fordCecilia Ford, who has been a psychologist in private practice in New York City since 1987, has addressed emotional issues for Women’s Voices in many articles over the years.



Recently I wrote about how to cope with fears in the wake of terrorist attacks. It is difficult to keep perspective these days and judge what may be a dangerous situation or not, which is precisely the goal of random violence. Another effect of violence coming closer to home is that it heightens our empathy for those who live with it on a daily basis. If the Paris attacks made us more acutely aware of others’ suffering, the California massacre made it all the more personal.

Therapist Joseph Brugo wrote a blog on The New York Times “Opinionator” site about an increased tendency lately in his patients to apologize about talking about their problems, which seem trivial in comparison to the magnitude of some of the crises in the news today. Sometimes they use the phrase “first world problems” when referring to this discrepancy. These are things that are luxuries compared to what many people have to deal with—not “life and death” issues—but things like marriage, mortgages, managing anxiety. They can feel ashamed that they are so concerned with these quotidian affairs when they are aware of, and genuinely concerned about the more serious level of problems others are experiencing elsewhere in the world. Bruno points out that before radio, television, and certainly the Internet, we didn’t have an up-to-the-minute awareness of what was going on outside the “first world” and he says:

“If we allowed every mass tragedy to affect us deeply, we would soon suffer from empathy overload. Most of us would agree that having empathy for other people is a good thing, a core human capacity that supports morality and civilization. But it’s also possible to have too much of a good thing. Empathy has a downside when it makes you ashamed of what matters to you, or when it distracts you from other important emotions of your own.”

I would argue that true empathy is always enriching—that it makes you more human to feel others pain. The dilemma is that we all live in a context dictating that we live the life we are living. It’s not your fault if your life involves a marriage and a mortgage. A mature, grounded person also has a sense of who she is in relation to the wider world. It’s a good thing to be aware that you are lucky to be in this position, to be concerned about and engaged in the fate of others around you.

There is an ethical teaching in the Torah that I often quote to patients who are concerned with this issue of self-centeredness. It says, “If I am not for myself, who will be for me?” I think of this as the moral equivalent of giving yourself oxygen first so you can pass it along to your children. But there is a crucial second part to the quotation as well: “If I am for myself alone, who will I be?”

After 9/11 this was a very big problem, particularly in New York, where I practice. Everyone was deeply affected by the Twin Towers, which was a national and international event, but local disaster as well.  In the past, if even one firefighter died in the line of duty it was on the front page of the Daily News, sometimes for several days. Yet here was an event that killed thousands of people including hundreds firefighters and police officers. It was hard to find a New Yorker who wasn’t directly touched by the attacks. And even for those who didn’t know someone personally, we New Yorkers take our municipal workers very much to heart, as was evidenced in the aftermath.

With one glaring exception (someone with an extreme narcissistic disturbance) none of my patients were able to keep thoughts of 9/11 out of their sessions for quite a while. I remember some people who worked in the arts questioning the value of their work and considering changing professions. As the weeks wore on, however, it became clear that as in all things, people were filtering the events through the lens of their own personal histories. One man, who had been burned on part of his upper body in a fire when he was a child, was preoccupied with that aspect of the event. Another person, who had always played the role of the “good girl” in her family, dwelled on the fact that most of the victims seemed to her to be the people who were doing their jobs, getting to work on time — the people who did the “showing up.” Someone else was angry at the idea that “bad guys” can get away with things and not get caught, something that had a lot of meaning to his personal history. In the months that followed, two women who were still overcome with grief began affairs with firefighters.

After World War II a Viennese psychoanalyst named Viktor Frankl came to the United States and published several books from the perspective of a psychoanalyst who had survived the Holocaust. Like most people he knew from his youth, he lost almost all his family members—his wife, his mother and father, by the end of the war. Some of his patients, aware of his experiences, expressed difficulties discussing their day-to-day concerns, which seemed so trivial compared to the pain he must have suffered. He would counter by explaining that each individual’s life must be taken in context and that everyone’s suffering is like gas in a bottle—it fills the whole bottle.

Obviously, it is important for us to maintain our sense of context within the wider world. But the fact is that most people who come for therapy are well aware of that. They are the people who worry that there is something wrong with them and want to change themselves. Usually, they are more sensitive than average to the world around them. The issue for many is how to retain our empathy and connection to others without being overwhelmed by the constant barrage of tragic and often frightening news on hand. We live in our own “bottles” but for most of us the glass is not opaque. And yet, as we all know that we can learn to selectively ignore or deny painful information if we are exposed to it often enough or in a way in which we cannot process it.

In most large cities, it is not uncommon to see homeless people begging for spare change on the street — often several on each corner in New York. There are several different strategies for “coping” with passing the homeless. One is to ignore them completely. They are so ubiquitous as to have become part of the landscape. Many people assume a good percentage will spend the money on drugs, and that the city provides them adequate services. A second is to think it through or rationalize: you say to yourself that you contribute to the homeless problem by donating your time and/or money to the church soup kitchen and that to give money on the street encourages bad habits. A third strategy is to respond directly and try to give money as frequently as possible, like my friend Bill who fills his pockets with spare change when he leaves the house in the morning. Of course, even he is then faced with the moral dilemma of what to do when he inevitably runs out of change and must either take the time to get more, start giving away bills, or stop donating for the day.

Bill would be the first to admit, however, that he is not risking his life or even giving away very much money relative to his income and prosperity (lower middle class, small savings for retirement). For each, there is a personal level of how “permeable” we are to feeling the pain of others. (It’s not usually a choice). Furthermore, there are some kinds of pain a given individual may be able to handle better than others. Some people cannot bear to even visit hospitals because they find them too upsetting. Yet an individual who becomes a doctor is not someone who is immune to the pain of others. Often it is the opposite: doctors are often people whose worry about suffering led them to their career as a way of mastering their feelings of helplessness about that worry.

As for people who pass by beggars, some do it because they don’t care, but some do it because they can’t process their feelings, and the best way to do that is to find an active way to express them that seems meaningful to them. This is why, in the wake of disasters, it is not just useful, but also cathartic to join in relief efforts. It is why, after the attacks in Paris, many people imposed the colors of the French flag on their Facebook profiles. It was a small, symbolic, but active expression of the empathy they felt for the Parisians’ grief and loss.

It’s true that the United States is lucky enough to be in the First World, and certainly most people in therapy have the “luxury” of dealing with only those problems that are well beyond the level of the fight for liberty or subsistence. Yet as Americans, many of us are just a few generations or less from immigrants who knew those fights and it has been part of our national culture (with some notable exceptions) to be responsive to the suffering of others. Empathy is not a weakness, but strength, especially if it can be channeled into meaningful expression. The problem lies not with the feelings, but with the sense of helplessness they can engender. Taking action, even small or symbolic ones, can help ease the pain of sharing others’ suffering, but the sharing itself is never the problem.



Frankl, Viktor,  Man’s Search For Meaning, 1946.


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  • Mindy January 26, 2016 at 3:35 pm

    Super interesting read.

  • January 18, 2016 at 5:39 am

    To stay alone is to remain alive, Cassie
    believes, until she meets Evan Walker.

  • Wendl in Manhattan December 24, 2015 at 8:28 am

    A small correction to an excellent article: the quote attributed as being in the Torah is not, in fact, found in Torah. It is credited to Hillel (d. 10 CE), a religious leader associated with the development of the Talmud and Mishnah.
    Hillel says, “If I am not for myself, who will be for me? But if I am only for myself, who am I? If not now, when?” Ethics of the Fathers, 1:14