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.
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.
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