Getting Real About Empathy – Part 2 of 5: Critical Roles and Contributions of the Less Empathetic

A guest post by L. P. Here are links to part 1part 3, part 4, and part 5.

Various affective and cognitive empathy levels can be adaptive or maladapative depending on the context. Psychologist Simon Baron-Cohen demonstrates this in his model of empathy which assigns a value to each type of empathy on a scale of 0 (least) to 6 (most) with a “positive” or “negative” tag. However, these values signify positions on a continuous spectrum (serving to facilitate communication regarding individuals’ position on the spectrum), so individuals can fall between these discrete values. Based on Carole Jahme’s review of Baron-Cohen’s Zero Degrees of Empathy*:

Narcissists, borderline and psychopathic personalities are introduced as people lacking “affective empathy” – the ability to feel others’ feelings. Baron-Cohen’s new paradigm classifies these personality types as “zero-negative”: a zero amount of affective empathy being a negative condition, because the ability to self-regulate the way they treat others is significantly compromised.

By contrast, Baron-Cohen defines people with Asperger’s syndrome or classic autism, which is his own field, as “zero-positive”. Like the zero-negatives these people lack affective empathy, but in addition they score zero on “cognitive empathy” – thinking others’ thoughts.

Because some zero-positive individuals have, through their unusual ability to systemise, pushed human culture forwards with their discoveries (Einstein was late to talk – a sign of classic autism – yet he was an extreme systemiser who discovered E = mc2), Baron-Cohen categorises them “zero empathy positive”.

Although the examples above pertain to individuals who have a disorder or disability, the balance between affective and cognitive empathy varies among people without dysfunctions as well. See “The balance between feeling and knowing: affective and cognitive empathy are reflected in the brain’s intrinsic functional dynamics,” Social Cognitive and Affective Neuroscience Vol. 7, No. 6 (2012).

Returning to theexample of doctors, with which I ended part 1, zero affective empathy can be a positive condition as doctors and surgeons are able to perform their jobs best without affective empathy’s self-regulation. Hence, those who do well in these occupations tend either to have low affective empathy or to engage in regulatory tactics that shut off affective empathy as needed (e.g., talking themselves out of experiencing the emotional contagion). As there have been calls to rectify various medical professionals’ poor bedside manner, it’s important to note that even those who’re supportive of increasing doctors’ and surgeons’ capacity for empathy have called for restraint in this endeavor. In “Is the Quest to Build a Kinder, Gentler Surgeon Misguided?,” Wen Shen writes:

WE WANT IT ALL: brilliant technical surgeons with outstanding interpersonal skills. In trying to shape our trainees to be all things to everyone, however, we run the risk of creating a workforce caught somewhere in the middle, not doing anything well.

In “Why Doctors Should Be More Empathetic–But Not Too Much More,” Omar Sultan Haque and Adam Waytz add:

The job of any physician is therefore part empathic and part problem solving. This constitutes an inherent trade-off in medicine because the human brain does not have infinite computational resources or time to perform both tasks equally well. One must be caring while also figuring out a proper diagnosis, prognosis and treatment, often under conditions of uncertainty.

Just as only using one’s cognitive problem-solving skills would not necessarily lead to the best outcomes for patients, only employing one’s empathic and emotional skills doesn’t lead to the best outcomes, either. Empathy is not an inherent good in medical care, but a relative one. As with deliberative reflection and abstraction, empathy is also useful only in certain degrees and in certain contexts, but can be unproductive or destructive in others.

It is the interaction of context and empathy, rather than the inherent empathy surpluses or deficits by themselves, that determines whether the composition of context and empathy is positive or negative. This means that even a surplus of both affective and cognitive empathy, which Baron-Cohen would assign the value of 6, has the potential for negative outcomes. For example, one popular but wrong assumption is that psychopaths are unempathetic. This is inaccurate because, in order to be able to manipulate, one needs to understand other people very well. In fact, the consensus in psychopathology research is that psychopaths have strong cognitive empathy. Further, it’s not uncommon for them to have affective empathy as well. However, they are able to turn it on and off at will (see footnote). Carole Jahme mentions another negative manifestation:

A second book about altruism is due to be published later this year: Pathological Altruism, edited by Barbara Oakley et al. It’s a collection of essays focusing on the downside of empathy-fuelled altruism, and Baron-Cohen has contributed a chapter on the extreme female brain. This personality type is a candidate for maladaptive altruism because the more empathic one is the more the needs of others are prioritised over the needs of self.

What’s being described is a “6-negative” or “six empathy negative” which manifests itself in the type of dysfunctional helping described in this post. The fact that empathy can have negative as well as positive consequence should spur a number of interesting questions. For example: Which individual do you view more favorably, a zero-positive or a six-negative? How about a zero-negative and a six-negative? A zero-positive and a six-positive?

Returning to the aims of Sáez et al., it appears likely that increasing people’s sensitivity to social inequality and eliciting support for dividing resources equally has undesirable side effects. Disturbingly, however, I have yet to see such pro-empathy articles explore and discuss the potential downsides of inducing more empathy and compassionate action.  Again, these include increasing dysfunctional helping behavior in some individuals as well as negatively impacting the work of gifted zero-positive individuals, medical professionals, and others. Unfortunately, when balanced discussion is missing, I’ve found that people generally jump onto the pro-empathy bandwagon without thinking about the potential costs.

What else can go wrong if people’s empathy is amplified? In Part 3, I illustrate how empathy and compassion don’t necessarily translate into sound morals and, further, how empathy can spur unjustified aggressive acts.

Recap: Empathy isn’t all-or-nothing; there are degrees of it, both positive and negative. Further, it has both positive and negative effects. And it is just one personality trait among many personality traits that help to determine a person’s contributions to society.

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*While Simon Baron-Cohen is a recognized expert on autism, other prevalent cognitive and affective empathy patterns have been found for those with Borderline Personality Disorder, Autism, Asperger’s, and psychopathy. Specifically, others assert that individuals with Borderline Personality Disorder have affective empathy but not cognitive empathy. Rather than being low on both, those with Autism or Asperger’s have also been found to have affective empathy.

Meanwhile, psychopaths can either have cognitive empathy but not affective empathy or have both but are able to consciously regulate their own affective empathy. According to the LiveScience article, “Coldhearted Psychopaths Feel Empathy Too,” which summarizes a magnetic resonance imaging (MRI) study by neuroscientist Christian Keysers:

[W]hen the psychopaths were instructed to try to empathize while watching the videos, their brains showed the same level of activity in these brain areas as normal individuals.

“They seem to have a switch they can turn on and off that turns their empathy on and off depending on the situation,” Keysers told LiveScience.

The findings suggest psychopaths are, in fact, capable of empathy, if they consciously control it. This ability may explain why a psychopath can be charming in one instant, and brutal the next, the researchers say.

For more information on the information presented in this footnote, see the following articles:

Dissecting empathy: high levels of psychopathic and autistic traits are characterized by difficulties in different social information processing domains,” Frontiers in Human Neuroscience Vol. 7, Article 1 (2013).

Response to Smith’s Letter to the Editor ‘Emotional Empathy in Autism Spectrum Conditions: Weak, Intact, or Heightened?‘” J Autism Dev Disord Vol. 39, No. 12 (2009)

The balance between feeling and knowing: affective and cognitive empathy are reflected in the brain’s intrinsic functional dynamics,” Social Cognitive and Affective Neuroscience Vol. 7, No. 6 (2012)

Two systems for empathy: a double dissociation between emotional and cognitive empathy in inferior frontal gyrus versus ventromedial prefrontal lesions,” Brain Vol. 132, No. 3 (2009)

Who cares? Revisiting empathy in Asperger syndrome,” J Autism Dev Disord Vol. 37, No. 4 (2007)