In this element of the MI spirit, the clinician strives to understand the client’s point of view as accurately as possible before asking the client to consider change or offering anything.
You never really understand a person
until you consider things from his point of view…
Until you climb inside of his skin and walk around in it.
Help someone, you earn a friend.
Help someone too much, you make an enemy.
Stay curious. It is so easy to foreclose an exploration. After hearing some about your client’s motivations, you may say in your head, “Oh, I get it. This is what she wants.” Accurate empathy includes staying open to the fact that you may not have gotten it right or that there is more.
Listen carefully to the actual words the person says. This means taking the person at her word even if it does not sound logical. Reflecting back what you hear, no matter your response to it, may further your acceptance.
Aiming for accurate empathy means working to understand deeper meanings that are not said explicitly. You may hear emotions or themes that the person does not say in so many words. For example, you may sense frustration, concern, being overwhelmed, or pride in accomplishment. When you reflect back what you believe you are hearing, you help the client express what is important and contribute to engagement.
Ask the client to correct you if you seem to not get it and attend carefully to any hints that you are off track. For example, if the client suddenly looks away or becomes quiet when you reflect what you believe the client’s concerns are, you could say, “I sense that I’ve missed something important. Please help me understand how all this looks to you.” You could explicitly say that you need help understanding her perspective, “I am not in your shoes and I want very much to know what it is like for you.”
Cautions: It is human nature to identify with another when you are trying to understand his experience. It is tempting to express this identification, “I’ve had that experience, too, and so I understand.” Or “I have struggled with my weight, too.” These are not empathy, and this identification tends to shut off your ability to truly understand the client’s experience. Notice this tendency to identify and do your best to set it aside.
At times, a client’s perspective or beliefs may sound misguided. You will want to impose your own perspective and move forward with the counseling. This is the opposite of empathy and will cause you to lose engagement. In the spirit of MI, you can accept the client’s perspective while also offering yours. (See Tip #105, Addressing Myths and Misinformation, in Practice Workbook, Vol. 3.)