The Egoism–Altruism Debate
Historically, the Western perspective has been that human be-ings tend to be motivated by self-interest (egoism). It is therefore not surprising that investigators concerned with prosocial be-havior have debated the veracity of the concept of altruistically motivated prosocial acts in which others are benefited with no apparent short-term or long-term benefits for the helper. A model proposed by Batson (1987, 1998) is intended to account for altruism without invoking self-serving motives by establish-ing empathy as a key factor that drives altruistic behavior. Ac-cording to this empathy–altruism hypothesis, empathy provides a vehicle for adopting the perspective of the other in need that then motivates the helper to act with the goal of benefiting the other. Because empathic emotion is distinguished from that of a distress response, it is argued that helpful acts resulting from empathic determinants are carried out with the intention of enhancing the welfare of the other rather than the self. Three types of self-serving motives have been proposed to challenge the empathy–altruism hypothesis, including the prospect of self and social rewards for providing help, avoidance of self or social punishment for failing to help, and reduction of aversive arousal associated with feelings of empathy. In reviewing existing re-search, Batson (1998) concluded that none of these self-serving motives could adequately account for the relationship between empathy and helping behavior, and that, on balance, empirical findings generally support the empathy–altruism hypothesis that there are instances of altruism that can be distinguished from helping behavior involving self-serving motives. Batson (1998) further proposed a general model involving four categories of prosocial motivation, each of which is linked to specific val-ues. These include egoism (valuing self-enhancement), altruism (valuing other-enhancement at the level of the individual), col-lectivism (valuing other-enhancement at the level of the social group), and principlism (valuing maintaining faithfulness to specific moral ideals). Although ideally these four categories of prosocial motivation operate in cooperative and complementary ways, they also may at times come into conflict. In investigations of helping behavior, factors that influence whether or not an in-dividual will engage in helping others, focus on characteristics of the helper, the person who is in need of help, and the situation (Batson 1998) (Table 17.8).
The high value placed on aiding those in ill-health is ubiq-uitous in human life, exemplified at the cultural level by health care professions and health care institutions entrusted to care for those in need of medical intervention. Although multiple factors
contribute to the existence of health care institutions and per-sonal decisions to work in health-related fields, prosocial moti-vations are key among them. At the level of the individual, the family and peer group, caring and empathy may propel the desire to help those who are ill by providing emotional and instrumental support. As myriad empirical investigations have shown, these prosocial acts of social support provide beneficial health effects for individuals who receive them (Stroebe and Stroebe, 1996).
Empathy engenders a sense of interest in and care for oth-ers (Batson, 1998). The capacity for empathy is an important part of healthy social relationships in that it enhances understanding of others and thereby facilitates social connection and the sup-portive dimensions of relationships. As such, clinical assessment should incorporate an evaluation of empathy skills, especially in instances where clinical difficulties stem from maladaptive rela-tional patterns. Consideration of the balance of empathic versus self-serving interpersonal stances of the patient can be useful, not only in individual psychotherapy but also in work with cou-ples seeking help in resolving conflictual relationship patterns.
The clinical relevance of empathy extends to the clinical practitioner. Therapist empathy is crucial to the understanding of the patient and to the maintenance of the therapist’s concern for and desire to enhance patient well-being. It is, therefore, hard to imagine the practice of psychotherapy without empathic invest-ment of the therapist (Watson, 2002). Although a powerful tool of therapeutic change, accurate empathy requires that the thera-pist bear witness to considerable emotional pain in the process of helping the patient. In some instances, the therapist may be overwhelmed by the clinical issues of a given patient, and in re-sponse may retreat from an empathic stance by distancing from, avoiding, or becoming numb to the experience of the patient. It has been suggested that this empathic retreat is a factor in the phenomenon of clinician burnout (Batson, 1998). As such, em-pathic availability is an important variable for therapists to attend to in their day-to-day work with patients.