Understanding the Research: Empathy Impairments in Autism




Welcome to the first ‘Understanding the Research’ post. The idea of these is to make new research more accessible to non- academics, which let’s face it most of us will be! I am a firm believer that research on autism should directly help the people it is examining, yet much research is simply inaccessible to the general population, you need a subscription or to pay for articles, and then when you do get hold of it it’s filled with jargon. It is also important to stress that this research is not immune to criticism, just because it has been written by an academic for an academic journal it does not make it bullet proof. So once a month (hopefully) I will be reviewing a research paper on autism and sharing it with the masses (the 10 people who probably read this).

 

‘The self to other model of empathy: Providing a new framework for understanding empathy impairments in psychopathy, autism and alexithymia’
(Geoffrey Bird and , 2014).

There is a huge debate going on at the minute about whether individuals with Autism actually have empathy or not. Historically the disorder has been thought of as a lack of empathy, for example Simon Baron-Cohen and his team coined the ‘Extreme Male Brain Theory’ of Autism, which stated that people with autism typically are very good at systemising (understanding inputs and outputs, computers, physical, DIY etc) and not very good at empathy. Now before we go any further, what exactly does empathy mean? Empathy refers to the understanding of other people’s feelings and perspective, basically your ability to put yourself in their shoes. This sounds a little bit like Theory of Mind, which young children with autism in particular are quite bad at (look up the Sally Ann test). However, empathy is also about sharing one’s emotional experience, rather than just recognising them.

The problem with this theory is that lots and lots of individuals with autism are actually almost too sensitive to other people’s emotions, which kind of goes against the theory that they are lacking in empathy. ‘The Self to Other Model of Empathy’ by Bird and Viding (2014) attempts to describe this dichotomy. The self to other model of empathy (SOME) includes a few systems which work together to enable a person to feel empathy. One of these is the Situation Understanding System, for example if you were at a funeral this system would inform you of the situation and you would be alerted that usually in this situation it isn’t appropriate to laugh and that people might be feeling sad. It isn’t necessary to have Theory of Mind or direct experience of the situation for this system to work. The second system utilised is the Affective Cue Classification System, which interprets low level visual categorisation of the cues presented by another person, for example a facial expression or tone of voice. These are the two main systems for empathy, however a couple of others can influence the model. The Mirror Neuron System for example can provide automatic mirroring, so if a person is sad you may automatically mimic their facial expression as a result of this system. Next is the Theory of Mind System, which enables you to represent the mental state of others, and similar to that the Affective Representation System represents the current emotional feelings of the self. Lastly, and questionably of most importance, is the Self-Other Switch. This enables our own feelings to respond appropriately to the situation, for example if someone is upset at a funeral of a person we do not know, we will not cry uncontrollably and require comforting ourselves, we will be able to pay more attention to the other person who is upset and who actually knew the deceased. Some think that this switch is automatically switched to the self, and that it needs actively switching to the other.

So how does this model relate to autism? Well as you can see there are several things that could go wrong, but this would not necessarily mean the individual has no empathy. The main problem seems to be with the Theory of Mind System, and as most individuals with autism have some degree of impairment here that means most will also have some difficulties processing empathy. Another difficulty is that due to an autistic person’s lack of social attention and therefore lack of social scripts the Situation Understanding System may also struggle, and typically the Theory of Mind System would compensate for this. HOWEVER, all is not lost because there are other systems in place, meaning only those autistic individuals with severe Theory of Mind impairments will lack empathy completely. There are still mechanisms which mean that another’s affective state can cause a corresponding change in our own (the Affective Representation System). Some people have also theorised that there may be a problem with the Self-Other Switch in autism, specifically that it may be biased more towards the self. This would explain why some individuals with autism almost experience too much empathy and end up having huge meltdowns if those around them are sharing too much emotion.

Hurrah I hear you cry, there is a way through this maze! However, before we finish there is one further problem to add to the mix. A very high proportion (somewhere around 80%) of individuals with autism are also thought to have a condition called Alexithymia. This is a subclinical condition whereby individuals struggle to identify and describe feelings and have difficulties in processing bodily sensations brought on by emotional arousal, and tend to have a very externally orientated thinking style. If you’ve managed to follow this article then you might be questioning then how well the Affective Representation System works in these individuals, and this appeared to be the saviour system for people with autism who were lacking a couple of the other systems. I won’t go into any more detail here, but it is worth noting and may explain why some people with autism have bundles of empathy and other’s absolutely none. With so much that could go wrong but also so many compensatory systems in place, you would be hard pressed to find an autistic individual without some capacity for empathy.

Conclusion

The ability to understand and share other people’s emotions and perspectives (empathy) is dependent on a number of different systems. These rely on us being able to understand the situation, the person’s facial features and voice tone, as well as our own feelings and the ability to switch these to others. It would appear that those with autism may not be able to pick up on cues given in a given situation, however they may be able to compensate by understanding their own feelings in reaction to another’s. Therefore, empathy is not completely lacking in individuals on the Autism Spectrum, merely impaired in some areas.

 

Note: What is in this article is not ‘fact’, in fact nothing can really be proven. It is the author’s highly educated theory, and therefore there may be elements you disagree with and that the author’s have got wrong. Please feel free to comment on these.

To read the original article click below:
http://www.sciencedirect.com/science/article/pii/S0149763414002577

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9 Comments
  1. I have 2 children with Autism and I have found a way to help them heal and have less behaviors. My son has eye contact and the hand flapping stopped, and he’s beginning to speak. If you want to know more please contact me so that I may share it with you

    • Please do share your findings with me! We have been told our daughter must have autism for those exact reasons, not yet diagnosed (aggravatingly long process with many hoops to jump), but I don’t see the harm in treating her for it regardless of the chance she isn’t! She has a wiggle finger thing she does, and she gives great eye contact in my opinion but other family disagrees, she is behind with speech. It’s odd because she regressed. Started out ahead in language and then it’s as if that part of her brain took a nap like the hare in the Tortoise and the Hare. I’m glad you’ve found relief for your children!

  2. Thank you for the mention of the mirror neuron theory – your description of how it works clicked where others have not. I’d been thinking of something I routinely do, but didn’t have a name for, and now I know. I do this to help decipher what/how other people are feeling, but also to remember who they are. Even if I can’t identify a face, if I mimic the mouth area it will often bring the name to me.

  3. Just wanted to compliment you on the wonderful clarity and helpfulness of this. There hasn’t been this kind of synthesis anywhere else that I have seen, though I am not across all the research. Experiencing strong feelings of caring for others, while often being quite socially confused or anxious, and by contrast, at times too self-focussed to realize the effects I am having – all seem to characterise my memories of my earlier life. Gradually I think I learned to draw on the strengths and think through the deficits to overcome them.
    Anyhow, I thought the article was marvellous.

  4. I really need to get a diagnosis. When my ex mentioned he had BPD I assumed I had it as well-we had a lot in common as far as emotional outbursts and not feeling understood by others (in an extreme sense-not “everybody feels misunderstood”). Though typically he would think I was being too cold and insincere because I was not as expressive with my emotions until I was upset unfortunately. But years later we are working on a diagnosis for my three year old, too. Most assume she is autistic which I didn’t understand (I was very close-minded about what ASD means), I kept getting emotional telling people if she has it then I have it “and I do NOT have autism!” But the more research I do I feel I might be. Sorry if over-explaining, I feel I should get a diagnosis and return to have my input but hopefully this is interesting in the least! This article made me think of my potential of ASD because of the emotional/empathetic aspect especially. My closest friends would always tell me I remind them of a robot, which would bother me until I convinced myself it was a fun quirk. I always felt I had much more emotion than most-well more intense emotions. I managed to hide it is all. I learned it was unacceptable from an early age. I remember being in trouble for my emotional behaviors at a young age and I didn’t understand at all why my guardians insisted I was being angry or even sad on purpose. I know I had to stop myself from hugging the cat too tightly many times but it was seriously because I just loved my cat SO MUCH! Perhaps many autistic people appear to be un-empathetic because they have been trained to fear the repercussions of showing too much emotion. Many “normal” people that get to know me seem surprised when they discover the passions I have about certain things. SO I have yet to find what that means for me. I could not have ASD at all but I wanted to share in case it helps anything! Thank you if you’ve read all that!

  5. I have been told just recently that I have emotional autism as a result of growing up with much trauma. PTSD too. Brittany, I definitely relate to what youve said about feeling intense and yet
    Hiding it yet I also sometimes have numbed emotions (alexithymia). I also agree that perhaps as a result of the intensity of emotions we have felt and responding so strongly to sensory stimuli, some of us have learned to suppress emotions and perhaps dissociate. Ive just begun my research journey. Thanks for tgis enlightening blog and the video of women and girls with asd.

    • I don’t think there really is such a thing as emotional autism in a non-autistic; either you’re autistic or you’re not. However, the reason such a diagnosis might exist is because a lot of autistics grow up with trauma, especially since they are often bullied, abused, and/or subject to therapies or training that can result in PTSD, so some of the things that they do that are attributed to autism (but not all, not by a long shot) are actually symptoms of the trauma they have suffered, while others are a combination of the autism and the trauma. In fact, I don’t believe that the scientific literature has a good picture of what an autistic looks like when brought up in a non-traumatic manner. Of course, there are plenty of autistic traits that are there whether there is trauma or not; however, the effects of trauma are worth considering.
      By the way, it may be possible you actually are autistic, period, and would be whether you were traumatized or not.

      • Thanks for the response Lucy. As it turns out I am definitely on the spectrum – diagnosed by myself and clinical psychologist.
        On researching it, I find my Dad was definitely on the spectrum and I think, experienced heightened trauma as a result of fighting in our war. I agree about the dombination of trauma and autism. I think that autistic characteristics of sensitivity to environment and emotional states all around can traumatise someone with autism greatly, the trauma being orocessed more acutely.

  6. I definitly agree on the switching thing. When you feel too much of someone elses story. My mum told me about a girl who was raped and all of the information involved made me feel very bad, so bad I got angry with My mother for telling me the story. Im too sensitive to be told things like that

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