Autism and Empathy: Bridging the Gap in Understanding Neurodivergent Perspectives

We often make assumptions about others’ internal states based on their external behaviors. For example, if I see that you’re shivering, I might make a good guess that you’re cold. I might be correct most of the time, but these assumptions are not always accurate. It’s also possible that someone can be shivering but not cold, or cold but not shivering.

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Autistic behaviors are commonly misunderstood because autistic people have social and communication differences. This means that when someone guesses an autistic person's internal state based on what they see externally, they are less likely to guess correctly because the state may differ from what they expect. An autistic person may feel one way but appear differently to another person. One clear example of this is the assumption that some have made that autistic people must lack empathy.

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The question “Do autistic people have empathy?” prevails in blog posts and articles online––and the persistence of this question exemplifies the harmful myth that autistic people lack empathy. Autistic people do have empathy––and in fact, many have heightened empathy––even if the expression of this empathy appears differently.

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Autism spectrum disorder (ASD) is a neurodevelopmental disorder marked by social and communication differences and a preference for sameness and repetition. In the past, some researchers pursued the idea that a lack of empathy is a defining feature of the autism spectrum ––but this view has been challenged by other researchers who point out the flaws in these assumptions. 

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While autistic traits undoubtedly include social and communication differences compared to allistic (non-autistic) people, these differences do not equate autism to a lack of empathy. 

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Read on to learn more about different types of empathy, factors influencing autistic empathy and more.

Empathy is generally defined as the capacity to understand what someone else is feeling or going through and to share one's emotional experience.
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Researchers generally study two main aspects of empathy: cognitive (understanding) empathy and affective (emotional) empathy.

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Cognitive empathy 

Cognitive empathy is the ability to correctly guess what another person is thinking without being told. It involves understanding others’ emotions, thoughts, and experiences. Cognitive empathy is closely related to the ‘theory of mind,’ which is the ability to guess any person's thoughts and feelings based on cues like body language and tone. 

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Affective empathy 

Affective empathy (emotional empathy) is the state of feeling what another person feels. It is defined as vicariously sensing and sharing other people's emotions. 

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Research frequently focuses on cognitive empathy, highlighting differences in how autistic individuals infer others’ states based on cues like body language and tone. However, autistic individuals tend to report sharing the feelings of others’ emotions (affective empathy) to the same degree as neurotypical individuals. Although autistic individuals experience affective empathy similarly, they express it differently. Their presentation of affective empathy looks different from a neurotypical person’s presentation. 

Empathy research involving autistic individuals is influenced by several factors that contribute to a complex understanding of autism and empathy, including:

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Alexithymia

Research shows that autistic individuals score differently on cognitive empathy measures than allistic people but score similarly on measures of affective empathy. These differences are often attributed to alexithymia, a personality trait involving difficulty identifying and describing one’s emotions, which is more prevalent among autistic individuals. 

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Alexithymia (loosely translated from Greek to mean ‘no words for emotions’) is​​ difficulty identifying and describing emotions. About 50% of autistic individuals and 10% of the general population experience alexithymia. Studies by Dr. Bird and colleagues, as well as Dr. Speyer and colleagues, indicate no significant differences in empathy between autistic and allistic groups after accounting for alexithymia. 

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Autistic individuals with alexithymia score lower on both cognitive empathy and affective empathy, while those without alexithymia score lower on only cognitive empathy. This highlights that differences in empathy may stem from emotion recognition differences due to alexithymia rather than autism itself. 

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Alexithymia can influence how people recognize facial expressions and what part of their brain activates during empathy tasks. Additionally, many ways of defining empathy require an internal representation of one’s own emotions, which is difficult for those with alexithymia.
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The research regarding how autistic individuals experience their own emotions and the emotions of others is inconsistent and confusing, so we must remember that a high prevalence of alexithymia may contribute to or convolute these findings. However, it’s important to note that non-autistic people can experience alexithymia, too.  

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Differences in interoception

An important part of experiencing what others feel is being able to sense that feeling yourself. Interoception refers to how someone feels their bodily sensations and emotions. Autistic individuals often experience a reduced sensitivity (hypo-sensitivity) to interoception. This means they may be less sensitive to internal body cues like temperature, hunger, pain, thirst and physical sensations accompanying emotions. 

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When you’re less sensitive to the physical sensations of your emotions, you’ll also be less sensitive to your own response to others’ emotions. This is how interoception is linked to emotional awareness and may contribute to empathy misunderstandings. The sensations of emotions may not be readily accessible to someone with hypo-sensitivity to interoception. This is like the difference between someone who notices they’re cold and puts on a sweater and someone who is shivering but doesn’t notice they’re cold. Even if someone is less in tune with the physical sensations of empathic responses, it doesn’t mean that response doesn’t exist.

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Singular focus

Monotropism––a singular focus on one area of interest at a time––may also explain some differences in social interaction between autistic and allistic individuals. You can think of monotropism as having one very bright flashlight to view a dark room. In contrast, polytropism—which would be like turning on the overhead light—involves broad attention to multiple things at once.
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Monotropism can cause an autistic person to miss social cues while they’re deeply focused on a specific task. These attentional differences contribute to communication misunderstandings. Monotropism is a proposed explanation for many autistic traits. It relates to the research on empathy because an expected social response may not be triggered by a social cue when someone’s attentional system is focused on a singular other element of the environment. 

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The “double empathy problem”

A phenomenon known as the ‘double empathy problem’ typically results from gaps in understanding how people with different experiences communicate their emotions. Researchers have found that these communication breakdowns are more likely to occur between autistic and allistic individuals. Autistic people can struggle to infer what an allistic person is thinking without being told directly. Conversely, allistic people often struggle to interpret autistic body language and expressions, leading to misunderstandings that can be mistakenly attributed to an empathy deficit in autistic individuals.
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The double empathy problem emphasizes that misunderstandings are mutual and situational, not solely the responsibility of the autistic individual. A lack of the expected observed response may be assumed to be a lack of an internal state, but that outward response might simply not align with allistic social norms. An observer may misunderstand an autistic person’s experience of empathy because the autistic person is expressing themselves differently than was expected.

Just as each autistic person is a unique individual, autistic experiences with both cognitive empathy and affective empathy are highly individual and diverse. While some autistic individuals may believe they have less empathy, others say they experience a heightened sense of empathy known as hyper-empathy. Those who believe they may have less empathy speak about the conscious effort it may take to understand others’ thoughts (i.e., cognitive empathy) rather than intuitively understanding what others must be thinking and feeling. 

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Those who experience hyper-empathy describe experiencing others’ emotional states so overwhelmingly that they may be distressed to the point of shutdown. Feeling overcome by others’ states can be so strong that it’s difficult to separate from one’s own emotions, which can be exhausting for the autistic individual. If someone shuts down due to hyper-empathy, others may misunderstand it as not caring when, in fact, the complete opposite is true.

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Autistic empathy can manifest in unexpected ways. Additionally, some autistic individuals describe experiencing the most empathy for other autistic people, animals and people they feel close to. Many other autistic individuals are highly sensitive to how positive or negative others feel––the emotional valence––even if it takes conscious effort to know why or what others expect them to do about it. Some autistic individuals expressed that empathy can take effort because they may miss certain social cues, but some say they compensate for this by consciously and consistently looking for cues and taking others’ perceptions––a process that can be mentally exhausting.

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The unfortunate legacy of empathy deficit research has left the general population with a negative stereotype that autistic individuals lack empathy, which is harmful and perpetuates stigma. Negative stereotypes like this have allowed the burden of misunderstandings to disproportionately fall on the autistic individual and have been used to justify harmful practices aimed at making autistic individuals less autistic. This misconception about autism and empathy arises partly from flawed research methodologies, including culturally biased and vague survey questions that autistic individuals may interpret literally.
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Researchers like Dr. Harrison and colleagues have found that many practices contributing to these misunderstandings are neither accurate nor ethical. Even the referral process for an autism diagnosis can rely on outdated ideas about autism and empathy, meaning a lot of autistic people are not identified simply because they exhibit empathy. 

Empathy is a dynamic process influenced by social and situational factors. Differences in autistic communication styles and social norms can lead to misunderstandings, but these shouldn’t be mistaken for an absence of empathy. 

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Instead, a more inclusive approach to autism research and societal understanding is needed—one that values autistic perspectives and recognizes the diverse experiences and expressions of human empathy. 

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Debunking the myth that autism spectrum disorder is linked to a lack of empathy is essential for fostering inclusivity and reducing stigma. By addressing misconceptions and incorporating autistic voices into research, we can promote a more accurate and compassionate understanding of neurodivergent experiences and expressions of empathy.

Whether you’re seeking guidance, resources or a compassionate community, Prosper Health is here to help. Prosper Health’s virtual diagnostic evaluations and therapy provide mental health support for autistic and neurodivergent adults covered by insurance. 

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Prosper Health’s psychologists specialize in adult autism and are committed to empowering neurodivergent individuals and fostering understanding. Let us support your journey to thrive in a world that celebrates your unique strengths. Fill out the form below or give us a call to start today!