First published in NAAP News (Fall 2012 issue):

by Inna Rozentsvit

“…in its’ arguably most transformative and revelatory capacity it is the power that enables us to empathize with humans whose experiences we have never shared.” (J.K. Rowling)

“Let us treat men and women well;  Treat them as if they were real; Perhaps they are.” (Ralph Waldo Emerson)

In recent years, especially with the introduction of functional MRI (fMRI) technology, the socio-psychological phenomenon of empathy became the center of attention for neuroscientists. Today, everyone agrees that this phenomenon is pretty complex and that it should be looked at from a multi-disciplinary platform. Although this approach is the most efficient one, its potential downside could be the confusion of tongues between the collaborators of different educational backgrounds, with virtually imminent lingo biases. These biases include the general views on empathy as something very positive (which allows people to feel connected, supported, and helping others – by understanding what they are going through) or something controversial and even negative (as it can cause the “over-identification” with the client and be an obstacle in the analytic situation).

Empathy can be described as the ability to understand and to share the emotions of others, or the ability of putting oneself in the other person’s mental shoes, while there is a definite distinction between the self and the other during this experience. In the new MIT Press book “The Social Neuroscience of Empathy,” editors J. Decety and W. Ickes describe some perceptions of empathy as the “emotional contagion,” as “projection of one’s own thoughts and feelings,” and as a “fundamental aspect of social development.” Empathy is thought to involve not only emotions/feelings, but also observation, memory, and reasoning.

Modern neuroscientific discoveries show that “sharing of emotions of others is associated with activation of neural structures that are also active during the first-hand experience of that emotion” (T. Singer and T. Lamm, University of Zurich). Their research also revealed that although this activation seems first to be just “automatic,” empathy overall is not a pure automatic mirroring of other people’s feelings, but rather it can be moderated/ adjusted/enhanced or otherwise, depending on such factors as inter-personal relationships between the involved parties, adoption of the perspective of the other person, contextual appraisal, etc. They show that empathy involves “information sharing” (bottom-up information processing), perspective taking, and executive control to modulate one’s emotions (top-down processing) through very specific neural pathways that interact with each other.

British psychiatrist specializing in Autistic developmental spectrum disorders, Dr. Simon Baron-Cohen, proposed a new view on empathy as the measure of our human and social abilities (he even equates evil to “empathy erosion”). On the Bell curve distribution, a minority of humans will have the highest degree of empathy or the lowest (zero) degree of empathy, while the majority will be somewhere in-between. Dr. Baron-Cohen introduces another factor when evaluating the pathology of empathy, the “cruelty factor.” People with zero degrees of empathy, and cruel, are defined as zero-negatives (e.g. those with Borderline PD, Psychopathic/Antisocial PD, and Narcissistic PD). Those with zero degrees of empathy, but no cruelty (zero-positives), would usually be in the Autistic spectrum (like Asperger’s disorder). Their brains process information differently, and while these people are lacking social tools, their strength is in attention to patterns and details, which leads to giftedness and often innovation.

Neuropsychiatrists (like Drs. Baron-Cohen and Thomas Lewis) see empathy as a complex psychological process with different components (emotional, cognitive, metacognitive; biological and social). Insecure attachments (due to neglect/abuse), studied first in young delinquents by John Bowlby, are the environmental factors contributing to low/zero empathy. The genetic pool of young teens with conduct disorders/ low empathy shows low activity of MAO-A gene (as per Caspi). Other genes associated with low empathy conditions are: CYP11B1, HSD17B2, GABRB3, etc. Also, studies showed that higher testosterone levels in the amniotic fluid during pregnancy is associated with significant difficulties for these children (when eight years or older) in reading faces (which is one of the measures of empathy). Recent studies at Utrecht and Cambridge Universities also supported the idea that the influence of testosterone is responsible for low empathy states (and inability to “mind-read” the social cues in “normal” adults).

The neurobiological “center” of empathy was discovered with personality changes (not language/memory/reasoning, but severe problems with socialization and empathy) in the famous patient Phineas Gage (1848). A metal rod pierced through his Ventro-Medial-Prefrontal Cortex (VMPFC) (as later found with fMRI by Dr. Hanna Damasio and others) and changed his life forever. Further, neuroscientists discovered the whole network/circuitry for empathy. It includes the Dorso-Medial-Prefrontal Cortex (DMPFC), Orbito-Frontal Cortex (OFC), Anterior Insula (AI), Somato-Sensory Cortex (SMC), and others. With the help of fMRI again, they found that in personality disorders, empathy circuits are underdeveloped or low-functioning. From the neurobiological perspective, empathy is a process, which involves covert modeling (of the feelings/suffering of others), as well as imaginative projection (located in Posterior-Superior Temporal Sulcus, PSTS) via the “mind’s eye” through space/time/identity, which allows later taking the perspective of “another.”  Empathy also involves the ability of adjusting the balance between self and others (through frontal cognitive areas).

Empathy is also an evolutionary and a social process. Studies on monkeys who refused to pull the chain (associated with availability of food) when they had learned that it was also associated with pain induced to other members of the group, speaks volumes… In one of his lectures, Dr. Baron-Cohen said: “Empathy can save the world.” I agree. Otherwise, as Mark Twain said once, “By trying we can easily learn to endure adversity – another man’s I mean.”