To Paul Bloom’s list of empathy’s hazards—excess, burnout, relational asymmetry—I would add a few more. For starters, empathy can fuel an ironic kind of self-absorption: the encounter with another person’s experience becomes another way of experiencing oneself. I think of this as the Agee effect: in James Agee’s Let Us Now Praise Famous Men (1941), an account of three sharecropper families in Alabama, Agee’s feelings about poverty constantly threaten to upstage the poverty itself. We feel his guilt and anguish so exquisitely that the material conditions that have inspired them sometimes blur into the background. Empathy becomes the main event; it risks undermining its own best intentions.

Compassion that involves feeling for rather than with comes at a cost.

Empathy can thwart its own goals through exhaustion or preoccupation: one may be too depleted or distracted by one’s own feelings to act on them. It can also offer a dangerous sense of completion: that something has been done because something has been felt. It is tempting to think that feeling someone’s pain is necessarily virtuous in its own right. The peril of empathy isn’t simply that it can make us feel bad, but that it can make us feel good, which can in turn encourage us to think of empathy as an end in itself rather than part of a process, a catalyst to ameliorating the pain that has prompted it.

I see Bloom’s critique of empathy in similar terms: as the beginning of a process rather than its completion. It is not that empathy does or doesn’t make us better, but that it can make us better. We need to ask ourselves how.

Empathy offers two major kinds of good: the enabling of better care and the consolation of witnessing itself. Though it is dangerous to see empathy as the end of a process rather than its inaugural gesture, sometimes the act of trying to empathize can offer solace.

Last year I reported a story about Morgellons disease, a controversial illness that leads patients to report a variety of dermatological symptoms, most notably fibers inexplicably emerging from their skin. Because the disease is controversial, Morgellons patients are usually dismissed by doctors. I found that the simple fact of being listened to—having their experience imagined, and thus validated—meant something to them.

More recently I was involved in a public event in which the autobiographical writing of several incarcerated men was read aloud. Attendees were invited to write responses to the authors. Having their experiences heard—knowing that a room full of people had imagined their lives—did nothing to set these men free. But they did say it mitigated the sense of invisibility that makes incarceration so painful. Empathy should not be confused with advocacy, but acts of witnessing and listening and feeling do carry meaning. And these efforts can lead to better care by providing not only an emotional impetus but also an understanding of what kinds of care might be useful.

Bloom is right, regarding the example he cites from my book The Empathy Exams, that I appreciated the care of a doctor who didn’t simply echo my fears. But without empathy, this doctor wouldn’t have been able to offer the care I ended up appreciating. He needed to inhabit my feelings long enough to offer an alternative to them and to help dissolve them by offering information, guidance, and reassurance.

My doctor’s form of empathy was successful because it was specific: he was able to discern and respond to my particular concerns. Specificity is what makes empathy so powerful. It is also what makes me distrustful of the distant compassion that Bloom advocates.

This kind of compassion involves feeling for rather than with; it is grounded in a general ethos of care rather than in particular sentimental attachments. It is more durable and efficacious in the long run because it is more general and less immersive. But this distance comes at a cost. We lose access to the particular contours of someone’s needs. Our offers of concern or aid can suffer as a result. If burnout and exhaustion are the dangers of too much empathy, then abstraction is the danger of too little: the risk that kinds of pain will become kinds, assumed rather than interrogated. Too much abstraction can mean we end up causing harm even when we mean to offer care.

Bloom is right to question the notion that empathy is inherently valuable. But he shouldn’t dismiss empathy so much as issue the call to examine the nature of its power. How can it create good? How should it be deployed? His position represents the beginning of a longer conversation in which we ask ourselves not just whether empathy makes us good but what good empathy is made of.