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.

Sources and Suggested Reading:

About the Author: Nicole Nicholson is an adult with Asperger’s who prose appears at Woman With Asperger’s, and whose poetry appears at Raven’s Wing Poetry. Inside and Out: A Few Words about Empathy appears here by permission.

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13 Responses to “Inside and Out: A Few Words about Empathy”

  1. When I was a child, rather than gloating when my brother or sister was in trouble, I felt as though I was in trouble, too. If Dad starting yelling, he might as well have been yelling at me.

    I do tend to put myself in another’s shoes when they are mistreated. Do neurotypical people place themselves on the side of the aggressor? Typically, too, I am very defensive around NT’s. When in defensive mode it’s difficult to feel for them.It’s like the supposed cluelessness is a form of self protection. Being “nice” seems to open you up to hurt.

    I love my sister, but dealing with her overwhelms me. She is highly NT, a top dog type. I hear her viciously tear down people (but strangely, she is highly empathetic.) In my dealings with her, I just feel like I give her material to tear me down.

    ASD’s may be clueless, but they are overall a very gentle people…far, far more so than NT’s.

    Good post, I plan to read your link-outs. Thanks for going through the trouble to find and post them!

    rose

  2. chavisory says:

    Yup, I physically cringed all the way through “Office Space” at how Milton gets treated.

  3. [...] of my posts, “Inside and Out: A Few Words About Empathy” was republished over at Autism and Empathy today. Feel free to go and check it out…as [...]

  4. Michael says:

    Excellent post.

    I’ve always found the things you’ve said to be true of me anyway. Other peoples emotions, particularly negative emotions, overwhelm me in a way that feels like your drowning in an ocean!

  5. Phil Schwarz says:

    A propos “theory of mind deficits” as a hallmark of autism: http://scienceblogs.com/cognitivedaily/2006/06/autism_memory_and_personality.php#comment-118288

  6. anonymous says:

    Recently I met with “autism expert” Bryna Siegel at the UCSF Autism Clinic, and was appalled at her statements that if someone really has autism, you can’t even teach them what Theory of Mind *means*. Not that they screw up sometimes in reading others, but that they can’t understand the definition.

    She also said that most people associate Asperger’s with low intelligence, and that autistics can’t laugh.

    I know she usually deals with babies and toddlers, but what’s with having such a restricted and outdated view of autism?

  7. Kaz says:

    This is an excellent post!

    I think the pulling-back thing makes a lot of sense. Because… I suspect, although I can’t know, that for a lot of NT people empathy is more like – they cognitively know what the other person is feeling and may feel some degree of hurt on their behalf, but they don’t literally start feeling what they imagine the other person is. I, on the other hand, *do* to a certain degree. So of course I am not good at comforting someone who’s in pain – for the same reason you wouldn’t ask that person to go about comforting others that moment! Dealing with an emotionally-charged situation like that really requires you to put away distracting feelings of your own so you can focus on the people in pain and how to ease that, which is going to be pretty much impossible for me because I’m being bombarded with upset and hurt. Instead, I withdraw so that a) I stop hurting b) I stop being in the way and distracting other people from comforting the person in pain! The last thing I want to do is, for instance, turn into a sobbing wreck and have people start worrying about me instead of the person who’s actually experiencing the pain. And it frustrates me that people think this means I have no empathy for the other person, when the problem is that I have so much empathy it means I can’t actually help them.

    I also really love that you bring up the way working out what someone is thinking or feeling is going to be de facto difficult for autistic people because of autistic people having trouble reading those sorts of signals by definition, and that a lot of talk about empathy is built on the sort of “do unto others as you would like them to do unto you” that doesn’t really work for autistic-NT interactions. (In fact, it doesn’t really work in both directions – I’ve heard a lot of stories of and experienced myself NT people really screwing up how to interact with an autistic person because they assumed that what would work for them would work for the person in question. Of course, in *that* case it’s never a failure of the NT person’s empathy, it’s autistic people being defective.) It’s just that NTs are in the majority. This is actually one of the things that really gets me about the Sally-Anne test, because in a way it tests the exact opposite of what people says it does – to “pass” it you need to not only know that other people have minds that are different from yours, but that they have minds that are different from yours but will still behave similarly to how you would in the same situation. I might have failed that test as a kid, not because I thought Sally had the same knowledge I did, but because I was used to all the people around me using logic that was totally incomprehensible to me and being aware of information where I had no idea where they got it from – so Sally knowing the marble had been moved when I wouldn’t have in her place wouldn’t have struck me as in any way odd.

  8. Belfast says:

    Assorted thoughts (in no particular order) brought to mind as result of reading this excellent post:
    —–
    When a friend says “xyz happened to me”, or that “someone did xyz to me”, my reaction varies from too much to too little.

    I’ll either: feel unable to get engrossed enough, caught up in their troubles (and feel bad for not being “normal” & sensitive in this way)-or I’ll get more upset & for longer than my friend seems to be.

    He/she is ready to move on & I’m still brooding/fuming on their behalf.

    I may even feel scared just by the tone of voice my friend used to convey how someone else was treating them. Despite the anger not being directed at me, I experience a recreation of it (realistic simulation) that activates “fear reflex” in me, as my friend is acting it out in the telling.
    Alas, misery feels stubbornly more contagious than mirth.

    If it’s positive news the person has to share, I tend more towards under-reaction. I feel relief (gratitude that something went well) for that person, but beyond that, I can’t vicariously (via osmosis) absorb/”catch” strong positive emotions about other people’s stories.
    —–
    I can’t presume to know what someone else wants/needs-at least I’m aware that I can’t accurately imagine what’s in their heads. I’ve learned that others do not have same likes/dislikes as I-they’re “mindblind” towards me, but don’t even realize it.

    I understand “those who are like me”, though I don’t know if/when anyone else actually is similar to me (example: in how they react to sensory stimuli). The “golden rule” is misguided when applied to people of disparate (non-overlapping) preferences.

    Simple/concrete example: most people think “pizza=good”, but I loathe the taste & smell, so for me “pizza=bad”.
    People in general seem to understand best those who react in similarly to themselves. My responses just happen to be in a minority, thus by definition they are uncommon & not what comes to mind for most people. Therefore, statistically, there is continual & mutual misunderstanding between myself & most other people.
    —–
    I also feel confusion & anxiety about when it’s more polite (or “caring”) to maintain eye contact vs. when it’s more polite to look away-in such instances of vulnerability as when someone is crying/hurt.

    If I look at person (to show that I’m still “there for them”), that can seem unkind/confrontational. If I look away (to express wanting to give them dignity/privacy), it can seem as if I’m ignoring/disavowing them.
    —–
    Among the many difficult “judgment calls” made all-the-more baffling by my ASD, I struggle with the usual conflicting impulses/urges that arise in response to a distressed individual.

    Should I approach or avoid, and on what am I basing my decision ?

    Knowing my significantly limited sensory tolerances, is this a situation I can-realistically-help with ? I’m quite a pessimist (and no good at lying), so I don’t imagine that I can cheer or comfort anyone-I can barely manage to do so for myself.
    Will I be able to recover my own equilibrium after engaging with another person’s subjective reality ? Will I have sense of where to draw the line if/when I have no more to give this person, or will I end up sacrificing myself too much ?
    —–
    …and thank you for link to Szalavitz article.

  9. Renata says:

    Hello, I’m a student of psychology and work with Aspergers in Brazil. I must say that your post is amazing and I agree with you. The young people I work with have difficulties with empathy, but I don’t think they don’t feel a thing but there is a confusion regarding the definition of empathy and how to handle certain emotions. Thank you very much for beeing so kind and share with us your thoughts and feelings.

    Renata

  10. Katie says:

    Thank you for your thoughtful blog. I am a 28 year old female discovering I share so many traits of AS. I’ve always been ‘different’ in some way, but myself and others have never been able to put their finger on what it was. I am a VERY gentle and compassionate person. In a way, I am scared of many people because I have experienced them to be callous, and to misunderstand me. Often the emotions I feel and the 6th sense I have about others can lead me to feeling overwhelmed in social circumstances. I don’t think I have trouble understanding what other people are feeling so much as often there is so much going on around me and in my mind sometimes I can miss things. For example I was praying for a woman yesterday and she was crying. I was sensing some deep problems in her, trying to listen to the Holy Spirit, trying to listen to the other woman praying for her and to decide the best course of action I should take and I completely missed the fact that she needed some tissues! She asked for the tissues, but I felt bad about it. In addition, my reluctance to trust others means I’m wary of sharing my thoughts, emotions for fear of being hurt or ridiculed as I was so often whilst growing up. I perhaps as a result of this come off as aloof and unemotional (because I’m so unwilling to share) when in fact there is a great depth and richness in my inner world that I am just not comfortable sharing! People then perceive me incorrectly.

  11. Hudson says:

    This is a very interesting development.
    Because I have always been empathetic, I did not understand how people could assume that Asperger’s automatically made me unfeeling.
    Also growing up, even when I home for holidays, if my parents or siblings fight, especially loudly, I have a highly physical reaction to it. And they are mostly unsympathetic to my reaction, believing that it is “in my head” as my father put it.

  12. Ricky says:

    As someone who suspects they have Asperger Syndrome, yet is yet to get it diagnosed (I’m actually trying to see a psychiatrist about it right now), I don’t know how valid my view is on this, but… imagining for a minute that I was diagnosed positively (which I would say is a 95% possibility)…

    A lot of this article makes sense. Despite coming across as cold and antisocial, I am internally highly sensitive to others’ feelings once I fully understand them. For instance, I very easily start crying when watching television, but the biggest thing is when it comes to embarrassment, because that’s the emotion I guess I feel easiest to understand and identify. I can’t stand humour based around the embarrassment of others, because I feel incredibly embarrassed in return; and even if said others don’t get embarrassed, I still often get embarrassed for them. I also get very upset when my friends get upset, especially if I’ve caused it from reacting wrongly to a social situation. And at one point, one of my online friends was being picked on for asking politely for people to stop swearing, I started crying even before they had read what others had said, because I was upset about them getting attacked.

    I think it’s this hypersensitivity toward my closest friends that makes the relationships so deep – that and the fact that the closest relationships I have are via the internet, where it is far far easy to avoid making social mistakes. It creates relationships that said friends (who although probably don’t have an ASD, aren’t exactly what you’d call NT either… they’re all somewhat different from the norm in some way… and anyway, most NTs don’t want to stay friends with me for long for some reason I am yet to figure out) never even thought would be possible, and yet in my mind feel perfectly rational. And I know one friend in particular is extremely glad to know me, and often describe me as “the best person ever” whenever I’m feeling down because of my hypersensitivity and the emotional closeness it can cause. And since I’ve started being able to make these relationships online, I’ve been becoming increasingly upset by my parents’ claims that I am cold and selfish.

    I also feel some understanding toward the do-unto-others thing, because I have the same problem. Quite a few times, it’s even led to me not helping people, because I wouldn’t want help in a given situation, then getting scolded for apparently behaving uncaringly.

    Also as an added note… I didn’t actually register there could be a link between my loathing of itchy clothes and AS… just something else to prove that it’s definately a good idea to get a diagnosis.

  13. A professional just told me the other day I could not have Asperger Syndrome because I have too much empathy, I was carrying on a conversation with her just fine, I wanted to be around other people, and she had worked with many individuals with AS and I just wasn’t showing the signs.

    I think the difference with the Golden Rule most people use is that they go about it logically, but what I ask my daughter is always about how she or another person feel. For example, if she doesn’t care if someone makes fun of her shoes, and so she feels its okay to make fun of another kid’s shoes, I ask her, “But what if you DID care that someone made fun of your shoes? How would you feel then?” When I point this out to her, she always says she would not feel very good. And then she always understands that the Golden Rule is about how she makes other people feel. This requires more thought for people to regard each other in these ways. It took me a long time to figure this out, and I had to recognize it in my own behavior first, but once I did, it makes the Golden Rule much more simple, albeit not easy.

    On the flip side, we also have to deal with telling people the truth about things. The truth hurts no matter how much we try to make it fluffy. So we have to learn how to be less straight forward with it to ease the blow. I’ve been on both sides of that feeling. The strange part is, I’ve noticed many NTs not “get it” when I say the truth in a round about way ( I think this is because I see so deeply into them, in places they aren’t aware of). Then when I come right out and say it, they become very angry and can’t fathom such things about themselves. I’m still learning ‘NT-speak’ to find that balance because I don’t like hurting people. Some of them just flat out ignore me no matter what I do, constantly demanding their needs over mine, so then I just have to slowly back away…
    Most people do not want to go about interpersonal communications this way, but then society is becoming less connected in quality ways. It seems people are less willing to deal with faults and see it doesn’t make them less, but actually more, to do so. This has a lot to do with culture and is a whole other subject.

    I agree with your post and it is really great to read this after trying to get diagnosed and being told I am too empathetic to be AS. Its strange to me that the ‘professionals’ have less information about these things than we do, and many are unable to step away from their degrees long enough to realize the information on AS is rapidly evolving. The professional I spoke to actually said something to the effect of her being able to provide for me more than the internet. She could see that I had worked through many personal issues in my life, I’ve made leaps and bounds, but she could not give credit to that same internet that helped me, to my knowledge of AS! It was strange to realize I knew more than she did.