The Psychotherapy Networker, Sept/Oct 2004
Mirror, Mirror: Our Brains are Hardwired for Empathy
Babette Rothschild, MSW, LCSW
Empathy is the connective tissue of good therapy. It’s what enables us to establish bonds
of trust with clients, and to meet them with our hearts as well as our minds. Empathy enhances
our insights, sharpens our hunches, and at times seems to allow us to “read” a client’s mind. Yet,
vital as it is to our work, empathy has remained a rather fuzzy concept in psychotherapy. To
many of us, it seems to arise from a kind of potluck stew of emotional resonance and insight,
seasoned with lots of attuned presence and a generous dollop of luck.
Far from the therapy office, in the precisely measured environment of the research lab,
brain scientists are discovering that a particular cluster of our neurons is specifically designed and
primed to mirror another’s bodily responses and emotions. We are hardwired, it appears, to feel
each other’s happiness and pain—more deeply than we ever knew. Moreover, the royal road to
empathy is through the body, not the mind. Notwithstanding the river of words that flow through
the therapy room, it’s the sight of a client looking unhappy, or tense, or relieved, or enraged, that
really gets our sympathetic synapses firing.
This news is both exhilarating and scary. The good news—for therapists, their clients,
and the world at large—is that human beings may be more deeply capable of empathy than we
ever imagined. If we’re truly born to connect, perhaps there is hope for us all. The scarier news: If
we’re truly designed to mirror each other’s feelings, we therapists may be exquisitely vulnerable
to “catching” our clients’ depression, rage and anxiety, and succumbing to the ravages of
"compassion fatigue." Given the hardwired nature of empathy, is it possible to say yea or nay to
its effects on us? What steps might we take to harness and channel our natural-born empathy for
the good of our clients—and ourselves?
I first recognized the physical force of empathy as a college student, with the help of my
friend, Nancy, who was studying to be a physical therapist. As we walked down a street together,
she would follow total strangers and subtly mimic their walking style. Copying a stranger’s gait,
and feeling it in her own body, gave her practice in identifying where one of her patients might be
stiff, or in locating the source of a limp. Intrigued by this mysterious way of “knowing” someone, I
asked her to teach me to do it, too. I began to surreptitiously mimic the walks of all manner of
unsuspecting folk, from unsteady older people to cooler-than-thou teenage hipsters. What startled
me was that not only did “walking in someone else’s shoes” change the way I felt in my body, but
it often altered my mood, as well. When I copied the swaggering gait of a cocky young man, for
example, I would momentarily feel more confident--even happier--than before. I found this secret
street life fascinating and fun, but I didn’t think much about it until a few years later, when I started
practicing clinical social work.
Breathless
On my first job in the mid-1970s, working in a family service agency, I began to notice
peculiar things happening in my body while I sat in my office with clients. Some of my responses
could be blamed on newbie jitters, but I strongly sensed that there was more to it than that. I
particularly remember my bodily reactions to a young client named Allison. As she recounted the
crises of her week in a spacey, disconnected way, she kept her body very still, and I had to lean

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forward to hear her whispery, almost inaudible voice. As we worked together, I began to notice
that I often felt lightheaded. When I began to pay attention to what was happening in my body, I
found that my breathing had become very shallow—in fact, nearly undetectable. No wonder I was
feeling lightheaded and spacey: I wasn’t getting enough oxygen.
Turning my attention back to Allison, I noticed that her chest was barely moving. I was
taken aback: We were breathing alike! I remembered, then, how my mimicry of walking patterns
in college had often affected my bodily sensations and moods. Were my lightheadedness and
general feelings of disconnectedness just the result of new-therapist nervousness, or the direct
result of my imitation of Allison’s breathing? If our respiration had actually become synchronized, I
thought, it was totally unconscious on both our parts.
In all of my graduateschool discussions on the therapeutic relationship, including the fine
points of transference and countertransference, I couldn’t remember anyone ever mentioning the
possibility of “catching” bodily behaviors. Intrigued and a bit bewildered, I took my observations to
my supervisor. I still remember her look of startled skepticism. “What an odd hypothesis,” she
finally remarked, her cool tone clearly implying that my experience was not to be taken seriously.
I was dumbfounded by her lack of curiosity, but I never doubted my own sensations. On the
contrary, increasingly fascinated with the role of the body in relational and emotional life, I began
a serious study and practice of body psychotherapy.
In contrast to my suspicious supervisor, my body psychotherapy colleagues and teachers
seemed to easily assume that their bodies were “in tune with” or “resonating with” those of their
clients. Like actors, they regarded their bodies as essential, finely-honed instruments of their
craft. From these practitioners I learned “postural mirroring,” a technique instigated by dance
therapists, wherein I would attempt to get a reading on a client’s emotional state through copying
the way he sat, stood, or moved. There wasn’t a lot of debate about the usefulness of such a
technique: Body psychotherapists simply assumed that "the body doesn't lie."
Tracking Down the Source
While I was heartened by the confirmation of my own observations, I was concerned
about body psychotherapy's uncritical acceptance of a link between a therapist's and client's body
states and emotions. I needed to know more: Where does our ability to resonate with each
other—and with such stunning immediacy and accuracy—come from? What core processes
drove the dance-like synchronizations of movement and mood that I kept encountering?
Throughout the 1990's I became a voracious student of neuroscience—first to learn
about the physiology of trauma. In the course of those studies I discovered the term "vicarious
traumatization" and documentation that therapists could actually suffer symptoms similar to their
traumatized clients. At once I was both concerned and excited. I wondered if the emotional and
physiological reactions that accounted for this might have any relationship to my earlier gait
experiments with Nancy, the incident with Allison, and my body psychotherapy colleagues'
enthusiasm for client mimicry. I would need to dig further.
I nurtured my curiosity at the library, on the internet, and with PsychInfo and Medline
databases. From the vast literature of social psychology, I learned that facial expressions were
contagious—when baby smiles, Mom usually does, too—and that such synchrony affects the
nervous system and can convey emotions. I also learned that people commonly—if
unconsciously—copy one another's posture and synchronize breathing patterns.
As exciting as that research was, I still felt something was missing. The writings of
neurologist Antonio Damasio, attachment specialist Allan Schore, and interpersonal
neurobiologist Daniel Siegel, and others told me that scientists could locate effects of empathy in
the brain. But, astonishingly, until the mid-1990's, no one had looked for a source of empathy in
the brain! And as I was to find out, the discovery of brain-to-brain empathy happened by accident.
Monkey See, Monkey Do
In 1996, an Italian neuroscience research team led by Giacomo Rizzolatti and Vittorio
Gallese was studying grasping behaviors in monkeys. They attached electrodes to the monkeys’
brains in order to observe precisely which neurons fired when a monkey grabbed a raisin with its
hand. The research was routine: monkey grasped, specific neurons fired.

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Then, during a break, one of the researchers hungrily reached out for a raisin. His fellow
researchers coincidently noticed something extraordinary on the monitor: Neurons in the
monkey’s brain fired—the exact same neurons that had fired earlier when the monkey grasped a
raisin itself!
The team was astonished: Nothing like this had ever been seen before. Their
serendipitous finding was the first clue to the existence of what scientists now call “mirror
neurons,” so-called because they appear to actually reflect the activity of another’s brain cells.
The monkey’s response was not just simple recognition, as in “I know what the researcher is
doing.” That kind of observation is activated elsewhere in the brain. What happened between
monkey and researcher required a brand new concept, an altogether new theory of behavioral
interdependence. The monkey’s neurons fired as if it had made the same movement itself. This
was a genuine brain-to-brain connection. In an instant, the definition of interconnectedness, the
notion of empathy, changed forever.
Subsequent neuroimaging research in humans suggests that we, too, may have a similar
mirror-neuron system that allows us to deeply “get” the experience of others. When people watch
other individuals drumming their fingers, kicking a ball, or biting into an apple, the sectors of their
brains that turn on are the same sectors that activate when they perform these behaviors
themselves. Meanwhile, in a paper published last year entitled “The Roots of Empathy,” Gallese
pushed the envelope further by hypothesizing that “sensations and emotions displayed by others
can also be ‘empathized,’ and therefore implicitly understood, through a mirror matching
mechanism” in the brain. Soon, he believes, scientists will discover a mirror neuron network that
establishes, beyond a doubt, that we are born to resonate with each other at the deepest
emotional levels.
Orchestrating Empathy
While neuroscientists continue the slow work of confirming these promising findings and
theories, therapists can begin to apply them now to empathize more strategically and effectively
with their clients. Because empathy is rooted in the body, the more mindful therapists are of their
own somatic responses, the more skillfully they can choose to engage mirror neurons to gain
valuable information about a client’s emotional state. Equally important, a therapist can choose to
slow down, or even halt, the brain’s rush to empathize when it might overwhelm the client--or the
therapist.
Let’s begin with the body’s gift for sleuthing. When you want to get a literal feel for what
it’s like to be in your client’s skin, you can consciously mirror some aspect of his or her behavior
or expression. I tried this when I worked with Fred, a new college graduate who’d come into
therapy to address his anxiety about dealing with authority on his first “real job.” Though he’d
grown up with a tyrannical father who had beaten him regularly as a child, Fred couldn’t see or
feel any relationship between his childhood trauma and his current fear of standing up to his
boss.
One afternoon, Fred arrived for his session deeply depressed. He’d been thinking about
suicide, he said, but had no idea why. I wasn’t sure either. As I asked him to describe what
"suicidal" felt like in his body, I tuned in by copying his flat facial expression and slumped posture.
Almost immediately, I began to experience in my own body the sense of deadness he’d just
described to me. It reminded me of the “freeze” response that is an instinctive reaction to
inescapable threat.
All at once, a light bulb flashed in my mind. “Fred,” I asked, “have you ever seen a mouse
that’s been caught by a cat?” He nodded yes. “What does the mouse do?” I prodded. “It plays
dead,” he replied, his face beginning to brighten with interest. We then discussed the protective
function of freezing for all prey, both animals and people. Finally, I asked Fred if he’d ever reacted
that way himself.
“Yeah,” he said softly, “when my dad beat me.” As his father hit him, he told me, his body
would lose all power and “go dead.” For the first time, he made a felt connection between his
childhood horrors and his current emotional state. It seemed a light bulb was also flashing in
Fred's mind. As he began to talk thoughtfully about his own “internal mouse,” his body posture
gradually became more upright and animated, and by the end of the session he reported that his
thoughts of suicide had receded.

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Could I have helped Fred make this breakthrough with talk alone? Perhaps, but it would
likely have entailed several more sessions full of the usual conversational roundabouts, byways
and detours. Instead, by mirroring him, I could quickly feel and then understand Fred’s deadness.
While purposefully synchronizing with your client can often provide added insight or even
jump-start a stalled session, be aware that the data you pick up is not “pure” information. Just as
gaps can occur between speaker and listener in verbal communication, so can somatic
communication be distorted by your own filters. If, for example, you mimic your client’s head tilt
and get a feeling of anxiety in your chest, your client may indeed be anxious. But it also could be
that you habitually tilt your head when you’re anxious, so that repeating this action triggers the
emotion. So, as I did with Fred, be sure to check out your bodily hunches with your clients.
The Risks of Resonance
Mirroring a client can be a bit of a tightrope act. You can easily lose your balance and
crash to the earth, especially if you fail to stay focused. I learned this lesson the hard way.
A few years ago, my client Ronald was angry with me because I was leaving town for a
few weeks. He was so full of fury that for the first hour of a double session he would not talk at all.
He sat half-facing away from me, tense and seething. From time to time, his eyes would fill with
tears. Repeatedly, I tried to make verbal contact with him, using such standard gambits as “You
seem very angry” and “This looks very difficult for you.” But I had the unmistakable feeling that my
words projected about a foot from my mouth, and then thudded heavily to the floor.
Finally, I decided to hold my tongue and let Ronald work it out himself. With my mind
emptied of fix-it schemes and nothing much else to do, I began to consciously copy my client’s
hyper-tense posture. I clenched my jaw, clasped my hands tightly in my lap, and crunched my
shoulders forward.
Two things happened. The first was that within a minute or so, Ronald’s posture began to
loosen up a little and he turned toward me, beginning to talk about his feelings of impending
abandonment. (I’ve since learned that mimicking another’s posture can nonverbally convey
understanding.) As he aired his rage and hurt, I was able to acknowledge his feelings and let him
know that I could understand and accept his anger. By the end of the session, he reported feeling
somewhat calmer.
But not me. After Ronald closed the door behind him, I realized that I was very
uncomfortable. Actually, that’s an understatement: I was practically unhinged with fury. But why?
Was I angry with Ronald? Had the session triggered something from my own life? I tossed
around a half-dozen possibilities in my mind, but nothing seemed to fit. Only later, when I talked it
over with a colleague did I remember: I had copied Ronald’s infuriated posture! My mirror
neurons had done their job too well. Once I made this crucial connection, the “infection” began to
drain: I could almost feel the fury leaking out of me. I returned to myself again in a matter of
seconds.
To some therapists, what happened between Ronald and me may look like a textbook
case of projective identification—a case of Ronald “putting” his uncomfortable feelings into me
and thereby “inducing” my fury. I couldn’t disagree more. I was a full participant in the process:
Only after I actively mirrored Ronald did I begin to feel angry. But while my mimicry was entirely
conscious—if later forgotten—I believe that this kind of brain-to-brain communication occurs at an
unconscious level between clients and therapists all the time. The next time you feel that you may
be suffering from the impact of a projective identification, you may need to look no further than
your own body to discover whether you have mimicked your client’s posture, facial expression or
breathing pattern. Routinely adding such a simple step could eliminate blaming clients for feelings
that are, in fact, rooted in our own, naturally responsive neural circuitry.
There is liberation here. Particularly for therapists who often find themselves on the edge
of emotional overload. Active awareness of your own neurally-mediated role in absorbing clients’
feelings can help you to control the contagion. Once you become aware of your mimicry, any
behavior that brings you back to the sensations and feelings of your own body, and out of
synchronization with the client, will help you to apply the “empathy brakes.” You might stretch,
take a drink of water, get up to fetch a pen, or write some notes. These steps won’t short-circuit
empathy, but rather will allow you to return to yourself, to a place of clarity, presence, and helpful
attunement to your client.

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When a Client Feels Your Pain
Empathy, of course, is a two-way street. Our clients often unconsciously parrot our body
patterns and take on our corresponding emotional states. Many therapists instinctively foster this
process. When, for example, you slow your own breathing and your anxious client subsequently
slows his, you’re engaging his mirror neurons. No words need be exchanged for the client to
gradually match your slower respiration and begin to calm down.
But if clinicians' serenity is contagious, so, too, is their agitation. One morning, upon
returning to Copenhagen (my then home) after a long visit to the United States, I was suffering
from a particularly nasty case of jet lag. Though exhausted and headachy, I jumped right into my
usual work schedule. At the end of my afternoon session with Helle, I asked her, per usual, “How
are you feeling?” Helle proceeded to describe my jet lag in precise detail. “I feel very tired, and
there’s a feeling of pressure in my forehead,” she said, rubbing her eyebrows. “I also feel an odd
heaviness in my chest. And I’m hungry, though I shouldn’t be. I ate a good lunch just before I
came.”
I suggested to Helle that she stand up and walk around the room, hoping that the
physical activity would move her out of my somatic sphere of influence and back into her own
body. After pacing for a minute or two, she returned to her chair, noticeably more energetic. “My
exhaustion and hunger have disappeared!” she reported. I then told her how I was feeling, that
she had described my sensations precisely.
Since consciousness is an important part of the process of controlling the neuronal
dance, we spent a few minutes tracking down how Helle had "caught" my state. In retracing her
steps—and postures—she realized she had rested her head on her hand as I had tiredly done.
That ordinary act of unconscious mimicry was enough to make her vulnerable to feeling my jetlag
and the untimely hunger that accompanied it.
Psychiatrist and early attachment expert Daniel Stern calls the moments of true meeting
in therapy a “shared feeling voyage.” Though each voyage may last but a few seconds, we’ve all
experienced its potent rush—the sudden throb of feeling not just for but with a client, a sensation
of jolting connectedness that can be both exhilarating and fearsome in its intensity. What we’ve
always imagined to be a resonance born of voice, smile, tears, or touch is encoded in us, it turns
out, far more deeply and inexorably than we ever knew. It may be that our mirror neurons, those
tiny and inescapable vessels of empathy, encapsulate one of the most exciting challenges of
psychotherapy—that of attuning two brains, and two hearts, so that they warmly vibrate together
without melting into one.
Further readings:
Gallese, V. (2003). The roots of empathy: The shared manifold hypothesis and the neural basis of
intersubjectivity. Psychopathology 36: 171-180.
Hatfield, E., Cacioppo, J.T., Rapson, R.L. (1994). Emotional Contagion: Studies in Emotion and Social
Interaction. Cambridge, UK: Cambridge University Press.
Rothschild, B. with Rand, M.L. (2006). Help for the Helper: The Mind and Body of Compassion Fatigue
and Vicarious Trauma. New York: W.W. Norton.
Babette Rothschild, M.S.W., L.C.S.W., is in private practice in Los Angeles and gives professional
trainings worldwide. She is the author of The Body Remembers: The Psychophysiology of Trauma and
Trauma Treatment, The Body Remembers Casebook: Unifying Methods and Models in the Treatment of
Trauma and PTSD, and Help for the Helper: The Psychophysiology of Compassion Fatigue and Vicairous
Trauma. Mailing address: P.O. Box 241783, Los Angeles, CA 90024. E-mails to the author may be sent to:
babette@trauma.cc Website address: http://www.trauma.cc

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