From Kohut’s original descriptions to our most contemporary writers, the concept of empathic understanding and responsiveness has remained central to self psychology and intersubjectivity theory. But what is simple to describe is not necessarily simple to accomplish. The specific words we choose, the sequence in which we say them, our tone of voice, the emphasis we place on affect versus behavior, or external events versus internal reactions, feelings versus intentions, forward versus trailing edges, or hopes versus dreads are just some of the factors and choices that go into whether true empathic understanding and responsiveness are achieved. The co-created nature of analytic dialogue and the uniqueness of any given analytic pair add yet another level of complexity to this process. In this talk, the presenter will describe the theoretical assumptions that underlie our emphasis on empathy and then offer vignettes and clinical examples to describe nuances of how to listen and respond to patients in ways that facilitate an unfolding therapeutic process of connection and change.