Beyond empathy: Affect attunement in the care relationship

Abstract

Empathy is considered to be an important aspect of any care relationship. However, not all authors agree on a definition of this concept nor on the facets that compose it. In order to contribute to this debate, this article will propose a study of the sources of empathy, which are to be found in early intersubjectivity. In this context, the research carried out 40 years ago by the developmental psychologist Daniel Stern is particularly significant. Stern discovered the complex process of affect attunement between a mother and her baby and found that this phenomenon underpins the dynamics of interpersonal communion and communication. In light of these insights, we will apply the affective attunement model to the care relationship in hospitals through an analysis of two clinical examples. These examples will enable us to identify the bi-directional dimension of affective attunement, which enables a patient to be active in the healthcare relationship, to do his/her ‘patient’s work' (Anselm Strauss), and to empower him or herself. Finally, these hypotheses concerning attunement and misattunement in the care relationship will lead us to a de-idealised and arguably more realistic conception of empathy.