Autism and empathy: What are the real links? - Sue Fletcher-Watson, Geoffrey Bird, 2020

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• The myth of an empathy deficit in autism is now so well ingrained, that for an autistic volunteer to report they do not lack empathy is either to question the views of the large majority of medical and scientific professionals, or even to deny their diagnosis.

• When these others are neurotypical individuals who often fail to recognise the emotional and mental states of autistic individuals (Edey et al., 2016; Sheppard, Pillai, Wong, Ropar, & Mitchell, 2016), it is clear to see how such measures may provide information which is of limited value.

• When assessed using this paradigm, a group of autistic individuals demonstrated typical empathy for pain (Bird et al., 2010).

• Alexithymia is distinct from autism – it is neither necessary nor sufficient for an autism diagnosis, and there are autistic individuals without alexithymia and alexithymic individuals without autism – but alexithymia is much more prevalent in autistic (and other neurodivergent) people than in the neurotypical population.

• New evidence suggests that autism is associated with atypical theory of mind but not empathy, while alexithymia is associated with atypical empathy but not theory of mind (Brewer, Happé, Cook, & Bird, 2015).

• The second key development is a new focus on the out-group status of autistic people in relation to the non-autistic majority. A growing body of research finds that processes we have previously identified as ‘deficits’ in autism are in fact better understood as interactive and communication challenges that operate in both directions across the autistic/non-autistic divide.

• Very recent research shows that when we examine the interactions of two autistic people, we see higher rapport than for autistic/non-autistic pairs, both as rated by people in the interaction, and by naïve observers (Crompton, Fletcher-Watson, & Ropar, 2019)

• In some literature, lack of empathy has been used to link autism with terrorism (Palermo, 2013),

• Even worse, we might legitimately make an association between violations of the human rights of autistic people in residential care services (tragically frequent) and the use of language that dehumanises them – which includes labelling autistic people as lacking empathy, and (a short step) even lacking feelings all together

• there are also many theories about autism, including the notion that autistics lack empathy . . . When you have sensory dysfunction, you are overly tuned to the environment, which includes all the emotions of the people you are interacting with – even the unspoken emotions on their part. The result can be an emotional roller-coaster ride for me as I try to deal with all this bombardment of information in addition to their words. Neurotypical people may assume that we autistics are incapable of empathy, when in fact, we just happen to express it differently. Reactions by way of our facial expressions and body language may not match what society is used to and expects.1