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Anne Corwin

The Empathy Conundrum: Ethics, Emotion, and Autistic Cognition

Two Capacities, One Word? The word "empathy" gets bandied about a lot these days in popular media concerning brain and behavior-related topics. Specifically, I've noticed that articles about either autism or sociopathy and criminal behavior tend to discuss a supposed "lack of empathy" in autistics - and in the sorts of people who like to torture animals for fun. It is of great concern to me that the notion of particular kinds of people lacking empathy is so often brought up in a muddled, careless manner. I realize that most people writing about empathy and "mirror neurons" these days probably don't mean any harm by it, but that doesn't make the potential consequences of their writing any less worth pointing out and discussing critically. First of all, I have noticed that when most people use the word empathy, they're actually referring to one of two very different things: (1) The capacity of a person to "read" culture-typical social signals, respond in expected/predictable ways to common situations and experiences, and engage in a certain amount of "social learning" via particular kinds of imitation. (2) The capacity of a person to feel emotions "on behalf" of others, to care about others, and to feel compelled toward ethical behavior. I hardly think the two capacities described in (1) and (2) above could really be confused for each other, or assumed to mean the exact same thing, by anyone putting any actual thought into their discussion of what "empathy" means. And yet, it is not unusual to find people switching from talking about capacity (1) to talking about capacity (2) without any explicit indication that they are doing so, or any apparent understanding of what it might mean to conflate the two. For a particularly egregious example of this, consider the Empathy Quotient quiz. Based on some of the theories and writings of British autism researcher Simon Baron-Cohen (not to be confused with his cousin, comedic actor Sacha Baron-Cohen), the Empathy Quotient quiz includes such items as: - I can easily tell if someone else wants to enter a conversation. - I am very blunt, which some people take to be rudeness, even though this is unintentional. - I can pick up quickly if someone says one thing but means another. Notice that the three quiz items above all pertain to interpretation (1) of what "empathy" means.

Rather than having anything to do with whether a person actually cares about other people (or animals), these items all have to do with how someone might "operate" in the social arena. These items may indeed suggest areas where someone might experience social difficulty as a result of not functioning, thinking, or perceiving in a culture-typical manner, but they don't say anything about a person's capacity to respond emotionally to situations affecting other people. Nor do they say anything about a person's capacity to behave ethically or hold and adhere to principles. Now, consider the next example set of items from the quiz: - It upsets me to see an animal in pain. - Seeing people cry doesn't really upset me. - I get upset if I see people suffering on news programmes.

These items, in contrast to the previous three, are directly concerned with a person's internal, affective response to the suffering of others. Not with how the person "comes across" socially, or how good the person is at quickly noticing and responding to indirect communication and/or typical social cues. And that's a very important distinction to be aware of. But the "empathy quotient" quiz doesn't make this distinction. Nor, apparently, do many people who write articles about autism in the popular press. The Empathy Quotient quiz designates scores of 0 - 32 as "low", and suggests that "most people with Asperger Syndrome or high-functioning autism score about 20". I took this quiz this evening myself, and scored 18. So, while I don't put any actual stock in this quiz as a diagnostic instrument (its wording is extremely ambiguous in some places, among other problems), I certainly can't deny that my score does correlate with what my ASD diagnosis would supposedly predict. But what does that actually mean, if anything?

My Own "Empathic Deficit" I initially encountered the concept of "theory of mind" (and how it supposedly pertains to empathy) back when I was in the midst of the evaluation of my developmental history and cognitive/behavioral style that ended up leading to my diagnosis. At first, the idea that I might have "empathic difficulties" seemed to make sense and explain a lot of things about my pervasive and ongoing social difficulties. After all: - I have been called "insensitive" and "oblivious to other people" on numerous occasions. - I was reprimanded at the first two jobs I worked at for such things as "sweeping the floor too much" (meaning I was focusing too intently on cleaning and not intently enough on greeting customers), and coming across as aloof or even rude. - I have trouble spontaneously answering questions like "How are you?" (I actually have the comic below posted outside my cubicle at work).

- I have often been accused of missing the "emotional tone" of a conversation or situation -- e.g., my third grade teacher was once lecturing me about something (I can't remember what), and at one point she used a funny word, at which point I burst into laughter. I was then made to write "I will not laugh while I am being reprimanded" on a piece of paper multiple times. - I have always found most social situations to be overwhelming and confusing (particularly if there are large groups involved). - I have trouble keeping track of which people of my acquaintance know which pieces of information, and sometimes I get confused at the fact that things that seem "obvious" to me are not, in fact, "common knowledge". - I also remember one of my childhood nicknames being "Miss Contrary", as I often appeared to "insist" on doing everything in my own way as opposed to a way I was shown or told -- and while I will certainly admit to stubbornness as a character trait (it runs in the family), the fact of the matter is that I often can't match people's movements in learning to perform tasks. (I'm a lot better at figuring out how to operate devices and accomplish physical tasks by studying and experimenting with the relevant objects myself than by watching other people performing the tasks and copying their movements, and I often find that the presence of other people when I'm trying to figure out how to do something hurts more than it helps.) In light of all that, it seemed perfectly logical for me to figure that the popular literature conflating autistic cognition with a "lack of empathy" made sense. Until I was identified as being on the autistic spectrum, I'd tended to assume that I was "normal" and that other people were all weird and unpredictable. But learning that I might have "empathy deficits" turned the tables on that assumption, and for a while I found the notion that my social difficulties were due to such deficits quite useful as an explanatory tool.

Carelessness and Confusion But as I read more (in seeking to learn how to better function in the world given the particulars of my neurology), I started to realize that empathy was a massively important and significant topic in the estimation of numerous scientists and laypeople. Empathy, according to many, is a key part of what makes humans "human" -- or perhaps more generally, what makes any sentient creature worthy and capable of membership in civilization. So while I was (and am) perfectly okay with acknowledging my difficulties, I found myself becoming more and more distressed at how autistics were described in the media, particularly with regard to how tragic and horrible (or "bad for society") our existence was supposed to be, largely on account of our supposed empathic failures. What's more, I observed that in quite a few of the discussions of autism I came across, "having a conscience" was being

conflated or confused with "demonstrating and rapidly being able to interpret typical social signals". I don't think this is the kind of linguistic carelessness anyone can afford to just ignore or brush aside, regardless of how naive it might be. Ignorance, and the perpetuation of misconceptions about what it is actually like to be and experience the world as a certain kind of person, can have real and serious consequences for people who actually happen to be the kind of person in question. My concern is that if autistic people are culturally defined as "lacking empathy", and if people aren't exceedingly careful to define their terms (which they often aren't), and if "empathy" is widely considered to be a precursor to conscience, then we're basically being written off straight from the get-go. And when people are written off, there's very little motivation to think about extending basic human rights to them, let alone (gasp) learning to better accommodate and integrate different sorts of people into society. An example of what I mean by the confusion/conflation of "typical social skills" with "emotional response" can be found in the words of a commenter on a recent BoingBoing post referring to the Online Movement for Autistics' Rights. This commenter states that: Mirror neurons allow us to literally feel someone else's pain. When we see someone hurt themselves, or see someone who is clearly emotionally upset, mirror neurons are triggered in the observer's mind that are analogous to the other individual's mental process. This also allows us to learn through observation. You see someone going through a step-by-step process, and mirror neurons allow us to learn by having analogous neurons triggered. But since autistics don't have the same mirror neural activity, they don't learn the same way, and they also don't have the same empathetic response. The commenter quoted above is making what I see as the essential mistake in his appraisal of what it means to be autistic. He takes a particular mechanism by which learning may take place, notes that this mechanism may be difficult for (or inaccessible to) autistics, and jumps seamlessly to the conclusion that this has something to do with "being able to feel someone else's pain". And it is my assertion that this assertion is invalid and scientifically untenable.

Different, Not Ethically Bankrupt! A lot of discussions about autism, regardless of where they occur, seem to get stuck on the central dilemma of what autism actually is -- that is, what it means for a person to be autistic. Do you go strictly by the DSM-IV definition? The ICD-10? What about all those people claiming that autism is caused by vaccines, or television, or French fries, or "yeast overgrowth"? Is autism a "set of behaviors" that, if a person can suppress them, will indicate that the person has been "cured" (this is certainly what the behaviorists would have you believe)? Are autism and Asperger's the same thing, or two different things? Does Asperger's even exist? Is autism more easily identified according to a person's weaknesses, or according to a person's strengths?

Truly, the sheer range of questions on this subject boggles the mind. I can certainly see how people end up getting confused, and believe me, I was pretty confused myself about the whole thing when I first started learning about what it meant for a person to be autistic. But over time I've come to settle on something of a cogent idea in this regard. And that idea is the fact that as near as I can tell, autism isn't so much about what a person does as about how a person does it. It is quite apparent that autistics do tend to learn, think, and perceive differently than non-autistics do. There's good solid research backing this stuff up in the cognitive science arena, and I would dearly love to see it get more attention, seeing as the field of autism research has too long been dominated by the ghosts of radical behaviorism and psychoanalysis (and has of late been further polluted by opportunistic quackery, antivaccination pseudoscience, and homeopathic nincompoopery). I agree very much with researcher Michelle Dawson (who works with the University of Montreal) who frequently and firmly asserts that autistics deserve the same high standards of science and ethics as nonautistic people can generally expect to enjoy. And this, to me, means that "deficit model" biases have no place in serious research. The best ways to help autistics -who can certainly sometimes have extreme difficulties with daily living and other skills -- are much more likely to be found if corners aren't cut scientifically or ethically, and if the focus is on understanding the autistic brain as opposed to merely "remediating" it or trying to "prevent" it. This is not an attempt to be cute. This is not an attempt to "romanticize" autism or the lives of the many individuals who fight in vain to find a place, a community, a school, etc., that can balance their needs with the needs of the cognitive/perceptual/functional majority. This is not "political correctness". This is, frankly, concern. And a little bit of desperation, perhaps, as the assumptions frequently made about the capacities (for thought, for feeling, for happiness, for a worthwhile existence) of autistic people appear to run so deep at times that I can scarcely imagine how we as a culture might effectively root them out. Empathy is only one area where particularly damaging assumptions tend to get made. There are many, many more, and I don't know if I could ever effectively cover them all in the depth they require. But empathy is an important subject -- an important word -- to hash through and define and consider in the relevant contexts.

The Bottom Line I'm almost beginning to suspect that some folks might actually believe that in order to have an internal, affective response to another person's suffering or delight, and in order to engage in ethical behavior (which should never be confused with, or conflated with, "nice" behavior), a person must also consistently display the ability to read and respond to typical social cues in expected ways very fast in real-time. And if anyone gets anything at all out of reading this, I would hope that it's some degree of reassurance that this is not, in fact, the case. Autism is not a "personality type", and it is certainly not just another word for "being a jerk". It is a neurodevelopmental difference that, according to the best science I can find, primarily affects the cognition and processing of low-level information. This difference in turn can influence what skills and types of interests a person might end up having, and it may make a person aware of different details in the environment than the nonautistic person would notice, and it can also contribute to documented patterns of strength and weakness. It can mean we use body language differently, that we don't make typical eye contact, and that we push the boundaries of

social norms as far as how we express happiness, distress, or other emotions. It can mean we use and relate to language in an idiosyncratic or peculiar-seeming manner. And so on, and so forth. Consequently, the autistic person can sometimes appear aloof, uninterested in social interaction (and may in fact be uninterested in culture-typical dominant forms of social interplay), unpredictable, "difficult", insensitive, or any of a number of other adjectives that skirt around the notion of "empathic deficit". But this does not mean that we hate people. It does not mean we see people as disposable objects, or that we are somehow like sociopaths. I'm not saying all autistics are going to seem "nice" or "sensitive" once you get to know us - I can be a pretty harsh character myself on occasion, particularly if I encounter people whining about how all the evil "disability extremists" and "political correctness zealots" are conspiring to take over the world and drain Your Tax Dollars so they can sit around all day watching sitcoms and producing hordes of deaf, autistic, and possibly even gay babies. If you insist on expressing racist, pseudoscientific, sexist, homophobic, or ableist attitudes, you will raise my ire, and the results will not be cute. I may not be able to tell when someone is "mildly irritated" or "subtly upset" easily (particularly if I'm trying to keep track of a conversation I'm having in real-time with that person), but if someone is crying or obviously in pain, I am powerfully (sometimes overwhelmingly) affected by it. Heck, I can't even stand to see robots (fictional or real) being smashed or otherwise abused. I used to hide my eyes as a kid while watching Short Circuit 2 during the scene where the robotic protagonist is beaten by a group of thugs. So, I don't personally have any doubt that I at least have whatever basic circuitry is necessary for a person to care about other beings. I don't have any inclination to believe that autistic neurology, regardless of whether you want to talk about "Asperger's"-labeled people, or "PDD"-labeled people, or those with labels of "Autistic Disorder", in any way, shape, or form negates a person's capacity for care, for love, or for ethics. And I firmly believe that if the future is to be an open, welcoming place for all the various forms that may come about due to choice or accident or experiment, it is vital not to confuse charisma with conscience.