Empathy Must Start With Ourselves (& Why Empaths Can Show The Least Empathy)

Lissa Rankin, MD
6 min readMar 24, 2023

Some of the least empathic people I’ve ever met are the ones who identify as “empaths.” But I do not blame these people for their insensitivity that can border on cruelty. I truly believe they know not what they do- because they cannot handle feeling all the feels and empathizing- with themselves.

In a world in need of more love, compassion, sensitivity, and empathy, it strikes me that some of the least empathic individuals I know are also the hardest on themselves. When some insensitive remark comes lashing out at you, you can bet they’ve hurled that same insult, criticism, or bullying thought towards themselves ten times for every one time it comes your way.

One of my dear friends, a survivor of significant trauma, turned on me one day, facing me with this hardened, mean gaze and slinging contempt my way. “You think you’re a doctor?” he said, mocking me, accusing me of being an imposter, and hurling one slur after another. I was so shocked by the behavior of my typically kind, generous friend that I was stunned into silence, until a little voice inside of me said, “He usually talks this way to himself.”

I knew in that moment that whatever was going on was not actually about me at all. When I voiced this and asked if this abusive part talked to him the same way, he broke down in tears. It was in that moment that I realized why he could be so insensitive to me when I was feeling vulnerable, scared, sad, or lonely. When he was the one feeling those feels, this mean inner judge came in and dripped sarcasm all over him. And every now and then, when I was the one feeling needy, that mean judge came after me.

It became clear to both of us in that moment that the mean judge was the one that needed empathy from us both. I was able to set a boundary with the mean judge in order to protect myself, but with the boundary firmly in place, I felt sorry for this guy inside. Why did he have to be so mean to my friend, and why did he get so mean with me sometimes? The two of us went to see a therapist to help us work through how to deal with the contemptuous mean judge, who melted when our empathy extended to him.

They say that in order to love others, we must first love ourselves, but that’s a hard sell to most people who try to love. Loving others can feel like the opposite of loving ourselves, since competing needs often require us to choose what seems good for either ourselves or for others. Rarely does a choice feel like win win. And those of us wired to caregive others will usually take the loss for ourselves in order to help others win.

But this way of thinking and choosing is misguided. Yes, it can be loving to extend ourselves, sometimes beyond our comfort zones, in the name of serving others. Such extension can even feel like it requires some degree of self sacrifice, even martyrdom. That’s the edge we need to pay attention to, the moment when we realize we’re giving beyond our capacity, beyond our resourcing, beyond our sincere generosity of spirit, into the realm of over-giving and resentment, maybe even into the realm of controlling someone vulnerable as a way to feel superior to them.

When we are truly loving and empathizing with the needs of others, we are grateful to have the opportunity to be the best version of ourselves, to have the intimacy to be with our loved ones in moments of need, to pay it forward for all the ways others have been generous with us when we were the needy one.

But often, this is not how we actually feel when we are showing up for others. We see a loved one in pain, and instead of feeling grateful, we feel put upon, we feel a heavy burden of obligation, we resent our loved one for being so needy, and especially if the one we are serving is angry, cranky, or seeming ungrateful, we feel irritated, unappreciated, and resentful.

When we notice this, it’s time to do what in Internal Family Systems we call the “You-turn.” Get quiet and go inside to see how your parts inside are feeling. There’s a good chance you have more than one part feeling more than one way. You may have a part that is exhausted from caregiving, depleted to the core, running on empty, and full of self pity, wondering “When is it my turn to get the care?” You may have a part that actually hates the person you’re extending care towards. You may have a part that really does love caring for others and gets a boost of self worth or identity off caretaking others. You may have a part that just wants to curl up and cry from all the ways you’ve neglected it while turning your care outwards towards others, thereby neglecting the little ones inside. You may have a part that bullies you or bullies other parts, yammering away about how you should just stop feeling, quit your bellyaching, and get back to caregiving.

The key is that whatever is going on inside when you feel depleted or resentful requires your empathy and compassion, not your neglect or bullying. As long as you’re not capable of extending empathy inside, finding the loving heart of a good enough parent to your inner parts, you’ll never be capable of truly extending empathy and compassion towards others. You may be able to extend a kind of performative empathy, saying and doing the things you think might look and feel empathic to others. But ultimately, people will feel this inauthenticity and bust you.

Especially if you’re an empath who takes on other people’s emotions like a boundaryless sponge, you’ll be too easily overwhelmed by everyone else’s emotions to sensitively handle your own.

The good news is that empathy can be learned! But empathizing with other begins by empathizing with the parts of you that feel distressed, resentful, needy, lonely, scared, sad, hurt, burdened, overwhelmed, angry, hopeless, helpless, worthless, or otherwise cranky. When you’ve mastered showing up for your own distressed parts (without one ounce of bullying your own parts), then you’re well on your way to feeling generous and understanding when someone else is distressed, resentful, hurt, scared or otherwise cranky- because you’ve been there too, and you know how it feels.

Next time someone you care about is in pain, try checking in with yourself to see how resourced you are to show up for their pain. If you do the You-turn and discover that you’re in pain too, it’s okay to say so. Then both of you can ease the loneliness of being in pain alone- and tend to one another when you’re both in pain, rather than one of you overextending and feeling resentful because you’re neglecting parts inside that are needy too.

If you’re the parent of young children in this situation, find another adult who can empathize with you while you empathize with yourself- and with them. Since kids aren’t expected to have adult levels of empathy until they’ve crossed certain developmental milestones, and because it’s our job as parents to role model empathy for our children, rather than using them to meet our own needs, it’s important that we adults all have good friends and supportive partners who can show up to hold us if the neediness of our kids overwhelms us from time to time.

Try this now, if it feels good to do so. Close your eyes and check inside to see how balanced your inner system feels with regard to how much care you’re giving others and how much care you’re needing from yourself or from others. On a scale of 0 to 100, with 100 being you’re 100% needy and 0 being you’re 100% giving to others and need-less, where are you right now? Are you giving more than you’re resourced to give? Or are you taking more than you’re giving to others? What small, single empathic action could you take today to bring that number closer to the middle ground of 50/50 reciprocity?

Originally published at https://lissarankin.com.

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Lissa Rankin, MD

Lissa Rankin, MD, New York Times bestselling author of Mind Over Medicine, The Fear Cure, and The Anatomy of a Calling.