Double empathy, defined | Spectrum
Difficulty navigating social interactions permeates even the earliest accounts of autism. This defining characteristic of the disease has influenced the prevailing theories about its roots as well as the design of many autism treatments.
But a new work area supports a more nuanced view of the social skills of autistic people. Proponents of an idea called the “double empathy problem” believe that communication disorders between autistic and non-autistic people are a two-way problem caused by mutual understanding difficulties on both sides. This “double problem” challenges long-held theories about autism, which point to the social inadequacies of people with autism as the cause of the flop in interactions. It also reflects the principles of neurodiversity in its assumption that autistic people simply have a different way of communicating than a poor one. “As a theory, it corresponds to the autistic phenomenology that comes from inside reports,” says Damian Milton, an autism researcher who teaches developmental and intellectual disabilities at the University of Kent in the UK.
While scientific support for the theory is growing, it is not yet rock solid. And not all researchers are set for this new direction, says Matthew Lerner, associate professor of psychology, psychiatry, and pediatrics at Stony Brook University in New York. “The problem of double empathy is empirically a more recent theory,” he says.
What is the problem of double empathy?
The basis of the theory is that a mismatch between two people can lead to faulty communication. This separation can occur on many levels, from conversation styles to the way people see the world. The greater the separation, the more difficult it becomes for the two people to interact with each other.
In the case of autism, a communication gap between people with and without the disorder can occur not only because autistic people have difficulty understanding non-autistic people, but also because non-autistic people have difficulty understanding them. The problem, so the theory goes, is mutual. For example, difficulty reading the other person’s expression can hinder conversations between autistic and non-autistic people.
What are the origins of the theory?
This perception of social problems in autism as a one-way street is decades old. Autistic activists like Jim Sinclair have argued since the 1990s that autistic forms of communication conflict with neurotypical ones.
Milton first coined the term “double empathy problem” in 2012. For him, the idea offered a way to reformulate the long-held notion that individuals on the spectrum have an impaired theory of mind – the ability to infer the intentions or feelings of others – to include potential misunderstandings by non-autistic people.
What evidence supports this?
Rather than focusing on how people with autism behave in social situations, new studies are examining how non-autistic people behave when interacting with autistic people. The results suggest that the blind spots of non-autistic people contribute to the communication gap. For example, in one study, non-autistic people struggled to decipher the mental states that autistic people portrayed through animation. Other work shows that non-autistic people have difficulty interpreting the facial expressions of autistic people accurately.
Non-autistic people can also make quick judgments about autistic people that prevent, limit, or sour interactions between the two. For example, non-autistic people may have a tendency to have negative first impressions of people with autism without knowing their diagnosis – they rate them as less approachable and more uncomfortable than neurotypical people – or to see them as misleading.
But aren’t social difficulties a core characteristic of autism?
Yes, there is ample evidence that people with autism differ in several social areas from those without the condition, such as: B. Facial expressions, language patterns, and moment (although the last performance may be shaky).
However, a number of studies also show that the social and communicative problems of autistic people are not apparent when interacting with other people with autism. For example, in the “phone” game, where a message is passed from one person to the next in a whisper, chains of eight autistic people keep the message as good as groups of eight non-autistic people. Only in mixed groups of autistic and non-autistic people does the message quickly subside.
There are other signs that people on the spectrum connect well with one another. Autistic people report that they feel more comfortable with other autistic people than with non-autistic people. Many teens with autism prefer interacting with autistic peers over non-autistic ones. And people with autism often develop a greater sense of connectedness and share more about themselves when talking to others on the spectrum. One reason for this pattern could be that autistic people are less concerned with typical social norms such as reciprocity in conversation and therefore do not mind as much if these rules are not followed.
The principle of social acceptability can be extended beyond diagnoses of autism to include characteristics of autism. For example, the more similar two non-autistic people rate each other in an autism characteristic assessment, the more likely they are to rate their friendship.
So how does this theory fit into current thinking about autism?
The problem of double empathy contradicts several popular ideas about people with autism, namely that their social difficulties are inherent, says Milton. For example, one of the most important diagnostic criteria for autism, as described in the Diagnostic and Statistical Manual for Mental Disorders, is “persistent deficits in social communication and social interaction in multiple contexts”. Similarly, the social motivation theory of autism assumes that people with autism have a decreased drive to social interaction.
But the new theory isn’t necessarily inconsistent with these ideas, says Simon Baron-Cohen, professor of developmental psychopathology at the University of Cambridge in the UK about the way autistic people deviate from the norm.
Are autism researchers changing their approach to the problem of double empathy?
Some are. For example, scientists are rethinking how they examine social skills and are calling for a revision of autism studies to assess the strengths, not the limits, of autistic communication. Researchers are also finding ways to study the dynamics of social interactions rather than the isolated behavior of people lying in a brain scanner or sitting at a computer, says Noah Sasson, associate professor of behavioral and brain sciences at the University of Texas at Dallas . “I was a little jaded doing the same face processing and eye tracking studies that really didn’t tell us much,” he says.
Additionally, researchers studying predictive coding – the way people build internal models of the outside world – are studying how a discrepancy in people’s predictions could hinder their interactions. For example, if an autistic person’s expectations about the course of a conversation differ from those of a non-autistic person, their interaction can stall.
However, not everyone is convinced or even aware of the theory, says Lerner. Some questions at the core of the theory remain unanswered, he says. For example, researchers are still discovering why communication goes more smoothly when people with autism interact with each other than when they interact with non-autistic people. And much of the evidence that exists for the theory is based on anecdotal reports and small studies.
If the theory works, what are its implications?
Not only can the double empathy problem open up new prospects for research, but it can also explain why some autism assessments and treatments are inadequate, Sasson says. For example, standard measures of social skills do not seem to predict how autistic people will fare in actual social interactions.
And therapies designed to teach autistic people normative social skills aren’t all that effective at helping them navigate real-world situations like forging friendships, studies suggest. “The emphasis is often only on changing the autistic person,” says Milton. Assessing the social situations around autistic people and finding ways to facilitate their unique communication style could be a more useful approach, he says.
Similarly, the double empathy problem underscores the importance of training programs – for doctors or law enforcement, for example – that help non-autistic people interact appropriately with autistic people.
The theory also points to possible causes of mental health problems in autistic people, suggested a team of researchers in an article published in January. Regular misperception can lead to loneliness and isolation. And trying to conform to social norms by suppressing who you are can be exhausting, say many experts.
Quote this article: https://doi.org/10.53053/MMNL2849
