How Power Destroys Empathy & Compassion

In 2007, after twelve years of training to become a doctor, I left the hospital, only seven years after completing my training. Why? Because, in my estimation, to rise in the medical hierarchy requires trading in empathy and compassion for power- and it’s a bad trade, one I wasn’t willing to cooperate with.

When I quit, the medical director of my hospital, the male doctor at the top of our hospital’s medical hierarchy, told me I was a waste of a medical education, that they had to train two women in medicine to equal the value of one man these days. And there it is. No empathy. No compassion. He was shameless in saying something so cruel to a woman who was leaving medicine in order to keep hold of her tenderheartedness.

I started my day today reading Celeste Davis’s wonderful review of women’s history as it relates to the anti-war movement. Celeste’s essay was about how we shouldn’t be listening to men talking about how to stop war with other men they’re playing war games with, because anyone who is benefitting from hierarchical systems is at risk of becoming blind to the oppression inherent in any dominator system, whether we’re talking about male supremacy, white supremacy, heterosexual supremacy, wealth supremacy, able-bodied supremacy, US supremacy, or the medical hierarchy.

I was moved by the history Celeste shared about Julia Ward Howe, who in the 1870’s, wrote “An Appeal to Womanhood Throughout the World” and declared June 2 “Mother’s Day.”

Too tender. That stopped me in my tracks. I literally stopped reading and looked at Jeff with tears in my eyes and said, “That is why I had to quit medicine. Because I was too tender towards the mothers who entrusted me with their care.”

I was too tender not to cry when their babies died, not to climb into their beds with them and hold them while we both wept. Back then, when I’d done just that and one of my male OB/GYN medical school professors caught me hugging and crying with the mother of the dead baby I’d just delivered, he screamed at me, attacking me in front of my crying patient, telling me I’d never amount to anything in this career if I couldn’t stop feeling so goddamn much. He tried to kill my vulnerability- and hers, which signaled to me that he had already killed his own.

Because I was too tender, and I refused to play the game that would require me to sacrifice my empathy in exchange for power, I had to leave medicine and give up all that power, privilege, and money. I realized that, to stay, I would have to dehumanize my patients- like the men did, like the female OB/GYN’s who were willing to agree to the devil’s bargain- so that I could control, dominate, and earn a living from taking care of women.

On the night I got attacked for hugging the mother of the dead baby I’d just delivered, two female midwives, who were below me on the medical hierarchy, even though they were far wiser and more experienced than me, saw me get attacked over and over because of my empathy for other women. They held me in their arms when I was crying and warned me, “Don’t ever let them break you.” (I wrote a prize-winning essay about that night in a medical literary journal here. Or listen to me read it here.)

But ten years later, when I was seven years into my OB/GYN practice, when I had been squeezed to try to see 25 patients a day when I’d started my job, and when I was then expected to see 40, I realized my empathy would have to go by the wayside if I was to meet the demands of the job. I would have to stop caring in order to stay employed. I would have to close my ears when my patients wanted to tell me how much sex hurt- or how their vaginas would close on the penises of the men who loved them because of the men who had abused them when they were children. I would have to close my heart to women who told me they regretted becoming mothers or regretted getting pregnant or regretted saying yes to man who gave them HIV.

To spend 7 1/2 minutes with a patient would mean that I would have to become like the others- to rush, to silence, to refuse to listen, to bully, to keep my hand on the door, to turn my back to the patient so I could type on a screen. I would have to care less. I would have to care almost not at all about the most sensitive things these women had ever spoken to anyone about. I would have to trade empathy and compassion for money and power, and it was a trade I wasn’t willing to make. I was still too tender. I still am- but only, I believe, because I left. I don’t believe I’d still be tender if I’d stayed. I’d have become like the other men and women who saw 40 patients per day- hard as nails, but rich and powerful, holding life and death in my own powerful hands.

I had a hot buttered epiphany when I finished reading Celeste’s article. I stayed with that quote, “We, women of one country, will be too tender of those of another country to allow our sons to be trained to injure theirs.”

It made me think of some of my romantic and professional relationships with powerful cis, white, hetero, Ivy League-educated men- about how little empathy they seem to feel when they’ve done something to hurt me. About how my pain somehow becomes all about how I’m hurting them by protesting the behavior that hurts me, how they center themselves in the very moments when I need to be centered- with empathy, with compassion, with care for my own pain, with humility, with repair, with tenderheartedness.

I want to ask them, “What is it like to have lost your empathy because you traded it for power and privilege? What does it feel like- or does it not feel like anything at all? Do they even know they do this?”

But I imagine that if I did ask, they wouldn’t like the question. They’d take it as an attack, as a ding in the armor of their “good guy” image. They wouldn’t realize I wasn’t intending for the question to hurt them or to even be about them. I would ask because I’m trying to understand- for myself– what it feels like to be numb to the pain of people you hurt, people who suffer, people you rape, people whose freedom you take away by enslaving them or trafficking them or locking them in psychiatric hospitals.

Because I can’t understand- simply cannot fathom- how men who play war games with innocent people seem unfazed by their own cruelty. Because I can’t understand what it’s like to be someone who causes immeasurable suffering to immigrants in Minneapolis and those who are their allies. Because I can’t understand how anyone could do to girls and women what Jeffrey Epstein and his powerful friends did to girls and women. Because I cannot begin to grok the enormity of how anyone could ever enslave an entire race, just to ruthlessly maximize their own self-interest, as the very foundation of the country I live in, the so called United States of America.

Clearly, anyone capable of doing such things has traded empathy and compassion for power- and it’s still a bad trade. And yet, I don’t even feel safe to name the names of the powerful cis, white, hetero men who have hurt me professionally and romantically- because they intimidate me. Because they might sue me. Because I have too much empathy for how what I write about them might hurt their image or their feelings, if I were to expose how these people feel entitled to treat me.

It made me think about two studies Jeff and I quoted in our upcoming book RELATIONSICK, which is about the health implications of “power over” relationships and narcissistic abuse, about how giving too much and receiving too little in relationships can make us “relationsick”- and how to heal our relationships and rebalance the power dynamics in order to optimize our health.

Preorder RELATIONSICK here.

One study Power, Distress, and Compassion: Turning a Blind Eye to the Suffering of Others (Keltner et al., 2008) examined what happened to the empathy of ordinary people when you gave them a hit of power in an experimental setting. Experimental psychology research suggests that power can erode empathy in otherwise ordinary people. In a study led by Dacher Keltner and colleagues, participants were experimentally assigned to feel either powerful or powerless and then asked to listen to another person describe a difficult life experience. Those placed in the high-power condition showed significantly less compassion and emotional responsiveness to the speaker’s suffering. Physiological measures also suggested greater emotional detachment. The researchers concluded that feeling powerful tends to reduce people’s sensitivity to the emotional states of others.

In The Perspective-Taking “E on the Forehead” Study (Galinsky et al., 2006) by social psychologist Adam Galinsky, researchers found that power also undermines perspective-taking, a key ingredient of empathy. In this well-known experiment, participants were asked to draw the letter “E” on their foreheads. Those primed to feel powerful were far more likely to draw it from their own point of view, meaning it appeared backward to someone looking at them. Participants primed to feel less powerful were more likely to draw the E so that others could read it correctly, indicating a spontaneous awareness of another person’s perspective. Together, these studies suggest that when people feel powerful, their attention often turns inward—toward their own goals, perceptions, and priorities—reducing empathy and compassion and making it harder to instinctively imagine what others are feeling or seeing.

Take a moment to think about the current global situation from that perspective. Several years back, I wrote some of my thoughts about Getting Out Of The Power Game. In that essay, I made the case that we sacrifice intimacy to attain power, and it’s a bad trade. To benefit from hierarchical systems like patriarchy, white supremacy, heterosexual supremacy, wealth and greed supremacy, academia, medicine, politics, etc, we lose empathy and sacrifice intimacy- men with women, white people with BIPOC, able-bodied people with disabled folks, US-born with immigrants and those from other countries, rich folks with poor folks, and so on. We’re so obsessed with gaining power, not even realizing how much we’re losing by gaining it.

Even in goddess circles, in my limited experience, the focus seemed to be on leveraging our power, as women, to overpower or disempower men. Or to attract the male gaze via some sort of female empowerment. Or to step on other women to lift ourselves up in the power hierarchy of some patriarchal goddess circles who claim to be matriarchs but are actually just using the master’s tools to create their own cages.

As we examine what’s happening in our culture right now, think about who has the most power (cis, white, hetero, male, Ivy League, grad school educated, able-bodied, tall, US-born) and what it means if the people we give the most power to are set up to have the least empathy.

I dared to ask a friend of mine, a powerful cis, white, hetero male doctor, a sincere question. As a woman with all the power and privileges except maleness, youth, and, especially as I age, stereotypical female beauty, I know what it’s like for me to have been expected to trade empathy and compassion for power. I wrote a whole book about it- The Anatomy Of A Calling- which one of my female physician friends described as “you did heart surgery on me with that book.” In that book, I blew the whistle on my experience as a young woman in a patriarchal, hierarchical medical system.

But I wanted to know what it was like to stay, to not quit, to not leave in protest, because of the moral injury staying would have required. I left. My friend stayed. What was it like to have all the power and privileges- to be a cis, white, hetero, male, able-bodied, tall, grad school educated, wealthy doctor who was willing to trade empathy for power. I sincerely wanted to be able to empathize, because I’m having a hard time doing so right at this moment in US and world history.

My beautiful psychiatrist friend who is widely considered one of the most compassionate, humanistic psychiatrists on the planet, didn’t like the question, bristling with the white male fragility I’ve come to expect every time I get curious about what it’s like to be a white man with all the powers and privileges. I pressed anyway, really wanting to understand. What was it like to have that much power, and what was he sacrificing and losing because of it?

I knew what it was like to have the power to cut someone open, to put my fingers in their vaginas and feel their pelvises, to cut out their wombs or tie their tubes, to bring a life into the world when I delivered a baby, to terminate a life with an abortion, to hear their stories about sex, rape, incest, violence, love, loss, STD’s, affairs, postpartum depression, and wanting to hurt their own children. It’s an enormous amount of power that our patients entrust us with.

But what was it like to have the power to lock up and hold the key to institutionalize women, children, and other men society has determined to be too mentally ill to be free- all in the name of saving their lives or protecting society? I wanted my psychiatrist friend to help me understand, doctor to doctor, what it was like to stay in the hierarchical medical system that requires us to dehumanize people to such a degree that we feel entitled to lock them up, inject them with medications they’re not consenting to, practice Electroconvulsive Therapy (ECT) on human beings.

I already knew, as a surgeon, what it was like to acquire enough power, knowledge and skill to cut someone open, splay them raw, penetrate their bodies with our bodies. I knew we had to be robbed of some of our empathy in order to do so. That was part of the point of Gross Anatomy, to take ordinary 22 year old human beings, rob us of our empathy, turn us into perpetrators who mocked our cadaver’s bodies, and churn out surgeons.

The men had it the worst. Cutting off another man’s penis, even when he was dead, was the hardest part for most of the men. They still had enough empathy to feel pain over what they were doing to another man. But that empathy would be gone by the time they finished their medical training, just like mine almost was. Almost, but not entirely, which is why I couldn’t stay.

I wanted to hear what had to happen to see not a woman but a psych patient, not a human body but “Room 201,” not a scared woman but a court-ordered guardianship? What was it like to have that much power and yet not even be able to talk about it because of white male fragility?

I wanted to know, to understand, to practice perspective taking, to empathize. I wanted to hear someone tell me the truth, but I haven’t yet found anyone willing to answer my question. I suspect this is because they feel scared and ashamed, like I did, when I realize, even now with the power of my pen, how easy it would be to abuse all that power and privilege. I read House of God. I went through that system and came out changed. I know I was harmed by it, even though it gave me power.

I also know that if anyone ever found out that I’d abused my power and privilege, I could fall off whatever pedestal someone might have put me on. Someone like the doctors who abused their power by cleaning up Epstein’s messes, taking care of his girls instead of calling the police. The idea that someone “one down” could have the power to call me out, to take me down a notch, to get me in trouble, to land me in jail, even. If I’d had sex with a patient or abused a client or exploited anyone financially or objectified and taken advantage of someone “one down” from me, the way so many powerful people in my industry- and in the Epstein files- seem to feel entitled to do, I could imagine I’d be a deer in the headlights right now, running scared, terrified that someone female, someone BIPOC, someone disabled, someone poor, someone who was an immigrant, someone who might have fawned me in another time and place, could take away some of my power.

That might make me struggle to talk about such things right now too. I too might have some of that much-maligned “white male fragility.” At least that’s what I imagine when I try to empathize and make sense of the bizarre behaviors of powerful white men (and women) that I’m observing right about now.

My partner Jeff is a psychiatrist, so I was trying to talk about some of my thoughts about all this today, to process these issues of power and privilege with him. I actually considered becoming a psychiatrist, when I was a young medical student trying to decide on a medical speciality. But I couldn’t do it. I couldn’t lock up someone, even if I believed it was “for their own good” or “for the good of society.” I couldn’t restrain someone and listen to them cry and beg to be released. I couldn’t inject someone to force them into silence and catatonia. I did eight weeks in a psych ward as part of medical school. Then I did another eight weeks in residency. I’m still haunted by it.

I couldn’t even handle reading a book about such things. I bawled my eyes out when I was required to read One Flew Over The Cuckoo’s Nest for 11th grade English and wouldn’t sleep in my own bed for a month. I was so disturbed by it that I slept on the floor next to my mother, because she wouldn’t let me in bed with her and my father.

I couldn’t get the image out of my head of what happens at the end of the book—when McMurphy, once so rebellious and alive, is reduced to a lobotomized shell of himself. When Chief Bromden realizes what has been done to him, he understands that the man who fought the system so fiercely was gone, disappeared, annihilated by those with the power to steal his mind, his autonomy, his rebel spirit. In an act that is both mercy and grief, he smothers McMurphy with a pillow so his friend won’t have to live in that emptied-out state, then lifts the heavy hydrotherapy control panel and throws it through the window to escape the ward.

That final image haunted me: the price of defying a dehumanizing system, and the quiet, heartbreaking empathy and loyalty of someone who refuses to let a friend live as a hollowed-out version of himself. Even as a teenager, something in me understood the terror of institutions that can crush a human spirit—and the fierce tenderness of someone who bears witness and refuses to pretend nothing has been lost. Then again as a new mother, at age 37, I realized the price I’d have to pay to stay in the hierarchical system of medicine that requires doctors to sacrifice our empathy and compassion in order to get ahead.

It’s not just men who lose empathy when they gain power. As I wrote about in my viral blog post about Blowing The Whistle on Deepak Chopra and others in the self-help, wellness, and spiritual space, women who attain a lot of power can behave nearly as badly as the men. Just like the men, they abuse their power and privilege to sleep with students, clients, and patients. They abuse their power by exploiting vulnerable people financially. They abuse their power by lacking empathy for people who have entrusted them with their vulnerability at Large Group Awareness Trainings (LGAT’s.)

Even in medicine, this was true. The women in my OB/GYN group weren’t much better than the men when it came to empathy. I had a baby of my own. I was a mother and an OB/GYN, and yet the other women in my medical practice expected me to be back at work 4 weeks after a C-section, one week after my father’s funeral, 8 weeks before I was even scheduled for my postpartum checkup with my OB/GYN, 8 weeks before we allowed our patients to go back to work after a C-section.

Some of them were mothers too. They had paid the price that is required to get ahead, and they lacked an ounce of empathy for me as a woman, mother, daughter, and doctor who had to wean my baby at 4 weeks, to pump instead of nurse, to guarantee that my daughter would have avoidant attachment, which was readily apparent by 7 months of age, when she refused to take my breast any longer at bedtime, because she barely knew me. They had made the bad trade, and their children would suffer from it too.

And yet, they were still women. They still lacked one form of power because of patriarchy. They had internalized patriarchy and become its representative. They colluded with the hierarchical medical system to be proximate to power, to gain power for themselves. But at what cost?

I spent ten years working with female doctors at the Whole Health Medicine Institute. It took me only one question to discover that these female doctors still had at least some of their empathy intact. I asked them “How did you have to sell out your body to become a doctor?” They cried with each other, time after time, listening to how much we had to lose empathy for ourselves, for our own vulnerability, for our tenderheartedness- in order to earn the power of becoming a doctor. Together, we cried, we empathized, we healed. But then, many of them could not go back. Like me, many of them left the hospital.

I won’t begin to examine what it would mean to give up some of our power, in order to reclaim our empathy, in order to build more intimacy, relationally, communally, globally. I did a little bit of that conjecture here, but honestly, I think BIPOC women, queer women, disabled women, BIPOC disabled queer women- would do a much better job attempting to answer that question than I would.

So I’ll just conclude with this. If we want to stop war, perhaps the question is not how to out-strategize the men playing war games. Perhaps the question is much more uncomfortable than that.

Because if the research is right—and my lived experience in medicine as a woman suggests that it is—then power doesn’t just grant privilege. It changes people. It narrows their field of vision. It makes it easier to objectify, to dehumanize, to dominate, to silence, to justify cruelty in the name of efficiency, security, profit, or “the greater good.” It turns mothers into “Room 12.” It turns refugees into “the border problem.” It turns frightened psychiatric patients into “bed 201.” It turns whole populations into targets on a map.

Empathy and compassion, on the other hand, disrupt the whole system. Empathy and compassion are what make it impossible to rush through a 7 1/2 minute visit with a woman who is confessing the most intimate pain of her life. Empathy and compassion are what make it unbearable to watch a young man beg not to be restrained by a cop who will then kill them. Empathy and compassion are what makes it impossible to rip an immigrant child from his family or rip an immigrant from his home. Empathy and compassion are what make it impossible to bomb a city where someone else’s mother is making dinner and someone else’s child is doing homework at the kitchen table.

Empathy and compassion slow everything down. Yet hierarchical systems built on domination cannot tolerate that kind of slowing down. Which is why tenderness is dangerous, why it is conditioned out of boys and men, why it is conditioned out of doctors who must make rapid fire “life or death” decisions without questioning ourselves at all.

Julia Ward Howe understood that when she wrote that women might be “too tender” toward the women of other countries to allow their sons to be trained to injure theirs. Tenderness makes it impossible to maintain the psychological distance required for domination. Tenderness collapses the illusion that some lives matter more than others.

Perhaps the world doesn’t change because powerful people suddenly become more powerful or because marginalized people rise to the ranks of the powerful and topple those at the top. If power distorts empathy and compassion, perhaps we have to give up the power hungry ghost. Perhaps the world changes when enough people refuse the bad trade.

When enough doctors refuse to stop listening and caring. When enough mothers refuse to celebrate war. When enough romantic partners refuse to sacrifice intimacy for power. When enough of us choose tenderheartedness, even when the system tells us that tenderness is weakness.

The midwives who held me in their arms that night in the hospital warned me, “Don’t ever let them break you.” Leaving medicine was the way I kept that promise. And maybe that’s the question we should all be asking ourselves now—not how to gain more power, but how to protect the part of us that power is always trying to kill.

The tender part.

Warmly,

Lissa