Unanswered questions of empathy, and resulting reflections on blogging

seventh sense

Image by woodleywonderworks via Flickr

The idea that autistic people lack empathy, is as often stated as it is attacked. Some of the disagreement turns on definitions, which isn’t surprising since the common usage and dictionary definitions of terms like empathy, sympathy and compassion, are not consistent.

I’d written a post (as yet unpublished) looking at and testing each definition. It was humming along nicely to begin with; I came across new ideas and information, about things like “alexithymia”, and psychopaths vs autistics, and how some autistic people are actually overly aware and sensitive to others emotions (to the point of pain and extreme anxiety). But the more I read, and the more I collated what I’d read into that post, the clearer it became that any meaningful answer to the question of autistic people and empathy, had to deal at some level with the question of language (both verbal and body language), and had to confront questions of theory of mind (which is closely related to the issue of language).

Essentially, theory of mind is the ability for someone to imagine what is happening in someone else’s mind. In order to figure that out, the prior development of language – or more so, some form of communication and meaningful social interaction with others – is apparently required. This is obviously a challenge for autistic people. So, arguably, without having the usual communication skills, the ability to empathise (which I’m taking at this point to include sympathy and possibly compassion) is necessarily compromised. (Or is it – I’ll get to that soon.)

Then there’s the question of the relative importance of spoken versus body language for forming a theory of mind. Studies have shown that not being able to see another person (being blind) did not change the areas of the brain that were active when dealing with theory of mind tasks. So not making eye contact or being able to read people’s gestures and body language, is apparently not as vital as verbal language for empathy. So if an autistic person won’t look you in the eye or watch your body, but otherwise has good verbal language skills, they’re not necessarily missing some “key” to empathy.

Even the theorists who propose this link between language and theory of mind, recognise the capacity to teach an autistic person to recognise and respond to emotion, so the deficits can be addressed. Often such learning will be in the form of rote-learning recognition and responses (which is arguably the first step towards “real” response, though some believe rote-learning is the best you can hope for with many autistic people). Does teaching the rote-learnt recognition and responses, actually mean the autistic person now has a theory of mind? For the purposes of the question of empathy, does it mean that the autistic person is then truly empathetic, or have they just learnt behaviours to make it look like they are? (And how much does the difference matter, if the resulting behaviour – acts and words of compassion – are the same.)

And what of this theory of mind in the first place, does it really incorporate emotions, or must emotions be treated as a separate consideration: Is there a vital difference between being able to understand what someone else is thinking, and being able to share in what someone else is feeling. If different parts of the mind are at play (and at least one study I came across suggested there are), then the talk of “theory of mind” perhaps needs to be separated out from issues of empathy.

Once I started getting my head around all of that, and the chicken-and-the-egg questions that kept popping up at each stage (do you need X for Y, or Y for X, and then is X a pre-requisite, or just helpful, to achieve Y, etc), I started working my way through some incredibly thought-provoking blog posts. Such as one about replacing “theory of mind” with “theory of self”; that the problems autistic people have with integrating their inner worlds is the more essential and prior problem to figuring out whether they can understand other people’s worlds. And some very good points about how empathy comes hand-in-hand with deception; being able to understand other people’s emotions and thoughts also means you can do some down-right nasty things to them, which don’t come naturally to autistic people either. (Who’s the psychopath now.)

After all that, my brain was feeling a bit… full (if you’ve ever studied for weeks on end for an exam, you know the feeling). I’d learnt a hell of a lot, some of it so important that it has changed the way I now think about certain aspects of my son’s past and current behaviour. Some of the lessons I’ve learnt are ones I want to share (such as the incredible importance of realising that your autistic child may be avoiding eye contact and shutting themselves away, because they are over sensitive to emotional input – or it’s causing anxiety because they can’t but really want to understand it  – so either way you need to be careful and thoughtful about what emotions you exhibit around them). The post I’d initially written turned into spin-off stories about my son, and my Aspergers friends, and was turning into a top-heavy monster: Lots of spin-off, not enough foundation, not stable enough to hit publish.

So here I am. Writing a post about a post I didn’t publish yet. Trying to make sense of this huge wealth of information that has broadened my horizons and my passion about autism yet again. My inner academic tells me to go back to university and do a proper degree that allows me to specialise in autism, but my inner academic is an expensive pain in the butt, and I’m busy raising children right now, so it can just sit down and be quiet thank-you-very-much. Some day, maybe. But for now, I’ll keep reading, and writing, and learning: From others’ posts, from compiling my own posts, and from what people share with me in the comments. Isn’t blogging awesome 🙂

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15 Responses to Unanswered questions of empathy, and resulting reflections on blogging

  1. sharon says:

    Wow, so much to consider. This is a topic I ponder quite a bit, particularly as before my sons dx with Autism I had an interest in socio/psychopathy. (there’s a book called Evil Genes that’s worth a read) So I really enjoyed your point above about how empathy lends itself to the capacity to understand therefore manipulate others. Something psychopaths are brilliant at.

    I think that empathy and theory of mind are incredibly complex, and are shaped by many variables including culture. I also think there are lots of NT people who struggle with empathy. Ironically this can often be seen in how NT people talk about those with Autism. Another question is, where does empathy end and projection begin?

    Like you I often think of topics I would love to go back to uni and study around the topic of ASD.

    • Insightful and interesting comments sharon. I hadn’t thought directly about questions of culture and projection, but you’re absolutely right that they too must be considered when attempting an understanding of empathy (empathy in general, aswell as empathy in regards to people with autism).

  2. Cecile says:

    A very good post about a post yet to be posted – I’ll keep a lookout for that one!

    I have been thinking/reading/mulling/wondering about this so much lately. What exactly is empathy? TOM? Compassion? I find it very complex, and it frustrates me that so many people blithely make statements about empathy and autistic people.

    I like the way you write.

    • Rachel says:

      Most of the problem is that people confuse cognitive empathy (being able to read subtle nonverbals and respond in culturally appropriate ways) with emotional empathy (feeling for and with another person). Thus, you get statements like, “Autistic people lack the most basic thing we have — empathy, which makes us human.” That statement implies that we lack emotional empathy, which is absolutely untrue. In fact, studies have clearly shown that autistic children tend to respond with more emotion to scenes of pain and suffering than non-autistic children (I certainly did, and still do), and that autistic people are no more prone to psychopathology than anyone else. Unfortunately, not many of the researchers are bothering to clarify this important issue, which has major repercussions on the lives of autistic people everywhere.

  3. Rachel says:

    Regarding ToM, I would add that the ability of non-autistic people to figure out what goes on in the minds of autistic people can be severely impaired, with some pretty terrifying consequences (such as the incarceration of my intelligent, autistic great-aunt in state mental institutions from the time she was 11 until she died at the age of 25, of TB). Theory of mind has everything to do with the fact that like minds understand like minds. That’s all. I understand autistic people better than I understand non-autistic people because our minds and senses work similarly. I know why the autistic kids in a workshop I supervise are getting overstimulated and upset, I know how acutely sensitive they are to the emotional and sensory world, and I know how to address these things in ways that most NT people intuitively cannot.

    The problem, of course, is that NT thinking is defined as “normal,” so everyone is expected to intuitively understand it, while autistic thinking is considered “abnormal,” so no one is expected to intuitively understand it. Thus, you have people doing researching studies and teaching courses and doing all kinds of analytical work on how we operate, and no one thinks that shows a lack of empathy at all! And you’ve also got lots of autistic people who have never had to take a course or fund a research study to figure out how NT people operate. We just do a lot of watching and figuring things out from hard experience. I’m quite well practiced at seeing things from various perspectives, because I’ve had to be in order to survive. Most NTs I’ve met are not nearly so practiced and have trouble imagining that autistic people have any perspective at all (present company excepted, of course). 🙂

    • Fantastic comment Rachel, some excellent points there that I hadn’t come across before, and an excellent example of why it is so incredibly important to talk directly to – and not just about or for – people with autism.

  4. Bill says:

    I am endowed with Asperger’s.
    The kind of AS I have is clearly heritable, and what I share here may be unique to my specific genetic make-up, or maybe not.
    I most very definitely have empathy; it just seems to be less consistent and with different triggers than in neurotypicals.
    My mother once lost an infant, and she could not ever discuss the loss without becoming very obviously emotional. Seeing her pain, I could not think of that loss without intense emotion. Since her passing, I no longer get emotional at the memory of the loss. I did not get emotional at the loss of either of my parents. Best as I can figure it; if they can no longer feel pain, how can I empathize with their pain?
    I can read a passage in a book where the author has cleverly intended to twang our heartstrings, and it works; I become emotional, even though I see right through the author’s contrivances, even if it is the third time I am reading the book, and even if it is a work of fiction and I know the character never existed, as I keep reminding myself. It is almost as if some portion of my brain is hardwired for emotion, even as some other part of my brain is saying “You doofus!” (This dichotomy has other dimensions- as a child I rarely recalled dreams- as an adult I dream more often, but as I dream, a part of my brain acts as a referee/critic, pointing out nonsense and irrationality, and sometimes even manipulating the dream.)
    Face blindness contributes to empathy problems too. It is difficult to describe the face blindness because it is not an absolute, black and white thing. I recognize photos of Osama Bin Laden, for instance. If you were to have shaved off his beard, and put him in a business suit and a bowler hat I would probably have never recognized him in a million years. I can’t necessarily study a photograph of anyone and from that study gain the ability to recognize the same person’s photograph taken from a different angle, or to recognize them in a line-up. I can’t recognize old photographs of my own children unless I can spot some chronological clue, or I have seen that photograph enough times to have memorized who is in the photo. (I cannot recognize any of my children’s voices over the phone either!) If it was someone often photographed, say, Charlie Sheen, his putting on sunglasses would have absolutely no effect on my ability to recognize him, since the eyes are apparently not in the construct my mind uses to recognize somebody. Standing in a labyrinth of office cubicles, where all I can see is the very top of people’s heads bobbing by, I can still reliably recognize my co-workers.
    All this said to point out I am likely going to miss emotional nuances on a person’s expression; My mind isn’t fixating on the eyes or eyebrows. I was totally bewildered in grade school, never could remember any of my teachers, (still don’t), and no wonder; they were all nuns wearing identical habits! If I am not going to see emotional nuance, I am not going to have the opportunity be very empathetic!
    I could also theorize that we previously undiagnosed Aspies may have gotten inured to some of the emotion. Countless times in my youth I got bawled out by teachers or my parents for things which were very obvious to them, which they felt I had deliberately chosen to do, and I would be totally bewildered about what they were talking about! After a while, you just get resigned to your fate of being a whipping boy and ignore their rants as best you can. You learn to bury some of your emotions, and the conflict between the world as you see it, and they see it. I was never permitted to forget how stupid I was because I was unable to memorize the multiplication table, yet my memory for less abstract things clearly surpassed my peers. (I still have never been able to memorize the multiplication table, but lucky for this engineer they invented the scientific calculator just as I entered college!)

    • Wow. That was very interesting. I am impressed with your ability to analyse your own experiences, and to make them accessible to others in the way you have here; I mean that comment in the general sense – not just because you have AS – the way you have shared your story makes me want to read more of what you have to say. If you have a blog or similar, I would love to read it. Thank you, very much, for your comment.

      • sharon says:

        Yes I really appreciated Bill’s response. Thought of blogging Bill?

      • Bill says:

        I won’t start my own blog, because I am afraid if I ever came out of the closet, I would lose my job. (Made that mistake at a previous employment)
        This is the first time I have spotted this particular site; I have left my opinion on other sites. I almost always identify myself the same way, “I am endowed with Asperger’s”, so if you Google that phrase and confirm it is a comment from “Bill”, it is mostly likely one of my previous posts. One odd thing; some of my old posts have been copied and pasted onto other websites by persons unknown, and those may be altered or out of context.
        If A&O wishes to contact me by E-mail regarding something which particularly piques your interest, feel free.
        I first started sharing my opinions because I felt some parents were harming their children by not vaccinating and promoting dangerous alternative treatments, and I have too much empathy for my peers on the autism spectrum to stand by and do nothing. It is obvious to me, looking at the incidence of Asperger’s from generation to generation within my family, that my AS has a genetic cause. The unbalanced ratio male vs female suggests a genetic cause, and familial relationships between AS and autism strongly suggest a common genetic cause. Coupled with the inability to tease a connection between vaccines or mercury out of the statistics in large studies, at the very least means the vast majority of cases of autism/AS are not caused by vaccines. This does not preclude some tiny percentage of autism being caused by vaccines, but weighing the millions saved by vaccines vs the tiny vaccine threat, vaccines win handily. For the tiny percentage of harmed families, that’s what the special vaccine court (in the US) was devised for, and it has indeed paid out in the past. I am not even convinced of the propriety of even those cases; if someone’s body or mitochondria or whatever could not handle a weakened virus, and harm was caused by the vaccine, what harm would have been caused by the contagious virus in an unvaccinated population? Would not that same child have died if exposed to the actual contagious virus if their immune system could not even handle the weakened virus?

      • I’ve done a search as suggested Bill, and might I say, you are a fascinating and insightful man. I’ll be sending you an email soon. Thank you again for sharing your thoughts and experiences.

  5. nostromo says:

    I find Bills comments quite fascinating too. The face recognition issue especially. I wonder what it is?
    I can recognise a face anywhere and never forget..names though; meaningless! I am an engineer too.
    While I have no ASD I can recognise things in my sons behaviour..specifically his Autistic behaviour that seem to have roots in his mother and I. Autism is a big puzzle.

  6. Rory Allen says:

    These posts raise very important issues over empathy and alexithymia. Alexithymia is key to the whole thing. This an area that I have been working on, and my results so far published can be found at the Academia.edu website under the name Rory Allen if interested.

    I am guessing (and it has to be a guess because nobody knows for sure) that ‘deficits’ in empathy are often apparent rather than real, and are due to alexithymia, inability to verbalize feelings. If you can’t talk about feelings, others think you don’t have feelings: we are a verbal society. People with autism often love music and respond emotionally to it. But interacting with neurotypical humans is often complex, even frightening if you don’t have the right language for emotions.

    By the way, I find that the best ideas for what autism/Aspergers is about come from people actually with autism or Aspergers. I am currently writing another paper about emotion and music in which the principal idea came from someone with Aspergers (and he is listed as one of the authors). He told me that if you have autism, you can learn about social emotions from opera, in which the music makes you feel the emotions, and the plot tells you about the social context. Hence, you can learn about social emotions by an associative learning process through watching opera. It’s a great idea, though it may not work for everyone.

    • I enjoyed perusing the summaries of your papers Rory, thank you for pointing me (and my readers) in their direction. You clearly have a passion in this area, and it was great to see your acknowledgment of the difficulties in measuring such issues and responses in autistic people, and trying to find ways to respond to those challenges. Very heartening, and important, work.

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