Support and Empathy: A Sustaining Presence – Chapter 5 Vocabulary

Vocabulary flashcards summarizing the major concepts, skills, and pitfalls related to support and empathy in clinical practice.

Supportive Presence

The combination of clinician attitudes and actions (warmth, acceptance, validation, etc.) that create a sustaining therapeutic environment.

Clinical Repose

A relaxed, anchored, client-centered steadiness that lets clients stay focused on themselves without fear of judgment or abandonment.

Warmth and Caring

Genuine concern for a client’s well-being, conveyed through appropriate verbal and non-verbal behavior.

Acceptance

Unconditional positive regard that appreciates and affirms the client while suspending judgment.

Societal Norms

Culturally defined standards of conduct, often codified into law, that shift over time and across groups.

Culture-bound Syndromes

Psychological or somatic symptoms found only in specific cultures; called “cultural concepts of distress” in the DSM.

Personal Values

Beliefs developed through family and sociocultural influences that shape how one views people and behavior.

Stylistic Differences

Habitual preferences in behavior or communication that make some client-clinician pairings feel more natural than others.

Genuineness

Honest, congruent interaction free from pretense or hypocrisy; meaning what one says without saying everything one thinks.

Congruence

A clinician’s authenticity and freedom from professional masking when relating to a client.

Availability

Being physically and psychologically accessible and flexible—sometimes using technology or crisis contact—to create a safety net.

Validation of the Client’s Story

Clinician endorsement and appreciation of the realities within a client’s narrative.

Universalizing

Verbally situating a client’s feelings or experiences within a larger community to reduce isolation.

Strengths Perspective

A view that values client assets and potentials, highlighting resources already used or that could be developed.

Transferability of Skills

The idea that coping methods effective in one area of life may work in other situations as well.

Provision of Concrete Supports

Helping clients secure material or practical services that meet basic needs and build alliance.

Advocacy

Working with institutions or social groups to expand benefits, rights, and opportunities for clients.

Empathy

Experiencing another’s subjective world while maintaining one’s own observer perspective.

Basic Empathy

Understanding and reflecting what the client has already expressed on the surface.

Advanced Empathy

Sensing and reflecting material the client has not yet verbalized or may not be aware of.

Cognitive Empathy

The ability to take another’s perspective and understand their intentions, desires, and beliefs.

Emotional Empathy

The capacity to feel the emotional state of another person.

Emotional Regulation

Self-soothing so that empathy does not overwhelm and the clinician can act helpfully.

Clinical Empathy

Developing, communicating, and acting on an empathic understanding within the therapeutic relationship.

Mutual Empathy

Reciprocal caring that leaves both clinician and client feeling seen, understood, and moved by each other.

Mirroring

Subtly matching a client’s posture, expressions, or gestures to build rapport and empathy.

Behavioral Synchrony

Natural matching of postures and gestures in conversation that enhances rapport and empathy.

Facial Mimicry

Automatic matching of another’s facial expressions, aiding emotional recognition and rapport.

Empathic Echo

A verbal reflection of both the content and affect in a client’s story to show attentive presence.

Empathic Reflection of Content

Restating the client’s narrative details from the client’s perspective.

Empathic Reflection of Affect

Verbally reflecting the feelings expressed—or underlying—within the client’s story.

Empathic Failures

Responses that miss, distort, or overload the client’s experience, damaging rapport.

Boilerplate Empathy

Clichéd responses such as “I feel your pain” that feel generic or insincere.

Piling It On

Excessive sympathy that overwhelms or distracts from the client’s actual experience.

Getting the Facts Wrong

Misstating details of the client’s story (e.g., confusing an uncle with a father).

Trivializing/Universalizing

Minimizing a client’s unique experience by making it sound commonplace (“A lot of people get sad”).

Mistaking Similarity for Empathy

Assuming one’s own past experience is the same as the client’s and offering self-focused reassurance.

Countertransference

Unconscious redirection of a clinician’s unresolved past relationships onto the client.

Projection

Attributing one’s own disavowed feelings to the client (“I’m not angry—she is!”).

Overidentification

Emphasizing similarities and denying differences between clinician and client, blurring boundaries.

Ways to Avoid Empathic Failures

Process recordings, video review, supervision, role-play, and personal therapy to sharpen empathic accuracy.

Learning from Empathic Failures

Using mistakes and two-way feedback to strengthen mutuality and the therapeutic alliance.