People with Autism Can Read Emotions, Feel Empathy

There is a persistent stereotype 
that people with autism are individuals who lack empathy 
and cannot understand emotion. 
It’s true that many people with 
autism don’t show emotion in ways that people without the condition would recognize.
But the notion that people with 
autism generally lack empathy and cannot recognize feelings is wrong.
Holding such a view can distort our perception of these individuals and 
possibly delay effective treatments.
We became skeptical of this notion several years ago. In the course of our studies of social and emotional skills, some of our research volunteers with autism and their families mentioned to us that people with autism do display empathy.
Many of these individuals said they experience typical, or even excessive, empathy at times. One of our volunteers, for example, described in detail 
his intense empathic reaction to his sister’s distress at a family funeral.
Yet some of our volunteers with autism agreed that emotions and empathy 
are difficult for them. We were not willing to brush off this discrepancy with 
the ever-ready explanation that people with autism differ from one another. 
We wanted to explain the difference, rather than just recognize it.
So we looked into the overlap between autism and alexithymia, a condition defined by a difficulty understanding and identifying one’s own emotions. 
People with high levels of alexithymia (which we assess with questionnaires) might suspect they are experiencing an emotion, but are unsure which 
emotion it is. They could be sad, angry, anxious or maybe just overheated. About 10 percent of the population at large — and about 50 percent of 
people with autism — has alexithymia.
IGNORANCE OF ANGER
It’s tempting to think that having autism somehow causes alexithymia, 
but it’s worth remembering that you can have autism without alexithymia 
and vice versa. Also, even though there are higher rates of alexithymia in people with autism, there are equally high rates in people with eating 
disorders, depression, substance abuse, schizophrenia and many other psychiatric and neurological conditions.
So can alexithymia explain why some individuals with autism have 
difficulties with emotions and some don’t? 
Perhaps it is alexithymia, not autism, that caused the emotional difficulties 
we heard about from some of our participants, the difficulties that people 
often assume happen in everybody with autism.
To find out, we measured empathy for another’s pain in four groups 
of people: 
individuals with autism and alexithymia; 
individuals with autism but not alexithymia; 
individuals with alexithymia but not autism; 
and individuals with neither autism nor alexithymia.
We found that individuals with autism but not alexithymia show typical 
levels of empathy, whereas people with alexithymia (regardless of whether 
they have autism) are less empathic. So autism is not associated with a lack 
of empathy, but alexithymia is.
People with alexithymia may still care about others’ feelings, however. 
The inability to recognize and understand anger might make it difficult to respond empathically to anger specifically.But alexithymic individuals know 
that anger is a negative state and are affected by others being in this state. 
In fact, in a separate test we conducted last year, people with alexithymia showed more distress in response to witnessing others’ pain than did 
individuals without alexithymia.
FACING FEELINGS
Autism is associated with other emotional difficulties, such as recognizing another person’s emotions. Although this trait is almost universally accepted 
as being part of autism, there’s little scientific evidence to back up this notion.
In 2013, we tested the ability of people with alexithymia, autism, both conditions or neither to recognize emotions from facial expressions. Again, 
we found that alexithymia is associated with problems in emotion recognition, but autism is not. In a 2012 study, researchers at Goldsmiths, University of London found exactly the same results when they tested emotion recognition using voices rather than faces.
Recognizing an emotion in a face depends in part on information from the 
eyes and mouth. People with autism often avoid looking into other people’s eyes, which could contribute to their difficulty detecting emotions.
But again, we wanted to know: Which is driving gaze avoidance — autism 
or alexithymia? We showed movies to the same four groups described above and used eye-tracking technology to determine what each person was looking 
at in the movie.
We found that people with autism, whether with or without alexithymia, 
spend less time looking at faces than do people without autism. But when individuals who have autism but not alexithymia look at faces, they scan the eyes and mouth in a pattern similar to those without autism.
By contrast, people with alexithymia, regardless of their autism status, 
look at faces for a typical amount of time, but show altered patterns of 
scanning the eyes and mouth. This altered pattern might underlie their difficulties with emotion recognition. (People who have autism or alexithymia and would like to participate in our studies can click here for details.)
EMOTIONAL RESCUE
We think these results, and the others we have found since, disprove the theory that autism impairs emotion recognition. If people assume that 
someone with autism lacks empathy, they will be wrong about half the time (because only half of individuals with autism have alexithymia). Making this assumption is unfair and can be hurtful.
What’s more, our work demonstrates that we urgently need tools to help individuals who have both autism and alexithymia understand their own 
and other people’s emotions. Meanwhile, people with autism who don’t 
have alexithymia might focus on building on their emotional strengths to mitigate the social difficulties associated with the condition.
At the same time, alexithymia doesn’t preclude acting in a prosocial and 
moral fashion. Indeed, one of our studies shows exactly this in individuals 
with autism. Although people who have alexithymia but not autism find it acceptable to say hurtful things to others, people who have both autism 
and alexithymia do not. We think people with autism use other information (such as social rules) to decide whether what they say will be hurtful, rather than relying on their understanding of emotions.
We recommend that researchers test some of the basic assumptions about 
the capabilities of people with autism. Importantly, they should try to 
separate the impact of autism from that of conditions such as alexithymia 
that frequently accompany it.
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This article is reproduced with permission from spectrumnews.org. 
The article was first published on July 12, 2016. 
~
Rebecca Brewer
Lecturer, University of East London
https://www.scientificamerican.com/article/people-with-autism-can-read-emotions-feel-empathy1/