Autism, Empathy, and Sympathy

Misconceptions about autism and empathy are common. Autistic people are sometimes said to lack empathy (the ability to feel along with others) and/or sympathy (the ability to feel for others). While this stereotype is often used to describe all autistic people, these challenges are not experienced by everyone on the spectrum.

mother comforting toddler boy

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This article looks at autism and empathy, and what the research says about how autistic people experience this emotion.

Autism, Empathy, and Sympathy

Research into the link between autism, empathy, and sympathy has evolved over the past 40 years. Initially, it was believed that a lack of empathy and sympathy was a universal trait of autism, but more recent research indicates that this varies among individuals diagnosed with autism.

The answers to the following questions are more nuanced than early research suggests:

  • Can autistic people truly empathize or sympathize with others?
  • What stands in the way of a traditional emotional response?
  • Can emotional responses like empathy be taught?
  • Does an apparent lack of empathy or sympathy really reflect a lack of emotional connectedness?

A lack of expressed sympathy or empathy may not be the result of a lack of emotion in an autistic person, but rather due to underdeveloped skills. There are several elements involved in showing empathy to others.

To connect with another person in these ways, one must:

  • Recognize the other person's feelings
  • Understand the other person's hopes, dreams, and/or expectations
  • Have the emotional experience to relate personally to another's feelings
  • Have the tools to physically and verbally express empathic feelings
  • Share a cultural understanding that displays of empathy are expected and desired

Autistic people who struggle to show empathy and sympathy may have difficulty with one or more of these.

Recognizing and Feeling Emotions

Empathy is a two-dimensional emotion. It is experienced on a cognitive level—recognizing and understanding another’s mental state. And it is experienced on an affective or emotional level—feeling the emotions of others.

In autistic people, these experiences can sometimes seem at odds with one another.

Cognitive Empathy

Research shows autistic people may struggle with cognitive empathy because they are unable to recognize and name emotions based on facial expressions. Eye scan studies found autistic people tend to look at the periphery of a face rather than pay attention to the eyes and mouth, where emotions are typically displayed. 

Affective Empathy

While cognitive empathy can be lower in autistic people, affective empathy—which is based on instincts and involuntary responses to the emotions of others—can be strong and overwhelming. In fact, newer research suggests that some autistic people may actually feel other people's emotions more intensely.

Picking up on others' emotions and experiencing them internally can feel overpowering and confusing. This may cause a person to shut down and withdraw from crowds.

Can Autistic People Feel Love?

Autistic people feel love and many other emotions, just like neurotypical people (meaning those with brain functions and behavior considered standard). When it comes to romantic relationships, though, autistic people may have more difficulty connecting. Dating involves many subtle social cues that autistic people often miss. 

Labeling Emotions

The ability to name emotions is an important step toward experiencing empathy and sympathy. Many autistic people experience alexithymia, which is an inability to recognize and label the emotions they feel. Alexithymia can also occur in autistic people, and the connection between empathy and alexithymia is being explored.

A 2018 study published in the Journal of Autism and Developmental Disorders found that people with alexithymia have a harder time expressing empathy, regardless of whether or not they also have autism. However, people with this condition who do not have alexithymia were better able to show empathy.

The study authors note the ability to understand and label your own emotions appears to be the key to recognizing those emotions in others.

Responding to Social Cues

Most typically, growing people learn appropriate body language and words to express sympathy and empathy by observing and imitating parents and other people. For example, a neurotypical 4-year-old might recognize an expression of pain from a friend and respond by kissing the boo-boo because she's seen someone else do that before. 

Autistic children, however, may miss social cues and not respond in the same way as others for a number of reasons. Among them:

  • Autistic people often have difficulty interpreting non-verbal communication, such as body language and facial expressions. 
  • Autistic children do not tend to engage in spontaneous imitation of others. Because children learn social skills through mimicry and repetition, autistic people may have difficulty displaying typical expressions of empathy.

The skill of "mind-reading"—understanding another's thoughts through careful observation of body language, vocal tone, facial expression, etc.—is key to empathy and sympathy. Autistic people often have a very difficult time with this aspect of emotional responsiveness.

Autism and Sympathy

Unlike empathy, a shared perspective isn’t required to feel sympathy for others. For example, one can feel sympathy for animals or people who have been through a terrible ordeal that they themselves have not personally experienced. But for autistic people, sympathy may not come as naturally as it may for others.

In a 2018 study, 254 autistic adults and 133 people without were given an online survey and asked to rate photographs based on the amount of sympathy they had for the individual in the photo. Researchers found autistic people gave lower sympathy ratings for people in distressing scenarios, compared to controls.

The study authors note that this does not mean autistic people are uncaring. The results suggest a difference in how individuals with lower levels of cognitive empathy process emotional cues.

While autistic people may have difficulty showing sympathy for others, research shows they are more likely than the general population to express sympathy for objects.

A 2019 study published in the journal Autism gave an online survey to 87 autistic people and 263 neurotypical adults. Researchers found autistic people commonly engage in object personification attributing emotions to inanimate objects.

For example, a shirt that never gets worn is lonely or a doll that isn't played with feels sad. Notably, those on the spectrum often used distressing emotions to describe how objects felt, which may indicate personification is used as a way to process their own emotions.

Can Empathy Be Taught?

Cognitive empathy can be taught to autistic children, according to older research published in the Journal of Applied Behavioral Analysis.

The study used puppets or dolls to role-play situations that elicit empathetic responses and used a token system to reward the expected empathetic response. Over the course of several sessions, subjects learned how to demonstrate empathy using appropriate words and gestures.

Further research shows autistic children can be taught empathy using modeling, prompting, and reinforcement to respond to another person's emotions with appropriate phrases, tone of voice, facial expressions, and gestures.

While these techniques can be used to teach empathetic behavior, they cannot teach empathy at the emotional level. A few small studies have explored potential methods for teaching affective empathy to autistic people, but more research is needed.

Equine Therapy

Equine therapy is a form of experiential therapy that involves interactions between patients and horses. It appears to help autistic people open up and become more aware of their own emotions and the emotions of those around them. Research has found that riding and interacting with horses seems to resonate emotionally with autistic people. Equine therapy may also help individuals improve eye contact, body language, and verbal communication.

Summary

While many autistic people may appear to lack empathy and sympathy, it is not the case for all autistic people. For those who struggle with displaying appropriate empathetic responses, the reasons may relate more to social communication issues than a lack of underlying emotional response.

Autistic people may lack the ability to recognize and label emotions, and they may have difficulty responding to social cues. This can vary from individual to individual.

Cognitive empathy can be taught, so it is possible for autistic people to learn empathetic behavior. Other therapies may improve emotional empathy.

11 Sources
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  1. Mul CL, Stagg SD, Herbelin B, Aspell JE. The feeling of me feeling for you: interoception, alexithymia and empathy in autism. J Autism Dev Disord. 2018;48(9):2953-2967. doi:10.1007/s10803-018-3564-3

  2. Marchetti A, Miraglia L, Di Dio C. Toward a socio-material approach to cognitive empathy in autistic spectrum disorder. Front Psychol. 2020;10:2965. doi:10.3389/fpsyg.2019.02965

  3. Attwood T, Garnett M. Understanding empathy and autism.

  4. Poquérusse J, Pastore L, Dellantonio S, Esposito G. Alexithymia and autism spectrum disorder: a complex relationship. Front Psychol. 2018;9:1196. doi:10.3389/fpsyg.2018.01196

  5. Rigby SN, Stoesz BM, Jakobson LS. Empathy and face processing in adults with and without autism spectrum disorder. Autism Res. 2018;11(6):942-955. doi:10.1002/aur.1948

  6. Holt R, Upadhyay J, Smith P, Allison C, Baron-Cohen S, Chakrabarti B. The Cambridge Sympathy Test: Self-reported sympathy and distress in autism. PLoS One. 2018;13(7):e0198273. doi:10.1371/journal.pone.0198273

  7. White RC, Remington A. Object personification in autism: This paper will be very sad if you don't read it. Autism. 2019;23(4):1042-1045. doi:10.1177/1362361318793408

  8. Schrandt JA, Townsend DB, Poulson CL. Teaching empathy skills to children with autism. J Appl Behav Anal. 2009;42(1):17-32. doi:10.1901/jaba.2009.42-17

  9. Argott PJ, Townsend DB, Poulson CL. Acquisition and generalization of complex empathetic responses among children with autism. Behav Anal Pract. 2017;10(2):107-117. doi:10.1007/s40617-016-0171-7

  10. Jo HJ, Chung SJ, Satterfield D. Indirect teaching for all and autism spectrum disorder (ASD) in design class (ITAD) encouraging their emotional empathy. In: Advances in Affective and Pleasurable Design: Proceedings of the AHFE 2016 International Conference on Affective and Pleasurable Design. Springer International Publishing;2017:581-591.

  11. Malcolm R, Ecks S, Pickersgill M. 'It just opens up their world': autism, empathy, and the therapeutic effects of equine interactions. Anthropol Med. 2018;25(2):220-234. doi:10.1080/13648470.2017.1291115

By Lisa Jo Rudy
Lisa Jo Rudy, MDiv, is a writer, advocate, author, and consultant specializing in the field of autism.