22 Jun Box 7.5 THEORETICAL FOUNDATIONS
Box 7.5 THEORETICAL FOUNDATIONS
Theory of Problematic Integration, continued
Consider the example of advance-care planning provided by Stephen
Hines (2001). Medical professionals have typically been disappointed by
patients’ disinclination to specify what care they wish to have (or forgo)
should they become too ill to express their wishes. Hines suggests that
people shy away from the issue because health care professionals, in their
desire to reduce their own uncertainty in end-of-life situations, have not
been very sensitive to the uncertainties experienced by prospective patients
and their loved ones. In short, people may neglect to file advance-
care directives—not because they are indifferent or stubborn—but
because the uncertainty they present feels unmanageable.
This brief review does not encompass all the facets of problematic integration
theory, but hopefully it does illustrate something about the way
people constitute, challenge, and transform their understandings, particularly
in health-related crises.
Suggested Sources
Babrow, A. (2001). Uncertainty, value, communication, and problematic
integration. Journal of Communication, 51(3), 553–573.
Babrow, A. S. (1992). Communication and problematic integration: Understanding
diverging probability and value, ambiguity, ambivalence,
and impossibility. Communication Theory, 2, 95–130.
Bradac, J. J. (2001). Theory comparison, uncertainty reduction, problematic
integration, uncertainty management, and other curious
constructs. Journal of Communication, 51(3), 456–476.
Ford, L. A., Babrow, A. S., & Stohl, C. (1996). Social support messages
and the management of uncertainty in the experience of breast cancer:
An application of problematic integration theory. Communication
Monographs, 63, 189–208.
Hines, S. C. (2001). Coping with uncertainties in advance care planning.
Journal of Communication, 51(3), 498–513.
Overempathizing
Overempathizing is actually something of a misnomer, because it applies only
to a particular type of empathy, called emotional contagion. In a general sense,
empathy is the ability to show that you understand how someone else is
feeling. Miller and colleagues (1995) have identified two components of empathy:
Empathic concern is an intellectual appreciation of someone’s feelings;
emotional contagion involves actually feeling emotions similar to the other
person’s. Research shows that the second kind, emotional contagion, can be
overdone.
Chapter 7. Social Support 199
One drawback of emotional contagion is that it can be exhausting. Miller
and colleagues (1995) identified a link between emotional contagion and emotional
exhaustion among people who work with homeless individuals. As you
may recall from Chapter 4, emotional exhaustion is a component of burnout
characterized by reduced motivation and compassion.
Taken to extremes, emotional contagion can also be detrimental to support
receivers. Some of the literature on support groups warns that members sometimes
empathize so much with each other that they perceive people outside the
group to be ignorant and uncaring. Jeffrey Fisher and co-authors noted this effect
among HIV/AIDS support group members (Fisher, Goff, Nadler, & Chinsky,
1988). The perception that others are less empathic may discourage group members
from developing social networks with diverse people.
Another danger is that people may hesitate to express themselves to listeners
who are likely to become upset. In Eric Zook’s (1993) case study, a man
who cared for his dying partner at home remembers: “As long as I was kind of
detached and logical about it, he would take it [his declining health] very well”
(p. 117). The perceived need to seem unemotional and in control can make it
seem that people do not need social support, when in fact they do. Men, particularly,
may be uncomfortable with emotional displays (Chesler & Barbarin,
1984), and may prefer to confide in people who will remain calm.
Finally, some people find emotional empathy overwhelming or belittling
(Goldsmith, 1994). They may avoid scenes in which others seem to pity them.
Wayne Beach (2002) describes the “stoic orientation” adopted by a father and
son discussing the news that the mother was diagnosed with cancer. The son
received the news calmly. Rather than reacting emotionally, he initially responded
with a series of “OKs” and technical questions such as “That’s the one
above her kidney?” (p. 279). Beach speculates that this factual, stoic orientation
saved the father and son from immediately “flooding out.” In this way, they
were able both to maintain composure and to display that they were knowledgeable
and capable of coping with the news.
Implications
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