviors, not just verbal expressions. They posit that "giving names to these interactional events [and behaviors] renders them more visible, facilitating both teaching and subsequent research" (Suchman et al., 1997, p. 681). Nonverbal communication. In addition to looking at how verbal communication can generate feelings of empathy in clients and patients, researchers have also 34 investigated the importance of nonverbal behaviors on empathy. However, after surveying this literature, McHenry, Parker, Baile, and Lenzi (2012) recently noted that "nonverbal communication is less frequently addressed in the empathy literature," and they go on to point out that this is ironic because of the large body of research that has shown that nonverbal communication "is critical to understanding and conveying emotion" (p. 1073). Despite this lack of research, several studies have shown that certain communicative gestures, such as eye contact, posture, touch, vocalics, and proxemics have contributed to clients' and patients' feelings of empathy during interactions with their counselors, social workers, or physicians (Dowell & Berman, 2013; Gaushell, 1982; Graves & Robinson, 1976; Hall, 2009; Kelly, 1972; Lynch & Garrett, 2010; Shiel, 1996; Tyson & Wall, 1983; Young, 1980). The following are some examples of this type of research. McHenry et al. (2012) conducted a study that analyzed audio recordings of oncology healthcare providers talking with cancer patients. They did this by playing segments of the recordings to a group of listeners (i.e., 27 graduate students in a voice disorders class). They had each of the students classify how they interpreted the empathic qualities of the voices on the recordings. The results of the study showed that all but one of the healthcare providers reduced their speaking rate, and that a majority of them reduced their pitch when they had to give a patient bad news. As a result of their analysis, the listeners collectively interpreted that when a healthcare provider actually lowered their pitch and reduced their speaking rate they were perceived as more caring and empathic in their tone. The researchers argued that greater attention needs to be given to the importance of vocalics during empathic interactions. 35 In addition to paralanguage, researchers have acknowledged the importance of kinesics in empathy interactions. Maurer and Tindall (1983) studied the influence of nonverbal behaviors on the perception of empathy by having 80 participants meet with counselors seeking guidance. The counselors assumed two different body postures when meeting with the participants: They either mirrored the position of the participant's arms and legs or they did not. Following the session, the participants rated the level of empathy they felt from their counselors. The results showed that the counselors that enacted mirrored behaviors were rated significantly higher on an empathy scale than those that did not. The researchers posit that counselors should consider mirroring the behaviors of those sitting across from them as a way to help them feel more comfortable and to feel that they are being understood and validated. The importance of kinesics have also proven empathically valuable in healthcare. Ellinston and Buzzanell (2008) asked women who were being treated for breast cancer what communicative behaviors from their physicians helped them feel empathy. After qualitatively analyzing the narratives, the researchers found that the patients preferred doctors who used nonverbal cues such as more eye contact and facial expressions when discussing their illness. Moreover, the narratives also identified the importance of haptics, as the women expressed how empathically comforting it was to have appropriate forms of physical touch. Frank (2004) conducted a similar study, asking patients to give narratives about how they experienced or did not experience empathy from their physicians. This study also noted the importance of nonverbal communication, particularly eye contact and touch. Nonverbal and verbal messages of empathy. Examining the research on empathic behaviors, scholars have acknowledged that there is still a greater need for empathy 36 research that accounts for both the verbal and nonverbal, rather than just one or the other. Specifically, they argue that research in this way "would contribute to a more thorough understanding of the complex processes involved in the expression and perception of empathy and eventually to the enhancement of communication curricula development" (McHenry et al., 2012, p. 1077). My review of the literature confirmed those findings that indeed there is a very limited amount of research that has looked at the verbal and nonverbal behaviors of communication simultaneously. Perhaps this is because it may appear easier to separate them and to look narrowly at one or the other. However, the following examples highlight some of the attempts to conduct this type of research that examines the two behaviors together. Haase and Tepper (1972) had 26 seasoned counselors view films of 48 counselor-client dyads and rate their verbal and nonverbal behaviors based on an empathy scale. After viewing the recordings, the counselors identified both the verbal and nonverbal as important in contributing to the empathic communication being demonstrated by the therapist in the film. However, collectively they overwhelming rated the nonverbal communication as more empathic. In particular, they identified eye contact, trunk leanings, body orientation, and the distance between counselor and client as important elements of nonverbal communication. A few years later, Tepper and Haase (1978) recreated their study but added in the client's perspective. In this study, they had 15 counselors and 15 clients rate videotaped recordings of counselor-client interactions and identify their perception of the empathic communication being displayed. Similar to their first study, the researchers found that once again, the nonverbal communicative behaviors were perceived to make the most impact. However, by adding the client's perspective, the 37 researchers discovered that the majority of the clients and counselors disagreed on the strength of which communicative behaviors were the most empathic. Specifically, the clients found facial expressions and vocalics to carry a great deal of empathic weight. Together these studies supported the notion that perhaps nonverbal communication needed to receive more attention when teaching and training counselors to be more empathic. Consequently they also found that there needed to be a balance of verbal and nonverbal communication in order to achieve a more complete empathic experience. Wanting to add further insight into the communication between psychologists and their clients, Bachelor (1988) also chose to look at specific empathy behaviors by conducting research on client's perceptions of their interactions with therapists. However, rather than having the participants fill out empathy measures or scales, Bachelor opted for a qualitative approach that allowed the clients to provide narratives of their experiences. Following their therapy sessions, the clients wrote out open ended responses to questions about their interactions with their therapists, and the empathic behaviors and dynamics they perceived and experienced during the interaction. After analyzing the data, four types of communicative empathy were identified. The first is cognitive, which focused on a therapist's verbal communication, such as questions, reformulations, interpretations, and other statements that caused the client to believe that the therapist had correctly understood their perspective. The second type of empathic communication was affective. While there were some verbal features of this, clients noted that this type of empathy came primarily through nonverbal communicative behaviors that made the client feel that the therapist understood the way they felt. The third type that Bachelor identified was sharing empathy, which manifested itself verbally when a therapist shared a personal 38 experience or opinion that helped the client feel they had something in common. The final type of communicative empathy was labeled "nurturant" and involved both verbal and nonverbal behaviors that caused the clients to feel that the therapist was being supportive, security providing, and completely attentive. Ironically, the author does not delineate specific behaviors for this category. Another study that looked at the verbal and nonverbal aspects of empathic communication was conducted by Wynn and Wynn (2006). The authors conducted a qualitative analysis of 20 videotaped interactions between psychotherapists and clients to investigate the way empathy manifested itself in the actual conversation between the two conversants. The researchers analyzed the tapes and "special focus was placed on identifying sequences where empathy was an issue directly or indirectly" (Wynn & Wynn, 2006, p. 1387). Following their analysis, the researchers identified three types of communicative empathy that coincided with types found by Bachelor (1988), namely cognitive empathy, affective empathy, and sharing empathy. Cognitive empathy was coded when a "therapist directly expresses understanding of the thoughts, feelings, or behavior of the patient" followed by a confirmatory response by the patient (p. 1389). For example, the following is an exchange taken directly from their data: Patient, "I have been feeling so down." Therapist: "And you are very anxious too." Patient: "Yes." By correctly identifying and verbally acknowledging that the patient was "anxious," the therapist was able to communicatively demonstrate they understood the perspective of the patient. Affective empathy was coded by the researchers in "sequences where the therapist demonstrates that he/she partakes in the patients' feelings" and the 39 patient shows acceptance of the therapist's expressions (p. 1390). For example, when a therapist briefly touched the shoulder of a client during difficult or emotional moments during their conversation, this was interpreted as an empathic gesture by the therapist to partake in the client's feelings and comfort them. Lastly, sharing empathy, which the researchers noted as being "characterized by the patient perceiving his/her therapist as expressing that they have something in common, for instance, in the form of personal opinions or experiences" (p. 1392). The example they used in the study was of a therapist using "we" and "us" language when speaking to a client about the physiological reactions people and animals have when frightened. Making sense of their research, Wynn and Wynn (2006) offered further support for looking at empathic communication sequentially, positing that the key to understanding empathy in interaction consists of looking at three part sequences. The sequences they identified were: 1) the distressed individual initiated an empathic opportunity, 2) an empathy provider responded in an empathic way, either verbally, nonverbally, or both, and 3) then the empathic gesture is received and confirmed by the empathy receiver. Furthermore, the researchers noted that there was a range of behaviors and responses that manifested themselves during the empathic interactions. When empathy was expressed by the provider, the patient typically received the empathic expression by responding appropriately to the provider's prior utterance. The reception of the empathic utterance can involve a range of different utterances, including the answering of questions, agreeing with assertions, demonstrating understanding, and an appropriate showing of feelings (Wynn & Bergvik, 2010). Looking at the collective studies on empathy and communicative behaviors 40 reveals at least two areas that need to be addressed. First, there seems to be a discrepancy in the impact of the behaviors identified. As was highlighted above, when patients or clients are asked to provide narratives of the communicative behaviors they found most empathic in therapists or physicians, they constantly place nonverbal communication as being essential. Ironically, studies have shown that this perception is not shared by physicians and therapists. For example, in 2010, Coran, Arnold, and Arnold asked 36 physicians what communicative strategies they felt were most effective in their communication with their patients. A qualitative analysis of their open-ended responses showed they felt that verbal communication was most strongly linked to empathic communication. Looking at this mismatch, the authors conclude that: Perhaps this is the time to change the way communication has been taught and perceived in the medical field and move to a more interdisciplinary, dyad centered training approach that allows a more relational and co-constructed relationship between the physicians and their patients. (Coran et al., 2010, p. 10) Given this discrepancy in impact of verbal and nonverbal empathic communication, it is clear that more qualitative research is needed to help the academic community understand the way empathy behaviors influence empathy recipients so that more effective empathy training and development programs can be created and instituted. However, there is also a second gap that needs to be filled in this body of research. Surveying this cluster of research on the verbal and nonverbal empathic behaviors, whether they have been studied separately or together, reveals that the scope of these studies has been limited to the contexts of psychology and healthcare. As was pointed out earlier, because of the clinical interpersonal work in these fields it makes intuitive sense why they would be the most interested in understanding empathic communication in this way. However, as a result, what we know about empathy behaviors as an academic 41 community is almost exclusively limited to a sick bed or a therapist's couch. After surveying the literature on empathic communication, Wittenberg-Lyle et al. (2012) lamented: Thus far the majority of research on empathy has been based in a physician-patient context, yielding important conclusions about physician communication and patient expectations, yet little is known about empathic communication in other clinical [and nonclinical] settings. (p. 32) There is simply a glaring need for research that asks individuals to share their lived experiences of empathy and empathy behaviors beyond clinical settings. While it may be that the empathy behaviors these studies have identified are universal in nature, further research is needed in order support that assumption. Consequently, it would also not be surprising to find out that the context of the empathic experience makes a qualitative difference in the way an individual interprets and feels empathy. Based on this, my study will explore the lived experience of individuals outside of a therapeutic or healthcare setting, and while the results of my exploration are not meant to draw generalizations that transcend the small sample size used for the study, they should enlarge the narrative surrounding empathy behaviors and their impact on individuals. In addition to extending the current understanding of empathic communication by looking at new interpretations of empathic behaviors (i.e., the dance steps of empathy), there is a need for developing a more complex understanding of the nature of communication when people interact empathically (i.e., the dance itself). Collaborative Empathy After surveying the landscape of empathy research, Clark (1980) argued that scholars had only scratched the surface of the topic and reasoned that there was a need for 42 greater empathy research from an interpersonal communicative perspective. Heeding this call, Bennett (1980) published a qualitative argument calling for a new way to view empathic communication. He argued that the assumption of similarity in the research on empathy (i.e., the Golden Rule of assuming that others experience the world as we do) actually fostered a linear sympathetic communicative strategy that assumed that people experience interactional realities conterminously. Bennett saw this as ethnocentric and advocated for a platinum rule that would allow for multiple realities to exist and would push empathy towards dialogic communication where both parties were focused on understanding the other's worlds causing communicative partners to "do unto others as they would have done unto themselves" (p. 417). Barrett-Lenard (1981) built on Bennett's theorizing by arguing that empathy is a phenomenon that is best understood as a collaboration between a therapist and a client as opposed to the conventional thinking which espoused that empathy was both a relational quality and strategy that a therapist should "give" to a client. This shift in empathic emphasis invited the academic community and clinicians to move beyond seeing empathy as a series of strategic responses and to move toward viewing it as a collaborative act whereby the individuals involved were using communication to facilitate joint understanding of each other's worlds. This new viewpoint on empathic communication revealed there was a need for research and theorizing that accounted for the transactional meaning making process of empathy. It was within the instructional context that scholars would pursue this line of thought. In 1983, Stewart published an article extending the thinking of collaborative empathy. In this piece, Stewart provides an alternative to the psychologically driven 43 definitions of empathy that situate it as the cognitive process of trying to see the world from another's perspective. This alternative involves shifting the focus away from psychologized notions of empathy toward an awareness and application of interpretive listening, where decentering and perception checking help interlocutors co-create shared meaning through communication. Stewart posits three pedagogical advantages for making this shift; first, it "can help turn students away from the tendency to objectify selves" and instead help them be "sensitive to the communicating that is happening between or among persons"; second, it encourages students to seek understanding of another through dialogic probing questions and perception checking rather than trying to mentally visualize their worlds; and third, "students can also learn that not only can it be productive to ‘listen your way into new ideas,' but it also works best to ‘listen your way into new relationships'… because of the mutually-creative contact that occurs between persons" (p. 389). Following Stewart's invitation to reimage empathy in more complex communicative ways, intercultural communication researchers heeded his call. In an essay addressing the need for greater empathic communicative theorizing in the literature on intercultural communication, Broome (1991) posited that communication research needed to move beyond linear thinking and toward transactional models that accounted for the relational dynamics at play in any given empathic interaction. Specifically, Broome (1991) posited that, "the development of shared meaning must move the focus beyond both self and other to the interaction between communicators" (p. 247). DeTurk (2001) supported such an approach as being valuable to helping individuals communicate across cultures in many contexts. Rather than focusing on the cognitive exercise of one individual attempting to place themselves into the situation of another 44 individual, which implies a crossing of experiential borders between two people, DeTurk advocates for an empathic perspective the removes borders and focuses on the interconnectedness of the human experience. In what way is this type of empathy possible? DeTurk's answer is this: "returning, then, to the question of empathy in intercultural interactions, it seems that attempting to perceive others' internal frames is not what is important or appropriate. Instead, we should foster relational empathy through dialogue" (p. 380). Taking such a position places the emphasis of empathy on understanding as opposed to accuracy. Rather than hitting or missing the bull's-eye on how a person sees or feels in any given situation, relational empathy asserts that it is far more important for individuals to communicate openly and develop a relationship where each feels the other is trying to understand them. Another major component of the relational empathic approach that DeTurk (2011) advocates is for a more complex understanding of identity and power. As in all human relationships, power is ever present and thus influences the communicative dynamics of any interaction. This holds true for empathy as well. Because DeTurk is critiquing the dominant empathic paradigms used in intercultural communication literature, namely that empathy is a competency that individuals can develop as a way to understand the cultural experiences of another, she posits that there needs to be a greater appreciation for the way power and privilege silence identities in empathic interactions. "Every individual is a web of identities, including gender, race, age, occupation, sexual orientation, and nationality, to name a few… and these identities may be triggered" during any empathic exchange (DeTurk, 2001, p. 379). For power differences to be broken down, DeTurk believes that individuals should feel safe to bring their whole selves into an empathic dialogue without 45 the fear of being misunderstood because they are female or black or a member of any other historically underprivileged group. Again, adopting such a stance places emphasis on the importance of fostering understanding empathic relationships where individuals feel comfortable creating dialogues of shared meaning as opposed to one individual suppressing multiple identities to find empathic acceptance. Following DeTurk's (2001) article and invitation to reframe empathy research in collaborative and relational ways, scholars, particularly communication scholars, have failed to pursue this line of theorizing. What has happened instead is communication researchers interested in interpersonal communication and empathy have developed more quantitative empathy scales to add to the abundance of such scales that have been created in other fields, particularly psychology. The newest wave of this type of empathy research in the communication field has focused on empathic listening. Building on other listening styles measures (e.g., Johnston, Weaver, Watson, & Barker, 2000; Watson, Barker, & Weaver, 1995; Weaver, Watson, & Barker, 1996), Bodie, Gearhart, Denham, and Vickery (2013) have developed an Active-Empathic Listening questionnaire that seeks to measure a person's predisposition for being an empathic listener by having them rate themselves on empathic listening attributes. The questionnaire has also been used to measure an individual's perception of others' empathic listening attributes (Bodie, 2011). While there is merit in developing such measures, they fail to account for the collaborative nature of empathy discussed above and they continue the linear theorizing (i.e, focusing on senders and receivers) that has dominated nearly all of the interpersonal empathy research to date. Because of this, there is still a great need to heed the call from Stewart (1983), Broome (1991) and DeTurk (2001) to look at empathic communication 46 as a collaborative activity. This is one of the primary focuses of my study, to explore the way students' lived experiences with empathic communication shape the way they view the collaborative nature empathy gets enacted and felt. Looking at the research on empathy and communication (as delineated above) demonstrates that there is a need for further research on not only developing a deeper appreciation for empathic communication, but also for how to teach and develop such an understanding in individuals. Because my study is a longitudinal study that was created around helping students develop a deeper understanding of empathy and communication, it is necessary to review the literature on empathy and education. Thus, it is to that topic the focus now shifts. Empathy and Education The connection between education and empathy has captured the interest of educators, school administrators, school counselors, and researchers interested in helping individuals learn empathy or develop greater empathy within an educational setting (Suthakaran, 2011). As a result of the interest in empathy education, several teaching models and approaches have been used in a variety of fields and learning contexts. Because the primary target of this research project is to explore students' learning of empathy from a communicative perspective it is necessary to document the trajectory of empathy education and development. Thus, this section will offer a literature review of the relevant work that has paved the way for those interesting in facilitating empathic learning. As mentioned in the previous section of this literature review, empathy instruction 47 and early education attempts came from the field of psychology following WWII in conjunction with the rise of humanistic approaches to therapy (Rogers, 1980). These early approaches centered on teaching therapists and counselors to communicate more empathically when dealing with distressed patients. This approach has had a strong influence on how empathy has been studied within the educational domain. The majority of the early research on empathy in education focused on helping teachers communicate empathically with their students, analogous to the Rogerian client-centered therapeutic process, where the teachers represent the counselor or therapist and the students the patients or clients (Carkhuff & Berenson, 1967). However, as empathy research in education progressed, the importance of empathy in students continued to be linked to positive outcomes such as academic success, social and emotional competence, prosocial and moral behavior, regulation of aggression and regulation of other antisocial behaviors (Bonner & Aspy, 1984; Brehm, Fletcher, & West, 1981; Chang, 2003; Findlay, Girardi, & Coplan, 2006; Zeidner, Roberts, & Mathews, 2006). These benefits have spawned various approaches to teaching empathy at all levels of education in the U.S. According to Feshbach and Feshbach (2009), the approaches to teaching empathy can be grouped into two categories. The first are programs that focus on methods or techniques used to increase empathy (as a skill) with the belief that this will then lead students to positive outcomes. The second set of programs focuses on teaching empathy in a way that targets cognitive, affective, behavioral, or academic goals based on the assumption that this will then foster skill development and bring the positive attributes attributed to empathy. Both of these schools of thought have made their way into the literature on teaching empathy to students from kindergarten to higher education. 48 Those who adopt a skill-improvement approach to teaching empathy have used many different pedagogical methods and techniques to help students of all ages increase their empathic skill. Role taking or role-playing has been identified in multiple studies as being an effective way to increase a student's empathy (Barak, Engle, Katzir, & Fishier, 1987; Underwood & Moore, 1982). This can happen in multiple ways where teachers have the students imaginatively play the role of a fictitious or historical personality or by having them try to experience what it would be like to be someone of another race, gender or background (Hammond, 2006). Central to this approach to teaching empathy is helping students practice perspective taking as a way to try and experience what life might look like and feel that for another individual. Research has shown that when students increase this skill, they are more likely to raise their levels of empathy (Feshbach & Konrad, 2001). In addition, research on helping people develop emotional intelligence, such as becoming skilled at recognizing the emotional state of others, as well as one's own emotional landscape, have been shown to increase the empathic skills of students (Kremer & Dietzen, 1991). Perhaps this is why many disciplines in higher education are using role-play as a way to teach communication and empathic skills (Rao & Stupans, 2012). This has proven particularly true in the medical field, where role-playing exercises have often proven more successful in helping medical students develop empathic communication skills in comparison to traditional, lecture based teaching methods (O'Brien et al., 2007). Educators and instructors who subscribe to the second pedagogical position on teaching empathy, i.e., focusing on educational goals rather than skill development, have also developed teaching techniques that are targeted towards increasing a student's 49 understanding of empathy. One of these techniques is helping students find similarities between groups of people or points of connection, to break down barriers to empathy that are more likely to be put into place when individuals feel that the world of an "other" is very different from their own (Brehm, Fletcher, & West, 1981). Modeling empathic behavioral responses is another way teachers have reported helping students increase their understanding of empathy. This can happen either through live enactments or video clips from television shows or movies (Kohn, 1991). Others believe that exposing students to groups and individuals from different socioeconomic backgrounds and cultures fosters learning experiences in empathy, which can happen either through mediated exposure, bringing guests into the classroom, or having students take field trips to places such as homeless shelters or hospitals (Sinclair & Fraser, 2002). Lastly, some efforts have been made to help students develop greater empathic perspectives by making curriculum changes in the way students learn subjects such as art, history, literature, and social studies. These efforts range from having students do projects that require empathy and coordination with their fellow students (Arnson, 1979), to changing the materials covered within a course subject to include examples that invite students to have empathy for a variety of different types of people (Lizarraga, Ugarte, Cardella-Elawar, Iriarte, & Baquedano, 2003). The two different approaches for teaching empathy identified by Feshbach and Feshbach (2009), as delineated above, are by no means mutually exclusive. In fact, in recent years there have been efforts to integrate both approaches to foster a more holistic curriculum for teaching empathy. One of the most successful of these efforts comes from programs designed to teach social emotional learning, or SEL, in K-12 schools. The 50 primary goal of this approach is to help students acquire emotional and social intelligence competencies through exercises in skill development and by promoting subject material that targets cognitive learning in those areas (Greenberg, 2010). A recent meta-analysis of SEL programs has provided evidence that they are helping students on both a social and emotional level, as well as academically (Durlak, Weissberg, Dymnicki, Taylor, & Schellinger, 2011). The pedagogical foundations of these efforts have also made their way into higher education. Zajonc (2013) has noted: During the last fifteen years a quiet pedagogical revolution has taken place in colleges, universities, and community colleges across the United States and increasingly around the world. Often flying under the name "contemplative pedagogy," it offers to its practitioners a wide range of educational methods that support the development of student attention, emotional balance, empathetic connection, compassion and altruistic behavior, while also providing new pedagogical techniques that support creativity and the learning of course content. (p. 83) With its focus on holistic learning, professors and academic administrators have created and advanced many programs and practices that promote empathy development. These not only draw on some of the pedagogical approaches identified above, but more importantly, they focus on allowing the student to bring their whole selves into the learning space by engaging in collaborative learning activities. Educators interested in teaching and facilitating empathic growth now have many student-centered, engaging options to choose from, such as team-based learning, inter-teaching activities, discussion circles, and creating jigsaw classrooms (Nowak, 2011; Saville, Lawrence, & Jacobsen, 2012). In addition, a growing number of teachers are using critical pedagogy to challenge their students' assumptions about race, class, sexuality, and gender, by using dialogic teaching that centers on fostering empathy (Zembylas, 2012). Other creative approaches for teaching empathy or fostering empathy development in higher education have 51 involved empathic listening role-playing (Hatcher et al., 1994), using narrative fiction (Whalen, 2010), film (Hunter, 2008), poetry (Ingram & Nakazawa, 2003), acting (Deloney & Graham, 2003), music and dance (Ziolkowska-Rudowicz & Kladna, 2010), and storytelling (Charon, 2001). Each of these approaches centers on helping students develop not only on an intellectual level, but also on nurturing personal growth in areas such as compassion and empathy in nondidactic ways to strengthen communities and the global family (Palmer & Zajonc, 2010). The methodologies associated with these holistic and creative approaches to teaching empathy move educators to adopt new forms of assessment and learning objectives. In looking at empathy teaching and learning, research has shown that using a variety of methods, longitudinally, seems to impact student learning and behavior the most. Carrell (1997) conducted a study on empathy in the classroom to identify how students can develop empathy in communication courses. She used two communication courses in the study, one hybrid class that combined interpersonal communication and public speaking, and one mass media communication course. She used other sections of these courses as control groups. In the mass media class she had the students do an assignment where they were required to complete a video project on a diversity related topic. In the hybrid course, she had the interpersonal communication students complete several in class activities that focused on empathy and diversity, and she had the public speaking students prepare one speech on a diversity related topic. The student's empathy was measured at the outset of the class and again at the conclusion of the semester. Carrell found that having the students do a one-shot assignment had no effect on student empathy but that students that engaged in multiple empathy activities showed significant 52 gains in their empathy scores. Carrell invited educators and instructors to consider the pedagogical application of her study, namely, that to develop empathy in students, instructors need to incorporate multiple activities and assignments that require students to consider the views and feelings of others, rather than hoping to achieve this by giving them a single assignment. She acknowledged that her research was only a starting point for further research in how communication courses can be used to facilitate empathy learning and development in students. In light of all of this, my research is an attempt to build on Carrell's (1997) method of using communication courses to facilitate empathy development and growth. Where Carrell quantitatively measured students' empathy levels given empathy instruction, as the method section will show, I chose to qualitatively explore students' understanding of empathic communication by looking at how empathy instruction, experiential learning, and empathy journals influence student learning of empathy over the course of a semester. Adding to this growing body of research in higher education is important because of the critical developmental stage most undergraduate students are in when they enter the classroom. Thus, using undergraduate students for this study provides a special glimpse into a collective group of people that are in a pivotal stage of learning and development. The following section will draw on the literature around student development and learning to support this rational. Student Development and Learning Because empathy is a concept that can be taught as a skill or a cognitive concept, it invites those interested in teaching it to consider their pedagogical approach. According 53 to Hoffman (2000), it takes a mature individual to develop a deeper understanding of empathy and the ability to enact it with relational and emotional intelligence. Thus, while teaching empathy can be beneficial to people of all ages (Levine, 2012), teaching it to young adults can be particularly impactful because of the stage of development they are entering. Beginning in the 1960s, researchers interested in learning and growth in higher education began to draw on the works of Dewey (1938), Piaget (1955), and Erikson (1959) to conduct research and create theories of student development. Since then, many student development theories have emerged (Evans, Forney, Guido, Renn, & Patton, 2010). As a result, a core concept of student development theorizing is the notion that educators need to recognize that the majority of students who occupy the chairs of higher education courses are not only individuals learning academic concepts, but are human beings at a pivotal stage in their overall life development (King, 2009). Researchers have long noted that adolescence is a time of "identity crisis" for most individuals, where they engage in highly egocentric behaviors and struggle to negotiate new relational and social dynamics (Tennant & Pogson, 1995). However, as teens move into early adulthood, they enter a maturation period where they begin to find a balance between the need for a unique identity and defining themselves in terms of their relationships with others. For this reason, when a young adult enters an institution of higher learning, their social, emotional, physical, spiritual, and mental growth are extremely important, as they will forge identities and life strategies that will often persist throughout the rest of their lives (Baxter Magolda, 1999). When educators recognize the pivotal role they play in helping young adult 54 students forge new ways of being and relating, in addition to the academic knowledge students are acquiring, they open themselves up to using a variety of pedagogical approaches to teaching and learning in the classroom. Levinson (1986) identified the early adult transition years falling between the ages of 17-22 years old. He believed that these years were vital to an individual's development and advocated that the role of educators during this period is to "both challenge old perspectives and support the acquisition of new perspectives" (Kitchener & King, 1991, as cited in Tennant & Pogson, 1995, p. 130). This emphasis on helping students develop perspective taking, as has been pointed out earlier in this literature review, is a foundational aspect of empathy development. Thus, helping students understand the importance of empathy and develop the ability to apply it to their lives, strikes at the roots of student development. In addition, research has shown that students who develop their empathic abilities in their young adult years are more likely to enjoy greater personal and relational success as they transition into the adult years (Goleman, 1995). For these reasons, understanding how to help young adult students develop empathy at the university and college level is an important part of their development and maturation process. In addition to the life stage theories of students' development articulated above, there are two major alternative models that invite educators to consider when thinking and theorizing about adult education. These are life events theory and life course theory. The first of these, life events theory of human development proposes that it is more productive to think of human development occurring across the life span of an individual, rather than tying it specifically to age-related stages (Tennant & Pogson, 1995). The research backing up this theorizing has often focused on gender differences. For example, 55 Caffarella and Olson (1993) found that the developmental stages of women are often less linear than men's because of the drastic changes that often accompany their roles, such as motherhood. One implication here for student learning in higher education is the increasing numbers of women coming back to college or universities following divorce, child-rearing, or because of the need for a second income (Pusser et al., 2007). The development of these students can be just as pivotal for their life growth as those who are in the plasticity of early adulthood. Moreover, the life course theory of human development invites researchers and educators to consider that life development is contextual and dialectical in nature in that individuals are constantly learning and changing as their relationships and the environment and society they are embedded in change (Tennant & Pogson, 1995). Regardless of the developmental theory one prefers, the body of research that has been collected in this area demonstrates the importance of developing effective methods for teaching empathy at the university level, not just K-12. Unfortunately, this area of empathy research is lacking. Lam, Kolomitro, and Alamparambil (2011) conducted an extensive review of the literature on empathy training and instruction and found only 29 studies in the last 20 years, 9 of which were conducted in the last 10 years pertaining to empathy training and instruction. These authors noted that this limited amount of research has left us with more questions than answers on how to teach empathy effectively. More recently, Bouton (2014) undertook a similar literature review and noted that there was a serious lack of studies "attempting to determine how and if empathy can be taught" and posited that an essential need of the academic community is for more rigorous research on the methods of empathy instruction and their outcomes (p. 21). 56 Again, the purpose of my study is to do just that, which is to add to the conversation on empathy instruction in higher education by capturing the learning experience of students during a pivotal stage in their development. One of the primary ways my research will do this is through employing experiential learning methodologies. As a result, it is necessary to provide a deeper understanding of experiential learning in this literature review. Experiential Learning The promulgation of the importance of experience in education is not a new debate and traces its roots far back to the days of Plato and Isocrates. For centuries, scholars and philosophers have argued about the utility of experience in knowing and learning. Historically, those who adopted the rationalist perspective argued against information that is garnered through an individual's senses, rather than a through logic or reasoning. Conversely, empiricists have advocated that knowledge, even abstract concepts, are only discovered as they are experienced through the senses. Kant (1787) was one of the first to argue that both rational and empirical faculties are important in the learning process, as we rationally make sense of the world we experience. Building on the work of Kant and other philosophers, the great pragmatist thinker John Dewey (1938) became the primary champion of experiential learning. As an educational reformer, Dewey advocated for a pedagogy that promoted learning through doing, or experiential education. He believed that through problematizing various aspects of education and then affording students the opportunity to have experiences in trying to solve the problems posed, students reached greater levels of reflection and learning (Dewey, 1938). However, Dewey made a clear distinction on 57 what types of experiences would be considered educative. He posited: The belief that all genuine education comes about through experience does not mean that all experiences are genuinely or equally educative …. Any experience is mis-education that has the effect of arresting or distorting the growth of further experience …. A given experience may increase a person's automatic skill in a particular direction and yet tend to land him in a groove or rut; the effect again is to narrow the field of further experience. (pp. 25 - 26) From this philosophical position, Dewey believed that only those experiences that led to further growth to the individual and their active role in the community would qualify as experiential education. He sought to advance democratic processes in schools that allowed students to be active and reflective in their education. Because of this, it was important to Dewey to consider how educators structured experiences for students. He felt that experiences needed to have a level of authenticity to them that would compel those involved to feel that they had a genuine experience rather than a contrived one that merely scratched at the veneer of learning. Thus he posited, "Experience in this vital sense is defined by those situations and episodes that we spontaneously refer to as being ‘real experiences'; those things of which we say in recalling them, ‘that was an experience'" (Dewey, 1934, p. 275). Furthermore, Dewey believed that for experiences to have a level of authenticity to them, they must connect on a pragmatic level, intellectual level, and emotional level. Many of Dewey's assumptions about the value of experiential education have been supported by the work on cognition, development, and language done by Piaget (1955) and Lewin (1948). Building on the work of these theorists, scholars have taken these concepts and constructed models and paradigms for learning based on experience; the most notable of these is David Kolb (1984). The work conducted by Kolb has helped to distinguish the difference between experiential learning and experiential education. 58 Experiential learning is a term that is broadly used in education and psychology and has taken on multiple meanings and obfuscating definitions, some of which often become conflated with experiential education. Kolb (1984) has defined experiential learning as "the process whereby knowledge is created through the transformation of experience" (p. 38). This is a broad definition which encapsulates many of the ways various other scholars and psychologists have used the term (Moon, 2013). At its most basic level, it describes learning that individuals achieve because of their experiences. However, Kolb (1984) conceptualizes experiential education as the process whereby instructors design experiences for their students that will meet specific educative learning outcomes. This is an important distinction as it explicates the necessity of a conscious instructor to guide the experiential processes. If a teacher simply conducts an activity or game in their classroom without a clear educative purpose in mind, they have not achieved experiential education. However, some students may have the awareness to learn from the activity, in which case experiential learning would have taken place. To help educators understand experiential learning, Kolb (1984) developed a model that instructors can use to ensure that learning has actually occurred (Figure 1). Figure 1: Kolb's Experiential Learning Cycle 59 One of the challenges posed by educators who employ experiential learning in their classrooms is finding ways to properly assess the actual learning that has occurred (Katula & Threnhauser, 1999). While there are different approaches to doing this, one of these is through reflective journaling (Moon, 2013). This is largely because research on journaling has afforded scholars and clinicians a better understanding of how skill development and the acquisition of dispositional characteristics are fostered in individual's behavioral and cognitive efforts (King & LaRocco, 2006). Furthermore, research on learning in higher education found that when instructors provide guided reflective journaling for students, they are able to access the way students' perceptions and understanding of concepts change overtime (Dunlap, 2006). Consequently, there is precedent for using a journal approach to teach empathy, particularly in the medical field. For example, Chabon and Lee-Wilkerson (2006) conducted a study about medical students' ability to achieve the desired learning outcomes of diversity training. They had students keep reflective journals throughout the semester to track their thought process related to the concepts being discussed in the class. At the end of the study they noted, "what we found was that students produced many more descriptive and empathic reflections throughout the semester than analytic and metacognitive reflections" (p. 156). Thus, they were able to see how and in what ways the course content and experiential learning provided facilitated a greater empathic perspective in students. The work of Chabon and Lee-Wilkerson (2006) illustrates that the use of journaling can be an effective way to access the empathic learning students achieve over a period of time. However, their work only scratches the surface on the different ways 60 experiential learning journals can be used in a classroom. As the methods section will show, my study has sought to extend this line of research by using empathy journals in a variety of ways throughout the course of a semester. This should prove to be an important addition to the research on experiential learning and journaling, particularly as it relates to empathy learning and instruction. Summary The literature review provided in this chapter has provided an outline of how empathy has been studied in the academic community broadly and more specifically in the communication field, as it relates to empathic communication behaviors and empathic collaborative communication. It has also looked at the trajectory of empathy education and the importance of empathy development and instruction. While the case for the following study was built along the way, the following is a short summary of the important ways my study will contribute to the growing body of research on empathy and communication. While the topic of empathy dates back to antiquity, the concept as we have come to know it today has really only been rigorously studied for a little over 60 years. To date, there is a great deal of disagreement about what the borders of empathy research should be and how to define it. Overall, researchers tend to see empathy as containing cognitive and affective elements. However, there is a growing voice inviting the academic community to consider a third important characteristic of empathy, namely communication. Consequently, because this notion has escaped many of the definitions and theorizing about empathy, there is a strong need to explore empathy from a 61 communicative standpoint. Unfortunately, communication researchers have been slow to join the conversation. Despite the intuitive connection between empathy and communication, to date only 25 articles that specifically focus on empathy (i.e., empathy is in the title of the article) have been published in seven of the most prominent communication journals over the last 40 years, those journals being: Communication Quarterly, Communication Research, Western Journal of Communication, Communication Research Reports, Southern Communication Journal, Communication Studies, Communication Education, and Communication Monographs. While these 25 articles provide useful additions to the ever expanding knowledge base on empathy, the mere fact that only a third of these articles have been published in the last decade shows that the communication field still has much to offer to the collective discourse on empathy. My study is designed to do just that in a number of ways. First, this study will look at the communicative behaviors that make up empathic interactions as reported by participants in those interactions. While this topic has been examined by researchers, there is a discrepancy over the impact of verbal and nonverbal communication on generating feelings of empathy. In addition, the vast majority of the research that has looked at empathy behaviors has been conducted in clinical settings, specifically in psychology and healthcare. This has left a need for additional research on the perception of empathic behaviors outside of those contexts. My study was designed to fill that need by asking students to identify empathy behaviors in their everyday lives. Furthermore, the growing body of research on empathy and communication has focused on empathy as a linear process rather than a transactional one. While a few communication researchers, i.e., Bennett (1981), Stewart (1983), Broome (1991), and 62 DeTurk (2001), have attempted to move empathy theorizing beyond cognitive-centric linear models, this line of thinking has been largely ignored in by the academic community and the communication field as it relates to empathy research. As a result, there is a strong need for research that explores the way empathy is co-created and jointly produced in dynamic ways. Throughout my study, I hope to fill that need and bring added complexity to the notion of empathic communication by tracking the longitudinal learning students achieve throughout the course of a semester. By exploring empathy in this way, my study will also further the need for more research on empathy instruction. While many techniques and methods have been developed about how to teach empathy, scholars have acknowledged that more research needs to be done, particularly in higher education. With the new emphasis being placed on holistic education, experiential learning, and student development, my study is meant to expand the narrative on how educators can foster empathy learning and growth in students. Ultimately, this exploration should be pivotal in moving us toward developing a deeper understand of empathic communication and empathy instruction. Based on this literature review, the specific questions that guided this research project are as follows: Research Question 1: What are the communicative behaviors and patterns that facilitate feelings of empathy in the lived experiences of a group of students? Research Question 2: In what way can empathy instruction, from a communication standpoint, shape students' understanding of empathic processes? 63 CHAPTER 3 RESEARCH METHODS: USING GROUNDED THEORY TO EXPLORE EMPATHIC COMMUNICATION The previous chapter showed that research on empathy has largely been studied in the fields of medicine and psychology, which have privileged the use of quantitative methodologies within limited settings. While this large body of research has provided many important insights into empathy as a cognitive and affective phenomenon, it has also left c