June 13/2018

Cultural and Social Aspect of Empathy

Purpose
• Help to stimulate conversation on the need to understand cultural and
social aspect of empathy
• Help to connect and become better listeners, become receptive to our
patients' values and needs with different culture, become more caring,
increase the trust of the patients and our own work satisfaction, and thus
decrease the chance of burn out.
• Help to develop empathic attitude which will also create better
relationships with other members of the health care team, and with
family and friends

Culture
• Culture refers to a historically inherited system of meaning and
significance in terms of which groups of people understand and structure
their individual and collective lives.
•  It defines the meaning or point of human activities, social relations and
human life in general, and the kind and degree of significance or value to
be attached to them

Cultural diversity
• 'Cultural diversity' is having different cultures respect each other’s
differences.
• Cultural diversity is an inescapable fact of modern life.
• To say that almost every modern society is culturally diverse is to say that
its members live by different though overlapping systems of meaning and
significance
• Cultural diversity in modern society has several sources. Many societies
include different ethnic, religious, cultural and other communities, with
their more or less distinct ways of life

How did we handle this diversity?

• 1) Cultural learning - Argyle‟s (1969)
- This approach is based on the assumption that cross-cultural
problems arise because cultural novices have difficulty managing
every day social encounters.
- Adaptation, therefore, comes in the form of learning the culture-
specific skills that are required to negotiate the new cultural milieu
(Bochner, 1986; Masgoret & Ward, 2006)
• 2) Stress, appraisal and coping – Lazarus and Folkman’s ( 1984)
- This approach conceptualizes cross-cultural transition as a series of
stress-provoking life changes that tax resources used in adjustment
and require coping responses.
- From this perspective, adaptation is reflected in psychological well-
being, and its predictors have been linked to life changes, personality,
stress appraisal, coping styles, and acculturation strategies (Berry,
 2006; Berry & Sam, 1997; Ward & Kennedy, 2001)
• 3) Cultural intelligence (CQ) – Earley and Ang (2003)
- Most recent one
- It is defined as “a person’s capability to adapt effectively to new
cultural contexts”
- It is multidimensional
A) Cognitive CQ
- Refers to an individual’s level of cultural knowledge
- Cultural knowledge includes knowledge of oneself as embedded
in the cultural context of the environment
- Given the wide variety of cultures in the contemporary world,
cognitive CQ indicates
- Knowledge of cultural universals as well as knowledge of
cultural differences
- Those with high CQ are consciously aware of the cultural
preferences and norms of different societies prior to and
during interactions.
B) Motivational CQ
- Reflects the capability to direct attention and energy toward
learning about and functioning in situations characterized by
cultural differences
- Those with high motivational CQ direct attention and energy
toward cross-cultural situations based on intrinsic interest (Deci &
Ryan, 1985) and confidence in cross-cultural effectiveness
(Bandura, 2002).
C) Behavioral CQ
- Reflects the capability to exhibit appropriate verbal and nonverbal
actions when interacting with people from different cultures.
- Behavioral CQ refers to the extent to which an individual acts
appropriately (both verbally and nonverbally) in cross-cultural
situations.
- Behavioral CQ is a critical component of CQ, because verbal and
nonverbal behaviors are the most salient features of social
interactions

Factors that influence CQ

• 1) Ethnocentrism and CQ – Has negative significance
- Sumner defines ethnocentrism as "The view of things in which one´s
group is the center of everything, and others are scaled and rated
with reference to it. Each group nourishes its own pride and vanity,
boasts itself superior, exalts its own divinities and looks with
contempt on outsiders." (Sumner, 1906).
  - Ethnocentrism is the propensity to view one’s own cultural
traditions and behaviors as right and those of others as wrong
(Black, 1990).
- Ethnocentric attitudes may generate feelings of prejudice, mistrust,
and insecurity (Gouttefarde, 1992), leading to less motivation to
develop relationships with colleagues, poorer adaptation to the
general environment, and stronger desire to return to one’s home
 city/region/country (Shaffer et al., 2006).
- The opposite pole of ethnocentrism is cosmopolitanism, which has
generally, been defined as the tendency to view one’s own
traditions, culture and patterns of behavior as no better than other
distinct traditions, cultures, and behaviors (Shaffer et al., 2006).

- From a socio-analytic perspective (Hogan & Shelton, 1998), such

attitudes will perpetuate the ambiguities and uncertainties
associated with cross cultural social situations and inhibit the
ability to get along with others culture and to find meaning in
the other’s social and cultural environment (Church, 1982;
Stening, 1979).

2) Cultural Empathy and CQ – Has positive significance

- Ruben (1976) defined it as “The capacity to clearly project an

interest in others, as well as to obtain and to reflect a reasonably
complete and accurate sense of other’s thoughts, feelings, and/or
experiences”.
- In other words, this dimension refers to the ability to empathize
with the feelings, thoughts, and behaviors of members of
different cultural groups (Mol et al., 2001)
- People with cultural empathy are more tolerant of the
differences of those from other cultures.
- Cultural empathy makes for smoother and more pleasant
interactions and working relationships
- For example, a culturally empathetic person who sees a Muslim
woman wearing a hijab will typically not automatically come to
the conclusion that this woman is oppressed and controlled by
her religion and/or husband. This culturally empathetic person
may consider the idea that this woman has chosen to fashion her
hijab as a personal choice -- as a symbol of religious and cultural
pride and female empowerment rather than gender injustice.

Cultural Empathy involves two major skills: Perceiving and communicating

• A) To perceive and be aware of another’s situation while taking in to

account another’s point of view (Ex: putting your self in their shoe)

• B) Using both verbal (words) and nonverbal (actions, physical cues) ways
of communicating helps you be perceptive to others thoughts and feelings

Questions to ask
• Am I compassionate enough to care about understanding the other
persons’ culture / feelings?
• Can I put myself in the other persons’ shoes so completely that I do not
criticize or judge them?
• Can I let myself enter in to the others feeling and personal meanings to
see these the way they do?
Reference:

• Atkins, David (2014) The Role of Culture in Empathy: The Consequences

and Explanations of Cultural Differences in Empathy at the Affective and
Cognitive Levels. Doctor of Philosophy (PhD) thesis, University of Kent
• Samantha, A and others. Teaching Empathy to Medical Students: An
Updated, Systematic Review. Academic Medicine, 88 (8)/ August 2013
• Riess, H and others. Empathy Training for Resident Physicians: A
Randomized Control Trial of a Neuroscience-Informed Curriculum.
Journal General Internal Medicine 27 (10): 1280-6, 2012.
• Lisa M. Vaughn, Farrah Jacquez , Raymond C. Baker, Cultural Health
Attributions, Beliefs, and Practices: Effects on Healthcare and Medical
Education, The Open Medical Education Journal, 2009, 2, 64-74
• Yaaghob Ahmadi, Anwar Shahmohamadi, Maryam Mahdi Araghi, The
Study of Effect of Socio-cultural Factor on Cultural Intelligence (CQ) (Case
Study: Sanandaj City), International Journal of Humanities and Social
Science, Vol. 1 No. 12; September 2011