Your points are well taken and as important as usual. I found Ian Suttie's writing helpful when I was starting my work on the nature of love, and am glad to find another fan of his. I'm so impressed by the idea of asking patients whether they made their needs known that I will simply incorporate it into my therapeutic work from now on. Thank you.
I think that sympathy has gotten its bad name because of what in poetry is called "the factor of address," the position from which one person addresses another. In empathy, we feel along with the feelings experienced by the other person; empathy can only occur when one of the two people is a broadcaster of affect experienced at the moment. Mature empathy, then, involves peers, equals, who are momentarily linked by the affective experience even though one or the other may use the empathic wall to pull back from the affect in order to process it, and then to help the other person process it.
In sympathy, we acknowledge, reference, describe, take note of the misfortune of another person. Doing this, we are more removed from that person than when we are in the affective link of empathy. In sympathy we are superior to the immediate experience of the other (and thus run the risk of shaming that other person), while in empathy we are right there with the person. In sympathy we say that your situation is awful, and it certainly is not my situation. In empathy, we say that both of us share the feeling, that your situation is my situation for the moment, that I will use my personal skills to manage it, and that perhaps my way of handling the affective situation may be of use to you. In sympathy, we say that certainly I am not in your situation but that if you follow my advice, you will avoid it next time or find out how to extricate yourself from it.
Given this difference in the factors of address and the built-in assymetry of power, I suspect that sympathy might be a source of shame for the recipient unless the donor were to remain aware of such potential. I've been thinking a lot about your suggestion that sympathy for the afflicted is a necessary and proper condition for entry into our field, and at least at this moment, I disagree. I don't think the surgeon feels that the owner of the hot abdomen is lesser, but only that a hot belly is a great place to work. I don't think that a therapist needs to look at a suffering citizen as lesser and needy, but rather as a great place to work. If I work from the vantage point of empathy, then I am motivated to help my fellow creatures because I really do feel their pain and know how to alleviate it, rather than the position that I know about their pain and am willing to study it with them as long as they listen to me.
I'm sure you have some thoughts about these pre-dawn musings, and look forward to your reaction.