Empathy and Alterity in Cultural Psychiatry

In this article, I explore the limits of clinical empathy in situations of radical otherness. Cultural difference, extremity of experience, and psychopathology constitute different sorts of challenges to the affective, communicative, and imaginative processes that underlie clinical empathy. When empathy reaches its limits, the other may be experienced as alien and unknown. Theories of psychopathology offer ways to explain alien or inaccessible experience. Clinicians learn to use these models to guide their response to patients and, in some circumstances, such technical models or explanations may enhance or restore empathy. Patients too continue to struggle to present their experience in language that calls for close listening and imaginative engagement. Ultimately, empathy depends on an interactional process between two people able to allow mutual influence. This interaction, in turn, depends on a larger political context that allows dialogue in situations of unequal power. [empathy, intercultural communication, psychiatric consultation, clinical ethnography]