Ah, that's interesting.
When I see someone who's both emotionally close to me and actually physically in front of me experience physical pain, I feel lurchy unpleasant physical sensations, but no pain.
When someone's emotionally upset and in front of me, I feel very distressed, but not necessarily in tune with what they're feeling - whether their feeling is anger, fear, or sadness, my emotion is generally anxiety, extreme discomfort and/or panic. It's almost unbearable and I urgently want to make it stop (for both of us), but have no idea what to do about it. I usually try to make my face look like it's supposed to look in that situation, but correct reactions are very difficult. Because physical touch is difficult for me when I'm distressed, it's hard for me to have the correct physical response of touching the person, because their distress upsets me too and when I'm upset I can't handle touch, IYSWIM, but I try to ignore that and touch them anyway. It's not easy but the only way I'll feel better is if they feel better (because I hate other people being distressed - it's awful for them) so I try to do it.
So, empathy is supposed to involve feeling the same type of feeling the other person does? I can't always tell exactly what emotion the other person is feeling, but I can tell they're distressed IYSWIM, and I want them to not be distressed.
If it's happening on a TV screen, whether it's fiction or not, it has no emotional effect (except that I get pissed off about injustice or unfairness to people).