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Breaking out of Empathic Distress, Pathological Altruism, and Codependency

In the classic, The Artist’s Way: A Spiritual Path to Higher Creativity, Julia Cameron writes,

The reward for attention is always healing. It may begin as the healing of a particular pain—the lost lover, the sickly child, the shattered dream. But what is healed, finally, is the pain that underlies all pain: the pain that we are all, as Rilke phrases it, “unutterably alone.” More than anything else, attention is an act of connection.

In my Empathy, Altruism, and Codependency blog, I discussed the risk factors for and the risks of empathic distress, and how this can lead us to pathological altruism and even codependency. I also promised to write a blog about how to reregulate ourselves once we have lost our autonomy.

And, then I didn’t—instead, after avoiding the issue for a few weeks, I wrote Sustained Commitment to Partial Solutions. During that time of not-writing about reregulation when in empathic distress, I thought I wasn’t writing that blog because I was preoccupied with retiring—and, I was. Concurrently, as Cameron writes, I was paying attention. And did the Universe deliver! Be careful, fair reader, to what you attend.

Recently, we had house guests. The first night of the visit, I went to bed feeling frustrated. I felt that I hadn’t been listened to. Further, I wondered if my need to be heard was leading to engaging in the same behavior that I perceived in them: impatiently waiting my turn to tell my story, rather than engaging with their story. I decided that, the next day, I would prioritize commenting on and asking questions about their stories. I framed it as a game for myself, and self-affirmed my successes in listening. The second night, I went to bed less frustrated, having enjoyed our interactions more. On the third day, I forgot to play the “listening game.” Because I hadn’t had an attitudinal shift, my automatic responses were unchanged.

The next morning, as I journalled (a daily habit I developed many years ago thanks to The Artist’s Way), I berated myself for avoiding emotional engagement with this person. Why couldn’t I be compassionate enough to listen? For many years, I have realized that I fear being consumed by, losing myself, in them. But, I mistakenly attributed this to selfishness—to an insensitivity to their pain and inability to care about them. Now, I saw that it was the exact opposite.

It’s not that I am without empathy, it is that I feel deep empathy—this relationship is extremely important to me. Their anxiety is a strong trigger to me to fall into empathic distress. Unawares that this is what was happening, I was trying to be more attuned to them—to imagine what it was like to be them. And what I needed instead was to return to my body, feel into myself, and affirm my separateness. Then, and only then, reregulated in my autonomy, could I practice true empathy: caring about them, wanting to stand barefoot next to them, while also being aware of our individuality. I could see their pain and anxiety—as I perceive it—while not assuming it.


So, the fourth day of the visit, I practiced the LovePOEM. When I became aware of unease in my body, I returned to Pause—I took a few deep breaths. Then, I Observed. What do I notice in my body? What might they be feeling? Next, I Empathized—with both of us. I acknowledged my pain, my needs—and theirs. And, finally, I crafted my Messages. To myself, I celebrated my awareness, growth, and skills. The Message I gave my beloved was compassionate, and authentic. I was no longer playing a game.

Yes, I still slipped sometimes—I had to recall myself to my body. But, compassionately noticing my empathic distress was a huge accomplishment in this relationship for me. And, each time I noticed, I returned to the LovePOEM. I regrounded myself in my body.

Arguably, empathic distress, which leads us to pathological altruism and codependency, had some evolutionary advantages. And, it has costs to the individuals who experience it. For those of us who are in less privileged social groups—particularly we who are poor, people of color, and/or women—those with power rely on us to care for their needs and wants at cost to ourselves. This is heavily reinforced by social media and stereotypes. So, it’s an uphill battle to recognize these inequities, and how we may be playing them out in our intimate relationships.

If we are in relationships with others, we will experience empathic distress and pathological altruism. Additionally, I would argue that we are all codependent to some degree—that it is a continuum rather than a binary. Often, these interaction patterns are learned quite early in life. Empathic distress, pathological altruism, and codependency are the costs of being imperfect in our loving.

And, we can become more aware of when this happens, reducing both the frequency and impact of, as Joan Halifax calls it, falling over the edge. As Cameron wrote, “The reward for attention is always healing.” But to heal, we must direct the light of our attention to illuminating our pain. And when we embrace our pain—including our pain of unutterable aloneness—we find connection. It’s joyfully perverse. As Cameron advises,

In times of pain, when the future is too terrifying to contemplate and the past too painful to remember, I have learned to pay attention to right now. The precise moment I was in was always the only safe place for me.

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