Autism and Empathy

I’ve been spending the weekend putting together my preliminary research questions and a working bibliography for my graduate program. To my great surprise, I’ve actually been able to read some of the blazingly unempathetic papers about our supposed lack of empathy without spluttering in a fit of moral outrage every five minutes. I call that progress. In fact, I read several articles and found myself able to critique the problems in them rather effortlessly. I credit this development to two things: a) the critical theory I’ve been reading, which helps me to see the larger issues of power and privilege that weave themselves throughout the literature and b) my support network of over 40 people I can call on when the going gets tough.

And then, I read a 2004 article by Uta Frith, and I moved away from my stance of critical detachment toward one of absolute moral outrage.

There I was, enjoying a quiet day at home, reading by the woodstove, minding my own business, and wanting nothing more than to have an enjoyably uneventful time, when I stumbled upon the following piece of remarkably nuanced thinking and stellar prose in Frith’s Emanuel Miller lecture: Confusions and controversies about Asperger syndrome:

“One way to describe the social impairment in Asperger syndrome is as an extreme form of egocentrism with the resulting lack of consideration for others.” (Frith 676)

Don’t you just love when these kinds of prejudicial statements rise up and punch you in the gut? I know I do. It’s just so much fun to read about myself in these terms. You have no idea. And what makes it all the more fun is that the irony of the statement is entirely lost on the writer. She engages in a prejudicial generalization about an entire group of people (otherwise known as a stereotype) and, in the same breath, tells us that we’re the ones with a “lack of consideration for others.”

And here I thought it was autistic people who couldn’t understand irony.

Now, you might not think it could get worse, but that’s because you haven’t read a lot of papers on autism and theory of mind. As it turns out, not only are we egocentric, but we’re unlike those “normal selfish” people who can use egocentrism to their advantage. At least, with them, someone gets something out of it, right? But with us — well, we just can’t help ourselves:

“The self-absorption and disregard of others is not like the strategy that a normal selfish person might deliberately adopt and flexibly use according to what is currently in his or her best interest. Autistic egocentrism, by contrast, appears to be non-deliberate and not determined by what might currently be in the best interest of the individual.” (Frith 676)

In other words, nature has made us selfish. We were just born that way. It’s taken us over and it’s out of our control.

And guess what happens once you peg a whole group of people as being egocentric and selfish? Everything becomes our fault. All the problems in our personal relationships? All our fault! All the problems in our social world? All our fault! You don’t believe me? Read on, my brothers and sisters:

“This egocentrism seems to present a huge difficulty in forming successful long-term interpersonal relationships. Spouses and family members can experience bitter frustration and distress. They are baffled by the fact that there is no mutual sharing of feelings, even when the Asperger individual in question is highly articulate.” (Frith 676)

Yes, you heard it here. We cause people “bitter frustration and distress.” Of course, they do not cause us “bitter frustration and distress.” No. Never. Just doesn’t happen. If we feel “bitter frustration and distress,” it’s all our damned fault for being so, you know, abnormal. If we were only normal, we wouldn’t feel frustrated and distressed. Problem solved!

And, of course, it’s absolutely UNHEARD OF to find a neurotypical person who has difficulty expressing his or her feelings. It just doesn’t happen. Those men I dated and broke up with because I couldn’t get them to articulate a feeling to save their lives? I must have misunderstood where they were coming from. When they were telling me I was hormonal — or refusing to speak altogether — I guess their body language was actually saying, “Yes, honey, I understand and am awash in feeling.”

But of course, I wouldn’t know anything about that, because apparently, I’m just not able to imagine what other people might be thinking. Or so says the author:

“One obstacle seems to be an inability on the part of the person with Asperger syndrome to put themselves into another person’s shoes and to imagine what their own actions look like and feel like from another person’s point of view. Another way to describe the social impairment is as a failure of empathy, involving a poor ability to be in tune with the feelings of other people.” (Frith 676)

I’ve just spent the weekend going through dozens and dozens of articles, and these kinds of statements keep coming up, over and over and over. I can only conclude that the researchers are perseverating on a theme. And I don’t mean for a day, or a week, or a month, but for years and years and years. It’s incredible. You’d think they’d be more flexible and want some change — a broadening of perspective, so to speak — instead of this incessant sameness.

But you know what happens when you try to separate a person from his or her perseverations? It’s not a happy moment. Witness then, the way that the author responds to the fact that autistic people have been writing self-reflective narratives for some time. In a section whose title, “Listening to people with Asperger syndrome,” should really have been “Dismissing people with Asperger syndrome” (or did I miss the intentional irony?), the author makes the following assertions regarding people with Asperger’s who see themselves as having a different experience of the world and a unique perspective on life, rather than being a collection of deficits:

“Researchers and clinicians can agree with this to some extent. However, they may point out that a peculiar lack of insight and an egocentric viewpoint are typical of the syndrome, throwing doubt on at least some of the self-assessments of needs and expectations.” (Frith 681)

In other words, the “experts” have determined that we lack insight and suffer from egocentricism, so whatever we say about our own desires, our own needs, our own experiences, and our own expectations of other people is suspect. Got that? If that’s not a perfect formula for disempowering hundreds of thousands of autistic people, I don’t know what is. And it very neatly closes off the potential for measuring the external validity of the research findings, too.

But, of course, those of us who reflect upon ourselves and others in insightful ways probably don’t have Asperger’s anyway:

“One problem with the autobiographical literature is that the authenticity of the diagnosis is not guaranteed” (Frith 681-682).

Will people ever get tired of the perseverative need to keep saying this? Would it be possible for them to just walk in our shoes and say, “Oh, I see. Now I understand. Thank you for providing a reality check on my lab tests”? Would that really be so terribly difficult?

But the zeal to save a theory from the clutches of reality does not simply extend to talking about our inherent egocentricism and casting doubt on our diagnoses. Oh no. It moves into misinterpretations so extreme that they beggar belief. Take, for example, the following:

“The autobiographies of individuals with Asperger syndrome indicate a high degree of retrospective self-analysis that came with adulthood. This can be seen, for instance, in Gunilla Gerland’s autobiography (1997) and in Clare Sainsbury’s collection of over twenty individuals’ reminiscences of their school years (2000). These works suggest that self-knowledge and sharing of knowledge with others was poor in childhood.” (Frith 683)

So, let’s get this straight: Because we now look back on our childhoods and understand things that weren’t clear before, that in itself is evidence that we lacked self-knowledge and understanding of others as children. Of course, the questions that jump immediately to mind are the following: What self-reflective adult doesn’t look back on childhood and understand things that were opaque before? And what small child understands things the same way as an adult? When non-autistic people look back, reinterpret, and reweave the stories of their lives in narrative form, we laud them for being mature, creative, and insightful. But when autistic people look back, reinterpret, and reweave the stories of our lives in narrative form, we’re told it’s evidence that we lacked theory of mind in childhood.

Not too much confirmation bias there.

But the theory must be saved. Oh, yes. And its subjects must be dismissed.

Source

Frith, Uta. “Emanuel Miller lecture: Confusions and controversies about Asperger syndrome.” Journal of Child Psychology and Psychiatry 45, no. 4 (May 2004): 672-686. doi: 10.1111/j.1469-7610.2004.00262.x.

About the Author: Rachel Cohen-Rottenberg is a wife, mother, writer, and artist. She was diagnosed with Asperger’s Syndrome at the age of 50. This piece first appeared on her blog, Journeys with Autism.

So, one of the popular medical theories surrounding the “puzzle” of autism spectrum disorders involves theory of mind — or lack thereof. Possessing a theory of mind involves the illusion that one can understand what another human being is thinking or feeling, a neurotypical ESP of sorts. Theory of mind largely concerns empathy, the ability to place oneself in another’s shoes, so to speak. Many autism specialists, among them Simon Baron-Cohen, argue that people on the autism spectrum either lack a theory of mind or have an impaired theory of mind. Autistics supposedly cannot empathize with or predict the NT world, and they thus have a whole bunch of communication issues.

Of course, I think that this theory has done quite some damage. Autistics have been represented as characteristically unempathetic individuals. And this “unempathetic” characterization has often been conflated with emotionlessness, conceitedness, apathy, and plain old malevolent and murderous evil. While I don’t deny that I’m hardly able to place myself in the shoes of others, I do posit that no one can really, truly place themselves in someone else’s shoes, unless we’re talking about literal shoes with similar foot sizes. In any event, I think there’s a limit and a danger to this thing we call empathy, because empathy isn’t wholly concrete and logical. Empathy, by definition, involves assumption and guesswork.

Empathy (or imagined understanding) can only be remotely successful when engaged between people with similar backgrounds, people who occupy similar social stations. Thus, in the same manner that auties have difficulty empathizing with NTs, so too do NTs have difficulty empathizing with auties. (James Wilson, in Weather Reports from the Autism Front, makes this very point about empathy. He can’t pretend to understand his autistic son’s experiences, his ways of knowing and being. Neurotypicals are just as empathetically impaired as autistics.)

[Jenny McCarthy: "expert" on autism, empathy, and strapless bras]

I like Dennis Lynch’s complication of empathy in “Rhetorics of Proximity: Empathy in Temple Grandin and Cornel West.” In his article, Lynch suggests that true empathy is never possible because such an act results in “bodily displacement,” in colonization or assimilation. So, in order for an NT to step into an autistic’s shoes, the autistic has to physically remove her feet from her shoes. As a result, when an NT claims to empathize with autistic experience, the NT is really imagining what it would be like for an NT to be an autistic — not what it is like for an autistic to be an autistic. The same could be said about an autistic person attempting to empathize with an NT: bodily displacement results.

Of course, because neurotypicality is the dominant neuro-discourse, NT ways of empathizing are considered more acceptable than autistic ways of empathizing. Warning of empathy’s co-optive dangers, Lynch writes,

Empathy in this way may seem like a harmless practice as one imagines how another may be feeling about an event, circumstance, or issue, but, as these critics argue, whatever’s empathy’s expressed aims may be, asking people to empathize usually locates the obstacles to empathy—to listening and to being heard—solely in the minds and habits of individual participants, and so obscures or ignores the political and economic and bodily dimensions of social struggles. (6)

This isn’t to say that empathy is inherently bad or wrong. However, empathy has its limits and dangers — severe limits and dangers. In assuming we can experience the fullness of another person’s “lifeworld,” we erase, or make transparent, very real differences (Lynch 9).

About the Author: Melanie Yergeau is an autistic woman and an assistant professor of English at the University of Michigan, where her academic interests include rhetoric and composition, digital media, and disability studies. She currently serves on the board of the Autistic Self-Advocacy Network (ASAN). This piece first appeared on her blog, Aspie Rhetor, and is reprinted here by permission.

…because nearly everyone else seems to be writing about it.

At the age of three or four, I had a meltdown watching a Punch and Judy show. This was the seventies; Punch and Judy was ‘traditional’ back then, that is, Mr Punch had a stick nearly as big as himself, which he used to beat Mrs Punch and their baby, and the policeman, and anyone else with the temerity to tell him he was wrong.

I can remember the puppet Punch, with its hooked nose (antisemitism, much?) beating its wife while shrieking That’s the way to do it! That’s the way to do it!

I started screaming.

Around me several dozen children were laughing so much the tent seemed to shake and billow around me. They saw Mr Punch hitting and hitting, and to them it was the funniest thing imaginable. You know what small children are like when they find something enormously funny; they jump out of their seats, they wave their hands, they shout encouragement.

And I kept screaming.

The next thing I remember I was outside, with my parents apologising to other adults for the fuss and laughing at how I’d got so worked up over a puppet show.

[I hate puppets. So often they're used to portray behaviour that would never be acceptable under any other circumstances.]

And until I was diagnosed, I had no explanation for why thirty children found that violence acceptable and I did not.

When Punch hit his wife, he was hitting me. I could feel the blows land. When he hit the baby I felt its pain, its helplessness. I was three or four years old, at an age where most autistic children, even the high-functioning ones, are regarded as having not yet developed a theory of mind. And yet I immediately identified with the pain and distress of being the object of violence, while around me the NT children wept with laughter.

I still cannot work out how Punch and Judy shows were ever considered funny. Most have now been altered, to reflect our ‘modern’ sensibilities – which means in effect that the horrifying portrayal of what is essentially domestic violence has been removed. But how could any adult view the beating of a baby with a large wooden stick as remotely amusing? How could anyone in their right mind think this was appropriate entertainment for children?

And how could they treat the one child who saw this as unfettered, terrifying violence as inappropriate and oversensitive?

Oversensitive.

That was a word my parents used a lot about me, when they thought I wasn’t listening. Because they never asked how I actually saw the world, they never knew how from my perspective it was full of violence and fear. I knew how, as with Mr Punch, the violence came out of nowhere, was disproportionate and unstoppable.

I didn’t want to hurt anything, ever. My theory of mind ran out of control. Everything had an independent existence; a picture of a cat could feel pain when torn just as a real cat felt pain. The knives and forks in the drawer got upset and hurt if they were put in the wrong places. Books felt abandoned if I forgot them. Every object in my world had feelings, and it was overwhelming. But no one else seemed to feel like this, and I quickly learnt that to mention it was childish, inappropriate.

Now, of course, I have it (mostly) under control. And as I write that sentence I realise that by control, I mean ‘still feel it but stop myself from exhibiting the distress that NTs find unacceptable’. When I break a mug (as I did last month) I want to cry for its pain and my loss, but I don’t. I still struggle at throwing away pictures of animals – I know they’re not ‘real’, my logical mind understands that, but I feel sick doing it. I wonder, sometimes, if this is the foundation of hoarding. NTs wouldn’t even begin to comprehend this kind of attachment, of distress, and explaining it to them is likely to invite laughter, disdain or dismissal. It’s not part of their understanding, so it’s not important.

This kind of distress also prompts withdrawal. The easiest way to reduce the pain you cause to inanimate objects around you is to control your environment such that things can rarely be damaged or destroyed. You can’t share your life with an NT, because they are likely to find you ridiculous, and to embark on horrible plans to force you to confront your stupidity in order to cure you of it.

I suspect that the only way to cure me of this would be to crush all compassion and empathy permanently. And then you can point and say ‘Look! she has no empathy! She must be a real autistic!”

Edit: This is a great post about identifying with the trauma of broken things: http://www.kitaiskasandwich.com/2011/03/13/putting-the-pieces-together/

About the Author: Fiona Wallace is a writer and artist on the autism spectrum. This piece first appeared on her blog, Lyssa and Me, and is reprinted here by permission.

Empathy. For most people, the word is synonymous with humanity.

The American Psychological Association calls empathy “the trait that makes us human.” ¹ According to author D.H. Pink, empathy is “a universal language that connects us beyond country or culture. Empathy makes us human. Empathy brings joy…. Empathy is an essential part of living a life of meaning.” ²

In the popular mind, in scientific journals, and in autism-related books and websites, the canard that autistic people innately lack empathy (or have deeply impaired empathy) continues to hold sway. Of the innumerable reiterations of this trope, a few representative instances will have to suffice:

According to Vilayanur S. Ramachandran and Lindsay M. Oberman, “[T]he chief diagnostic signs of autism are social isolation, lack of eye contact, poor language capacity and absence of empathy…^{” 3}

In his latest book, Simon Baron-Cohen writes that autistic people have “abnormalities in the empathy circuit in their brains” resulting in “zero degrees of empathy.” ⁴

And in a truly shameless display, physician Roy Q. Sanders, Medical Director of the Marcus Autism Center in Atlanta, GA suggests that “teaching empathy to someone with autism/Asperger’s is almost like teaching a pig to sing — it is a waste of time and annoys the pig (at least most of the time).” ⁵

I could adduce an abundance of further examples, but these assaults on our humanity are almost too much to bear.

—

In late June of last year, I began publishing posts and links on the website Autism and Empathy: Dispelling Myths and Breaking Stereotypes. In order to find material, I’ve been searching online using the terms autism and empathy. The results are often excruciating, especially when they consist of choice words like the following:

“It’s as if they do not understand or are missing a core aspect of what it is to be human; to be and do like others and absorb their values,” says psychologist Bryna Siegel, director of the Autism Clinic, University of California, San Francisco. “Their worlds are more barren, their social world is very distorted, and they come out of their world not when you want them to, but when they want to.” ⁶

Such statements tend to flow rather freely in the autism world, and when I read them, I always find myself wondering why some professionals do not come out of their world and into the world in which we live.

Much formal research employs similarly dehumanizing imagery, albeit in rather colder, more clinical language — language that betrays a propensity to see the world in vitro rather than in vivo:

“Contrary to some previous accounts, both apes and some children with autism do appear to understand actions as goal directed if not fully intentional; that is, they
understand that others have goals, persist toward them, and perceptually monitor the process. This means that both of them show some skills of social learning, though not as powerful or pervasive as those of human 1- and 2-year-olds. However, neither apes nor children with autism follow the typical human developmental pathway of social engagement with other persons… In general, it seems that neither apes nor children with autism have — at least not to the same extent as typically developing human children — the motivation or capacity to share things psychologically with others.” ⁷

Placing apes and children with autism in the same category, in contradistinction to “human 1- and 2-year-olds,” generates nary a whisper of protest or the slightest expression of disgust from the research community — with the sterling exception of Morton Ann Gernsbacher, whose brilliant piece On Not Being Human speaks eloquently to the issue:

“Sixteenth-century theologians, Victorian anthropologists, and 20th-century Nazis are not the only ones who have deemed various groups of humans ape-like or nonhuman; some current-day American psychological scientists are just as guilty of this crime… [I]n a recent New York Times “notable book of the year,” an internationally acclaimed psychological scientist segregated autistic people from other humans and placed them ‘together with robots and chimpanzees.’” ⁸

Can you imagine the outcry from within the scientific community — and from the general public — if any researcher attempted to place African-Americans and apes in the same category?

Where is the outcry on our behalf?

—

I continue to wade through the debris, searching for the gems that describe us in the full light of our humanity. I find those gems in abundance, but the search is still a difficult undertaking. I sometimes feel as though I am facing down a never-ending procession of men and women, armed with prestigious titles and advanced degrees, all asking the same question: “Are autistic people truly human?”

After all, if empathy is synonymous with humanity, then spending millions of dollars and entire careers researching the question of whether autistic people have empathy is nothing more than a thinly veiled attempt to address the question of whether we are human at all.

—

In August, I was posting links to research when I felt an overwhelming sadness. Why should we need to adduce evidence to prove our humanity? I thought. Why is it simply not a given?

And so I must ask outright: Why is the question of our humanity the fodder for so much scientific endeavor? And why has the very act of posing that question not caused a storm of protest in defense of our human rights?

—

In a few weeks, I will return to graduate school to pursue a second master’s degree. For some time now, I’ve intended to make a critique of the research on autism and  empathy my area of study.

Truth be told, the prospect of spending three years reading about our allegedly deficient humanity fills me with apprehension. But in the service of the greater good, I am willing to address the issue. I am willing to engage in the tedious process of revealing the potential biases of the test instruments. I am willing to critique the conclusions drawn from studies — studies, I might add, that measure such things as how often autistic children anthropomorphize abstract objects moving across a computer screen, or whether autistic adults respond “appropriately” to a series of exaggerated facial expressions outside of any meaningful context. I am even prepared to argue the wisdom of attempting to measure the complex spiritual, emotional, psychological, and physical experience of empathy with recourse to questionnaires and brain scans.

But I am also beginning to rethink the entire project. After all, doesn’t approaching the issue from the standpoint of scientific critique give credence to the idea that science should engage the issue of our humanity as a subject of study?

—

I know that it’s difficult for non-autistic people to understand us. I know that, in general, it’s difficult to understand anyone across the divide of difference. But isn’t that the divide that empathy must bridge?

Where is the empathy that should restrain psychologists from creating dehumanizing caricatures and engaging in stark generalizations?

Where is the empathy that should engender humility about the things that science cannot touch?

Where is the empathy that should cause professionals and laypeople alike to respond with outrage against the dehumanization of autistic people, to protest the injustices done, and to cry out in the face of the devastating impact of these injustices on our hearts and on our minds?

In this day and age, if mainstream researchers engaged in studies purporting to prove that gay and lesbian people are incapable of love, that African-Americans lack intelligence, or that Jews are especially good with money, the outcry from both the scientific community and the general public would be loud and long. The prejudices that such research lays bare would be met with outrage.

I’m still waiting for our day.

© 2011 by Rachel Cohen-Rottenberg

—

Sources

¹ Defining the trait that makes us human. APA Monitor, 28(11), 1, 15. Bailey, S. (1994)

² Pink, D. H. A Whole New Mind: Why Right-Brainers Will Rule the World (2nd ed.). New York: Penguin Group, 2006.

³ Ramachandran, Vilayanur S. and Oberman, Lindsay M. Broken Mirrors: A Theory of Autism. Scientific American. October 16, 2006.

⁴ Baron-Cohen, Simon. The Science of Evil: On Empathy and the Origins of Cruelty. New York: Basic Books, 2011.

⁵ Sanders, Roy Q. Experts Reflect on Parenthood Finale. Accessed September 4, 2011.

⁶ Stars ‘CAN-do’ about defeating autism. April 10, 2002. Accessed September 4, 2011.

⁷ Tomasello, Michael; Carpenter, Malinda; Call, Josep; Behne, Tanya; Moll, Henrike. Understanding and sharing intentions: The origins of cultural cognition. Behavioral and Brain Sciences (2005) 28, 000–000.

⁸ Gernsbacher, Morton Ann. On Not Being Human. Association for Psychological Science (February 2007), Volume 20, No. 2. The “internationally acclaimed psychological scientist” is Steven Pinker, who wrote in The Blank Slate: The Modern Denial of Human Nature (New York: Viking, 2002), “Together with robots and chimpanzees, people with autism remind us that cultural learning is possible only because neurologically normal people have innate equipment to accomplish it.”

About the Author: Rachel Cohen-Rottenberg is a wife, mother, writer, and artist. She was diagnosed with Asperger’s Syndrome at the age of 50. This piece first appeared on her blog, Journeys with Autism.