Maia Szalavitz on Empathy

Originally posted on our collaborative site, Ourblook.

OurBlook interview with Maia Szalavitz, co-author of the new book “Born for Love: Why Empathy is Essential — And Endangered”

How do you define empathy, and what new scientific findings have emerged about it?

MS: Empathy is the ability to put yourself in someone else’s shoes and care what it’s like to be there. It has at least two distinct parts. The first is what can be called “cognitive empathy” or “theory of mind.” This is basically understanding that there are other minds out there, they have different perspectives from yours and that by projecting yourself mentally into their heads, you can usually get a sense of what they might feel or want. This is the part that often causes problems for people with autism.

The other piece is the caring aspect or “emotional empathy.” This is feeling the feelings of others and wanting to help. Autistic people are actually frequently very sensitive to emotion and some seem to suffer from being overwhelmed by emotional empathy … not from having a lack of it.

The people who truly lack emotional empathy are sociopaths. They actually have a surfeit of cognitive empathy … they can easily consider other people’s perspectives but they use this information to manipulate them, not to help.

There are literally thousands of new scientific findings on empathy that have emerged over the last decade or so … social neuroscience is one of the hottest areas of research and empathy is at the center of social connection. One of the most important is the discovery of “mirror neurons” that respond by simulating someone else’s actions when you watch them. For example, if I smile at you, neurons in your brain that fire when you smile will start firing and will even stimulate the muscles involved in smiling slightly even if you don’t reciprocate. Your brain is giving you a hint that I’m happy by running a model of what happens to you when you smile … and this obviously prompts a tendency to reciprocate.

Such neurons provide an obvious explanation for the inclination we have to emotional contagion and for the basis of the ability to understand other minds. There are some controversies over the specifics, but the idea has great explanatory power and there are lots of reasons to believe some kind of system like this exists.

How can we tell when we have too much empathy for a person or situation, too little or the appropriate amount?

MS: Too much empathy can result in something called “empathic over-arousal” where you get so distressed by someone else’s pain that you run away or distract yourself rather than help. So, that’s something that can cause problems.

The right level of empathy, of course, also depends greatly on the situation. Doctors need to shut off empathy for pain … there was a recent study showing this with brain imaging … in order to function in the hospital. They aren’t going to be able to help you if they are sitting around worrying about how much pain you’ll feel when you wake up from surgery. When they ignore their own family’s distress, however, that’s not so good. But this shutdown of empathy is so common in professions like medicine and law enforcement that the insensitive doctor and the cop who can’t maintain relationships have become cliches.

While empathy presumably would apply to all ages, is it of particular concern for children?

MS: Empathy is an innate capacity in most humans but it relies on certain environmental triggers in order to develop properly, just like language. If a baby never hears any words spoken to him, he’s not going to learn to speak and if the situation isn’t remedied rapidly, his ability to use language can be impaired for life. Similarly, if a child doesn’t receive enough nurture early in life, she’s not going to learn to take pleasure in connecting to other people and therefore she won’t share others’ pain, either.

This is why so many children adopted from orphanages have difficulties with bonding with their new parents and have other kinds of delays and behavior problems. A baby can’t get enough nurture being parented by an institution … he needs to be beloved to at least one person.

And as with language, if enough nurture isn’t received during these early life “sensitive periods,” lifelong impairment can result. Though thankfully most children are resilient, virtually all of those who commit the most violent and heartless crimes have suffered abuse and neglect early in life and early life trauma increases risk for every mental illness and behavior problem that has been studied.

Communication in our society used to be done face to face verbally or in handwritten notes. Now there are many methods such as e-mail and various social media venues. How does that affect empathy?

MS: There are pros and cons. For the littlest children … infants and toddlers … screen time is clearly detrimental and when it substitutes for face-to-face time, cannot provide the nurture needed for the development of empathy. But please don’t interpret this in a way to make parents crazy … a little TV time isn’t going to hurt and parents need a break, too. The problem comes when little children are parked in front of a screen for hours day after day, rather than playing with adults or other kids. In the book, in fact, we tell the story of one little boy who spent most of his early life in front of a TV … most of his vocabulary came from ads. Not good.

In terms of social media, they are a positive force when they enhance our connections to people … and a negative force when they substitute for them. A kid who has no friends at school because he’s geeky but has friends online is better off than a kid who has no friends, period. But we do need face to face interaction and the younger the child, the more important it is to provide unstructured free play with others. A decline in unstructured social time the way we’re seeing now in many middle class kids may not leave them enough time to truly develop social skills.

Some psychologists have said that words are only a part of communication … that factors such as body language also play a major role. How does that affect empathy if at all?

MS: We learn empathy first through touch. In fact, babies can actually die if they aren’t held or cuddled enough … loving touch is needed to stimulate the production of growth hormone to keep them alive. And, before we can understand words, we understand tone of voice. One reason that online life is a poor substitute for in-person contact is the lack of ability to touch, read tone of voice in text and really see the richness of body language. So, all of that nonverbal stuff is essential for the early development of empathy and for ongoing social connection.

In your new book, you say empathy can affect not only emotional health but physical health. Can you tell us about that?

MS: Social connection … which relies on empathy … is the way we first learn to cope with stress and it is important for stress relief throughout life. Every time a parent soothes a baby, the baby is learning to connect other people with pleasure and stress relief. A new study just out showed how simply hearing their mother’s voices on the phone reduced the levels of stress hormones in young girls. Even elderly people show lowered blood pressure holding their mother’s hands.

Now, mild-moderate stress is good for us … we can’t learn without it. But excessive, chronic stress that comes from things like abuse, trauma, deprivation can change the settings in the stress systems early in life and overrun the brain with stress hormones. Chronic high levels of stress can produce high blood pressure, cardiovascular disease, depression … lots of major killers. Add to this the self-medication with cigarettes, food, and drugs that often comes with stress and you’ve got a great deal of mortality risk.

With strong social connections, however, stress is relieved and overly high stress hormone levels reduced. So through empathy, through caring, we actually mitigate the effects of chronic stress and this is why people who are kinder, who have more and higher quality relationships are healthier and live longer.

You also contend that empathy can have an impact on social and political problems such as the economic recession and even war. Can you tell us about that?

MS: This works through the mechanisms described above that relate stress relief to empathy and connection. For example, one of the hormones thought to be critical in the mother/child bond and in the healing qualities of empathy is oxytocin. As with mirror neurons, there’s lots of overly simplistic oxytocin hype.

However, studies show that oxytocin is not only linked with bonding but with trust in others. Research also finds that oxytocin levels are affected by early childhood nurturing or lack thereof. And there’s lots of economic research connecting high levels of trust in a society to economic growth. This makes sense when you think about it: if you can’t trust people, you need all kinds of mechanisms like police and lawyers and locks and this taxes all your transactions. If you have high trust and can do a deal with a handshake, however, your economy will work much better. Of course, too much trust can be a problem, too … but that’s not the one we face now.

With regard to war, the obvious connection is that war requires the suppression of empathy for the enemy and this is what boot camp and other military training is designed to do (incidentally, this is part of why boot camps are not a good idea for reforming criminals!). But the more subtle connection is that war and other catastrophes can create high levels of stress in a society and this can produce a vicious cycle in which parents are too stressed to nurture their children effectively and these children grow up less empathetic and more warlike and on it goes. There are much more complicated and varied factors involved as well … but it is undeniable that high stress reduces empathy and that this can be passed from parent to child.

Is there anything else you would like to say about empathy or any other issue in your book?

MS: I think this gives a pretty good overview … but I will say that once you start thinking about empathy and its connections to stress and how it works in the brain, you start seeing how these links affect many, many aspects of life and it provokes a lot of interesting thought.

Maia is a senior fellow with and a journalist who covers health, science and public policy. Her book is published by William Morrow/HarperCollins. The co-author, Dr. Bruce Perry, is a leading child trauma expert. She also wrote “Help at Any Cost: How the Troubled-Teen Industry Cons Parents and Hurts Kids” (Riverhead, 2006), which led to state investigations into the industry as well as federal legislation. She has written for the New York Times, Washington Post, Newsday, New York Magazine, New Scientist, Newsweek, Elle, Salon, Redbook and other major publications. She has also worked in television, including as a producer for PBS’ Charlie Rose.

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