What’s The Difference Between Sympathy & Empathy? Psychologists Explain

The suffix -pathy comes from the Greek word for “suffering,” pathos. The U.S. medical system is built around pathology, which simply means diagnosing suffering and treating disease. Similarly, mental health professionals find social connections critically important to the ways that people cope with and overcome suffering, grief, and trauma. Words like sympathy, empathy, and even apathy describe the nuanced differences between the very complex social connections and reactions humans display when we are suffering or when we witness others in pain.

While subtle behavioral differences might seem obvious to therapists, counselors, and psychologists, it’s not so easy for everyone else. So we spoke to Atlanta-based therapist Habiba Zaman, LPC, NCC, Pepperdine University professor of psychology Steven M. Sultanoff, Ph.D., and licensed clinical psychologist Bruce L. Thiessen, Ph.D., about simple ways to define sympathy and empathy—and their relationship to compassion.

Defining sympathy.

“Sympathy is when you understand someone else’s suffering and feel sorrow or pity for the experience they are facing,” Zaman explains. “It involves having a value judgment on someone else’s experience.”

While often well intentioned, this value-judgment-centered response often creates a palpable distance between the person in pain and the person who is listening. So, Zaman says, sympathy is often extended when a person doesn’t necessarily relate to, fully comprehend, or appreciate the circumstances of suffering facing someone they know or love.

“The emotion of sympathy is my experience of (reaction to) your situation. Sympathy lacks understanding,” Sultanoff adds. “When you are sympathetic, you get caught up in your own emotional reaction to how you are experiencing the world. This, for the most part, does not demonstrate any understanding of the person in distress.”

He notes that sympathy can create a barrier to understanding that can be activated because a sympathetic person may shift focus away from the person in distress to focus on themselves instead. Sympathy is the emotional reaction of the listener, who might say things like “I feel so sorry that this is happening to you,” or “I get so angry just listening to your story.” Other common ways it can show up are as pity (e.g., “I feel so bad for you”) or even as envy (e.g., “I’m sorry for your loss, but I sure wish I had as much time with my loved ones as you did”).

Defining empathy.

“When one expresses empathy, one draws upon personal experience, in relating to another person in the midst of a similar experience or hardship,” Thiessen explains. “An example of an empathetic statement might be, ‘I also have recently lost a loved one and know what it feels like to experience that deep sense of sorrow and grief.”

He says that this sense of commonality is a key differentiator between empathy and sympathy.

“Empathy is the ability to feel intimately and see the other person’s perspective. It is not just to understand what they are going through but rather, being able to walk in the other person’s shoes,” Zaman explains. “It is being able to say, ‘I am here to feel with you’ and let you know you are not alone.”

She adds that empathy is best defined by how the listener connects with the person in pain. Without judgment, an empathetic person would try to create and hold space for a person’s feelings and experiences. Empathy, which can be taught and honed over time, involves honoring how a person in pain sees their own situation, even if that is not how others might view it.

Understanding the key differences.

When it comes to understanding the key differences between empathy and sympathy, there are both internal and external factors to keep in mind. Sympathy and empathy are largely distinguished by external behavioral and performative aspects, which most people believe are a reflection of how the listener internally feels about the person who is suffering. Instead, the experts say that the difference is more about the relationship between the listener and the sufferer.

On the outside, sympathy often appears socially distant, like a one-off message of condolences, with no follow-up. Zaman says this is because sympathy lacks intimacy, but there may be situational reasons why that might be the case. In certain corporate settings or power structures, it might be appropriate to emotionally withhold to maintain decorum or to preserve group dynamics that extend beyond just the listener and the person in pain. Social dynamics and the appropriateness of displaying curiosity toward a person in pain might make a listener moderate their naturally emotive behavior.

“Sympathy is used in social situations where there isn’t an intimate connection between two people. It would be perfectly appropriate in a corporate environment to experience sympathy from coworkers or a boss. A card or flowers that share in acknowledging grief is perfectly acceptable and is expected in those environments because anything more could be perceived as inauthentic, unless that initial and genuine connection is there,” Zaman says.

Meanwhile, she says, that very same gesture of sending a card and flowers might be wholly inadequate for lifelong friends. Thus, the relationship and social context between the people involved is very important.

Also, no matter how close or distant the relationship, Sultanoff says that empathy is an internal experience of feeling caring, concern, and understanding toward another human being or living creature that is best shown through active and reflective listening.

“Responding by repeating back (but not parroting) what you heard from the other person, while especially attending to their feelings, demonstrates focus on the person and letting go of your own internal distractions,” he says.

In an attempt to be empathetic, a person who genuinely wants to help might share problem-solving advice, but Sultanoff says that this behavior does not necessarily show empathy for the other person’s immediate emotional state. In many ways, the difference between sympathy and empathy is the desire to understand the experience of a person who is suffering, not necessarily the drive to stop their suffering.

What about compassion?

“Both empathy and sympathy, when coming from a place of sincerity, are sensations and open expressions of compassion,” Thiessen says. After all, compassion, which simply means “to suffer together,” is an expression of caring and warmth.

He says that compassion from empathy typically comes from sharing similar experiences with another person, but compassion from sympathy can be just as useful. “For example, the act of researching the types of suffering experienced by an abused child might increase a person’s sympathy for abused children, regardless of whether or not the researching party had ever been a victim of child abuse,” offers Thiessen.

And this ability to extend emotions beyond one’s own personal experience is good because compassion allows humans to be motivated to alleviate harms they, personally, have never experienced.

“Expressions of compassion, be they in the form of empathy, or sympathy, or some palpable act of kindness, can be experienced as a healing balm on the psyche and the soul,” Thiessen says.

Moreover, that emotional inspiration can spark activism, philanthropy, or public advocacy in the service of moral causes that are far-reaching and socially impactful. In this way, actively cultivating compassion can allow an observer in one situation to be a force for change in many others.

The bottom line.

In the simplest of terms, empathy is an internal emotion that is directed outward toward another person, Sultanoff says. It demonstrates a true understanding of the other person, without any personal biases interfering with that understanding. Sympathy, however, is internally directed.

If you are watching someone in mourning or grief, empathy is focused on understanding the person in pain, while sympathy is focused on your reaction to watching that person deal with their pain. “From a mental health perspective, empathy is very healing, and sympathy is not,” Sultanoff says.

“Generally, it feels better to be the recipient of empathy than simply sympathy, because it allows for a point of connection and intimacy. Also, an expression of sympathy may be more difficult to trust unless it is coming from a genuine relationship and a place of genuine concern,” Thiessen summarizes.

All that said, both feelings can serve socially positivity purposes when tied with compassion and action.

Nafeesah Allen, Ph.D.

By :  Nafeesah Allen, Ph.D.

Nafeesah Allen, Ph.D., is an American writer and independent researcher with a particular interest in migration, literature, gender identity, and diaspora studies within the global

Source: Sympathy vs. Empathy: The Key Differences & Social Uses

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Deeply Empathetic People Process Music Differently in Their Brains

People with who deeply feel the pain or happiness of others differ in the way their brains process music, according to one study. The researchers found that those with higher empathy process familiar music with greater involvement of the reward system of the brain, as well as in areas responsible for processing social information.

“High-empathy and low-empathy people share a lot in common when listening to music, including roughly equivalent involvement in the regions of the brain related to auditory, emotion, and sensory-motor processing,” said lead author Zachary Wallmark, an assistant professor in the SMU Meadows School of the Arts.

But there is at least one significant difference. Highly empathic people process familiar music with greater involvement of the brain’s social circuitry, such as the areas activated when feeling empathy for others. They also seem to experience a greater degree of pleasure in listening, as indicated by increased activation of the reward system.

“This may indicate that music is being perceived weakly as a kind of social entity, as an imagined or virtual human presence,” Wallmark said. Researchers in 2014 reported that about 20 percent of the population is highly empathic. These are people who are especially sensitive and respond strongly to social and emotional stimuli.

This SMU-UCLA study is the first to find evidence supporting a neural account of the music-empathy connection. Also, it is among the first to use functional magnetic resonance imaging (fMRI) to explore how empathy affects the way we perceive music. The  study indicates that among higher-empathy people, at least, music is not solely a form of artistic expression.

“If music was not related to how we process the social world, then we likely would have seen no significant difference in the brain activation between high-empathy and low-empathy people,” said Wallmark, who is director of the MuSci Lab at SMU, an interdisciplinary research collective that studies—among other things—how music affects the brain.

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“This tells us that over and above appreciating music as high art, music is about humans interacting with other humans and trying to understand and communicate with each other,” he said. This may seem obvious.

“But in our culture we have a whole elaborate system of music education and music thinking that treats music as a sort of disembodied object of aesthetic contemplation,” Wallmark said.

“In contrast, the results of our study help explain how music connects us to others. This could have implications for how we understand the function of music in our world, and possibly in our evolutionary past.”

The researchers reported their findings in the peer-reviewed journal Frontiers in Behavioral Neuroscience, in the article “Neurophysiological effects of trait empathy in music listening.”

“The study shows on one hand the power of empathy in modulating music perception, a phenomenon that reminds us of the original roots of the concept of empathy—’feeling into’ a piece of art,” said senior author Marco Iacoboni, a neuroscientist at the UCLA Semel Institute for Neuroscience and Human Behavior.

“On the other hand,” Iacoboni said, “the study shows the power of music in triggering the same complex social processes at work in the brain that are at play during human social interactions.”

Comparison of brain scans showed distinctive differences based on empathy

Participants were 20 UCLA undergraduate students. They were each scanned in an MRI machine while listening to excerpts of music that were either familiar or unfamiliar to them, and that they either liked or disliked. The familiar music was selected by participants prior to the scan.

Afterward each person completed a standard questionnaire to assess individual differences in empathy—for example, frequently feeling sympathy for others in distress, or imagining oneself in another’s shoes.

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The researchers then did controlled comparisons to see which areas of the brain during music listening are correlated with empathy.

Analysis of the brain scans showed that high empathizers experienced more activity in the dorsal striatum, part of the brain’s reward system, when listening to familiar music, whether they liked the music or not.

The reward system is related to pleasure and other positive emotions. Malfunction of the area can lead to addictive behaviors.

Empathic people process music with involvement of social cognitive circuitry

In addition, the brain scans of higher empathy people in the study also recorded greater activation in medial and lateral areas of the prefrontal cortex that are responsible for processing the social world, and in the temporoparietal junction, which is critical to analyzing and understanding others’ behaviors and intentions.

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Typically, those areas of the brain are activated when people are interacting with, or thinking about, other people. Observing their correlation with empathy during music listening might indicate that music to these listeners functions as a proxy for a human encounter.

Beyond analysis of the brain scans, the researchers also looked at purely behavioral data— answers to a survey asking the listeners to rate the music afterward. Those data also indicated that higher empathy people were more passionate in their musical likes and dislikes, such as showing a stronger preference for unfamiliar music.

Precise Neurophysiological relationship between empathy and music is largely unexplored

A large body of research has focused on the cognitive neuroscience of empathy—how we understand and experience the thoughts and emotions of other people. Studies point to a number of areas of the prefrontal, insular, and cingulate cortices as being relevant to what brain scientists refer to as social cognition.

Activation of the social circuitry in the brain varies from individual to individual. People with more empathic personalities show increased activity in those areas when performing socially relevant tasks, including watching a needle penetrating skin, listening to non-verbal vocal sounds, observing emotional facial expressions, or seeing a loved one in pain.

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In the field of music psychology, a number of recent studies have suggested that empathy is related to intensity of emotional responses to music, listening style, and musical preferences—for example, empathic people are more likely to enjoy sad music.

“This study contributes to a growing body of evidence,” Wallmark said, “that music processing may piggyback upon cognitive mechanisms that originally evolved to facilitate social interaction.”

Source: Deeply Empathetic People Process Music Differently in Their Brains

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The Invisible Addiction: Is It Time To Give Up Caffeine?

After years of starting the day with a tall morning coffee, followed by several glasses of green tea at intervals, and the occasional cappuccino after lunch, I quit caffeine, cold turkey. It was not something that I particularly wanted to do, but I had come to the reluctant conclusion that the story I was writing demanded it. Several of the experts I was interviewing had suggested that I really couldn’t understand the role of caffeine in my life – its invisible yet pervasive power – without getting off it and then, presumably, getting back on.

Roland Griffiths, one of the world’s leading researchers of mood-altering drugs, and the man most responsible for getting the diagnosis of “caffeine withdrawal” included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the bible of psychiatric diagnoses, told me he hadn’t begun to understand his own relationship with caffeine until he stopped using it and conducted a series of self-experiments. He urged me to do the same.

For most of us, to be caffeinated to one degree or another has simply become baseline human consciousness. Something like 90% of humans ingest caffeine regularly, making it the most widely used psychoactive drug in the world, and the only one we routinely give to children (commonly in the form of fizzy drinks). Few of us even think of it as a drug, much less our daily use of it as an addiction. It’s so pervasive that it’s easy to overlook the fact that to be caffeinated is not baseline consciousness but, in fact, an altered state. It just happens to be a state that virtually all of us share, rendering it invisible.

The scientists have spelled out, and I had duly noted, the predictable symptoms of caffeine withdrawal: headache, fatigue, lethargy, difficulty concentrating, decreased motivation, irritability, intense distress, loss of confidence and dysphoria. But beneath that deceptively mild rubric of “difficulty concentrating” hides nothing short of an existential threat to the work of the writer. How can you possibly expect to write anything when you can’t concentrate?

I postponed it as long as I could, but finally the dark day arrived. According to the researchers I’d interviewed, the process of withdrawal had actually begun overnight, while I was sleeping, during the “trough” in the graph of caffeine’s diurnal effects. The day’s first cup of tea or coffee acquires most of its power – its joy! – not so much from its euphoric and stimulating properties than from the fact that it is suppressing the emerging symptoms of withdrawal.

This is part of the insidiousness of caffeine. Its mode of action, or “pharmacodynamics”, mesh so perfectly with the rhythms of the human body that the morning cup of coffee arrives just in time to head off the looming mental distress set in motion by yesterday’s cup of coffee. Daily, caffeine proposes itself as the optimal solution to the problem caffeine creates.

At the coffee shop, instead of my usual “half caff”, I ordered a cup of mint tea. And on this morning, that lovely dispersal of the mental fog that the first hit of caffeine ushers into consciousness never arrived. The fog settled over me and would not budge. It’s not that I felt terrible – I never got a serious headache – but all day long I felt a certain muzziness, as if a veil had descended in the space between me and reality, a kind of filter that absorbed certain wavelengths of light and sound.

I was able to do some work, but distractedly. “I feel like an unsharpened pencil,” I wrote in my notebook. “Things on the periphery intrude, and won’t be ignored. I can’t focus for more than a minute.”

Over the course of the next few days, I began to feel better, the veil lifted, yet I was still not quite myself, and neither, quite, was the world. In this new normal, the world seemed duller to me. I seemed duller, too. Mornings were the worst. I came to see how integral caffeine is to the daily work of knitting ourselves back together after the fraying of consciousness during sleep. That reconsolidation of self took much longer than usual, and never quite felt complete.


Humanity’s acquaintance with caffeine is surprisingly recent. But it is hardly an exaggeration to say that this molecule remade the world. The changes wrought by coffee and tea occurred at a fundamental level – the level of the human mind. Coffee and tea ushered in a shift in the mental weather, sharpening minds that had been fogged by alcohol, freeing people from the natural rhythms of the body and the sun, thus making possible whole new kinds of work and, arguably, new kinds of thought, too.

By the 15th century, coffee was being cultivated in east Africa and traded across the Arabian peninsula. Initially, the new drink was regarded as an aide to concentration and used by Sufis in Yemen to keep them from dozing off during their religious observances. (Tea, too, started out as a little helper for Buddhist monks striving to stay awake through long stretches of meditation.) Within a century, coffeehouses had sprung up in cities across the Arab world. In 1570 there were more than 600 of them in Constantinople alone, and they spread north and west with the Ottoman empire.

The Islamic world at this time was in many respects more advanced than Europe, in science and technology, and in learning. Whether this mental flourishing had anything to do with the prevalence of coffee (and prohibition of alcohol) is difficult to prove, but as the German historian Wolfgang Schivelbusch has argued, the beverage “seemed to be tailor-​made for a culture that forbade alcohol consumption and gave birth to modern mathematics”.

In 1629 the first coffeehouses in Europe, styled on Arab and Turkish models, popped up in Venice, and the first such establishment in England was opened in Oxford in 1650 by a Jewish immigrant. They arrived in London shortly thereafter, and proliferated: within a few decades there were thousands of coffeehouses in London; at their peak, one for every 200 Londoners.

To call the English coffeehouse a new kind of public space doesn’t quite do it justice. You paid a penny for the coffee, but the information – in the form of newspapers, books, magazines and conversation – was free. (Coffeehouses were often referred to as “penny universities”.) After visiting London coffeehouses, a French writer named Maximilien Misson wrote, “You have all Manner of News there; You have a good fire, which you may sit by as long as you please: You have a Dish of Coffee; you meet your Friends for the Transaction of Business, and all for a Penny, if you don’t care to spend more.”

London’s coffeehouses were distinguished one from another by the professional or intellectual interests of their patrons, which eventually gave them specific institutional identities. So, for example, merchants and men with interests in shipping gathered at Lloyd’s Coffee House. Here you could learn what ships were arriving and departing, and buy an insurance policy on your cargo. Lloyd’s Coffee House eventually became the insurance brokerage Lloyd’s of London. Learned types and scientists – known then as “natural philosophers” – gathered at the Grecian, which became closely associated with the Royal Society; Isaac Newton and Edmond Halley debated physics and mathematics here, and supposedly once dissected a dolphin on the premises.

The conversation in London’s coffee houses frequently turned to politics, in vigorous exercises of free speech that drew the ire of the government, especially after the monarchy was restored in 1660. Charles II, worried that plots were being hatched in coffeehouses, decided that the places were dangerous fomenters of rebellion that the crown needed to suppress. In 1675 the king moved to close down the coffeehouses, on the grounds that the “false, malicious and scandalous Reports” emanating therefrom were a “Disturbance of the Quiet and Peace of the Realm”. Like so many other compounds that change the qualities of consciousness in individuals, caffeine was regarded as a threat to institutional power, which moved to suppress it, in a foreshadowing of the wars against drugs to come.

But the king’s war against coffee lasted only 11 days. Charles discovered that it was too late to turn back the tide of caffeine. By then the coffeehouse was such a fixture of English culture and daily life – and so many eminent Londoners had become addicted to caffeine – that everyone simply ignored the king’s order and blithely went on drinking coffee. Afraid to test his authority and find it lacking, the king quietly backed down, issuing a second proclamation rolling back the first “out of princely consideration and royal compassion”.

It’s hard to imagine that the sort of political, cultural and intellectual ferment that bubbled up in the coffeehouses of both France and England in the 17th century would ever have developed in a tavern. The kind of magical thinking that alcohol sponsored in the medieval mind began to yield to a new spirit of rationalism and, a bit later, Enlightenment thinking.

French historian Jules Michelet wrote: “Coffee, the sober drink, the mighty nourishment of the brain, which unlike other spirits, heightens purity and lucidity; coffee, which clears the clouds of the imagination and their gloomy weight; which illumines the reality of things suddenly with the flash of truth.”

To see, lucidly, “the reality of things”: this was, in a nutshell, the rationalist project. Coffee became, along with the microscope, telescope and the pen, one of its indispensable tools.


After a few weeks, the mental impairments of withdrawal had subsided, and I could once again think in a straight line, hold an abstraction in my head for more than two minutes, and shut peripheral thoughts out of my field of attention. Yet I continued to feel as though I was mentally just slightly behind the curve, especially when in the company of drinkers of coffee and tea, which, of course, was all the time and everywhere.

Here’s what I was missing: I missed the way caffeine and its rituals used to order my day, especially in the morning. Herbal teas – which are barely, if at all, psychoactive – lack the power of coffee and tea to organize the day into a rhythm of energetic peaks and valleys, as the mental tide of caffeine ebbs and flows. The morning surge is a blessing, obviously, but there is also something comforting in the ebb tide of afternoon, which a cup of tea can gently reverse.

At some point I began to wonder if perhaps it was all in my head, this sense that I had lost a mental step since getting off coffee and tea. So I decided to look at the science, to learn what, if any, cognitive enhancement can actually be attributed to caffeine. I found numerous studies conducted over the years reporting that caffeine improves performance on a range of cognitive measures – of memory, focus, alertness, vigilance, attention and learning.

An experiment done in the 1930s found that chess players on caffeine performed significantly better than players who abstained. In another study, caffeine users completed a variety of mental tasks more quickly, though they made more errors; as one paper put it in its title, people on caffeine are “faster, but not smarter”. In a 2014 experiment, subjects given caffeine immediately after learning new material remembered it better than subjects who received a placebo. Tests of psychomotor abilities also suggest that caffeine gives us an edge: in simulated driving exercises, caffeine improves performance, especially when the subject is tired. It also enhances physical performance on such metrics as time trials, muscle strength and endurance.

True, there is reason to take these findings with a pinch of salt, if only because this kind of research is difficult to do well. The problem is finding a good control group in a society in which virtually everyone is addicted to caffeine. But the consensus seems to be that caffeine does improve mental (and physical) performance to some degree.

Whether caffeine also enhances creativity is a different question, however, and there’s some reason to doubt that it does. Caffeine improves our focus and ability to concentrate, which surely enhances linear and abstract thinking, but creativity works very differently. It may depend on the loss of a certain kind of focus, and the freedom to let the mind off the leash of linear thought.

Cognitive psychologists sometimes talk in terms of two distinct types of consciousness: spotlight consciousness, which illuminates a single focal point of attention, making it very good for reasoning, and lantern consciousness, in which attention is less focused yet illuminates a broader field of attention. Young children tend to exhibit lantern consciousness; so do many people on psychedelics.

This more diffuse form of attention lends itself to mind wandering, free association, and the making of novel connections – all of which can nourish creativity. By comparison, caffeine’s big contribution to human progress has been to intensify spotlight consciousness – the focused, linear, abstract and efficient cognitive processing more closely associated with mental work than play. This, more than anything else, is what made caffeine the perfect drug not only for the age of reason and the Enlightenment, but for the rise of capitalism, too.

The power of caffeine to keep us awake and alert, to stem the natural tide of exhaustion, freed us from the circadian rhythms of our biology and so, along with the advent of artificial light, opened the frontier of night to the possibilities of work.

What coffee did for clerks and intellectuals, tea would soon do for the English working class. Indeed, it was tea from the East Indies – heavily sweetened with sugar from the West Indies – that fuelled the Industrial Revolution. We think of England as a tea culture, but coffee, initially the cheaper beverage by far, dominated at first.

Soon after the British East India Company began trading with China, cheap tea flooded England. A beverage that only the well-to-do could afford to drink in 1700 was by 1800 consumed by virtually everyone, from the society matron to the factory worker.

To supply this demand required an imperialist enterprise of enormous scale and brutality, especially after the British decided it would be more profitable to turn India, its colony, into a tea producer, than to buy tea from the Chinese. This required first stealing the secrets of tea production from the Chinese (a mission accomplished by the renowned Scots botanist and plant explorer Robert Fortune, disguised as a mandarin); seizing land from peasant farmers in Assam (where tea grew wild), and then forcing the farmers into servitude, picking tea leaves from dawn to dusk.

The introduction of tea to the west was all about exploitation – the extraction of surplus value from labor, not only in its production in India, but in its consumption by the British as well. Tea allowed the British working class to endure long shifts, brutal working conditions and more or less constant hunger; the caffeine helped quiet the hunger pangs, and the sugar in it became a crucial source of calories. (From a strictly nutritional standpoint, workers would have been better off sticking with beer.) The caffeine in tea helped create a new kind of worker, one better adapted to the rule of the machine. It is difficult to imagine an Industrial Revolution without it.


So how exactly does coffee, and caffeine more generally, make us more energetic, efficient and faster? How could this little molecule possibly supply the human body energy without calories? Could caffeine be the proverbial free lunch, or do we pay a price for the mental and physical energy – the alertness, focus and stamina – that caffeine gives us?

Alas, there is no free lunch. It turns out that caffeine only appears to give us energy. Caffeine works by blocking the action of adenosine, a molecule that gradually accumulates in the brain over the course of the day, preparing the body to rest. Caffeine molecules interfere with this process, keeping adenosine from doing its job – and keeping us feeling alert. But adenosine levels continue to rise, so that when the caffeine is eventually metabolized, the adenosine floods the body’s receptors and tiredness returns. So the energy that caffeine gives us is borrowed, in effect, and eventually the debt must be paid back.

For as long as people have been drinking coffee and tea, medical authorities have warned about the dangers of caffeine. But until now, caffeine has been cleared of the most serious charges against it. The current scientific consensus is more than reassuring – in fact, the research suggests that coffee and tea, far from being deleterious to our health, may offer some important benefits, as long as they aren’t consumed to excess.

Regular coffee consumption is associated with a decreased risk of several cancers (including breast, prostate, colorectal and endometrial), cardiovascular disease, type 2 diabetes, Parkinson’s disease, dementia and possibly depression and suicide. (Though high doses can produce nervousness and anxiety, and rates of suicide climb among those who drink eight or more cups a day.)

My review of the medical literature on coffee and tea made me wonder if my abstention might be compromising not only my mental function but my physical health, as well. However, that was before I spoke to Matt Walker.

An English neuroscientist on the faculty at University of California, Berkeley, Walker, author of Why We Sleep, is single-minded in his mission: to alert the world to an invisible public-health crisis, which is that we are not getting nearly enough sleep, the sleep we are getting is of poor quality, and a principal culprit in this crime against body and mind is caffeine. Caffeine itself might not be bad for you, but the sleep it’s stealing from you may have a price.

According to Walker, research suggests that insufficient sleep may be a key factor in the development of Alzheimer’s disease, arteriosclerosis, stroke, heart failure, depression, anxiety, suicide and obesity. “The shorter you sleep,” he bluntly concludes, “the shorter your lifespan.”

Walker grew up in England drinking copious amounts of black tea, morning, noon and night. He no longer consumes caffeine, save for the small amounts in his occasional cup of decaf. In fact, none of the sleep researchers or experts on circadian rhythms I interviewed for this story use caffeine.

Walker explained that, for most people, the “quarter life” of caffeine is usually about 12 hours, meaning that 25% of the caffeine in a cup of coffee consumed at noon is still circulating in your brain when you go to bed at midnight. That could well be enough to completely wreck your deep sleep.

I thought of myself as a pretty good sleeper before I met Walker. At lunch he probed me about my sleep habits. I told him I usually get a solid seven hours, fall asleep easily, dream most nights. “How many times a night do you wake up?” he asked. I’m up three or four times a night (usually to pee), but I almost always fall right back to sleep.

He nodded gravely. “That’s really not good, all those interruptions. Sleep quality is just as important as sleep quantity.” The interruptions were undermining the amount of “deep” or “slow wave” sleep I was getting, something above and beyond the REM sleep I had always thought was the measure of a good night’s rest. But it seems that deep sleep is just as important to our health, and the amount we get tends to decline with age.

Caffeine is not the sole cause of our sleep crisis; screens, alcohol (which is as hard on REM sleep as caffeine is on deep sleep), pharmaceuticals, work schedules, noise and light pollution, and anxiety can all play a role in undermining both the duration and quality of our sleep. But here’s what’s uniquely insidious about caffeine: the drug is not only a leading cause of our sleep deprivation; it is also the principal tool we rely on to remedy the problem. Most of the caffeine consumed today is being used to compensate for the lousy sleep that caffeine causes – which means that caffeine is helping to hide from our awareness the very problem that caffeine creates.


The time came to wrap up my experiment in caffeine deprivation. I was eager to see what a body that had been innocent of caffeine for three months would experience when subjected to a couple of shots of espresso. I had thought long and hard about what kind of coffee I would get, and where. I opted for a “special”, my local coffee shop’s term for a double-​shot espresso made with less steamed milk than a typical cappuccino; it’s more commonly known as a flat white.

My special was unbelievably good, a ringing reminder of what a poor counterfeit decaf is; here were whole dimensions and depths of flavour that I had completely forgotten about. Everything in my visual field seemed pleasantly italicised, filmic, and I wondered if all these people with their cardboard-sleeve-swaddled cups had any idea what a powerful drug they were sipping. But how could they?

They had long ago become habituated to caffeine, and were now using it for another purpose entirely. Baseline maintenance, that is, plus a welcome little lift. I felt lucky that this more powerful experience was available to me. This – along with the stellar sleeps – was the wonderful dividend of my investment in abstention.

And yet in a few days’ time I would be them, caffeine-tolerant and addicted all over again. I wondered: was there any way to preserve the power of this drug? Could I devise a new relationship with caffeine? Maybe treat it more like a psychedelic – say, something to be taken only on occasion, and with a greater degree of ceremony and intention. Maybe just drink coffee on Saturdays? Just the one.

When I got home I tackled my to-do list with unaccustomed fervour, harnessing the surge of energy – of focus! – coursing through me, and put it to good use. I compulsively cleared and decluttered – on the computer, in my closet, in the garden and the shed. I raked, I weeded, I put things in order, as if I were possessed. Whatever I focused on, I focused on zealously and single-mindedly.

Around noon, my compulsiveness began to subside, and I felt ready for a change of scene. I had yanked a few plants out of the vegetable garden that were not pulling their weight, and decided to go to the garden centre to buy some replacements. It was during the drive that I realised the true reason I was heading to this particular garden centre: it had this Airstream trailer parked out front that served really good espresso.

This article was amended on 8 July 2021 to include mention of the Turkish influence on early European coffeehouses.

This is an edited extract from This Is Your Mind on Plants: Opium-Caffeine-Mescaline by Michael Pollan, published by Allen Lane on 8 July and available at guardianbookshop.co.uk

By

Source: The invisible addiction: is it time to give up caffeine? | Coffee | The Guardian

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Critics:

Caffeine is a central nervous system (CNS) stimulant of the methylxanthine class. It is the world’s most widely consumed psychoactive drug. Unlike many other psychoactive substances, it is legal and unregulated in nearly all parts of the world. There are several known mechanisms of action to explain the effects of caffeine. The most prominent is that it reversibly blocks the action of adenosine on its receptors and consequently prevents the onset of drowsiness induced by adenosine. Caffeine also stimulates certain portions of the autonomic nervous system.

Caffeine is a bitter, white crystalline purine, a methylxanthine alkaloid, and is chemically related to the adenine and guanine bases of deoxyribonucleic acid (DNA) and ribonucleic acid (RNA). It is found in the seeds, fruits, nuts, or leaves of a number of plants native to Africa, East Asia and South America, and helps to protect them against herbivores and from competition by preventing the germination of nearby seeds, as well as encouraging consumption by select animals such as honey bees. The best-known source of caffeine is the coffee bean, the seed of the Coffea plant.

Caffeine is used in:

  • Bronchopulmonary dysplasia in premature infants for both prevention and treatment. It may improve weight gain during therapy and reduce the incidence of cerebral palsy as well as reduce language and cognitive delay. On the other hand, subtle long-term side effects are possible.
  • Apnea of prematurity as a primary treatment, but not prevention.
  • Orthostatic hypotension treatment.
  • Some people use caffeine-containing beverages such as coffee or tea to try to treat their asthma. Evidence to support this practice, however, is poor. It appears that caffeine in low doses improves airway function in people with asthma, increasing forced expiratory volume (FEV1) by 5% to 18%, with this effect lasting for up to four hours.
  • The addition of caffeine (100–130 mg) to commonly prescribed pain relievers such as paracetamol or ibuprofen modestly improves the proportion of people who achieve pain relief

What The Vaccine Won’t Solve

While the start of vaccine rollouts offer hope that the worst of the pandemic may be over, its devastating financial impact for many will be felt for a long time to come. In research spanning 18 countries from the Deloitte Consumer Industry Center, we find evidence of continued household financial distress.[i] One in five consumers are spending more than they take in as income. During the course of the pandemic, they are twice as likely to have had their financial situation change for the worse and to indicate that they have cut back on staples like groceries and household goods. 

That can lead to tough choices like dipping into savings, increasing the use of debt or prioritizing which upcoming payments will be missed. Even larger numbers of consumers are worried about this becoming their fate.  Forty percent of all consumers in our study are worried about the amount of their savings and credit card balances.

Since the 2008 Great Recession the divide between more affluent consumers and lower income consumers has grown.[i] Just as the pandemic accelerated the adoption of contactless commerce, video conferencing and home gyms, it also accelerated this bifurcation. The pandemic has created one world among high income people who can work at home and make discretionary purchases, and a second world of people who are more likely to be unemployed and/or more limited in their buying ability. While the pandemic has inconvenienced more affluent consumers, others have experienced a severe economic crisis that is likely to extend for some time.

Economists talk about the “K-shaped” recovery—to describe how different segments have experienced, and will continue to experience, the effects of the pandemic.[ii]Our research shows that the K-shaped recession and recovery are features of many economies and a direct outcome of the pandemic’s acceleration of a long-term change in the labor force.

Globally, the chances of being unemployed were about six times higher among low income workers compared to high earners though that varies by country.  The ratio is higher in the United States (nine times as likely). While in Germany, low-income workers were only four times as likely to be unemployed. The difference is likely the result of Germany’s Kurzarbiet scheme to keep workers attached to their employers (so they aren’t officially unemployed) compared to the U.S. use of unemployment insurance. Similar schemes are set-up in all Western European countries.

With the pandemic, unemployment was, in many cases, spurred on by an inability to work from home. Consistent with World Bank research that finds that “jobs more amenable to WFH are more prevalent among workers with high levels of education, in salaried employment, and among younger workers,”[iii] high income workers in our tracker are almost twice as likely to be working at home as low income workers.[iv] 

Spending Bifurcation

Spending bifurcation is also very clear. We track spending intent on 15 categories of goods and services ranging from groceries to travel. Some of these, like housing and medicines, are essential, or non-discretionary from the point of view of the consumer. Others, like entertainment and electronics, can be more easily postponed or managed without. This is discretionary spending.

Globally, since early May, the difference in discretionary spending intent has widened. At that time, approximately 40% more high-income than low-income households planned to spend more on discretionary goods. By the beginning of January, about twice as many high-income households reported such plans.

Not only are high income households now even more willing to open their wallets for “nice to have” items, they are also a third more willing to pay for the contactless commerce and other forms of convenience accelerated by the pandemic. This differs quite a bit by country.  Germany and the Netherlands lead the way by being three to four times more likely to pay for convenience respectively. And despite the importance of convenience during the pandemic, lower income households are less willing (or able) to pay for it.

How should businesses respond? 

For the past few years, we have advised Retail and other consumer companies to prepare for a corresponding bifurcation between price-based value and value delivered through differentiated product or services.[i] Indeed, priced-based mass merchants and luxury brands fared well while others struggled during the pandemic. Possibly more than ever, companies should urgently refine their focus.

Specifically, they should:

  • Deepen empathy for consumers and employees. Wall Street and Main Street have experienced the pandemic differently. Don’t be fooled by rising indices. Reconnect with and evaluate your investments in your customers and employees to better understand their experiences and needs.
  • Make trust a guiding principle. Trust in institutions overall is in decline, but it is critical to success. Eighty-five percent of customers choose trusted brands over others, compared with only 60% who select brands they don’t trust.[v] Trust has clear impact on financial performance.[vi] Investing in and continuously building mutual trust with consumers can help ensure they come along with you on the journey, even when inevitable shocks occur.  
  • Become more granular in your consumer observations. The standard, historical data relied on pre-pandemic may not capture new consumer realities. Decisions made based on old data models can easily go wrong. While continuing to rely on judgment and instinct, leaders should also get creative in seeking new forms of outside-in real-time consumer, marketplace, competitive, and economic data to inform decisions.
  • Become more precise in your value propositions. Adjust how you segment consumers, prioritize channels, establish product portfolios, position your brands, and deploy service models in ways designed to address your chosen strategy and explicitly avoids getting caught in the shrinking middle. 
  • Be agile with your channels. The shift to digital was already happening, but COVID accelerated consumer adoption. Companies that invested heavily in their digital commerce, services, and offerings pre-pandemic (e.g., mass merchants) shifted faster between channels and fared better than those that did not. Recently, half of consumer company executives said they will be increasingly reliant on online and omnichannel strategies.[vii]

Other contributors to this piece: Steve Rogers, executive director, Deloitte Insights Consumer Industry, Deloitte LLP and Danny Bachman, US Economic Forecaster, Deloitte

[i] The Great Retail Bifurcation, Deloitte Insights

[ii] See Eric Morath, Theo Francis, and Justin, “The covid recovery carves deep divide between haves and have-nots,” Wall Street Journal, October 5 2020.

[iii] Maho Hatayma, Mariana Viollaz and Hernan Winkler, “Who can really work from home,” World Bank blogs, May 28, 2020.

[iv] Deloitte Global State of the Consumer Tracker[i] The Great Retail Bifurcation, Deloitte Insights and “The consumer products bifurcation,” Deloitte Insights

[v] Deloitte Consulting LLP, Deloitte HX TrustIDTM survey, May 2020.

[vi] Stephen M. R. Covey and Donald R. Conant, “The connection between employee trust and financial performance,” Harvard Business Review, July 18, 2018.

[vii] Deloitte 2021 Consumer Products Outlook

Leon Pieters

Leon Pieters is the Consumer Industry leader for Deloitte Global, where he is responsible for overseeing globally four consumer sectors: Automotive; Consumer Products; Retail, Wholesale & Distribution (RWD); and Transportation, Hospitality & Services (THS). Leon is charged with setting the overall strategic direction and go-to-market strategy for the practice.

Anthony Waelter

Anthony Waelter

Anthony is a partner in Risk & Financial Advisory within Deloitte & Touche LLP. He currently serves as both the US Consumer Industry Leader and Advisory Consumer Industry Leader. Previously, he led Advisory’s Finance Transformation practice and is a former member of Deloitte’s cross-business Finance Transformation leadership team. With nearly 30 years providing finance transformation services to multinational clients in the consumer products, manufacturing, transportation, retail and distribution sectors, he focuses on assisting clients with transformational projects involving the development and/or evaluation of finance operations and programs designed to improve financial integrity, compliance and operational effectiveness and efficiency.

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Yahoo Finance

Dr. Cedric Dark, Assistant Professor at Baylor College of Medicine & Board Member with Doctors for America joins Yahoo Finance’s Kristin Myers to break down the latest coronavirus developments as the U.K. authorizes emergency use of the Pfizer, BioNTech vaccine. For 2020 election results please visit: Election results: https://www.yahoo.com/elections Subscribe to Yahoo Finance: https://yhoo.it/2fGu5Bb

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Painkillers Like Paracetamol Should Not Be Prescribed For Chronic Pain

US-HEALTH-OPIOID-OXYCODON-ILLUSTRATION

Painkillers such as paracetamol, ibuprofen, aspirin and opioids can do “more harm than good” and should not be prescribed to treat chronic pain, health officials have said.

Draft guidance from the National Institute for Health and Care Excellence (Nice) said that there was “little or no evidence” the commonly used drugs for chronic primary pain made any difference to people’s quality of life, pain or psychological distress.

But the draft guidance, published on Monday, said there was evidence they can cause harm, including addiction.

Chairman of the guidance committee Nick Kosky said that, while patients expected a clear diagnosis and effective treatment, the complexity of the condition means GPs and specialists can find it very “challenging” to manage.

The consultant psychiatrist at Dorset HealthCare NHS University Foundation Trust added: “This mismatch between patient expectations and treatment outcomes can affect the relationship between healthcare professionals and patients, a possible consequence of which is the prescribing of ineffective but harmful drugs.

“This guideline, by fostering a clearer understanding of the evidence for the effectiveness of chronic pain treatments, will help to improve the confidence of healthcare professionals in their conversations with patients.

“In doing so it will help them better manage both their own and their patients’ expectations.”

Chronic primary pain is a condition in itself which cannot be accounted for by another diagnosis or as a symptom of an underlying condition, Nice said.

It is characterized by significant emotional distress and functional disability with examples including chronic widespread pain and chronic musculoskeletal pain, it added.

Nice said an estimated third to half of the population may be affected by chronic pain while almost half of people with the condition have a diagnosis of depression and two-thirds are unable to work because of it.

The draft guidance, which is open to public consultation until August 14, said that people with the condition should be offered supervised group exercise programs, some types of psychological therapy, or acupuncture.

It also recommends that some antidepressants can be considered for people with chronic primary pain.

But it said that paracetamol, non-steroidal anti-inflammatory drugs such as aspirin and ibuprofen, benzodiazepines or opioids should not be offered because there was little or no evidence that they made any difference to people’s quality of life, pain or psychological distress.

There was evidence that they can cause harm, including possible addiction, it added.

The draft guideline also said that antiepileptic drugs including gabapentinoids, local anaesthetics, ketamine, corticosteroids and antipsychotics should not be offered to people to manage chronic primary pain because, again, there was little or no evidence that these treatments work but could have possible harms.

Paul Chrisp, director of the centre for guidelines at Nice, said: “”When many treatments are ineffective or not well tolerated, it is important to get an understanding of how pain is affecting a person’s life and those around them because knowing what is important to the person is the first step in developing an effective care plan.

“Importantly the draft guideline also acknowledges the need for further research across the range of possible treatment options, reflecting both the lack of evidence in this area and the need to provide further choice for people with the condition.”

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