Thursday, June 7, 2012

The Hidden Autistics II: Asperger's in Adults and Empathy

A regular occurrence during sessions in my practice is my encountering of what I call "autistic empathy".

An oxymoron, you say?  I don't think so.  In fact, this happens so often during sessions that I've begun to think of Asperger's as a disorder often characterized by too much empathy, not a lack thereof.

Before I get started on this idea - one I expect will be viewed with skepticism, at best - let me describe what happened during one such session, one that illustrates my point.

My client - let's call him "Giles" - and I were discussing the use of gaming as a self-soothing tool, one that may solve for otherwise overwhelming emotional states.  Giles used few tools of escape, and we both agreed that his immersion in the world of online gaming came with a price.

At some point we compared his gaming to other self-soothing tools, and I mentioned my tool of choice: doughnuts. In response, Giles began to make a case for the harmlessness of doughnut overuse.  After a couple of minutes straight of his explaining why I should not feel guilty about my doughnut habit, I realized he was concerned I might have grown embarrassed.

I stopped him.  Could this be right?  Indeed, it was.  Giles, this adult with Asperger's, had sensed I was embarrassed, and was doing his best to make me comfortable.  There was no other way to explain it: this was empathy.

In fact, many clients have demonstrated the same level of empathy in myriad ways during sessions.  I see it when they tear-up describing their pet's pain.  I see it in their silent withdrawal when a parent is unfairly raging.  I see it in their pull towards social justice.  I see it in Asperger's men's groups, during which they are gentle and supportive of each other in ways that violate male social norms.

In fact I often wonder if the withdrawal adults on the spectrum resort to is emotionally necessary.  If they feel others' pain acutely, and on top of that often lack the social skills to offer "appropriate" comfort, what are they to do?  Withdrawal and distancing become more than relating styles: they become necessary tools for self-preservation.

Picture the plight of the teenager on the spectrum who comes home after school to find parents who are quietly angry at each other.  Because he is sensitive, he knows something is wrong.  His body is on alert, and he wants to help.  Because he is empathic, he would like to offer comfort.  However, because he is bright and learns from patterns, he knows that historically he has said the "wrong" thing in these situations, which has made things worse.  He determines, quite logically, that the best thing he can do is go to his room and put on an audiobook.  Both parents notice this, and note how little he appears to care about anyone but himself.

Adults on the spectrum often over-empathize.  To feel deeply, and fail miserably when they try to offer comfort, causes more injury than can be tolerated.  Retreating offers solace.  And confirms their image as non-empathic.

"Autistic empathy" is a powerful experience, and leaves the adult with no way to manage the strong emotions of others, which resonate so deeply in him.  Our job in relating to them is to look past the veneer of calm or indifference with quiet curiosity, to resist the outrage we feel when someone displays so little outward reaction.  Partners who do this are met with a rich world of sensitivity and attachment, the world they sense but cannot readily see.

35 comments:

Anonymous said...

You nailed it. This is me. I cannot tolerate how angry and upset people get and I do not know what to say to make it better. So I say the wrong thing and all that anger then gets directed at me. I cannot do anything but hide. You are right on with this, keep posting please. Todd

Anonymous said...

I actually just short-cut now to the hiding. I can't even stop long enough to realize how bad it is - I just withdraw. I would need to know it's worth it to feel all that pain. I feel like I have more empathy than most people, but I have nothing to show for it.

Anonymous said...

How is this a new idea? In Finland (btw diagnozed with asp) it actually seems to be the overall opinion of many professionals and nt's also.

Personally I can not take such situation where I "feel" sadness etc - as I do not have any other tools than my words which hardly ever are enough. I ended up in doing stand up -comedy to handle the angst from all the fuckedup situations where I could not stay.

I rarely meet people who think of me as a person who does not care.

It might be a cultural thing. It's more accepted to be silent and go away here. It is also seen in a somewhat positive light when I do this. People feel I give them room for their feelings.

But it's same for me too. Feelings first and actions later. If I try to do both I will most likely react in a way which is seen as a mistake by others.

I do not try to diminish the value of your blog. Read it before. Somehow it's weird as you seem like a real professional but I tend to think that what you are writing about could be done in just few chats with an aspie. Maybe I see these things easily.

Craig Hinder said...

Yes I think it is cultural too. In the US it would be seen as antisocial to leave a situation to attend to your own feelings. Sad but true. There's definitely an assumption that your behavior is a reflection of how you feel. So if you leave - well it's obvious the other person is not your priority. Definitely this way in canada too.

Anonymous said...

Should all aspies then move into Finland... We do get our share of trouble here too. As our drug policies are strict and alcohol is the go to drug for almost everyone I feel rather left out at parties etc.

Where could I find a similar culture than our in Finland but with more liberal drug laws?

Times I've tryed acids or exstacy have been fantastic. It is easy then to talk about the inner world I tend to go to when in larger social gatherings.

Ack!Tivity said...

Oh my goodness, I am totally bookmarking this post. This is what I can't seem to explain to people.

I *do* feel things, deeply, but don't know how to deal with them appropriately. It's easier to retreat than risk the rejection.

Thank you for this post.

Anonymous said...

Nailed it. Thx.

Anonymous said...

Consider Sweden, perhaps, or maybe Norway? I don't know how the Netherlands handles things, but I do know they're 420-friendly.

Tanya Suoranta said...

Finnish culture is an Asperger culture, and it's really hard to live so independently and privately if you grew up in a different culture... where feelings, ideas, hopes and serious probelms are shared with firiends and family and mayve even strangers!

D.J. Kirkby said...

Nice to read this post. My apparent empathy for my son baffles my son's psychologist because I am autistic therefore I shouldn't display empathy (apparently). Oh really? Allow me to disagree...I can do lots of things :)

Henric C. Jensen said...

YES!, this is exactly what it is all about - beautifully put!

Anonymous said...

This is exactly how I feel! It's not a case of little emotion or empathy, but too much. Thank you.

Anonymous said...

This nailed it for both me and my son. His teacher once complained that he seems to not care for his classmates, but I've found him sobbing over "Snoopy Come Home." I know he, and I, are both intensely empathetic, but it's hard for other people to see it the way we do. I have the hardest time with this at work, where I get overwhelmed by the emotions of my co-workers and my first action is to flee, which makes me look anti-social and mean.

Anonymous said...

I think one of the problems is that there are two (if not more) kinds of empathy, and people often conflate them. There's the feeling as another feels, and there's the responding in a way that shows that. But the two can occasionally be very disjoint.

For example, sociopaths lack the actual caring about people's feelings, but the good ones often nail the "doing all the appropriate responses to the situation". People on the autistic spectrum I believe are more often on the other side of the coin: They can often be fully aware of and sensitive to the emotions of others, but because they can't find the way to react properly, they're viewed as cold and not empathic.

I said two if not more, because I sometimes think it might be: 1) Recognizing outward signs of emotion in other people (something some people on the spectrum vary at and perhaps aren't always as great at), 2) Being able to 'put yourself in another person's shoes' (something they're better at, and possibly what happened in your doughnut example) and intuit how someone feels by a given situation, 3) actually CARING, feeling the pain as if it were happening to themselves (something they're generally really good at), and 4) responding in the appropriate way, whether it's actions or facial expression (another area they're not great at).

(Note: When I say 'they' to people on the autistic spectrum, I'm quite possibly referring to myself. I'm undiagnosed but a lot of this hidden autistic stuff resonates with me).

Anonymous said...

The Aspie experts have clearly sounded that aspies have empathy. You don't need to prove this as something novel. The experts have noted that their is often a misunderstanding related to: 1) ability to put one's self in another's shoes/mind blindness, and 2) emotional flooding. 1) re: mindblindness--you gave your client "Giles" the rule that your eating donuts was the same as him gaming. Thus, you did the hard work of mapping your experience to his. that's why he could build a case. Many attorney's are aspies and they have to build a case all the time. However, they're only good at familiar cases. 2) aspies are often overly sensitive--sensories and emotions. Thus, if a dog gets hit by a car, the aspie might inappropriately fall apart in the street whereas the NT person can feel saddened and work through the sadness of the experience without falling apart/making a scene.

Anonymous said...

You are the best writer on Aspergers experiences! This is just a great post about empathy. I have had a lot of experience with growing up in a volatile household. I was always accused of being selfish because I was overwhelmed. Now I understand what was happening. Thank you. Ashley

Rose Garden Romantic said...

As a mama to two Aspie boys, ages 10 and 8, I know from experience that this is true.

Lori Petro, TEACH through Love said...

Yes! Absolutely true. Extreme empathy has always been my experience - sometimes, I actually feel tingling/pain/sensations in my body when just hearing/thinking or looking at someone else's "pain."

I also had no idea about my Aspergers (until I was 38 ) because of the characterization of how people on the spectrum think, feel and why they act the way they do (and I'm female).

I scored a 68/69 on the Simon Baron Cohen test - extreme systemizing AND extreme empathy. My dad also has Aspergers - and many would claim he is without empathy, I am sure, but I know just how sensitive he really is.

It is amazing to me how often this myth is perpetuated by the NT community who make gross assumptions about behavior they don't understand. Thanks for adding another voice to the truth about AS!

Lori Petro, TEACH through Love said...

** oops that should have been "mis-characterization" of people on the spectrum...

Anonymous said...

Spot on! What an acute observation. Thank you for posting.

Anonymous said...

You are defining me in so many of the particulars that you mention. I often find my therapists and doctors, and family and friends dismissing my behavior with a wave of a hand, and their conclusion is that I don't care because I have a lack of empathy. It has been to the point of family doctors and so many more believing I don't feel. I've become quiet and depressed with no one realizing that just because I can't express my feelings doesn't mean they don't exist, and because of my diagnosis, don't believe when I tell them different as I don't say it with conviction, which cycles back to what my condition actually is.

Anonymous said...

maybe i have mild aspergers. my lack of empathy is extreme. it's hard to think of a time when i considered another person outside myself.

Anonymous said...

You got this absolutely right, I think.
From Delaware

Seven5tx said...

I was diagnosed at age 58 this past summer, June 2012. It has been a ride. I have alot of empathy. The unkindness in the world really bothers me. I don't understand. My desk at work changed and I now am next to a passive agressive male freak who is one of the most rude and mean people I have ever met.

This whole thing has been overwhelming. It seems that there is so little available. If I dressed up like a teddy bear for sex, or quilted, or scrap booked. But nothing for adult aspies to just hang out and talk to each other.

Whats up with that. I am in Houston!!! One of the largest cities in the USA

Anonymous said...

You just described me in a nutshell, as someone who thinks I'm probably autistic - not one of your 'hidden autistics,' though one who hasn't been diagnosed yet because my child psychologist felt labels were harmful.

When someone`s upset, I feel their upset acutely. But I can`t put a finger on the name of the emotion in question (I can`t identify my emotions, let alone someone else`s!). I just know they`re upset and it hurts me.

So because I can`t figure out how they`re upset, I usually sit there awkwardly trying desperately not to say the wrong thing that will make it worse. And when I try to say something, usually, I do say the wrong thing and that makes me feel even worse because I just added to their pain. So, they`re in pain and I want to help, but because my helping usually isn`t helpful in my experience, I`m terrified, and because I`m terrified, I can`t think straight or handle my emotions, and because of that, I can`t figure out their emotions, and because of that, I usually screw up if I try to help.

And I don't want to screw up because, as I said above, hurting other people makes me feel horrible. So, I usually stand there awkwardly or call someone I know who`s better at comforting and then beat a hasty retreat. Not because I don`t care, but because I do and don`t want to give the person more pain.

Anonymous said...

Thanks for this and all your posts! It is reassuring to read that there is a reason for so many of my Aspie quirks.
I think I am incredibly empathic and I have always been confused by the general assertion that Aspies lack empathy. I just lack the tools to act on it. Usually the stock responses in my reportoir come across as disingenuous and not personal enough. In addition, the body and eye contact that may be required are a terrifying prospect.

1branchonthevine said...

I score fairly high with Aspergers, and yes I would have to agree with this observation on so many levels. In fact, to add to it.. I have realized this is in part why I hate public speaking and being in large groups. I feel that I can clearly "feel" emotions around me. If one person in a group is frustrated, sad, angry etc. they become a like a light tower blinding my mind and I get so overwhelmed. Now imagin a whole group of blinding lightowers, I'm sertainly not going to be looking into their eyes when it's my turn to reply, now am I? When I'm at home with my wife, and if she's upset, I can't concentrate, or move on until we discuss what the issue is. Often this makes things worse, but without discussion, I have no little way of knowing what is the desired/appropriate way to comfort her. When people are grieving over an illness or death, my response is a change of topic or a distraction or a joke relating to the situation; since this is how I deal with things. I find comfort in detaching myself from the situation or loved one and trying to move on as quickly as I can, but apperently this seems cold and isn't what most people do. Yes, I would likely be that worthless friend that keeps running when you trip while being chased by zombies! It's not that I don't care, I just lack an ingrained knowledge of social responsibility, socially acceptable empathy, and healthy coping mechanisms.

Anonymous said...

You wrote: "our job is to look past the veneer of calm or indifference with quiet curiosity, to resist the outrage we feel when someone displays so little outward reaction".

"Outrage" is not the only thing "others" experience in this situation; some see their advantage, and use it.

They will correctly identify behind the veneer, perhaps through repetition of pattern, an inability to react appropriately, a tendency not to react, an inclination to refuse engaging in conflict, and aggressively they will take full advantage of that.

I was recently insulted by a colleague, also a subordinate, and one who resents being assigned to work in my team. His words were so injurious that, with witness, they would have landed him in court. There were no witnesses.

However, the impact on me was big and lasting, not so much because of the words spoken, but because I felt hugely diminished by my inability to return fire in any way whatsoever, and to assert control of the situation. Indeed, all I could attempt to do was to steady my own emotional ship and outwardly display an eerie sort of calm, totally out of step with the situation.

The person concerned knew that he had achieved more than just prevailing in a spat; he correctly detected that as long as he made sure such ugly scenes were kept private, then he would win every time, and he could, and does, use extreme verbal aggression to set his own terms in the working environment.

For my part, deconstructing the pattern does not help: there is still little I can do about it in the heat of the moment, and the only thing achieved by thinking about it logically and rationally for ever afterwards is that it keeps the experience, and the recollection of the experience, permanently high in the stress scale. (That is, every time I walk past his office).

Anger management only helps to manage the toxicity of after-the-event; it does nothing to enhance "useful responsiveness" to the event as it happens.

And a discreet plea to my line manager that "I don't do conflict" is not heard, because it's not a male thing to say and, from his point of view, managing is all about conflict (but perhaps not conflict resolution).

John McGuinness said...

That is a good point.

Those in relationships with those on the spectrum likely soon realize that they can tolerate a greater level of emotional heat than their AS "adversary."

So, if one wishes to prevail in a disagreement, one can keep turning up the heat until the person on the spectrum can no longer stand it and abandons his position.

This obviously has long-term effects on the relationship. But sometimes your don't care. Or the NT person can say that the problems are due to the spectrum disorder.

JC John Sese Cuneta said...

Personally, I define what you explained the same way. The "empathy" the society defines and the asperger empathy.


Being an Asie myself, I know that we are not devoid of emotions, empathy included. Many of us I believe can easily put ourselves in someone else's shoes if we want to and experience them in ways an NT will never be able to. However, by society's definition, the way we express that emotion and thought is far too different.


For example, should I tell a friend in pain, say physical pain, "okay Ill stop, I know it is painful" or should I say "of course it is painful, what do you expect"? I go with the latter.

The same with emotional pain. I tell my friends bluntly why deserve that pain. No sweet words. Straight to the point!

To the society, that is lack of empathy, but for us, we know full well the pain but why coat it with sweet nothings barring the person's growth?

When my doctor told me before my operation for appendicitis, he kept telling me it is okay, it is not painful, blah blah. Society tells us that is empathy. For me, that is a complete nonsense. I want to tell him I am not stupid and to not take me for someone stupid. I even want to tell him to not put me to sleep. Lolz, they have to inxrease the dosage because I was strongly fighting the sleep haha, the doctors even got angry. I want to see myself get operated for experience sake!

We may react differently but it does not mean we are Vulcans. Heck, even Vulcans admit they have strong emotions, they just learned to control it in favour of logic.
We are no different. We prefer logic above all else. We see patterns. We analyze things. We see things NT people do not see because we can traverse the web of thoughts more effectively than NTs, becayse that is how our brains function.

Caroline said...

Hello! I'm French and this is my first time here! I just read a translation of that article on facebook! Such a great article!!
I recently went through a diagnosis process with a psychiatrist and neuropsychologist in an autism diagnosis center for adults, here in France, and they ended up telling me I can't be an aspie because I'm able to show empathy among other things such as I'm able to write fictions or show sensitivty, change jobs or have a "normal" conversation... It's quite pathetic actually (and upsetting!).
Another neuropsychologist (a woman) who seems to be more "modern" in her view of the AS keeps telling me she's sure I'm on the spectrum but she's not the one who can give an "official" diagnosis and she doesn't seem to know any other psychiatrist who could diagnose me!...
Please try to spread the word to your colleagues around here if you ever get the chance! Such a large part of France is still so much trapped in middle ages!!!

Bryce said...

I agree completely with the theory that Autistic people are highly empathetic. That is me. So sometimes we withdraw to spare ourseves the pain...of someone elses pain, other times we don't know what to do about it. To add a new reason though to the discussion, sometimes I detect someone elses pain and come to the conclusion that there is absolutely nothing I can do. Oftentimes within the social norms of our society people publicly display empathy to look like they care, not to actually help the hurting person in any way. Sometimes people want to be left alone rather than "comforted" especially if the person that is trying to comfort them is just a ham that wants to feel good about themselves. Sometimes people have to cry alone. Sometimes elderly people don't want you to hold doors for them and give them chairs, because its basically a way of saying you're old. I am pretty good at intuitively sensing that and just letting an old person suffer in dignity, if that is what they want to do. I got hit by a car so I know about walking with aches and pains in dignity. Sometimes empathy is about what you don't do. People tend to talk about empathy in the negative, feeling others pain. But empathy is feeling the feelings of other including the good ones. Sometimes Autistic actually share in the joys of others without actually showing it. I can think of many people I care a lot about I have barely even talked too, but I feel happy for them and they make me feel happy. I suppose they might be totally unaware I consider them good friends.

Caprifool said...

Well, I can only say; Yes! And thank you for describing it so accurately.

Hanne-Kari Havik said...

YES. My experience With other aspergers, are that they are VERY empathetic. I think that we, as a Group, simply feels TOO much, and that it gets to be difficult to handle, because of that. I can, personally, be thouroughly BROKEN, actually, by feeling sympathy towards other People.

Anonymous said...

I have self tested as positive for Asoergers and self tested as very high in empathy. I know what you say is true. I was not liked when I worked but anyone who was in pain came to me for help. The same happened with their stuggle to make an ethical choice.
A sociopath married me and nearly destroyed my life. I rescued myself and my children because of empathy for my children otherwise I might have experienced death by suicide.
The only medical intervention was to tell me I was codependant.
I believe the answers are in learning about mirror neurons. There must be ways to test children early and teach them that it is very good to be the way they are. Aspergers children should be protected from bullying.