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TYPE
Original Research
PAGE NO.
28-34
10.37547/tajmspr/Volume07Issue08-05
OPEN ACCESS
SUBMITED
15 July 2025
ACCEPTED
05 August 2025
PUBLISHED
21
August 2025
VOLUME
Vol.07 Issue 08 2025
CITATION
Korobeinikova Olga Ivanovna. (2025). The Role of Empathy and the
Therapeutic Information Field in Contemporary Psychosomatic
Practice. The American Journal of Medical Sciences and
Pharmaceutical Research, 7(8), 28
–
34.
https://doi.org/10.37547/tajmspr/Volume07Issue08-05
COPYRIGHT
© 2025 Original content from this work may be used under the terms
of the creative commons attributes 4.0 License.
The Role of Empathy and
the Therapeutic
Information Field in
Contemporary
Psychosomatic Practice
Korobeinikova Olga Ivanovna
Director General Autonomous non-profit organization of
additional professional education "Academy of Conscious
Thinking" (ANO DPO "AOM") Madrid, Spain
Abstract
This article presents a theoretical and analytical review
of the mechanisms underlying the formation and
maintenance of therapeutic interaction in the context of
home-based palliative care, with a focus on the role of
empathy, emotional intelligence, and t
he practitioner’s
sensitivity to meaning. The study is based on an
interdisciplinary approach that integrates clinical
phenomenology, empathic diagnostics, and practices of
humanistically oriented care. Special attention is given
to the analysis of validated empathy and compassion
scales as sensitive indicators of emotional distress and
vulnerability
—
both on the part of the patient and the
accompanying professional. Three key categories of
risks characteristic of the home-based palliative context
are identified: clinical, communicative, and emotional-
semantic. For each, empathy-oriented support
strategies are proposed, including compassionate
observation, trust-based confirmation of understanding,
and telemedical empathy. The importance of
differentiating between cognitive and affective empathy
is emphasized in the interpretation of therapeutic risks,
the development of a stable therapeutic alliance, and
the preservation of the patient’s subjective sense of
safety. The central concept proposed is that of the
therapeutic information field, understood as a dynamic
structure responsive to the patient’s physical,
emotional, and spiritual condition. Its significance is
substantiated as a foundation for adaptive and ethically
attuned support, capable of integrating narrative,
existential, and clinical-social dimensions of care. The
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The American Journal of Medical Sciences and Pharmaceutical Research
article will be of interest to professionals in palliative
medicine, psychosomatic therapy, ethics of care, clinical
psychology, and interdisciplinary support for vulnerable
patient populations.
Keywords:
empathy, palliative care, emotional
intelligence,
psychosomatics,
therapeutic
field,
phenomenology, compassion, home care, clinical risks,
narrative approach.
Introduction
In recent years, there has been a steady rise in the
proportion of patients receiving palliative care outside
hospital settings, predominantly at home. This shift is
driven by demographic and economic factors and by
patients’ growing preference for care that prioritizes the
quality of remaining life, meaningful experiences, and
emotional connectedness rather than the invasive
prolongation of biological processes. Yet home-based
palliative care entails a number of systemic and
communicative risks. The most salient include
fragmented collaboration among professionals, delayed
recognition of clinical deterioration, diminished
sensitivity to the patient’s inner life, and pronounced
cognitive and emotional destabilization of both the
patient and the surrounding social network [2].
Patients with progressive chronic and terminal
illnesses
—
already burdened by physical exhaustion,
social isolation, and existential disorientation
—
are
particularly vulnerable. In such cases, traditional
biomedical models for assessing and monitoring care
quality prove insufficient because they fail to encompass
the depth of subjective suffering and the crises of
meaning that patients face. There is a growing need to
rethink the very foundations of quality assurance in
palliative support in favor of models capable of
addressing both the bodily and the emotional-spiritual
dynamics of dying.
Foremost among emerging requirements is the
integration of formal care instruments with approaches
grounded in empathy, emotional intelligence, and the
practitioner’s spiritual sensitivity. Within this context,
empathy acquires clinical and existential significance: it
underpins supportive presence, therapeutic trust, and
the capacity to perceive intangible signals of distress
that elude standard classification. A practitioner’s
emotional intelligence, in turn, makes it possible to
maintain inner equilibrium, exercise subtle self-
regulation in emotionally charged interactions, and
remain present without sacrificing professional stability
[1].
Meditation and mindfulness practices offer an
additional resource. They deepen contact with the
patient, strengthen empathic responsiveness, and
provide the therapist with an inner anchor. Such
practices allow the practitioner to be both observer and
co-participant, prepared to accompany the patient at
the boundaries of pain, uncertainty, and transcendent
experience.
The study seeks to analyze the role of emotional
intelligence, empathic sensitivity, and spiritual
connectedness as key factors in ensuring the quality of
home-based palliative care under conditions of the
patient’s
psyc
hosomatic
vulnerability.
Particular
emphasis is placed on understanding empathy not as a
personality trait but as a regulator of the therapeutic
space and a moderator of clinical, communicative, and
existential risks.
Materials and Methods
This study employs a theoretical-analytical approach
involving a multi-level reconstruction of the conceptual,
empirical, and existential foundations of palliative care
quality in the home-care setting. The primary strategy
combined comparative analysis, thematic synthesis, and
narrative analytics. This approach enabled identification
of key interdisciplinary contexts that elucidate the role
of emotional intelligence, empathy, and spiritual
sensitivity in maintaining a sustainable therapeutic
space. The analysis drew on peer-reviewed scientific
publications spanning several areas:
•
clinical and relational empathy;
•
therapeutic alliance and the phenomenology of
interaction;
•
psychosomatic vulnerability and bodily self-
experience;
•
emotional intelligence and practitioners’ self
-
regulation;
•
mindfulness and compassion practices in care;
•
spiritual and existential aspects of palliative support.
Howick [1] conducted a conceptual analysis of
therapeutic empathy as a relational process critically
important for establishing trust and sustaining contact.
Irarrázaval
[2]
examines
empathy
as
a
phenomenologically rich experience capable of
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The American Journal of Medical Sciences and Pharmaceutical Research
mediating the meaning of suffering in the home context.
Palumbo [3] highlights empathy as a resource for
preventing professional burnout within trauma-
centered therapy, a finding directly relevant to
multidisciplinary palliative care teams.
Contributions to understanding spiritual sensitivity and
the practitioner’s existential readiness to accompany
patients in extreme states come from Watson [10], who
formulates compassion as an operationalizable ethical
category essential for quality care of the dying, and von
Boetticher [9], who emphasizes the need to develop
practitioners’ conceptual and philosophical competence
to overcome a reductionist clinical-technical care model.
Additional studies on meditative and self-regulatory
practices were reviewed, interpreting mindfulness as a
method of psycho-emotional stabilization that deepens
empathic engagement and reinforces the practitioner’s
inner resilience.
Thus, the present study views the therapeutic
informational field as an integral interactional space
shaped by empathic, emotionally intelligent, and
spiritual signals. These parameters are not derived from
administrative or protocol-driven procedures but are
understood as key quality indicators mediating care
dynamics under conditions of high psychosomatic and
existential vulnerability.
Results
In the context of home-based palliative care, the
challenge of risk management gains particular
significance due to patie
nts’ high degree of bodily,
psycho-emotional, and existential vulnerability, limited
clinical oversight, and critical dependence on the quality
of interpersonal interactions among professionals,
family members, and the patient. The theoretical-
analytical synthesis of source materials identified three
key risk categories characteristic of palliative support at
home:
•
clinical risks;
•
communication risks;
•
emotional-existential risks.
Clinical risks encompass threats related to improper
medication use, lack of timely monitoring, and overload
of informal caregivers. Ruffalo [5] emphasizes that when
caring for mentally vulnerable patients (including
individuals
with
schizophrenia,
dementia,
and
pronounced anxiety disorders), the likelihood of
analgesic dosing errors, delayed responses to adverse
effects, and insufficient coordination among care
providers is especially high.
Communication risks cover situations of information
distortion or loss arising from emotional overwhelm,
misinterpretation of medical instructions, and absence
of a trusting space for clarification. As Von Boetticher [9]
notes, even terminological discrepancies between
practitioner and patient (for example, differing
understandings of “support,” “deterioration,” or
“hope”) can provoke anxiety, al
ienation, and frustration.
Watson [10] further points out that a deficit of
compassionate communication can exacerbate feelings
of isolation and existential loneliness.
Emotional-existential risks manifest as a sense of
abandonment,
loss
of
meaningful
orientation,
disruption of the “self” narrative, and internal
disorganization. Howick [1] demonstrates that deep
empathic engagement by the practitioner can create a
stabilizing therapeutic field in which such states may be
partially processed through support, joint narration, and
sustained presence.
A consolidated overview of these risk categories and
their
corresponding
empathy-oriented
support
strategies is presented in Table 1.
Table 1
–
Main categories of risk in palliative care and corresponding empathy-oriented support strategies
(Compiled by the author based on sources: [5], [9], [10])
Risk category
Manifestations in practice
Empathy-oriented strategy
Medication-
related risk
Overdose, missed doses, patient
anxiety about treatment
Compassionate monitoring, gentle clarification,
emotional attunement to the patient’s rhythm
Communication
Misunderstanding instructions, Verification of understanding through trust,
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The American Journal of Medical Sciences and Pharmaceutical Research
Risk category
Manifestations in practice
Empathy-oriented strategy
breakdown
shifts in meaning, withholding of
concerns
slowing the pace of communication, clarifying
without pressure
Emotional-
existential
destabilization
Feelings
of
abandonment,
alienation, existential anxiety
Telemedicine empathy, narrative listening,
symbolization of feelings and meanings
In the context of home-based palliative care, where
formal clinical and logistical procedures inevitably
intertwine with deeply personal, emotionally intense,
and often existential interactions, intangible quality
indicators assume particular importance. Among these
parameters is empathy
—
both as subjectively
experienced by the patient and professionally enacted
by practitioners. It is empathy that sustains a stable field
of trust, reduces internal destabilization, and fosters a
sense of shared presence in extreme life situations.
In recent years, standardized instruments for assessing
empathic states have been developed, capable of
serving as sensitive indicators of the emotional climate
within the care system. Their implementation enables
detection of communication breakdowns and emotional
exhaustion risks, as well as monitoring the evolution of
care quality at the level of interpersonal experience. For
example, Vieten [8] provides a comprehensive review of
scales suitable for analyzing practitioners’ empathic
engagement. One of the most valid is the Interpersonal
Reactivity Index (IRI), designed to measure cognitive and
affective empathy in medical staff and caregivers. Scores
on this scale capture practitioners’ emotional
responsiveness, the subtlety of perceiving others’
suffering,
and
the
presence
of
supportive
compassionate responses, while also revealing
tendencies toward emotional overload and reduced
sensitivity over long-term interactions.
Subjective perception of empathy by the patient can be
reliably measured using the CARE measure
—
a tool
aimed at evaluating the quality of interpersonal
interaction. As Watson et al. [10] note, this scale
provides direct feedback on the patient’s experience of
the professional relationship and indirectly gauges the
depth and stability of the therapeutic alliance, the
degree of co-presence, and attention to the meaningful
aspects of the patient’s concerns.
The internal state of both practitioners and patients can
be partly assessed with the Self-Compassion Scale (SCS),
which focuses on levels of self-empathy and the capacity
for compassionate acceptance of one’s own limitations,
pain, and frustration. Despite its limited use in clinical
management, this instrument can serve as an internal
indicator of professional resilience, especially when
working with emotionally intense cases, extreme
requests, and existentially challenging patient groups. A
summary of the discussed scales, along with their
functional applicability in the context of home-based
palliative care, is presented in Table 2.
Table 2
–
Approaches to Measuring Empathy and Compassion in Home-Based Palliative Care (Compiled by the
author based on sources: [6], [8], [10])
Scale
Target
Population
Measured
Components
Practical Applicability
Interpersonal
Reactivity Index
Medical staff,
caregivers
Affective
and
cognitive empathy
Monitoring empathic responsiveness;
preventing burnout
CARE measure
Patients
Relational empathy
Feedback on interaction quality;
therapeutic alliance adjustment
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Scale
Target
Population
Measured
Components
Practical Applicability
Self-Compassion
Scale
Patients
and
practitioners
Self-empathy;
emotional regulation
Internal
self-monitoring;
resource
support for professionals
As shown in Table 2, each of these scales allows
assessment of different facets of empathic interaction in
palliative care
—
from professional resilience to the
subjective validity of relationships. Their adoption
significantly broadens the understanding of care quality
beyond protocol-driven and biomedical criteria, drawing
on the deeper structure of human contact, co-presence,
and meaningful responsiveness.
Discussion
Despite the institutionalized importance of risk-
management strategies in healthcare, their classic
configuration reveals significant limitations when
applied to home-based palliative care. Standardized
control models
—
relying predominantly on clinical-
administrative indicators
—
are unable to capture the
nuanced emotional-existential, interpersonal, and
existential parameters that prove critical for patients in
terminal stages.
As Von Boetticher [9] emphasizes, the traditional
medical model overlooks the deeper facets of clinical
competence: the practitioner’s capacity to recognize the
internal context of suffering, interpret behavioural and
symbolic signals of disorganization, and create a
therapeutic field that transcends biomedical reduction.
In
the
home-care
environment
—
where
rigid
institutional protocols are absent and relational
dependencies are intensified
—
these shortcomings
become especially pronounced: many key processes
unfold in the non-verbalizable spaces of proximity, co-
presence,
and
trust,
eluding
conventional
quantification. Watson’s research [10] underscores that
much palliative suffering carries a transcendent and
existential dimension, irreducible to symptom checklists
or logistical metrics. Evaluating care quality solely by
formal measures risks devaluing patient experience,
fracturing the therapeutic alliance, and causing
secondary trauma. Moreover, Rodríguez-Nogueira et al.
[4] demonstrate that, without empathic exchange
between practitioner and patient, the therapeutic
alliance becomes fragmented and unstable, so that even
technically correct interventions fail to stabilize
suffering. Rubin [6] further notes that, even in a high-
tech setting saturated with algorithms and artificial
intelligence,
nothing
can
replace
affective
responsiveness, motivational rapport, and empathic
intuition
—
elements that constitute genuine therapeutic
support. It becomes evident that care quality hinges not
only on protocol but on human availability at moments
of utmost vulnerability.
Another key limitation of traditional approaches lies in
the undervaluation of intangible indicators
—
such as
empathy, compassion, subtle responsiveness, and
emotional presence. Although validated scales exist [8],
they are seldom integrated into routine practice as
monitoring tools. This omission forfeits the opportunity
to detect empathic breakdowns in time
—
breakdowns
that, as Ruffalo’s data reveal, can trigger a cascade of
serious clinical-communicative consequences [7].
One of the most promising directions for advancing
home-based palliative care lies in conceptualizing the
therapeutic informational field as a space where
empathic resonance, semantic responsiveness, and
relational dynamics among patient, family, and
practitioners converge. Such a model overcomes the
classic
“procedure–outcome”
dichotomy
by
incorporating subtle intersubjective and emotional-
semantic parameters into quality assessment
—
parameters that cannot be formalized yet exert a direct
influence on the stability of care.
A key distinction in this context is between cognitive and
affective empathy, as proposed by Irarrázaval [2].
Cognitive empathy involves mentalizing and accurately
interpreting another’s internal state, whereas affect
ive
empathy entails emotional attunement and shared
experience. In palliative practice, these two forms of
empathy function synergistically: cognitive empathy
enables practitioners to detect early signals of distress,
while affective empathy fosters an atmosphere of trust,
loyalty, and existential engagement.
Rubin’s study [6] underscores that even within
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automated decision-making systems, empathy remains
an unreplicable factor in sustaining therapeutic
impact
—
especially
when
patients
experience
fragmented consciousness or confront the irreversibility
of their condition, making decisions less algorithmic and
more rooted in interpretation of deep personal
experience. The concept of compassion also offers
additional heuristic value as a regulatory mechanism in
practitioner practice. Watson [10] notes that
compassion serves as a form of calibration: it helps
maintain the boundary between engagement and
burnout, mobilizes attention, shapes communication,
and minimizes emotional exhaustion. Table 3
systematizes the core elements of the therapeutic
informational field and their functional effects in
palliative support.
Table 3
–
Elements of the therapeutic informational field and their functional significance in palliative care
(Compiled by the author based on sources: [1], [3], [10])
Field element
Function and effect
Context of application
Empathic
resonance
Increases trust, reduces sense of abandonment
Contact with patient and family,
feedback
Semantic
awareness
Facilitates cognitive integration of diagnosis,
reduces anxiety
Discussing prognosis, supporting
difficult decisions
Dialogicality
Reveals non-medical dimensions of suffering,
enhances subjective control
Joint
planning,
narrative
communication
These elements are not reducible to external
administrative structures. They form the internal fabric
of palliative interaction, shaping trust, retention, and
profound connectedness. The therapeutic informational
field functions not as a mere tool or methodology but as
an ontological reality of interaction
—
within which the
meanings of care unfold, acute forms of suffering are
alleviated, and the grounds for a dignified presence in
extreme states are established.
Conclusion
The conducted study synthesized and conceptually
structured contemporary approaches to understanding
risks in home-based palliative care through the prism of
empathic sensitivity, phenomenological receptivity, and
the practitioner’s existential openness. It demonstrated
that embedding both cognitive and affective empathy
within the architecture of clinical reasoning opens
fundamentally new horizons for designing personalized
and sustainable care, especially in contexts of high
psychosomatic and existential vulnerability.
The necessity of incorporating intangible quality
indicators
—
such as levels of empathic responsiveness,
depth of co-presence, semantic integration of diagnosis,
and subjective sense of safety
—
has been substantiated.
The relevance of applying validated scales for empathy,
compassion, and self-compassion as tools to monitor
the emotional states of patients and practitioners has
been illustrated; these instruments can serve as early
markers of distress and professional burnout.
The proposed concept of the therapeutic informational
field is presented as an intrinsic, dynamic structure
formed through relational contact, which determines
both intervention effectiveness and the depth of human
presence. This field unites empathic resonance,
semantic awareness, and dialogicality as key quality
parameters that transcend formalized metrics.
Thus, the presented model highlights the need to move
from reductionist approaches to an empathic-
humanistic paradigm of support, in which patient
suffering is understood not as a biomedical failure but as
an experience warranting respect, responsiveness, and
shared presence. The theoretical outcomes lay the
groundwork for further empirical research, clinical
validation, and interdisciplinary integration into
palliative care practice at both the individual and
systemic levels.
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