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The English word is derived from the Ancient Greek word ἐμπάθεια (empatheia), "physical affection, passion, partiality" which comes from ἐν (en), "in, at" and πάθος (pathos), "passion" or "suffering".[2] The term was adapted by Hermann Lotze and Robert Vischer to create the German word Einfühlung ("feeling into"), which was translated by Edward B. Titchener into the English term empathy.[3][4] Alexithymia (the word comes from the Ancient Greek words λέξις (lexis, "diction", "word") and θυμός (thumos, "soul, as the seat of emotion, feeling, and thought") modified by an alpha-privative, literally meaning "without words for emotions"), is a term to describe a state of deficiency in understanding, processing, or describing emotions in oneself.[5] Definition Empathy has many different definitions that encompass a broad range of emotional states, including caring for other people and having a desire to help them; experiencing emotions that match another person's emotions; discerning what another person is thinking or feeling;[6] and making less distinct the differences between the self and the other.[7] It also is the ability to feel and share another person’s emotions. Some believe that empathy involves the ability to match another’s emotions, while others believe that empathy involves being tenderhearted toward another person.[8] Compassion and sympathy are two terms that many associate with empathy, but all three of these terms are unique. Compassion is an emotion we feel when others are in need, which motivates us to help them. Sympathy is a feeling of care and understanding for someone in need. In the field of positive psychology, empathy has also been compared with altruism and egotism.[9] Altruism is behavior that is aimed at benefitting another person, while egotism is a behavior that is acted out for personal gain. Sometimes, when someone is feeling empathetic towards another, acts of altruism occur. However, many question whether or not these acts of altruism are motivated by egotistical gains. According to positive psychologists, people can be adequately moved by their empathies to be altruistic.[8] [10] Since empathy involves understanding the emotional states of other people, the way it is characterized is derivative of the way emotions themselves are characterized. If, for example, emotions are taken to be centrally characterized by bodily feelings, then grasping the bodily feelings of another will be central to empathy. On the other hand, if emotions are more centrally characterized by a combination of beliefs and desires, then grasping these beliefs and desires will be more essential to empathy. The ability to imagine oneself as another person is a sophisticated imaginative process. However, the basic capacity to recognize emotions is probably innate[11] and may be achieved unconsciously. Yet it can be trained[12] and achieved with various degrees of intensity or accuracy. Empathy necessarily has a "more or less" quality. The paradigm case of an empathic interaction, however, involves a person communicating an accurate recognition of the significance of another person's ongoing intentional actions, associated emotional states, and personal characteristics in a manner that the recognized person can tolerate. Recognitions that are both accurate and tolerable are central features of empathy.[13][14] The human capacity to recognize the bodily feelings of another is related to one's imitative capacities and seems to be grounded in an innate capacity to associate the bodily movements and facial expressions one sees in another with the proprioceptive feelings of producing those corresponding movements or expressions oneself.[15] Humans seem to make the same immediate connection between the tone of voice and other vocal expressions and inner feeling. Empathy is distinct from sympathy, pity, and emotional contagion.[16] Sympathy or empathic concern is the feeling of compassion or concern for another, the wish to see them better off or happier. Pity is feeling that another is in trouble and in need of help as they cannot fix their problems themselves, often described as "feeling sorry" for someone. Emotional contagion is when a person (especially an infant or a member of a mob) imitatively "catches" the emotions that others are showing without necessarily recognizing this is happening.[17] Major theories and empirical findings Research investigating the social response to natural disasters looked at the characteristics associated with individuals who help victims. Researchers found that cognitive empathy, rather than emotional empathy, predicted helping behavior towards victims.[18] Others have posited that taking on the perspectives of others (cognitive empathy) allows these individuals to better empathize with victims without as much discomfort, whereas sharing the emotions of the victims (emotional empathy) can cause emotional distress, helplessness, victim-blaming, and ultimately to avoidance rather than helping.[19] Yet, despite this evidence for empathy-induced altruistic motivation, egoistic explanations may still be possible. For example, one alternative explanation for the problem-specific helping pattern may be that the sequence of events in the same problem condition first made subjects sad when they empathized with the problem and then maintained or enhanced subjects’ sadness when they were later exposed to the same plight. Consequently, the negative state relief model would predict substantial helping among imagine-set subjects in the same condition, which is what occurred. An intriguing question arises from such findings concerning whether it is possible to have mixed motivations for helping. If this is the case, then simultaneous egoistic and altruistic motivations would occur. This would allow for a stronger sadness-based motivation to obscure the effects of an empathic concern-based altruistic motivation. The observed study would then have sadness as less intense than more salient altruistic motivation. Consequently, relative strengths of different emotional reactions, systematically related to the need situation, may moderate the predominance of egoistic or altruistic motivation (Dovidio, 1990). But it has been shown that researchers in this area who have used very similar procedures sometimes obtain apparently contradictory results. Superficial procedural differences such as precisely when a manipulation is introduced could also lead to divergent results and conclusions. It is therefore vital for any future research to move toward even greater standardization of measurement. Thus, an important step in solving the current theoretical debate concerning the existence of altruism may involve reaching common methodological ground.[20] Contemporary neuroscience has allowed us to understand the neural basis of the human mind’s ability to understand and process emotion. Studies today enable us to see the activation of mirror neurons and attempt to explain the basic processes of empathy. By isolating these mirror neurons and measuring the neural basis for human mind reading and emotion sharing abilities,[21] science has come one step closer to finding the reason for reactions like empathy. Neuroscientists have already discovered that people scoring high on empathy tests have especially busy mirror neuron systems in their brains (Dr. Christian Keysers). Empathy is a spontaneous sharing of affect, provoked by witnessing and sympathizing with another’s emotional state. In a way we mirror or mimic the emotional response that we would expect to feel in that condition or context, much like sympathy. Unlike personal distress, empathy is not characterized by aversion to another’s emotional response. Additionally, empathizing with someone requires a distinctly sympathetic reaction where personal distress demands avoidance of distressing matters. This distinction is vital because empathy is associated with the moral emotion sympathy, or empathetic concern, and consequently also prosocial or altruistic action.[21] Empathy leads to sympathy by definition unlike the over-aroused emotional response that turns into personal distress and causes a turning-away from another’s distress. In empathy we feel what we believe are the emotions of another, which makes it both affective and cognitive by most psychologists.[6][9] In this sense, arousal and empathy promote prosocial behavior as we accommodate each other to feel similar emotions. For social beings, negotiating interpersonal decisions is as important to survival as being able navigate the physical landscape.[22] Emotions motivate individual behavior that aids in solving communal challenges as well as guide group decisions about social exchange. Additionally, recent research has shown individuals who report regular experiences of gratitude engage more frequently in prosocial behaviors than their lesser counterparts. Positive emotions like empathy or gratitude are linked to a more positive continual state and these people are far more likely to help others than those not experiencing a positive emotional state.[23] Thus, empathy’s influence extends beyond relating to other’s emotions, it correlates with an increased positive state and likeliness to aid others. Measures of empathy show that mirror neurons are activated during arousal of sympathetic responses and prolonged activation shows increased probability to help others. Another growing focus of investigation is how empathy manifests in education between teachers and learners.[24] Although there is general agreement that empathy is essential in educational settings, research has found that it is difficult to develop empathy in trainee teachers.[25] According to one theory, there are seven components involved in the effectiveness of intercultural communication; empathy was found to be one of the seven. This theory also states that empathy is learnable. However, research also shows that it is more difficult to empathize when there are differences between people including status, culture, religion, language, skin colour, gender, age and so on.[25] In order to achieve intercultural empathy, psychologists have employed empathy training. One study hypothesized that empathy training would increase the measured level of relational empathy among the individuals in the experimental group when compared to the control group.[26] The study also hypothesized that empathy training would increase communication among the experimental group, and that perceived satisfaction with group dialogue would also increase among the experimental group. To test this, the experimenters used the Hogan Empathy Scale, the Barrett-Lennard Relationship Inventory, and questionnaires. Using these measures, the study found that empathy training was not successful in increasing relational empathy. Also, communication and satisfaction among groups did not increase as a result of the empathy training. While there didn’t seem to be a clear relationship between empathy and relational empathy training, the study did report that “relational empathy training appeared to foster greater expectations for a deep dialogic process resulting in treatment differences in perceived depth of communication”. The environment has been another interesting topic of study. Many theorize that environmental factors, such as parenting style and relationships, play a significant role in the development of empathy in children. Empathy promotes pro social relationships, helps mediate aggression, and allows us to relate to others, all of which make empathy an important emotion among children. A study done by Caroline Tisot looked at how a variety of environmental factors affected the development of empathy in young children. Parenting style, parent empathy, and prior social experiences were looked at. The children participating in the study were asked to complete an affective empathy measure, while the children’s parents completed the Parenting Practices Questionnaire, which assesses parenting style, and the Balanced Emotional Empathy scale. This study found that a few parenting practices - as opposed to parenting style as a whole - contributed to the development of empathy in children. These practices include encouraging the child to imagine the perspectives of others and teaching the child to reflect on his or her own feelings. The results also show that the development of empathy varied based on the gender of the child and parent. Paternal warmth was found to be significantly important, and was positively related to empathy within children, especially in boys. Interestingly, however, maternal warmth was negatively related to empathy within children, especially in girls.[27] Applications The empathy-altruism relationship also has broad and practical implications. Given the power of empathic feelings to evoke altruistic motivation, people may unfortunately learn to suppress or avoid these feelings. This numbing or even loss of the capacity to feel empathy for clients may be a factor in the experience of burnout among case workers in helping professions. Awareness of this impending futile effort—such as nurses caring for terminal patients or pedestrians walking by the homeless—may make individuals try to avoid feelings of empathy in order to avoid the resulting altruistic motivation. Promoting an understanding about the mechanisms by which altruistic behavior is driven, whether it’s from minimizing sadness or the arousal of mirror neurons, allows people to better cognitively control their actions. However, empathy-induced altruism may not always produce prosocial effects. It could lead one to increase the welfare of those for whom empathy is felt at the expense of other potential prosocial goals, thus inducing a type of bias. Researchers suggest that individuals are willing to act against the greater collective good or to violate their own moral principles of fairness and justice if doing so will benefit a person for whom empathy is felt.[28] On a more positive note, empathically aroused individuals may focus on the long-term welfare rather than just the short-term of those in need. Empathy-based socialization is very different from current practices directed toward inhibition of egoistic impulses through shaping, modeling and internalized guilt. Therapeutic programs built around facilitating altruistic impulses by encouraging perspective taking and empathic feelings might enable individuals to develop more satisfactory interpersonal relations, especially in the long-term. At a societal level, experiments have indicated that empathy-induced altruism can be used to improve attitudes toward stigmatized groups, even used to improve racial attitudes, actions toward people with AIDS, the homeless and even convicts. Such resulting altruism has also been found to increase cooperation in competitive situations.[29] Types Affective and cognitive empathy Empathy can be divided into two major components:[30] Affective empathy, also called emotional empathy:[31] the capacity to respond with an appropriate emotion to another's mental states.[30] Our ability to empathize emotionally is supposed to be based on emotional contagion:[31] being affected by another's emotional or arousal state.[32] Cognitive empathy: the capacity to understand another's perspective or mental state.[30][33] The terms cognitive empathy and theory of mind are often used synonymously, but due to a lack of studies comparing theory of mind with types of empathy, it is unclear whether these are equivalent.[34] Although science has not yet agreed upon a precise definition of these constructs, there is consensus about this distinction.[35] Affective empathy can be subdivided into the following scales:[30][36] Empathic concern: sympathy and compassion for others in response to their suffering.[30][37][38] Personal distress: self-centered feelings of discomfort and anxiety in response to another's suffering.[30][37][38] There is no consensus regarding whether personal distress is a basic form of empathy or instead does not constitute empathy.[37] There may be a developmental aspect to this subdivision. Infants respond to the distress of others by getting distressed themselves; only when they are 2 years old do they start to respond in other-oriented ways, trying to help, comfort and share.[37] Cognitive empathy can be subdivided into the following scales:[30][36] Perspective taking: the tendency to spontaneously adopt others' psychological perspectives.[30] Fantasy: the tendency to identify with fictional characters.[30] In research A difference in distribution between affective and cognitive empathy has been observed in various conditions. Psychopathy, schizophrenia, and narcissism have been associated with impairments in affective but not cognitive empathy, whereas bipolar disorder and borderline traits have been associated with deficits in cognitive but not affective empathy.[35] Autism spectrum disorders have been associated with various combinations, including deficits in cognitive empathy as well as deficits in both cognitive and affective empathy.[30][31][35][37][39][40] Even in people without conditions such as these, the balance between affective and cognitive empathy varies.[35] A meta-analysis of recent fMRI studies of empathy confirmed that different brain areas are activated during affective–perceptual empathy and cognitive–evaluative empathy.[41] Also, a study with patients with different types of brain damage confirmed the distinction between emotional and cognitive empathy.[31] Specifically, the inferior frontal gyrus appears to be responsible for emotional empathy, and the ventromedial prefrontal gyrus seems to mediate cognitive empathy.[31] The Interpersonal Reactivity Index (IRI) is the only published measurement tool to date that accounts for a multi-dimensional assessment of empathy. It comprises a self-report questionnaire of 28 items, divided into four 7-item scales covering the above subdivisions of affective and cognitive empathy.[30][36] Development When children are shown videoclips with situations where they see people suffering pain by coincidence, neural circuits related to pain are being activated in their brain. By the age of two years, children normally begin to display the fundamental behaviors of empathy by having an emotional response that corresponds with another person's emotional state.[42] Even earlier, at one year of age, infants have some rudiments of empathy, in the sense that they understand that, just like their own actions, other people's actions have goals.[43][44][45] Sometimes, toddlers will comfort others or show concern for them at as early an age as two. Also during the second year, toddlers will play games of falsehood or "pretend" in an effort to fool others, and this requires that the child know what others believe before he or she can manipulate those beliefs.[46] According to researchers at the University of Chicago who used functional magnetic resonance imaging (fMRI), children between the ages of 7 and 12 years appear to be naturally inclined to feel empathy for others in pain. Their findings[47] are consistent with previous fMRI studies of pain empathy with adults. The research also found additional aspects of the brain were activated when youngsters saw another person intentionally hurt by another individual, including regions involved in moral reasoning.[48] Despite being able to show some signs of empathy, including attempting to comfort a crying baby, from as early as 18 months to two years, most children do not show a fully fledged theory of mind until around the age of four.[49] Theory of mind involves the ability to understand that other people may have beliefs that are different from one's own, and is thought to involve the cognitive component of empathy.[33] Children usually become capable of passing "false belief" tasks, considered to be a test for a theory of mind, around the age of four. Individuals with autism often find using a theory of mind very difficult (e.g. Baron-Cohen, Leslie & Frith, 1988; the Sally-Anne test). Empathetic maturity is a cognitive structural theory developed at the Yale University School of Nursing and addresses how adults conceive or understand the personhood of patients. The theory, first applied to nurses and since applied to other professions, postulates three levels that have the properties of cognitive structures. The third and highest level is held to be a meta-ethical theory of the moral structure of care. Those adults operating with level-III understanding synthesize systems of justice and care-based ethics.[50] Controversies Positive psychology The opposite of empathy is a complete lack of regard for another’s feelings or well-being, something like bullying. The mimicking behavior of motor neurons in empathy helps duplicate feelings.[51] This replication of feelings enables children to recognize and reproduce emotions by observations. The emotional strengths of kindness, forgiveness, and empathy all can be harvested by sympathetic feeling for another.[52] Hostility is the antithesis of this and demonstrates a lack of building up lesser strengths. Instead of relying on anger and power to bully, children and adults should attempt to “walk a mile in another’s shoes” and learn to relate to other’s challenges.[53] This definition ascribes to a limited idea of what it means to possess empathy and in doing so limits individuals to being either empathetic or entirely lacking empathy.[54] Individual differences Empathy in the broadest sense refers to a reaction of one individual to another’s emotional state. Recent years have seen increased movement toward the idea that empathy occurs from motor neuron imitation. But, how do we account for individual differences in empathy? It cannot be said that empathy is a single unipolar construct but rather a set of constructs. In essence, not every individual responds equally and uniformly the same to various circumstances. The Empathic Concern scale assesses “other-oriented” feelings of sympathy and concern and the Personal Distress scale measures “self-oriented” feelings of personal anxiety and unease. The combination of these scales helps reveal those that might not be classified as empathetic and expands the narrow definition of empathy. Using this approach we can enlarge the basis of what it means to possess empathetic qualities and create a multi-faceted definition.[55] Neurological basis Research in recent years has focused on possible brain processes underlying the experience of empathy. For instance, functional magnetic resonance imaging (fMRI) has been employed to investigate the functional anatomy of empathy.[56][57] These studies have shown that observing another person's emotional state activates parts of the neuronal network involved in processing that same state in oneself, whether it is disgust,[58] touch,[59][60] or pain.[61][62][63][64] The study of the neural underpinnings of empathy has received increased interest following the target paper published by Preston and Frans de Waal,[65] following the discovery of mirror neurons in monkeys that fire both when the creature watches another perform an action as well as when they themselves perform it. In their paper, they argue that attended perception of the object's state automatically activates neural representations, and that this activation automatically primes or generates the associated autonomic and somatic responses (idea of perception-action-coupling[66]), unless inhibited. This mechanism is similar to the common coding theory between perception and action. Another recent study provides evidence of separate neural pathways activating reciprocal suppression in different regions of the brain associated with the performance of "social" and "mechanical" tasks. These findings suggest that the cognition associated with reasoning about the "state of another person's mind" and "causal/mechanical properties of inanimate objects" are neurally suppressed from occurring at the same time.[67][68] In animals Empathy is easily noted and recognized in humans. However, new research has shown that the ability of empathy in other species is indeed attainable. Many instances of empathy have been recorded throughout many species, including but not limited to canines, felines, dolphins, primates, rats and mice. In animals, empathy-related responding could in fact have an ulterior motive such as survival, the sharing of food, companionship and pack-oriented mentality. It is certainly difficult to understand an animals intention behind an empathic response. Many researchers[who?] maintain that applying the term empathy in general to animal behavior is an act of anthropomorphism. Researchers Clay and Zana studied the socio-emotional development of the bonobo chimpanzee.[69] They focused on the interplay of numerous skills such as empathy-related responding, and how different rearing backgrounds of the juvenile bonobo affected their response to stressful events, related to themselves (loss of a fight) and of stressful events of others. It was found that the bonobos sought out body contact as a coping mechanism with one another. A finding of this study was that the bonobos sought out more body contact after watching a distressing event upon the other bonobos rather than their individually experienced stressful event. Mother-reared bonobos as opposed to orphaned bonobos sought out more physical contact after a stressful event happened to another. This finding shows the importance of mother-child attachment and bonding, and how it may be crucial to successful socio-emotional development, such as empathic-like behaviors. Empathic-like responding has been observed in chimpanzees in various different aspects of their natural behaviors. For example, chimpanzees are known to spontaneously contribute comforting behaviors to victims of aggressive behavior in natural and unnatural settings, a behavior recognized as consolation. Researchers Romero and Teresa observed these empathic and sympathetic-like behaviors in chimpanzees at two separate outdoor housed groups.[70] The act of consolation was observed in both of the groups of chimpanzees. This behavior is found in humans, and particularly in human infants. Another similarity found between chimpanzees and humans is that empathic-like responding was disproportionately provided to individuals of kin. Although comforting towards non-family chimpanzees was also observed, as with humans, chimpanzees showed the majority of comfort and concern to close/loved ones. Another similarity between chimpanzee and human expression of empathy is that females provided more comfort than males on average. The only exception to this discovery was that high-ranking males showed as much empathy-like behavior as their female counterparts. This is believed to be because of policing-like behavior and the authoritative status of high-ranking male chimpanzees. It is thought that species that possess a more intricate and developed prefrontal cortex have more of an ability of experiencing empathy. It has however been found that empathic and altruistic responses may also be found in sand dwelling Mediterranean ants. Researcher Hollis studied the Cataglyphis cursor sand dwelling Mediterranean ant and their rescue behaviors by ensnaring ants from a nest in nylon threads and partially buried beneath the sand.[71] The ants not ensnared in the nylon thread proceeded to attempt to rescue their nest mates by sand digging, limb pulling, transporting sand away from the trapped ant, and when efforts remained unfruitful, began to attack the nylon thread itself; biting and pulling apart the threads. Similar rescue behavior was found in other sand-dwelling Mediterranean ants, but only Cataglyphis floricola and Lasius grandis species of ants showed the same rescue behaviors of transporting sand away from the trapped victim and directing attention towards the nylon thread. It was observed in all ant species that rescue behavior was only directed towards nest mates. Ants of the same species, even conspecifics were treated with aggression and were continually attacked and pursued, which speaks to the depths of ants discriminative abilities. This study brings up the possibility that if ants have the capacity for empathy and/or altruism, these complex processes may be derived from primitive and simpler mechanisms. Canines have been hypothesized to share empathic-like responding towards human species. Researchers Custance and Mayer put individual dogs in an enclosure with their owner and a stranger.[72] When the participants were talking or humming, the dog showed no behavioral changes, however when the participants were pretending to cry, the dogs oriented their behavior toward the person in distress whether it be the owner or stranger. The dogs approached the participants when crying in a submissive fashion, by sniffing, licking and nuzzling the distressed person. The dogs did not approach the participants in the usual form of excitement, tail wagging or panting. Since the dogs did not direct their empathic-like responses only towards their owner, it is hypothesized that dogs generally seek out humans showing distressing body behavior. Although this could insinuate that dogs have the cognitive capacity for empathy, this could also mean that domesticated dogs have learned to comfort distressed humans through generations of being rewarded for that specific behavior. When witnessing chicks in distress, domesticated hens, Gallus gallus domesticus show emotional and physiological responding. Researchers Edgar, Paul and Nicol [73] found that in conditions where the chick was susceptible to danger, the mother hens heart rate increased, vocal alarms were sounded, personal preening decreased and body temperature increased. This responding happened whether or not the chick felt as if they were in danger. Mother hens experienced stress-induced hyperthermia only when the chick's behavior correlated with the perceived threat. Animal maternal behavior may be perceived as empathy, however, it could be guided by the evolutionary principles of survival and not emotionality. Anger and distress Anger Empathic anger is an emotion, a form of empathic distress.[74] Empathic anger is felt in a situation where someone else is being hurt by another person or thing. It is possible to see this form of anger as a pro-social emotion.[citation needed] Empathic anger has direct effects on both helping and punishing desires. Empathic anger can be divided into two sub-categories: trait empathic anger and state empathic anger.[75] The relationship between empathy and anger response towards another person has also been investigated, with two studies basically finding that the higher a person's perspective taking ability, the less angry they were in response to a provocation. Empathic concern did not, however, significantly predict anger response, and higher personal distress was associated with increased anger.[76][77] Distress Empathic distress is feeling the perceived pain of another person. This feeling can be transformed into empathic anger, feelings of injustice, or guilt. These emotions can be perceived as pro-social, and some say they can be seen as motives for moral behavior.[74] Atypical response Atypical empathic responses have been associated with autism spectrum disorders; particular personality disorders such as psychopathy, borderline, narcissistic, and schizoid personality disorders; conduct disorder;[78] schizophrenia; bipolar disorder;[35] and depersonalization.[79] Autism spectrum The interaction between empathy and the autism spectrum is a complex and ongoing field of research. Several different factors are proposed to be at play here. Alexithymia A study of high-functioning adults with autism spectrum disorders found an increased prevalence of alexithymia,[80] a personality construct characterized by the inability to recognize and articulate emotional arousal in oneself or others.[80][81][82] Based on fMRI studies, alexithymia is responsible for a lack of empathy.[83] The lack of empathic attunement inherent to alexithymic states may reduce quality[84] and satisfaction[85] of relationships. Recently, a study has shown that high-functioning adults with autism appear to have a range of responses to music similar to that of neurotypical individuals, including the deliberate use of music for mood management. Clinical treatment of alexithymia could involve using a simple associative learning process between musically induced emotions and their cognitive correlates.[86] A study has suggested that the empathy deficits associated with the autism spectrum may be due to significant comorbidity between alexithymia and autism spectrum conditions rather than a result of social impairment.[87] Mirror neuron activity One study found that, relative to typically developing children, high-functioning children with autism showed reduced mirror neuron activity in the brain's inferior frontal gyrus (pars opercularis) while imitating and observing emotional expressions.[88] EEG evidence revealed that there was significantly greater mu suppression in the sensorimotor cortex of autistic individuals. Activity in this area was inversely related to symptom severity in the social domain, suggesting that a dysfunctional mirror neuron system may underlie social and communication deficits observed in autism, including impaired theory of mind and empathy.[89] The mirror neuron system is essential for emotional empathy.[31] Theory of mind Previous studies have suggested that autistic individuals have impaired theory of mind. Theory of mind is the ability to understand the perspectives of others.[30] The terms cognitive empathy and theory of mind are often used synonymously, but due to a lack of studies comparing theory of mind with types of empathy, it is unclear whether these are equivalent.[30] Theory of mind relies on structures of the temporal lobe and the pre-frontal cortex, and empathy, i.e. the ability to share the feelings of others, relies on the sensorimotor cortices as well as limbic and para-limbic structures.[citation needed] Francesca Happe showed that autistic children who demonstrate a lack of theory of mind lack it for their self as well as for others.[90][citation needed] The lack of clear distinctions between theory of mind and empathy may have resulted in an incomplete understanding of the empathic abilities of those with Asperger syndrome; many reports on the empathic deficits of individuals with Asperger syndrome are actually based on impairments in theory of mind.[30][91][92] Cognitive and affective empathy Studies have found that individuals on the autism spectrum self-report lower levels of empathic concern, show less or absent comforting responses toward someone who is suffering, and report equal or higher levels of personal distress compared to controls.[37] The combination of reduced empathic concern and increased personal distress may lead to the overall reduction of empathy in those on the autism spectrum.[37] Professor Simon Baron-Cohen suggests that those with classic autism often lack both cognitive and affective empathy.[40] Research also suggests that people with Asperger syndrome may have problems understanding others' perspectives in terms of theory of mind, but on average demonstrate equal empathic concern as and higher personal distress than controls.[30] The generally heightened personal distress in those with autism spectrum conditions has been offered as an explanation to the claim that at least some people with autism would appear to have heightened emotional empathy,[37][39] although emotional empathy depends on mirror neuron activity, which (as described previously) has been found to be reduced in those with autism, and empathy in people on the autism spectrum is generally reduced.[31][37] Empathizing–systemizing theory Main article: Empathizing–systemizing theory The empathizing–systemizing (E-S) theory suggests that people may be classified on the basis of their capabilities along two independent dimensions, empathizing (E) and systemizing (S). These capabilities may be inferred through tests that measure someone's Empathy Quotient (EQ) and Systemizing Quotient (SQ). Five different "brain types" can be observed among the population based on the scores, which should correlate with differences at the neural level. In the E-S theory, autism and Asperger syndrome are associated with below-average empathy and average or above-average systemizing. The E-S theory has been extended into the Extreme Male Brain theory, which suggests that people with an autism spectrum condition are more likely to have an "Extreme Type S" brain type, corresponding with above-average systemizing but challenged empathy (see the next section).[93] Sex differences and autism See also: Empathy § Gender differences It has been shown that males are generally less empathetic than females.[93][94] The Extreme Male Brain (EMB) theory proposes that individuals on the autistic spectrum are characterized by impairments in empathy due to sex differences in the brain: specifically, people with autism spectrum conditions show an exaggerated male profile. A study showed that some aspects of autistic neuroanatomy seem to be extremes of typical male neuroanatomy, which may be influenced by elevated levels of fetal testosterone rather than gender itself.[93][95] Another study involving brain scans of 120 men and women suggested that autism affects male and female brains differently; females with autism had brains that appeared to be closer to those of non-autistic males than females, yet the same kind of difference was not observed in males with autism.[96] Personality disorders Atypical empathy is associated with some personality disorders, including psychopathy, borderline, narcissistic, and schizoid personality disorders. Psychopathy Psychopathy is a personality disorder partly characterized by antisocial and aggressive behaviors, as well as emotional and interpersonal deficits including shallow emotions and a lack of remorse and empathy.[97][98] The Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Diseases (ICD) list antisocial personality disorder (ASPD) and dissocial personality disorder, stating that these have been referred to or include what is referred to as psychopathy.[99][100][101][102][103] A large body of research suggests that psychopathy is associated with atypical responses to distress cues (e.g. facial and vocal expressions of fear and sadness), including decreased activation of the fusiform and extrastriate cortical regions, which may partly account for impaired recognition of and reduced autonomic responsiveness to expressions of fear, and impairments of empathy.[104][105][106][107][108] Studies on children with psychopathic tendencies have also shown such associations.[109][110][111] The underlying biological surfaces for processing expressions of happiness are functionally intact in psychopaths, although less responsive than those of controls.[108][109][110][111] The neuroimaging literature is unclear as to whether deficits are specific to particular emotions such as fear. Some recent fMRI studies have reported that emotion perception deficits in psychopathy are pervasive across emotions (positives and negatives).[112][113] A recent study on psychopaths found that under certain circumstances, they could willfully empathize with others, and that their empathic reaction initiated the same way it does for controls. Psychopathic criminals were brain-scanned while watching videos of a person harming another individual. The psychopaths' empathic reaction initiated the same way it did for controls when they were instructed to empathize with the harmed individual, and the area of the brain relating to pain was activated when the psychopaths were asked to imagine how the harmed individual felt. The research suggests how psychopaths could switch empathy on at will, which would enable them to be both callous and charming. The team who conducted the study say it is still unknown how to transform this willful empathy into the spontaneous empathy most people have, though they propose it could be possible to bring psychopaths closer to rehabilitation by helping them to activate their "empathy switch". Others suggested that despite the results of the study, it remained unclear whether psychopaths' experience of empathy was the same as that of controls, and also questioned the possibility of devising therapeutic interventions that would make the empathic reactions more automatic.[114] Work conducted by Professor Jean Decety with large samples of incarcerated psychopaths offers additional insights. In one study, psychopaths were scanned while viewing video clips depicting people being intentionally hurt. They were also tested on their responses to seeing short videos of facial expressions of pain. The participants in the high-psychopathy group exhibited significantly less activation in the ventromedial prefrontal cortex, amygdala and periaqueductal gray parts of the brain, but more activity in the striatum and the insula when compared to control participants.[115] In a second study, individuals with psychopathy exhibited a strong response in pain-affective brain regions when taking an imagine-self perspective, but failed to recruit the neural circuits that were activated in controls during an imagine-other perspective—in particular the ventromedial prefrontal cortex and amygdala—which may contribute to their lack of empathic concern.[116] Psychopaths may have a different baseline when it comes to empathy.[117] Professor Simon Baron-Cohen suggests that, unlike the combination of both reduced cognitive and affective empathy often seen in those with classic autism, psychopaths are associated with intact cognitive empathy, implying non-diminished awareness of another's feelings when they hurt someone.[40] Borderline personality disorder Borderline personality disorder is characterized by extensive behavioral and interpersonal difficulties that arise from emotional and cognitive dysfunction.[118] Dysfunctional social and interpersonal behavior has been shown to play a crucial role in the emotionally intense way people with borderline personality disorder react.[119] While individuals with borderline personality disorder may show their emotions too much, several authors have suggested that they might have a compromised ability to reflect upon mental states (impaired cognitive empathy), as well as an impaired theory of mind.[119] People with borderline personality disorder are very good at recognizing emotions in people's faces, suggesting increased empathic capacities.[120][121] It is, therefore, possible that impaired cognitive empathy (the capacity for understanding another person's experience and perspective) may account for borderline personality disorder individuals' tendency for interpersonal dysfunction, while "hyper-emotional empathy"[verification needed] may account for the emotional over-reactivity observed in these individuals.[119] One primary study confirmed that patients with borderline personality disorder were significantly impaired in cognitive empathy, yet there was no sign of impairment in affective empathy.[119] Empathy is the capacity to understand what another person is experiencing from within the other person's frame of reference, ie, the capacity to place oneself in another's shoes.[1] |
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