Difficult Conversations Podcast
Lessons I Learned as an ICU Physician
Episode 109 | September 15, 2020
The Power of Empathy
Dr. Helen Riess
Professor of Psychiatry at Harvard Medical School
Welcome to the Difficult Conversations with Dr. Anthony Orsini. Our special guest today is Dr. Helen Riess, a Psychiatrist and Associate Professor of Psychiatry at Harvard Medical School, Director of the Empathy and Relational Science Program at Massachusetts General Hospital in Boston, and the leading expert on the topic of empathy. She founded Empathetics.com, which is an organization that provides empathetic training for healthcare, business, and law enforcement. Her groundbreaking empathy training research was the first study to demonstrate that empathy can indeed be taught. Find out why Helen says, “The face is a roadmap of emotion and it’s the only part of our bodies that we don’t routinely cover.” Dr. Orsini keeps his promise about two things, that you will feel inspired, and you will have learned valuable lessons to be a better and more compassionate communicator.
Dr. Riess explains how she defines and perceives empathy, sympathy, and compassion. Imagination is the key word spoken here, and Dr. Orsini asks how we can train physicians to just imagine for a second that they are the patient, and go from sympathy, to empathy, to compassion. She lets us know one of her favorite sayings. In Helen’s book, The Empathy Effect, she explains the neuroscience of empathy and the evidence that the origins of empathy are based on evolution and survival. Helen shares with us her special relationship with Alan Alda, and then tells us how she teaches doctors to feel empathy. We will learn some great tips and techniques using the “E.M.P.A.T.H.Y” acronym and how important your tone of voice is in relationships with patients, family members and in business associates. Dr. Riess discusses empathy and the concept of “in grouping” which she talks about in her book. Dr. Orsini shares some great advice and makes a point to say that it’s so important to train people to be more empathetic, to be better communicators, and to find commonality. We’re in a very critical time in the world now because more empathy is needed now than ever before. Listen as Dr. Orsini discusses with Dr. Riess his concept of the “the second second” We learn about the last chapter in Helen’s book, “Self-Empathy” and how if we don’t treat ourselves with proper care, we will get depleted and result in burnout. Learn about Dr. Riess’s next big project: working with law enforcement to help police humanize and make a difference. If you loved this episode, please hit the subscribe button to find out more about what we do and how we teach communication. Go ahead and download this episode now!
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Dr. Helen Riess (1s):
The fact that the human brain is still so wired to perceive difference is a real challenge in our global society. I
do believe that the survival of our planet and our species is going to depend on seeing humans as human
period and a story. You’re a human I’m a human
Welcome to Difficult Conversations Lessons I learned as an ICU Physician with Dr.
Narrater (1m 11s):
Anthony. Dr. Orsini is a practicing physician and president and CEO of The Orsini Way. As a frequent
keynote speaker and author. Dr. Orsini has been training healthcare professionals and business leaders,
how to navigate through the most difficult dialogues. Each week, you will hear inspiring interviews with
experts in their field who tell their story and provide practical advice on how to effectively communicate.
Whether you are a doctor faced with giving a patient bad news or a business leader who wants to get the
most out of his or her team members or someone who just wants to learn to communicate better. This is the
podcast for you.
Dr Orsini (1m 14s):
Well, welcome to another episode of Difficult Conversations lessons I’ve learned as an ICU physician. This is
dr. Anthony Orsini and I will be your host again this week. Today, we are very blessed again, to have another
amazing guest, dr. Helen Riess talk the reef as a psychiatrist, an associate professor of psychiatry at
Harvard medical school. She has a director of the empathy and relational science program at Massachusetts
general hospital in Boston, and is widely considered the leading expert on the topic of Empathy. In 2012, Dr.
Dr Orsini (1m 44s):
Riess found empathetics.com, which was an organization that provides empathetic training for healthcare,
business education and law enforcement. She has devoted her career to the art and science of healing
relationships. Her research has been published in leading medical journals and has won many awards. Her
groundbreaking Empathy training research, which was highlighted in a 2012 New York Times article was the
first study to demonstrate that empathy can indeed be taught. This was the answer to decades of major
media attention, demanding more empathic care from medical professionals.
Dr Orsini (2m 17s):
Helen’s amazing TEDx talk titled the power of empathy has been viewed almost 600,000 times so far. I saw
it. It’s amazing if you haven’t seen it, go do it as soon as this podcast is over. Her new book The Empathy
Effect has been translated. Helen I think in 10 different languages now, is that correct?
Dr. Helen Riess (2m 36s):
It’s been licensed in 10 countries.
Dr Orsini (2m 38s):
That’s fantastic. Dr. Riess and her teams are dedicated to transforming health care into compassionate care
systems, and I’m especially excited to have her on this podcast, especially during that time, when we need
empathy more than ever. Thank you, Helen, for accepting my invitation. It’s OK that I call you Helen right?
You know, you and I had so much in common. We are both dedicated our careers to bringing compassion
back into health care. In full disclosure. You and I have never met before.
Dr Orsini (3m 9s):
In fact, up until just a few minutes ago, we’d never even spoken, but I’m a big fan. And when I decided to do
this podcast, you are on my short wishlist. But I thought about just taking a shot inviting you. And I think I
contacted you through LinkedIn and you immediately you got back to me and you were a gracious with your
time. And I want to thank you again for being here.
Dr. Helen Riess (3m 26s):
My pleasure. Thanks for inviting me.
Dr Orsini (3m 28s):
OK. So this is a time in each podcast and I renewed my promise to the audience. By the end of this episode,
you will feel inspired and you will have learned valuable lessons to be a better and more compassionate
communicator. So get ready audience you are about to be blown away. So thanks Helen for coming again.
I’m so excited, Helen, as I mentioned before, my big hurdle in preparing this talk was really getting it down to
a reasonable amount of time. I had so many questions for you after I read your book. I know what about you
for a while now? So there’s just so many questions that I want to ask.
Dr Orsini (3m 58s):
I’ll try to keep it down to just a few questions, but lets start off with what we really need to do is get on the
same page. if you would just defining what Empathy is and, most time we get that mixed up between
empathy, sympathy and compassion. And if you don’t mind just telling me audience how you perceive
Empathy and how that relates with those other terms.
Dr. Helen Riess (4m 19s):
Sure. Those terms are often confused. So it’s a great place to start. So Empathy is the newest of those
terms. It’s only been around for a little over a hundred years and it is defined as the ability to feel with and
understand the emotions and situations of others’ as if they were our own without losing the, as if quality.
Dr. Helen Riess (4m 51s):
So we temporarily our brains are hardwired to resinate with the feelings of others and we have the capacity
to use our imaginations to perceive the situations of others and because of this really unique capacity human
beings and some animals too are moved to help. And so when we perceive suffering in others, we feel
something and we’re often able to imagine what that might be like.
Dr. Helen Riess (5m 27s):
And that creates empathic concern. And once we feel concern were then at a decision point of whether we’re
going to act on what we have perceived or whether we’re not going to. And if we take the action, which can
be as brief and simple as a caring, look, a touch on the arm, a phone call or making a large donation to a
nonprofit organization. Those are acts of compassion because I view compassion as the action arm that is
motivated by empathy Sympathy, on the other hand is a really old term that really recognized that people
have similar feelings and that we catch emotions from one another, but it has really kind of morphed too
mean, feeling bad for people taking pity on them and feeling sorry for them.
Dr. Helen Riess (6m 26s):
And it’s a much more sort of self-focused feeling like I feel so bad. Like that happened to me too. I feel so
bad for you. Whereas Empathy really stays with the other person’s experience and mirrors that for the other
Dr Orsini (6m 41s):
The key word that you said was Imagination there and when I talked to Physician, it’s so important that we
do imagine or put ourselves in the other person’s shoes, especially before we give tragic news to the patient,
but even during our genuine interactions with patients. How do you train that? I know that you do a lot of
training of young physicians. How do you get them to that point where, you know, we’ll talk about burn out
later on, but how did you get them to that point where you train them to just imagine for a second, the they’re
the patient, and go from the sympathy to the Empathy to the compassion?
Dr. Helen Riess (7m 17s):
Well, it’s not a one-step process, but it does begin with opening our perceptions. So one of my favorite
sayings is the face is a roadmap of emotion and its the only part of our body’s that we don’t routinely cover.
So if we just start with looking at a human face, there is a wealth of information about the emotional state
that one of our key pieces of training is just open your eyes, go get your head out of the computer and out of
your iPhone or whatever you’re looking up and really just appreciate that there’s a unique human being
sitting in front of you.
Dr. Helen Riess (8m 1s):
That’s not just bringing a broken arm and illness or a disease to you, but a whole person with a background
and relatives and a past and a the future. And just to take that moment and recognize that this person, you
know, maybe hanging on every word you say, and if you don’t first perceive where they are emotionally, you
can create a disconnection, you know, in a half a second.
Dr Orsini (8m 30s):
So one of the things that I really love about your book is that you really go into the neuroscience of empathy
and we think that Empathy is something that either way you have, or you don’t and you have proven beyond
a doubt, but I think that’s true that empathy can be taught, but Empathy sometimes there’s a lot of, it was just
a soft thing, but there’s actually neuro-transmitters and there’s a Science basis for empathy and it’s based on
survival. Correct? Absolutely.
Dr. Helen Riess (8m 57s):
Right. I mean, if you really think about the most basic function of Empathy, it starts with mother infant
bonding. You can imagine if a mother is not moved by the sound of her crying baby or can’t feel a pit in her
stomach, if her baby is sick or about to, you know, step on glass or do something really dangerous, not too
many human infants would survive. So Empathy is built in to the human caring for offspring.
Dr. Helen Riess (9m 27s):
And of course it extends because we don’t live in isolation. We live in communities and it’s thought to be
hard wired because especially in the days of Hunter gatherers, most of the time males would go off hunting
and the women would be left in the village where they had to cooperate and collaborate to take care of
children while some of them sought food and you know, picked berries or whatever they did. And that they
had to perceive not only their infants cries or distress, but those of their, you know, fell on mothers and their
children to keep the community safe and well
Dr Orsini (10m 10s):
That’s great. And later my big question at the end, we are going to talk about In-groups and I can’t wait to
talk to you about that, but we’re going to save that for later. A question that you might not have been
expecting today is I want to talk to you about before we go on to talk about more about Empathy and, and
communication training in your relationship with Alan Alda because, and I’ll tell you why they have a special
story about Alan Alda. I’m a big fan of his, and I know that he wrote the foreword too. Your book, people ask
me on a regular basis, what made you decide to go into medicine and without hesitating my answer is
Dr Orsini (10m 41s):
It’s exactly true. Alan Alda. talks about in your book and he talks about it in his book and I love his book. The
title is amazing if I understand you, would I have this look on my face. I just love that title. But he talks about
very similar things that you speak about. It was very important to Alan all the way that the character of
Hawkeye Pierce was not just funny, but that he was a real person, and Alan Alda really show that he was a
doctor who cared. That character, Hawkeye Pierce, had Empathy flowing and compassion and you can see
that he would cry and he would get upset.
Dr Orsini (11m 19s):
He would get mad. He would go through anger. And if it sounds weird, but I’m a big MASH fan. I can
probably give you the lines of every MASH that was ever shown on TV, but that’s the kind of doctor I want to
be. How do we teach doctors? How to do that? How do we teach them to feel that empathy? You spoke a
little bit about imagining being the person in there, putting yourself in that shoes, but tell me about your
empathy training when you train young doctors.
Dr. Helen Riess (11m 49s):
So I’ll get to that, but I just, I am a true fan of Alan Alda and I just want to share that’s the way we got
connected is when he reached out to me to see if he could interview me for his book because he
understands Empathy like no other when it comes to putting himself in the shoes of others and being a
genuinely caring, connected person. But he wanted to learn about the neuroscience. And, you know, he
spent 10 years interviewing scientists’ on Frontier’s of American Science.
Dr. Helen Riess (12m 23s):
And the way, he could fully immerse himself in wanting to learn how Empathy works. It was such a great
example of his two interests coming together, being a TV doctor, but really also wanting to understand how
do we teach this in? How do we enable this in physicians? So I guess it really goes back to the reason why I
got interested in empathy training first, I really was watching a lot of burnout, a lot of patient dissatisfaction.
Dr. Helen Riess (12m 55s):
This is going back 10 to 15 years. As you know, you know, in the introduction of the electronic health record,
there was a lot of distraction and having to learn new ways to input information was requiring physicians to
load information into computers. Some of whom have never taken a typing coarse. And so they’re really was
a breakdown in the doctor-patient, patient- doctor relationship, because we just didn’t have the focus.
Dr. Helen Riess (13m 26s):
And as a psychiatrist, I was hearing a lot of pain about this feeling that people just weren’t paying attention to
them. Didn’t hear them ask the same question over and over again. And I could see that this was really
causing harm. You know, patients were losing motivation to stop smoking, to lose weight, stay on their
medication. That’s the first oath we take when we graduated from medical school is first do no harm. And I
realized that through these communication gaps and lapses that we were doing harm.
Dr. Helen Riess (14m 2s):
And so I reasoned that empathy can be beaten out of people. We certainly should be able to put it back in
because most people who choose medicine and nursing professions are they have some empathy, they care
about people or they would be doing other things. And so it just didn’t seem right, but well, meaning people
were suddenly just not connecting in a way that that was helpful to people.
Dr. Helen Riess (14m 32s):
So I studied the neuroscience of empathy for a couple of years. I did a fellowship at Harvard and got to really
immerse myself in that literature. And that’s where I realized that this is a brain-based capacity. It’s not just a
nice to have like being nice skill. It’s a survival skill. And if we could get physicians to lift their heads up and I
mean, physicians, nurses, medical students, residents to the whole team, PAs NPs, and really connect with
Dr. Helen Riess (15m 6s):
I really believe it, that is what’s needed to really engage people in being partners in their own healthcare.
And so it became a real quest of mine to understand how the brain perceives processes and expresses
empathy and compassion. And then to figure out ways that we could kind of expand this awareness building
and perspective, taking through some classroom instruction. And that’s when I did a study to see if what I’ve
put together actually could be perceived by patients in a study in a randomized control trial.
Dr Orsini (15m 44s):
And one of the things that I noted early on in my story that I talk about and my book about how I saw an
incredible doctor and mentor of mine, who was a very compassionate person who couldn’t communicate that
compassion to a patient. And that’s what made me so interested. He just, and the story, he just comes out
and tell somebody of your baby’s dead. And I knew this man was such a compassionate person, as most
physicians are empathic. And so I really understand what you’re saying is it’s all about the patient experience
that I think as physicians, we all get tied down, we get busy as nurses, but it also think, and I would like you
to comment on this there’s a lot of communication techniques out there that a lot of people don’t know, a lot
of people don’t understand.
Dr Orsini (16m 29s):
And when you teach them these techniques like tone of voice, which I’ll ask you about thinking really convey
that Empathy, that they had inside. But maybe didn’t know. When I was at a young resident, did a rotation
with the doctor who delivered me. That’s how old he was. And he practiced almost 45 years and was never
sued. And I had a great role model and he was able to look at each and every patient that came in there,
whether he met them are not and he was best friends with them in one minute.
Dr Orsini (17m 1s):
And he looked in their eyes really, really close. And I had a great role model. So talk a little bit about you talk
about the acronym that you used. Empathy a little bit about how some practical tips on how physicians or
anybody. I mean, it’s all about building rapport, right? And so give it some tips. There’s a great example. You
talk about in your book “Nice Shirt” and the different ways you’d change the tone. I love that because that’s
something that I also discuss all the time. So tell us about these, some of these techniques that you can give
to our audience.
Dr. Helen Riess (17m 33s):
Well, you’re starting with the middle of the acronym. Is that where you want me to start?
Dr Orsini (17m 37s):
I got to keep my promise. You’ve already inspired them. So I’m want to keep my promise. We’ll give them
some tips on how they can in the short version. I know this takes a long time to learn, but just little tips about
eye, posture, all of that stuff
Dr. Helen Riess (17m 52s):
Okay. So after doing all this neuroscience research, I just thought, how do we compress this into, you know,
teachable skills and human behaviors that people are gonna remember? And you know, on a walk in the
woods one day, it sort of came to me that the word Empathy held, I like most of the behaviors that express or
perceive empathy. And so the first one you already said is eye contact. And so we all think we’re making eye
contact. When we say hi, Mrs.
Dr. Helen Riess (18m 22s):
Smith, how are you? But one tip I give is to notice the person’s eye color. And when you leave, I don’t mean
staring at anybody. But when you meet someone’s gaze with intention, it’s a very different experience than if
you glance up and say, Oh, hi, Mr. Smith, how were you doing? And then you start typing. So write in that
first, second, you have a choice to either connect meaningfully or to just treat the person more like an illness
or an injury.
Dr. Helen Riess (18m 54s):
The M in Empathy stands for muscles of facial expression because there’s no F in Empathy for face. So I
had a fudge that one a little bit, but part of our empathetics training has facial expression, decoding
techniques, so that we learn the subtle differences between anger, disgust, contempt, and sadness. For
example, they all sound very different, but it’s hard for people to see the difference unless they get training.
Dr. Helen Riess (19m 25s):
And we also just try to get people to look at others, faces. Cause as I said, there are a roadmap of the
motion mixed facial expressions or a very common and suppressed emotions are common in patients. So
they won’t necessarily show you that they’re confused or angry. That’s why we have to become better at
reading the face. The P stands for posture. And there’s a lot, you can tell about a person’s mood just by how
they sit or stand.
Dr. Helen Riess (19m 55s):
And also we really encourage physicians to sit down at eye level. So they are not in a dominant position,
which doesn’t really foster collaboration in a cooperative conversation. The A stands for an Affect, which all
of your doctor, audience and nurses will know stands for emotion. And many people have used the term. If
you can name it, you containment. So if we can name an emotion like that person looks really anxious or
agitated, just naming in our heads.
Dr. Helen Riess (20m 30s):
It makes us attend to that differently than if we are just getting kind of catching the agitation and feeding off
of it. And then deciding I need to be more soothing. I needed to help calm this person down. T is tone of
voice. And of all of these empathic behaviors, tone of voice actually conveys the most about what we are
truly feeling. And so in the example you gave, that’s a nice shirt compare to that’s a nice shirt or that’s a nice
Dr. Helen Riess (21m 6s):
So one of them sounds like a genuine compliment. And the other one sounds critical and the other one
sounds like I can’t believe you’re actually going to walk out of the house wearing that.
Dr Orsini (21m 19s):
Even the way you say, how are you when you meet someone, it’s something that you notice all the time.
People will see somebody in the hallway and say, how are you? And it’s clear that they don’t really care. Your
just being polite. And you’re walking by in the other person who could say my dog died and you probably
wouldn’t even notice, but you can come and say, Hey, how are you? And that shows that you really care
what, and how you smile with your eyes or with your eyebrows. You know, we talk about that all the time. So
yeah, tone of voice, I think, is something that most people don’t pay attention to, but once it’s brought up and
they realize that I think they noticed it a lot more.
Dr. Helen Riess (21m 52s):
It’s something that a lot of people are not aware of. Like, I think that this is one of the ways that couples off
and get into arguments is that they’ll say things to each other where they’re not aware of just how like
disrespectful or disgusted they sound. They just think, Oh no, all I said was, you know, X, Y, and Z, but it’s
the tone. And 90% of what we are talking about is conveyed in tone. So that it’s really important. And there
are specific skills like trying to match the volume of the patient that you’re talking with.
Dr. Helen Riess (22m 28s):
So that if someone talks softly and slowly that we don’t come with a booming, you know, wild, fast voice, and
just, we talk about many adjustments. People can become more conscious of with tone,
Dr Orsini (22m 40s):
A famous director, Gary Marshall, I saw something on him, a documentary about him. They were talking
about when he directed during the scene, when the scene was filming, he would turn his back on the actors
and just listen to the tone and the cadence and the reflection of the voice. And he would be able to say, that’s
a wrap or do it again without ever seeing the scene. And that just as a great example, I think of how
important tone is
Dr. Helen Riess (23m 4s):
Definitely. So H stands for hearing the whole person, not just hearing and listening, but embedded in hearing
the whole person is perspective taking which means viewing the person and looking at their lives through
their lens, not our own. I think about like taking off my glasses and putting on yours so that I can see the
world as you see it because many people will say, Oh, treat the person like you would want to be treated.
Dr. Helen Riess (23m 38s):
We really need to treat the person like they would want to be treated. Right. So hearing the whole person
gets at that cognitive arm of Empathy, which is perspective taking and other people have talked about
perspective getting. Some people will say, well, why aren’t we are just trying to imagine, why don’t we just
ask the person so we can get their perspective. But sometimes we’re thinking about a patient before they
ever come into the office, you know, will know that a woman who’s husband died four weeks ago is having
Dr. Helen Riess (24m 14s):
And so we might think about that woman differently than if she were just coming in with chest pain. Cause
we can maybe imagine that there’s a lot going on in there. And then the final letter of the Empathy acronym
is Y, which is your reaction to the person. And that is to me like the key piece, because we all do share
emotions. And if we are at a pretty mindful place, when we enter a patient’s room and all of a sudden we’re
feeling either annoyed or agitated or confused, we must consider that we’ve just picked up their emotion
because we weren’t feeling that before.
Dr. Helen Riess (25m 0s):
And that’s the importance of settling ourselves before we walk into a patient’s room or bedside so that if we
start to pick up other feelings, we can really think about why am I having this reaction? And if we are
suddenly feeling agitated, you know, maybe you were picking up at that person is agitated or all of a sudden
we’re annoyed. And this is so important for medical professionals. Think about, could that person be
Dr. Helen Riess (25m 33s):
And I’m feeling annoyed. Cause they were annoyed in us. Like maybe if we said, we’d come back in 20
minutes with some results and now it’s four hours later and now they’re a little bit nichey or ya know, put out
and they are not being super respectful. And so is it our place to now be annoyed at the patient? Or should
we be really thinking maybe there are annoyed because I didn’t follow through with what I said and maybe
there’s an apology that’s needed.
Dr Orsini (25m 59s):
Well, it’s important to know that, you know, we are talking a lot about Healthcare because you and I are both
physicians, but these are great tips, no matter whether you’re in healthcare or not. In fact, a lot of my
audience is not in the health care sector. In fact, every other week in this podcast, we generally have a
guest, not from a health care at all. So these, our communication, as I say, if you can learn the communicate
and convey our empathy or compassion, you’re pretty much gonna be great in both your professional and
your personal life. The people who are good communicators, people who show empathy, as you say in your
book, just tend to do better in life, better for themselves and seem to go further.
Dr Orsini (26m 37s):
So it’s really important that these tips that Dr Riess is giving us are important for everybody and not just for
medical professionals. I know time is running out. So I wanna get to my, a great question that have been
waiting to ask for a long time. He goes the, the times here are very difficult times in the world right now. And
you talk about in your book about in grouping and I’ve long known and they say, neuroscientists have said
that within the first or second that you meet somebody, your chemicals in your brain have already decided
that whether that person is like or unlike or a friend or foe.
Dr Orsini (27m 12s):
Correct. So this is something happens quickly. And I do this talk sometimes about that. I called what
happens in a second second, and let’s discuss about how that you talked about empathy and the in
grouping. And that really came from survival and evolution. But now we’re not the same as we were when
we were in little tribes and caves. And we’re more of a global people. How do you get there? Because it’s in
your DNA per-say. How do you get to the second, second where we can then all be one?
Dr. Helen Riess (27m 44s):
That’s really the $10 billion question? Isn’t it? You know, I think it’s so important to recognize that it’s not that
long ago, given human history, that we were often separated by mountains, rivers, oceans, where we never
saw people that weren’t like us. And if we did, it was usually an invasion or somebody who was going to
compete for scarce resources.
Dr. Helen Riess (28m 14s):
And so recognizing Other was crucial to survival and that unfortunate change where nothing separates us
now, you know, except COVID shut down, but we can travel anywhere. I see people that are totally unlike
us. The fact that the human brain is still so wired to perceive difference is a real challenge in our global
society. I do believe that the survival of our planet and our species is going to depend on seeing humans as
human period End of Story.
Dr. Helen Riess (29m 1s):
You’re a human, I’m a human and all of these labels and identities and all of these things that we attribute to
one another that separate us. We’re in a very critical moment in history where we have to challenge these
automatic fears, mistrust difference competition, and be. There are so many feelings that go with perceiving
otherness. So I do think it’s the question of our time.
Dr. Helen Riess (29m 32s):
And I think we’re at a level of national discourse about this that’s different than its been before because of
our great conductivity. We have all seen the, of George Floyd dying, these ideas that certain people deserve
tough treatment. Like we just can’t accept these things anymore. So our work is truly aimed at humanizing
everyone and to stop dehumanizing anyone.
Dr Orsini (30m 4s):
Tony Robbins talks about building rapport and defines it as a finding commonality between two people. And I
think that is where the key lies. But when I coach physicians on patient experience or I talk to people about
teach them how to build a rapport, it’s all about finding commonality. And although your tribal response would
be, that person looks different once you can understand that no matter what they look like or where they’re
from there is something in common.
Dr Orsini (30m 34s):
And that gets you into the second, second, if you will. And when I discuss how to improve patient experience
scores, the physicians, and how to make that a patient experience better in build a relationship with the
patient. It’s been shown that you can do that in 56 seconds. A lot of it is just as you spoke about eye contact,
posture mirroring, but it’s also finding commonality. And as a physician, I’ll walk into, I’m a neonatologist. So
they take care of babies. So its not the patient experience. So I’m looking at it’s a family experience, but a
walk into a room when a mother who’s very upset about her baby, be in the neonatal ICU.
Dr Orsini (31m 10s):
If that mother was upset and before I would just introduce myself, I can find at sometimes it will be a book on
the table or they’ll have a TV. Sometimes they’re upset about something that happened. Maybe they’re angry
about something that they can go well. And I see that they have in New York Yankees hat on where they’re
wearing a Yankee shirts, what are they have a 973 area code? What I call them on the phone if I can just
say, Oh my goodness, are you from New Jersey? Because I recognize this area code. It’s an instant bond.
And that’s what you were talking about In-grouping. So the in group might not be our group here.
Dr Orsini (31m 42s):
I think we could find it in group with anyone. Don’t you agree?
Dr. Helen Riess (31m 45s):
Sure. Hope so. I mean, I think one in the most powerful ways to find common ground, his people who have
suffered in similar ways, you know, so if you’ve been through a loss and you’re patients going through a loss,
you know, to say, I really get this, you know, I’ve been so close to this, myself and people who are in support
groups together, let’s say something tragic, like losing a child or a teenager in a car accident.
Dr. Helen Riess (32m 18s):
It’s amazing how quickly the difference is between those people disappear. They have what your calling
common ground like. So common suffering is an incredibly powerful bond and but it really does mean
exposing vulnerability, right? Yes. And that I think is the key. Like we’re all human. We all have our foibles.
We’ve all had our disappointments, our rejections, our trauma’s or whatever.
Dr. Helen Riess (32m 48s):
When we share these things, that’s what unites human to human. But if we stand apart in judgment or
superiority or whatever, that does not allow these human bonds to form.
Dr Orsini (33m 2s):
And if you’re a physician who’s speaking to a patient, the first thing you want to do, I use an acronym called
PROGRAM and the G is for a genuine, if you could show that patient, you’re not just a doctor, that you’re a
real person. I’m from New Jersey. You had a rough day because you’re five-year-old, wouldn’t go to
kindergarten. Then you got off to the late start or going on vacation. Well, where you going Dr Orsini? I’m
going to see Mike family. And the important thing is too for leaders, right? What’s the difference between a
manager and a leader, a manager doesn’t know how to communicate and convey empathy.
Dr Orsini (33m 34s):
Right. But a leader knows how to do that in the best bosses I’ve ever worked. They were real people. They
didn’t stand up on the top. And I think that’s, that goes back to that commonality. Right?
Dr. Helen Riess (33m 43s):
I would hope that there are a lot of managers with Empathy and I’m sure there are, but I think what you’re
saying is the managerial role might be just to get tasks done, but a leadership role is to build morale, you
know, inspiration and to connect people.
Dr Orsini (34m 2s):
Yeah, that brings you to a different level. That’s my point is that for the whole thing? So why is it so important
to have empathy in that we’re not changing our first second or those neurotransmitters are those tribal
instincts immediately, but back to the Empathy we can train. Empathy like you’re doing such a great job in
medicine and in business. And we can train people to be more empathetic, to be better communicated, to
find commonality than maybe we can go to that global, scene that you’re talking about because we can, it’s
going to take time to change our DNA, but we can fix The Second Second, very quickly.
Dr Orsini (34m 38s):
And I think that’s how this relates.
Dr. Helen Riess (34m 40s):
I really loved that idea of the first and the second second, because you know, Empathy is automatic in most
people. There are certainly some people who just don’t have it, but it’s the exception of the rule. Many
people feel empathetic and were able to shut it off. And especially if we’re tired, hungry, overworked,
overwhelmed, sick. That all interferes with expressing empathy.
Dr. Helen Riess (35m 11s):
And so I think it’s so important for the Physician and health profession audience to understand that Self
Empathy, which is the last chapter in my book. It probably should be the first one that if we don’t treat
ourselves with proper care, sleep, nutritious food exercise, if we don’t fill the tank, we are going to get
depleted and it will show up as burnout. And when we’re burned out, we tend to objectify people, refer them
by their, to them as their disease or their condition, you know, instead of the human being that they are.
Dr. Helen Riess (35m 53s):
So empathy is really a key input output, just like so many things. There’s an afferrent and efferrent. We’ve
got take good care or to put us in the best position to give good care.
Dr Orsini (36m 6s):
I think that’s a great way to finish this whole interview. Take care of yourself first, because we’ve all been
there before, where we get for a lack of a better word, grumpy and we lose our Empathy. We talked about
In-grouping and that we tend to have empathy towards people that are like us more than people that are
unlike us. So I think the solution to that is to find commonality and perceive everybody is like you, and it will
be easier to empathize. And I think the work you’re doing is just absolutely amazing in my small way, I’m
doing the same thing, but I really love the way you’re doing all the teaching that your book is phenomenal.
Dr Orsini (36m 43s):
Your Ted talk is great. What’s next on the horizon for you? You’re doing so much.
Dr. Helen Riess (36m 48s):
I mean, I think it, as you said earlier, we were in a very critical time in the world where we need empathy
more than ever. And you might be noticing it’s mentioned in the news, like almost constantly. The most
exciting new development is being approached by law enforcement to help police forces, to humanize many
of the situations that they find themselves in many, the challenges because our police are being called in to
take care of mental health issues, domestic violence issues, you know, violence issues and getting a cat out
of a tree issues like they are, they pretty much have to do everything.
Dr. Helen Riess (37m 29s):
And you know, many of them are being asked to take roles that they’re really not trained to do. So I see this
as an opportunity to really make a difference in how just everybody, every professional is trained to like
appreciate the human being in front of us and to bring our best to every interaction.
Dr Orsini (37m 53s):
I think it’s great that you’re starting to work at law enforcement. I in fact, come from a whole family of law
enforcement. I’m the only physician in my family. Everyone else is police officers as a retired police officer for
my father, my uncle, my brother, my cousins. And so I think the topic that we really have to speak about is
that self empathy for themselves because they talk about burnout. My father said to me, when I was very
little Anthony, my mother and father are only ones that call me Anthony, Everyone else calls me, Tony.
“There’s only two people in the world that have to be perfect doctors and police officers.”
Dr Orsini (38m 24s):
And he said that for many, many years. And I think that that pressure it’s something that needs to be
acknowledged. So that Self Empathy that you talk about is so important because you do get jaded and
physicians to the exact way. We have a highest burnout rate of any profession right now. And so taking care
of ourself, I think is really a great thing. So it’d be want to be empathic towards other people. You have to first
Dr. Helen Riess (38m 47s):
It’s called putting on your own oxygen mask first it’s we get this instruction every time we’re on an airplane,
but so few people apply it to self care. People think of self care as being selfish. Yeah, there are definitely
ways people are selfish, but attending to your own physical, emotional, and social needs is just critical to
being effective in the world.
Dr Orsini (39m 13s):
You love that analogy, put your own oxygen mask on before he can help anyone else. And that’s fantastic.
So Helen thank you so much for doing this interview. I can talk to you for hours, but I know you have to go. It
was really a great interview and you certainly inspired the audience because I think it’s going to make people
speak about Empathy more, the more we speak about it, the more we’re aware of it. The more we’re aware
of when our Empathy slides up in their slides down, we can catch ourselves finding that commonality, using
the great techniques that you gave us communication techniques with the eye contact in the Empathy
acronym is really going to help them.
Dr Orsini (39m 49s):
And I think, especially when you’re doing Difficult Conversations, which is what the name of this podcast is.
So I really wanna thank you for being here and I just love the work you’re doing and I’m just make sure to
see what your next big thing is with the law enforcement. I think that’s awesome.
Dr. Helen Riess (40m 4s):
And might be picking your brain about that.
Dr Orsini (40m 8s):
I don’t remember as a kid, someone who would say to me, who is a police officer or in your family, and I
would say my uncle three cousin’s father and grandfather’s then they say, well, why don’t you go into the
police Academy? My answer was I’m afraid of guns. So I decided for something easy, like to become a
physician. So it’s so easy, right? So, but thank you for all that work you’re doing. Thank you for being such a
gracious host and for taking the time to be out here and thank you for inspiring our audience. Thank you.
Dr. Helen Riess (40m 35s):
You so much for having me. It’s been a genuine pleasure getting to know you.
Dr Orsini (40m 39s):
Thank you. And I hope we can speak again sometime soon. If you liked this podcast, please go ahead and
hit subscribe. Go ahead and download all the episodes. You’ll see a new episode downloaded every single
Tuesday. If we need to learn more, please contact email@example.com and Helen, how can they contact
you? What’s the best way. That’s great.
Dr. Helen Riess (40m 58s):
Dr Orsini (41m 1s):
Okay, so please contact telling if you have any questions, if you’re interested in her training, its amazing in
go ahead and I hope everyone has a great week and I will be here again next Tuesday. So thank you again.
Have a great day care. If you enjoyed this podcast, please hit the subscribe button and leave a comment in
review contact dr. Sini.
Dr. Helen Riess (41m 22s):
Dr Orsini (41m 25s):
Dr. Anthony Orsini
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