Inside and Out: A Few Words About Empathy

Got empathy? I do. And from all the testimonies I have read and heard, so do many other individuals on the autism spectrum.

Shocking? It might be, if you’ve believed up to this point that Aspies and other folks on the spectrum lack the capacity to empathize with other people – in other words, if you believe that we cannot feel or care about your pain.

There is lot of misinformation about autism spectrum disorders to begin with. What’s particularly damaging here is that some (and I emphasize, some) in the medical and mental health professions keep insisting that we lack empathy. For one thing, on many of the lists of symptoms and traits related to Asperger Syndrome I continually find such phrases as “lack of empathy” or “difficulty with empathy”. Another example is this article on the Global and Regional Asperger Syndrome Partnership (GRASP) website which cites a particularly damning quote from a 1999 article in the International Journal of Psychology:

“ …it would appear that both Asperger syndrome and psychopathy…share some common characteristics, notably the total absence of human empathy…”

What a load of bullshit! I thought. And I kept thinking this as I came across similar kinds of assertions in my later reading. What also got me thinking about this subject was an interview with Dr. Tony Attwood on this AWA Radio broadcast which I listened to last Sunday: he and the host mentioned recent studies that suggest that those on the spectrum are hypersensitive to the emotions of others — in other words, overempathetic (more about those studies later in this post).

I began considering the whole ball of wax with empathy. I remembered that in the past, when other people hurt, I hurt too. For example, there’s an incident that still sticks out in my mind from a prayer meeting that my fiance and I used to attend: there was a woman praying in a language I didn’t understand, but I could feel every bit of her words, which became more urgent, impassioned, and painful as the prayer wore on. I was crying by the end of her prayer.

And my capacity to hurt still rings true now. I ache when I find my stressed-out fiance at the end of a day, overloaded from dealing with caring for his elderly parents. I ache when my coworkers experience deaths in their families or other difficulties in their lives. I ache when I hear the pain inside the work of some of the poets in my community.

And it doesn’t seem to matter whether I know the people personally or not. Last week, a mural artist in our local poetry community died as a result of a lung condition. He was only 39. I’d never spoken to him, and my fiance and I had just seen him a few times, sketching in the corner at one of the local poetry nights. And we’d seen his work, which is phenomenal and vivid (and I do it injustice by even using those words to describe it) up and down one of the streets in town, on the sides of several buildings. But I literally hurt when I read the news posted on the pages of several of my friends on Facebook.

I’ll go even a bit further: I have trouble sometimes watching TV shows or movies that are emotionally evocative. It could be as simple as feeling embarrassed for a character on-screen, or it could be feeling hurt at how someone is being treated (for example, when watching the movie Office Space I literally wanted to jump through the screen and beat the crap out of Lumberg, the boss in the film for how he treats Milton, one of the computer programmers), or being unable to watch a movie more than once because it rips me apart inside (case in point — the 1991 Oliver Stone biopic about the The Doors: I could only tolerate watching Jim Morrison destroy himself once on screen).

So you can understand why I began challenging the conventional wisdom about empathy and Asperger Syndrome. I knew I was not emotionless and cold, and not lacking empathy. And wouldn’t it stand to reason that if this was true for me, it would be true for others Aspies as well? So I read, thought, and read some more, upon which I found two distinct causes of the so-called problem that folks on the spectrum have with empathy. Both of these are directly related to what goes on inside; in short, they explain part of the inner world of a person on the spectrum as follows:

1. “Theory of Mind” difficulties. This basically means that someone with Theory of Mind problems with be less easily able to work out what someone is thinking or feeling. Humans typically do this by reading tone of voice, facial expressions, body language, and other non-verbal kinds of communication — something that people on the spectrum typically struggle with. This leaves them with a reduced ability to “read” people or situations — this includes things that I’ve mentioned such as tone of voice and facial expressions but which also leads to a difficulty reading subtle social cues.

2. Hypersensitivity. This can come in a couple of different forms, but I’m calling attention to emotional hypersensitivity in this post. This 2009 article from The Star (Toronto, ON) reveals recent research findings that counteract the conventional wisdom that those on the spectrum lack empathy: in fact, the researchers suggest that they undergo “a hypersensitivity to experience”. In other words, not only can people on the spectrum sense the emotions of others, but they are be overwhelmed by them.  This idea is in line with the “intense world” theory of autism, which suggests that our nervous systems are hypersensitive and thus we experience stimuli more intensely than neurotypical individuals. More on the “intense world” theory in a future post. 

Now that I’ve unpacked the two reasons behind the misconception that we lack empathy, I’ll put the pieces together. If you consider the fact that we have difficulty reading people in varying degrees, you quickly understand why we may not immediately respond empathetically in some situations. Sometimes, it may not be so obvious to us what you’re thinking or feeling: me, I’m good with immediately understanding basic, bold print expressions of emotion (anger, happiness, and frustration) — but I tend to miss the subtleties.  But once I know, I do care. I do hurt. And in the earlier article from the GRASP website, the researchers who were exploring empathy in individuals with Asperger Syndrome came to the exact same conclusion:

“…our data shows that people with Asperger syndrome have a reduced ability to read other peoples’ social cues (such as facial expressions or body language) but once aware of another’s circumstances or feelings, they will have the same degree of compassion as anyone else.”

Also, there’s something else to be considered about theory of mind difficulties: they could lead to the problem of initially not knowing how to respond or responding incorrectly. Lynne Soraya mentions this very thing in this post over on her blog at Psychology Today:

“From a young age, I incorporated that axiom [‘do unto others as you would have others do unto you’] into my belief structure.  But here’s where the problem comes in – what I would want ‘done unto me’ is entirely different than what another might want.  Likewise, ‘Putting myself in the other person’s shoes’ would have me doing something very different than what another person might envision doing in a similar situation.”

What I take this to mean is that I am more likely to assume that someone else wants the exact same thing I would want in the same situation. This may work great in some cases, but lousy in others. A perfect illustration of this is a big mistake I made when I was in high school with a classmate one day: he looked like he was down, I thought he wanted to talk and get whatever it was off his chest (just what I would want in the same situation). I was quickly rebuffed. I walked away, confused — and never found out what was wrong. Of course, as Soraya points out later in her article, neurotypicals make the same kinds of mistakes. So what’s so different about us? Are our viewpoints, approaches to the world, mental states, etc., different enough from neurotypicals that they result in more or more obvious kinds of misunderstandings? I am not sure myself what the answers to those questions are — and I would love to hear your thoughts on this.

But now, let us next consider the emotional hypersensitivity aspect of Asperger’s and other autism spectrum disorders. The article from The Star that I cited earlier has more to say about empathy:

“Studies have found that when people are overwhelmed by empathetic feelings, they tend to pull back. When someone else’s pain affects you deeply, it can be hard to reach out rather than turn away. For people with autism spectrum disorder, these empathetic feelings might be so intense that they withdraw in a way that appears cold or uncaring.”

So if even neurotypicals tend to pull back when confronted with the pain of someone else, what of us on the autism spectrum? Perhaps our pulling back or lack of response is a result of an intense inner response to the pain of others. One only needs to look to our various sensory difficulties to infer that a sensitive nervous system that has trouble with things such as florescent lighting, loud noises, itchy clothes, and light touch would also have trouble with filtering and processing the emotions of others — which of course, the evidence of such would come in through  the same sensory channels that process all of  the other stimuli I mentioned earlier. Or as my fiance put it when we discussed this issue a few days ago (he’d read Soraya’s article about Asperger’s and remorse before our discussion), how can the same person who has extreme reactions and temper fits when overstimulated not also be affected by other people’s emotions? To him, the logic of someone like this lacking emotion and empathy didn’t make sense. And it doesn’t to me either.

What are we to conclude? I think it is safe to say that we are sensitive and empathetic to the point of being overwhelmed by the emotions of others, and that we sometimes have trouble “reading the signals” and maybe knowing how to respond. That is the inside. What’s outside is our reactions and behavior, from which the wrong conclusions have been drawn. Given this, the “don’t judge a book by its cover” axiom fits best here. It is detrimental and perhaps even dangerous to make assumptions about a person or a group of people unless you really know what is going on inside.

I sincerely hope that this post has shed more light about the issue of empathy with those who have Asperger’s and other autism spectrum conditions. Please, talk back to me and let me know what you think about this post via your comments below.

-Nicole

Sources and Suggested Reading:

• “Dr. Tony Attwood Discusses Unique Qualities of Females on the Autism Spectrum.” Originally broadcast October 17, 2009 on AWA Radio on Blog Talk Radio.
• “Empathy Missing in Asperger’s Syndrome? I Don’t Think So…” Bryan, Stacy. Published June 5, 2009 on Associated Content.
• “Asperger’s Theory Does an About-Face.” Szalavitz, Maria. The Star (Toronto, ON). Published May 14, 2009
• “Feeling Another’s Pain: Of Asperger’s and Remorse.” Soraya, Lynne. From Asperger Diary on Psychology Today’s website
• “Empathy, Mindblindness, and Theory of Mind.” Soraya, Lynne. From Asperger Diary on Psychology Today’s website
• The Intense World Hypothesis — An Alternative Hypothesis for Autism (from the United States National Center for Biotechnology Information)
• Who cares? Or: The Truth about Empathy in Individuals of the Autism Spectrum (from the GRASP website)
• Myth: Autistic People Lack Empathy (from the GRASP website)