The development of empathy

1
The development of empathy

• Christopher Gillberg, MD, PhD
• Professor of Child and Adolescent Psychiatry
• Universities of Gothenburg, London, and
  Strathclyde
• Queen Silvias Hospital, NCYPE, and Yorkhill
  Hospital
• Glasgow March 2006

2
Empathy as a concept

• Empathy (Einfühlung) has a long history in
  aesthetics, psychology and psychoanalysis
  (Vischer 1873)
• Einfühlung originally designated the projection
  of human feeling on to the natural world
• For a quarter of a century the term remained at
  the centre of psychological aesthetics before
  Theodor Lipps, a philosopher, much admired by
  Freud for 40 years, transferred it to psychology
  in an attempt to explain how we discover that
  other people have selves

3
Empathy as a concept

• Freud's conception of Einfühlung, first
  developed in 'Jokes and their Relation to the
  Unconscious' (1905), remained heavily
  intellectual throughout his career he viewed it
  as the process that allows us to understand
  others by putting ourselves in their place

4
Empathy as a concept

• Lipp (1902) wanted a new word for Einfühlung
• He used the Greek word pathos
• Freud believed it was the capacity that we all
  share to be able to intuit what goes on in the
  minds of other people
• Gillberg (1991) believed it was closely related
  to theory of mind (TOM)
• He launched the concept of EQ (Empathy Quotient)
• Gillberg 1992 (JCPP)

5
Empathy and TOM

• Being able to imagine that something (and what)
  goes on in the minds of people is sometimes
  referred to as having a Theory Of Mind (TOM)
• This ability is clearly a requirement for being
  able to empathize with other people
• In fact, the definition of TOM, is virtually
  synonymous with that of Lipps and corresponds
  almost literally to the definition of empathy
  outlined by S Freud
• Gillberg 1992 (JCPP)

6
Empathy and emotions

• Nowadays, in the minds of most people, empathy is
  a concept that involves both cognitive (TOM) and
  emotional aspects
• However, in order to be able to study it
  properly, empathy has to be either
• (a) kept clean as a cognitive factor
• (b) divided into its separate components of TOM,
  emotions, and, possibly, other parts (including
  communication aspects)
• (c) redefined

7
Empathy and active communication

• Nowadays, in the minds of most people, empathy is
  also something which has to be demonstrated in
  order to be present
• However, the communication part of empathy is
  closer to the concept of sympathy (or antipathy)
• In other words, empathy could be seen as a
  cognitive function whereas sympathy and antipathy
  are cognitive functions coloured by emotions (or
  affect)

8
Empathy and intersubjectivity

• The shared manifold of intersubjectivity
• It is through this shared manifold that it is
  possible for us to recognize other human beings
  as similar to us
• The same neural structures that are involved in
  processing and controlling executed actions, felt
  sensations and emotions are also active when the
  same actions, sensations and emotions are to be
  detected in others
• It therefore appears that a whole range of
  different "mirror matching mechanisms" may be
  present in our brain
• This matching mechanism, supported by mirror
  neurons originally discovered and described in
  the domain of action, might be a basic
  organizational feature of the brain, enabling our
  complex and diversified intersubjective
  experiences, including that of pain
• Saarela et al 2006

9
Empathy and shared attention

• It is likely that shared attention is an early
  branch in the development of the empathy skills
  shown to perfection in some adults

10
Empathy and imitation

• It is possible that early imitation skills are
  predictive of later empathy skills
• However, findings - largely clinical and
  anecdotal - from the field of autism spectrum
  conditions suggest that some individuals with
  Asperger syndrome (and a few with autistic
  disorder) have exquisite imitation skills (at
  least after a few years of development)

11
Empathy deficits - associated factors

• Males score lower than females on EQ
• Low EQ predicts ASC
• Wheelwright et al 2006
• Some research results suggest that impaired
  empathy in individuals with Asperger syndrome may
  be due to impaired integration of the cognitive
  and affective facets of the other person's mental
  state
• Shamay-Tsoory et al 2002

12
Empathy biological basis

• Happé et al (1996) in an early PET-study found
  Broddmanns area 8-9 in the medial left frontal
  lobe to be involved when individuals without
  Asperger syndrome solved TOM tasks
• They also found that those with Asperger syndrome
  activated an adjacent (but non-overlapping) area

13
Empathy biological basis

• Vollm et al (2006) confirmed these findings,
  using fMRI, but extended them to show that theory
  of mind and empathy overlap, and that when
  empathy is shown, additional areas are activated
  (including in the amygdala)
• Decreased connectivity across distant brain areas
  and normal/increased connectivity across close
  brain areas could, theoretically, account for the
  inability to fully empathize with the complex
  goings-on in the minds of other people
• The role of mirror neurons and facial processing?
  Fusiform gyrus? Amygdala? Cerebellum?

14
Emptahy skills normally distributed in the
general population

• Gillberg (1991) suggested that empathy/TOM skills
  are normally distributed in the general
  population, and that cases of ASC are at the
  lowermost portion of this normal distribution
  curve

15
Normal distribution of empathy in the general
population
16
Overlap of disorders of empathy