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Empathy is widely viewed as the cornerstone of effective therapy—but what if we’ve been misunderstanding it all along?

In this episode, Dr. Pete Kelly sits down with Dr. Douglas Flemons, to discuss his new book Empathic Engagement in Clinical Practice. Flemons challenges the common assumption that empathy is something therapists simply have, reframing it instead as something we do—moment by moment, in relationship.

Together, they explore empathy as an active, relational process; unpack the critical distinctions between empathy, sympathy, and compassion; and examine why well-intentioned empathic efforts can sometimes miss the mark or even undermine the therapeutic alliance. The conversation also addresses therapist burnout, emotional boundaries, and how clinicians can engage deeply with clients without overidentifying or becoming emotionally depleted.

This episode is essential listening for clinicians who want to refine their relational skills, strengthen therapeutic presence, and practice empathy in a way that is both clinically effective and personally sustainable.

🔑 Key Topics Covered

• Why empathy has become conceptually confused in psychotherapy
• Empathy vs. sympathy vs. compassion
• “Feeling into” rather than “feeling with” clients
• Empathy as a relational process, not a personality trait
• How empathy dissolves the therapist-as-outsider experience
• Common empathic missteps—and how to avoid them
• Empathy with individuals vs. couples and families
• “Both–and” empathizing in complex clinical situations
• Therapist burnout, boundaries, and emotional sustainability
• How clinicians can tell when empathy is truly landing

👤 Author Bio

Douglas Flemons, PhD, LMFT is an emeritus professor, AAMFT Clinical Fellow, and internationally recognized educator with decades of experience in psychotherapy, supervision, and clinical training. He is the author of Empathic Engagement in Clinical Practice (published by the American Psychological Association, 2026), a work that integrates philosophy, neuroscience, and clinical research to clarify what empathy actually is—and how it functions in therapeutic relationships.

Dr. Flemons is widely respected for translating complex theoretical ideas into practical, usable clinical guidance. His work emphasizes empathy as an interactive, ethically grounded process that strengthens therapeutic relationships while supporting therapist resilience, sustainability, and self-care.