Empathy: How Much Is Too Much?

Linda is a twenty-seven-year-old professional nurse at a respite unit at Boston’s Health Care for the Homeless. As a child and young adult, Linda faced many challenges within her family: her parents were divorced and her mother and sister were both mentally and emotionally unstable. By helping her mother and her sister, she learned to “reach out and help others.” Linda firmly believes that “pain brings empathy.” At the same time, Linda acknowledges that over-empathizing with people can be risky, because you can lose balance, or take on too much of a patient’s “sorrow and sadness.” Linda believes that it is important to have “balance” and “empathy” and “to know your limits” at the same time. 

Linda is twenty-seven years old, lives in Boston, and is a professional nurse. She works at a respite unit at Boston’s Health Care for the Homeless. She provides direct nursing care (treatments and assessments) to patients and is also responsible for staff development and education. 

Growing up, Linda led an unconventional life. She grew up in Washington, D.C., in the 1960s, a time when “people were speaking out,” especially about ending the Vietnam War. Her parents were divorced, and she was raised predominantly by her mother, who, as Linda describes, had a “strong ethic to be an active member in society.” Her mother worked to help others develop parenting skills. She often brought children home with her. This interaction and, in particular, learning about where these children lived, was an “educational experience.” Linda also mentions that her father, a clinical researcher, had “similar values,” and often “overextended himself to patients.” 

As a child, Linda was not engaged in a lot of  “structured activities;” rather, she spent a lot of time outdoors. Starting at the age of eleven, she lived in Vermont for two years as part of a commune specializing in political activism through theater. As a group, everyone in the community traveled together, performed, and got paid. Linda says that she was often “taunted” because she was “from the city.” 

As a child and young adult, Linda faced many challenges within her family. Her mother and sister were both mentally and emotionally unstable. Linda’s mother suffered from a lot of “emotional pain,” and her sister had “addiction problems.” Linda firmly believes that “pain brings empathy.” By helping her mother and her sister she learned to “reach out and help others.” Her sister’s illness pointed to a “compelling need” for education and leadership around addiction and mental-illness issues. From a young age, Linda realized that “we’re not all born with the same capacities, and we should help those in need.” As a child, she was intrigued in reading about the Holocaust and learning about individual experiences. Even today, she finds herself in “awe” of the human spirit. 

Though her adolescence was “troubled,” Linda “persevered” in spite of difficult circumstances. At the age of sixteen, she got her own apartment and managed to get a job in a lab. Since then, she has worked in service of others. Because of her own ability to manage, Linda feels a sense of “hopefulness” for others. Linda feels an “obligation” to do as much as she can and to use the strengths she has been given. She believes in working hard and not taking resources for granted. Linda talks about her need to help others. She doesn’t necessarily do it because she wants to; she does it because she feels she has no other choice. She explains: 

“The other night in Jamaica Plain, I was walking down the street and a homeless man who I’d worked with at the respite program … looked up at me and said, ‘Hello, Linda!’ And, you know … that [was] very powerful to see—and I think it was maybe a year since I’d seen him and five years since I’d worked with him as a nurse. But the connections that you make with people and the needs that you’re able to help them with … depending on who you are as a person, and what you need for your ego in life, I guess, being able to meet that kind of need for another human being meets a need for me.”

At the same time, developing these kinds of relationships and over-empathizing with people can be risky. Linda says: 

“If you choose to work with people who have really extreme, unmet needs, and you empathize to such a large extent, you [can] take on their sorrow, their sadness, and then you’re not going to be able to do your work as effectively, plus be really down and depressed a lot of the time … and it’s interesting: where do you draw the line between professional goals and barriers and then personal? I mean, I don’t know. It’s hard.”

Linda speaks from experience. She describes a relationship with Roberto, a patient from Guatemala whom she met at Healthcare for the Homeless and with whom she developed a “very strong, therapeutic relationship.” After he was no longer a patient, she reached out to be a supportive presence in his life. Roberto did not speak much English, had no family in the United States, and was struggling with alcoholism, loneliness, and depression. Linda’s boyfriend (also a nurse) befriended this young man as well, and both felt as though “Roberto was getting closer to making some major changes—decisions in his life that would be positive changes, and making contact with his family.” (He had been out of touch with them for a long time.) 

Particularly in light of these positive changes, Linda was shocked to learn that Roberto had drowned in the Charles River. Linda and her boyfriend worked hard to make all the arrangements for his funeral and burial, which they strongly felt should be held in Guatemala. They tracked down his family members’ telephone numbers from one of her old phone bills and Linda called his sister (with whom she later “developed an incredibly strong friendship”). They also called anyone and everyone they could think of to ask for donations so that his body could be sent home. Linda says, “Roberto would want to be home with his family, and his family would so much want to have his body buried at home.”

Linda and her boyfriend orchestrated every detail, knowing that they would be unable to make the trip to Guatemala to be present at his funeral and burial. She explains how she observed this very difficult day from a distance: 

“Even though I had reservations about churches— [reservations] built from a lot of stereotypes in society about organized religion—I went that day [to a Jesuit Urban Center], and a portion of the service … was in Spanish, which I just was so moved by, I mean I was in tears pretty much the whole service, but I felt so much support there … I … needed a place to be able to have those feelings of sadness. And I think maybe a lot of people in that setting could understand because maybe a lot of people do turn to religion for support in times of real sadness as well as other times, but for me, it made a big difference in a horribly tragic situation.”

As a result, Linda frequently visits the Jesuit Urban Center for a sense of belonging and support. In her words, she “found religion” as a way to handle the death of her close friend and former patient. Linda reflects on her need to empathize with those in need. As much as it helps those that she serves, she realizes that it serves her own needs as well. She recognizes the potentially damaging effects of this need: 

“My whole life, I’ve really liked to reach out to people in need and that can be a good thing and it also can also be a dangerous thing because you can never meet everyone’s needs—you have unmet needs in the world, or you’ll end up not even existing yourself, only existing in that context. And that’s a dangerous thing, and not a very healthy thing.”

Even though she is in the service industry, Linda describes dangerous “risks” inherent in her work. These include “losing balance” as well as over-committing to and over-empathizing with people and “taking on their sorrow and sadness.” In her work, Linda believes, it is important to have “balance” and “empathy” and, at the same time, to “know your limits.” 

Do you believe Linda is too involved with her work, or that she is doing too much for her patients? Why or why not? Do you believe it’s important to have balance between your work and personal lives and if so, how do you try to maintain that balance?