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1. Introduction:

Knowing someone’s pain, and feeling someone’s pain, on the surface, appear similar. However, they are drastically different psychological abilities, and can either enable an individual to dissolve social barriers, or to solidify them.

Empathy plays a key role among the psychological processes that are the basis for social perception and interaction. It is the neurological process which enables us to “dissolve the barriers between self and others” (Ramachandran 2006). Inadequacies in empathy can have significant consequences for social activity, and can result in disorders ranging from Autism Spectrum Disorders, to Clinical Psychopathy.

This paper will critically examine the extent to which empathy can be taught, in regards to the neurodevelopment of empathy in humans. The term empathy will be used to refer to a response stemming from the understanding of another’s emotional state similar to what the other person is feeling or would be expected to feel in the given situation. (Eisenberg et al. 1991) In this, the issue of whether empathy can be taught arises. Is empathy something an individual is born with, or is it something that can be developed and enhanced with time?

2. Being in the Shoes of Others

2.1 What is Empathy?

Empathy is the ability to understand the feelings of another (Hakansson 2003). The term empathy is applied to various phenomena which cover a broad spectrum of psychological abilities. These range from; the experience of feelings of concern for other people that creates a motivation to help them, an awareness and understanding of what others are thinking or feeling, experiencing emotions that resemble or match another individual’s emotions, to blurring the line between self and other (Hodges and Klein 2001).

In developmental psychology, empathy is generally defined as; an affective response stemming from the understanding of another’s emotional state condition similar to what the other person is feeling or would be expected to feel in the given situation. (Eisenberg et al. 1991) The term affective response refers to, a psychological component that implicates the automatic and unconscious process of affect sharing, or the mirroring of another person’s actions (Segal et al. 2015).

The terms empathy and sympathy are frequently conflated, however are immensely different psychological experiences. When defined simply, empathy is the ability to recognise the emotions of another with minimal distinction between the self and other. In contrast to this, sympathy can be simply defined as the experience of feelings of concern about the wellfare of others. By comparing and contrasting these terms it is made evident that; the experience of empathy is applied to all emotions, however, sympathy related solely to feelings of concern about the wellfare of others. The experience of empathy can lead to the experience of sympathy, but the dominant differentiation is that; empathy allows an individual to feel concern with another, whereas sympathy allows feelings of concern for another. This is the key definitional understanding that is necessary when defining the term empathy.

2.2 Levels of Empathy

Empathy plays a key role in the function and understanding of the biological, social and cognitive levels of psychology. Biologically, the human brain contains structures thought to be key to the experience of empathy, this includes the Mirror Neuron System (Gallese 2003, 2009) and the Amygdala (Reisel 2017). These structures are responsible for emotion response and understanding. The extent to which these biological structures affect the experience of empathy becomes evident when deficiencies in these areas are seen.

Empathy, as a psychological process, has drastic effects on social behaviours and interactions. The capacity for people to resonate with each other effectively is dependent on the experience of empathy (Hakansson 2003). All social activity is reliant on an understanding of others as well as one’s self, therefore empathy is at the root of all social interactions. The experience of stress, however, can supress brain development and impair an individual’s empathetic experience, meaning the social environment of which a person is exposed to has an extreme impact on their ability to empathise.

Not only does empathy have implications to the biological and social levels of analysis, but also to human cognition. The Cognitive Neuroscience Conceptualization of empathy suggests that, empathy comprises four subjectively experienced cognitive components; affective response, self-other awareness, perspective taking, and emotion regulation (Gerdes, Lietz, & Segal, 2011).

“Affective response is a component that implicates the automatic and unconscious process of affect sharing, or the mirroring of another person’s actions” (Segal et al. 2015). This psychological component is a result of the activation of the Mirror Neuron System (Gallese 2003, 2009). The other three components of empathy are cognitive processes, which consist of the ability to recognize and understand others experiences and emotions as well as distinguishing the self from others, through emotion regulation

As the experience empathy involves processes from, and has implications across many levels of psychology, the teaching or development of this ability is exceptionally important to human interaction. However, since there are biological, cognitive and social components that all contribute to an individual’s ability to empathise with others, the extent to and the way that empathy can be taught becomes increasingly complex.

3. The Neural Basis of Empathy

3.1 Monkeys and Empathy Neurons

In the early 1900’s, Italian Neurophysiologist Vittorio Gallese, who was a part of a research group at the University of Parma, discovered a class of brain cells in macaque monkeys. These cells are now referred to as Mirror Neurons, which collectively form the Mirror Neuron System (Gallese 2003, 2009). Gallese was working with a macaque monkey that had electrodes implanted in its brain. Neurons began to fire in the monkeys pre-motor cortex as Gallese reached for his food. (Iacoboni 2009, Society for Neuroscience 2008). These same neurons would fire when the monkey was by itself performing a similar goal driven action.

The inferior frontal cortex of the macaque brain contains pre-motor cells that are responsible for the neural control of goal orientated hand actions, such as; grasping, tearing, holding and manipulating (Rizzolatti et al. 1988). Within the macaque monkey’s inferior frontal cortex there are also pre-motor cells that concern mouth actions. These premotor cells concern both ingestive and communicative actions. The researches from Parma discovered that a subset of pre-motor neurons would also fire in the inferior frontal cortex when the monkey is merely observing another performing goal orientated actions. (Rizzolatti et al 1988, 1996.)

The original Parma experiments were confirmed in many other settings, further investigating the properties of mirror neurons, with regard to the coding of other individuals actions. Researches at UCCA found that cells in the human anterior cingulate, which generally fire when the patient was poked with a needle (“pain neurons”), will also fire when the patient watches another patient being poked. (Iacoboni 2005)

The discovery of Mirror Neurons was key to the advancement in psychologists understanding of the empathetic responses and provided potential explanations to a wide range of psychological processes. “Mirror Neurons will do for Psychology what DNA did for Biology: they will provide a unifying frame work and help explain a host of mental abilities that hitherto remained mysterious and inaccessible to experiments.” (Ramachandran 2006).

3.2 The Mirror Neuron System

The Mirror Neuron System (MNS) is defined as a mechanism directly mapping action perception and execution (Gallese 2003, 2009). A Mirror Neuron is a neuron that fires when an animal (or person) performs an action or when they observe someone else performing the action and “mirrors” the behaviour of another (Gallese 2003)

The MNS is: a small circuit of cells in the premotor cortex and interior parietal cortex that are activated by the observation or performance of a behaviour, internally firing/activating the motor neuron of the corresponding behaviour (Iacoboni 2005)

Mirror Neurons cannot be directly observed in humans because electrodes cannot be inserted into their brains. However, the use of Magnetic Resonance Imaging (MRI) and Functional Magnetic Resonance Imaging (fMRI) has shown patterns of brain activity consistent with the firing of motor neurons, much like in the research findings of the macaque monkeys, (Logothetis et al. 2001). Therefore, it has been assumed that Mirror Neurons also exist in humans.

The MNS demonstrates that there is a strong activation of pre-motor neurons and parietal areas during mere action observation.  (Stephens et al 2010). The same regions that are activated when we move are activated when we observe the same motor actions by others (Gallese 2009). Similarly, the MNS is involved in our capacity to share emotions and sensations with others (De Vignemont and Singer 2006) “The Mirror Neuron System is involved in human communication, amplifying cognition of the speech of others and enhancing the ability to communicate in an unknown language.” (Hasson 2002) Mirror Neurons are key to enabling an observer to understand the intention behind an observed motor act, in addition to the goal of it (Rizzolatti and Fabbri-Destro 2008).

A study supporting the effect of Mirror Neurons as the result of observing peoples behaviour is conducted by Iacoboni (2004). The aim of the study was to; determine whether looking at the emotion expressed on someone’s face would cause the brain of the observer to be simulated. The method included asking participants to look at human faces while in an MRI scanner. Participants had to imitate the faces shown and then watched as the faces were shown again. The results showed that the same area was activated both times.

The discovery of mirror neurons provides a psychological system that explains empathising, meaning that, through its development and enhancement, empathy can be taught.

3.3 Mirror Neuron System Development

Mirror Neurons have been identified in two cortical areas; the posterior part of the inferior frontal cortex and the inferior parietal lobule Rizzolatti and Craighero 2004). These two areas are anatomically connected and form an integrated frontoparietal MNS. It is important to consider the anatomical location of the MNS to understand the nature of its functions.

Studies of proactive goal-directed eye movements show that 12-month-old infants are able to predict the action goals of other people (Falck-Ytter, Gredeback, and von Hofsten 2006). Recent studies have demonstrated that human early imitative behaviour is not unique to humans. Infant Chimpanzees (Myowa-Yamakoshi et al 2004) and Infant Monkeys (Ferrari, P. F. 2006) show that imitative behaviour of facial and hand gestures that is similar to humans. Therefore, providing indirect behavioural evidence of the existence of a functioning MNS early in the life of primates.

A study on 6-7 month old infants was conducted with Near Infrared Spectroscopy (NIRS). The infants watched live actions and actions shown on a TV monitor. In the adult brain, live actions typically yield more robust responses than actions shown on a monitor. The infant’s NIRS showed a similar response pattern. Motor areas were activated by the site of both the live and televised actions, but the live actions yielded a much greater response. The data found suggests that the MNS is functioning early in human life (Shimada and Hiraki 2006), however, this data does not indicate how crucial the MNS is for the development of social competence.

In a Functional Magnetic Resonance Imaging (fMRI) study of observation and imitation of facial emotional expressions in typically developing ten year olds (Iacoboni and Dapretto 2006), it was found that the activity in the MNS correlated with empathetic concern and interpersonal competence. (Iacoboni, Dapretto and Mazziotta 2005). This correlation strongly supports the hypothesis that the MNS is a key neural system for social cognition (Gallese and Rizzolatti 2004).

3.4 Mirror Neuron System Dysfunction

The Mirror Neuron system is crucial to the experience of empathy, suggesting that when a dysfunction is present, there is a disruption to an individual’s empathetic responsiveness.

It is highly plausible that dysfunctions in the MNS can lead to social issues (deficits in social behaviour). Furthermore, it has been proposed that a core deficit of Autism Spectrum Disorder (ASD), a socially isolating disorder, originates from a dysfunction within the MNS. (Rogers and Pennington 1991). This hypothesis has been further developed by suggesting that the MNS enables the modelling of the behaviour of other people through a mechanism of embodied simulation (that is, internal representations of body states associated with actions and emotions). Embodied Simulation could provide “intentional attunement” – a direct form of experimental understanding of others (Gallese 2006). A disruption of MNS activity would preclude such experiential understanding of others, leading to the social deficits of autism. (Gallese 2006).

Autism spectrum Disorders (ASD’s) are largely characterised by deficits in imitation, pragmatic language, theory of mind and empathy (Williams et al. 2001; Obeman and Ramachandran 2007). Compared to control groups, they alone failed to attribute beliefs to others, indicating that the dysfunction is specific to ASD’s (Baron-Cohen et al. 1985).

If the MNS is able to be modified when a dysfunction has occurred, it will allow a pathway that empathy can be taught through. The modification and growth of the MNS, allows for those with a dysfunction to learn how to understand others emotions and experiences, while ultimately altering the neural system of the brain.

4. Social Isolation – Austism Spectrum Disorders

4.1 What are Austism Spectrum Disorders?

Austism is classified as; a behavioural syndrome caused by a developmental disorder (“scientific community REFERENCE). There are a range of different disorders that are included in the category of Austism Spectrum Disorder (ASD).

A deficiency in the Mirror Neuron System is present in children with ASD’s. Children with Austism Demonstrate significant difficulty or inability to express emotional reciprocity, in respect of either adults and peers. These traits can fall under different categorisations of ASD.

4.2 Empathy in Children with ASD

Autistic children experience severe problems with their own facial expressions, and with their understanding of the expressions of others.These children are not able to show an automatic mimicry of the facial expression of basic emotions; they do not show an understanding of others emotions. Children with ASD need to consciously and purposefully respond to show a mirroring of these emotions to present an empathetic reaction. This suggests that, empathy does not come naturally to them.

“It has recently been proposed that dysfunction of the Mirror Neuron System in early development could give rise to the cascade of impairments that are characteristic of autism spectrum disorders, including deficits in imitation, theory of mind and social communication.” (Dapretto et al. 2006)

Dapretto, Iacoboni and their colleagues conducted a study to investigate this proposed neural model.  Functional Magnetic Resonance Imaging (fMRI) was used to investigate neural activity during the imitation and observation of facial emotional expressions in ten high-functioning children with ASD, and ten typically developing children matched by age and IQ. The subject’s parents provided written consent prior to participation. The stimuli used consisted of 80 faces expressing 5 different emotions: anger, fear, happiness, neutrality or sadness. Each face was presented for 2 seconds according to an optimized random sequence. In two separate scans, subjects either imitated or simply observed the faces presented to them through high resolution magnet-compatible goggles.

Direct comparisons of the fMRI images of typically developing children and children with ASD showed that activity in the anterior component of the Mirror Neuron System was significantly greater in typically developing children. This demonstrated a link between Mirror Neuron Dysfunction and Austism Spectrum Disorders.

These findings exhibit that a biological and cognitive deficit, can have extreme implications to social behaviours, and indicates that children with ASD possess an abnormality in empathy understanding and ability.

4.3 Treatment of ASD

It is believed that empathy can be ingrained and enhanced in small children with ASD. An example of this is Mary Gordon’s (2005) Roots of Empathy Program. The program is known to significantly reduce aggression among school children while raising social and emotional competence, increasing empathy.

The program is an evidence-based classroom program, with the aim of teaching perspective taking skills that enable students to gain insight into how others feel and develop a sense of social responsibility for each other. A parent and an infant engage with students in a classroom setting, while an instructor guides the children as they observe the relationship between parent and baby, helping them understand the baby’s intentions and emotions.

A longitudinal research study on the impact of the Roots of Empathy Program (Berkowitz and Bier 2007) documented that Roots of Empathy children demonstrated a lasting:

• Increase in social and emotional knowledge
• Decrease in aggression
• Increase in pro-social behaviours (e.g. Sharing, helping, including)
• Increase in perceptions among Roots of Empathy students of the classroom as a caring environment
• Increased understanding of infants and parenting

The Roots of Empathy Program is a form of Cognitive Behavioural Therapy, which is used to treat Austism Spectrum Disorders, however, it has been proven that such disorders can only be treated up to a certain age in young children. There is no specific age bracket that the disorders can be successfully treated in, as it varies between individuals, but it is known that early childhood until early primary school ages are where treatment is most effective.

Cognitive Therapy involves a focus on changing the thought process of the child, challenging negative thoughts and providing the child with healthier thinking strategies. Whereas, Behavioural Therapy; aims to teach the child techniques or skills to alter their immediate behaviour and teaches more helpful behaviours, particularly to do with social situations. Cognitive and Behavioural Therapy, combines both of these approaches, and not only alters the behaviour of the child, but the thought processes behind those behaviours.

The treatment of ASD often requires the whole family to be involved, specifically parental figures, as this allows for the children to interact socially with someone they are close to, and are more likely to want to empathise with.

The treatment of Austism Spectrum Disorders, which are often caused by a dysfunction in the Mirror Neuron System, demonstrates that individuals can be taught to understand others emotions and empathise with them. However, the limitation of age interferes with this treatment and suggests that this can only be taught at a young age in children and is not applicable to adults.

5. The Amygdala

5.1 What is the Amygdala?

The Amygdala is a biological structure thought to be key to the experience of empathy (Gould et al. 1998). It is an almond-shaped section of nervous tissue deep within each of the hemispheres of the brain. There are two amygdalae per person, and they are thought to be a part of the limbic system within the brain. The Amygdala plays a role in the perception of emotions and the controlling of aggression. It stores memories of events and emotions so than an individual may be able to recognize similar events in the future. Normally, the larger and more active an individual’s Amygdala is; the more empathetic they will be.

5.2 Empty Emotion – Clinical Psychopathy

Dr Daniel Reisel (et al. 2014), studied inmates at Wormwood Scrubs High Security Prison in London, who had been diagnosed as clinical psychopaths. Over a period of months, the subjects were tested on their ability to categorise different images of emotions, and the study looked specifically at their physical response to those emotions.

Typically, when observing images of emotions, for example sadness, people show a slight measurable physical response: increased heart rate, sweating of the skin. It was found that although the psychopaths being studied could accurately describe the pictures, they did not show any physical response.

“It was as though they knew the words but not the music to empathy” (Reisel 2017)

Magnetic Resonance Imaging (MRI) was used to observe the brains of the subject group of clinical psychopaths. It was found that, the individuals were not only all victims of a troubled childhood, but also all showed a deficit in the Amygdala. This likely led to their lack of empathy and the immoral behaviour of the subjects, and provides an explanation for their abnormal empathetic responsiveness.

5.2 Amygdala Deficiencies

The structure of the Amygdala, can be varied in size, and when this structure is smaller than average, it is labelled as deficient. As the Amygdala is a part of the limbic system, a deficiency in this brain area will impact the entire Limbic System, which is involved in the experience of many emotions, and empathetic responses. (Reisel 2014). The main cause of deficiencies in this brain region is the experience of stress, as glucocorticoids (stress hormones) interfere with the development of new brain cells.

Amygdala deficiencies cause less empathetic responsiveness and provide evidence of biological structures as a cause of lacking empathy. However, if it was possible to develop and grow these brain structures, the psychological experience of empathy could potentially be enhanced and enriched.

5.3 Neurogenesis and the Effect of Stress on the Amygdala

In the 1990’s, studies following the lead of Elizabeth Gould at Princeton University, showed evidence of neurogenesis, which is the birth of new brain cells in the mammalian brain. These were found, first in the olfactory bulb, the hippocampus and finally in the Amygdala itself. This suggests that these brain structures could potentially be grown and enhanced when exposed to a nurturing environment that encourages neurogenesis.

Brains are exceptionally sensitive to stress in our environment. Stress hormones, glucocorticoids, released by the brain supress the growth of these new cells in the brain. (Reisel et al. 2014) This theory of stress negatively impacting the rate of neurogenesis was studied using mice (Reisel et al. 2014). The results showed that a mouse in a standard cage (essentially a shoe box), which was isolated without much stimulation did not thrive, and developed strange repetitive behaviours. It was found that the naturally sociable animal lost the ability to bond with other mice. However, the mice in an “enriched” environment – a large habitation with other mice, with areas to explore – demonstrated neurogenesis. The mice in the enriched environment, performed better on a range of learning and memory tasks. (Reisel 2014)

Reisel’s study presented evidence that stress supresses brain development by negatively impacting the rate of neurogenesis, which ultimately can lead to a deficiency in the Amygdala. This suggests that, when nurtured in an enriched and socially encouraging environment, deficient Amygdala’s can potentially be grown and developed through neurogenesis. Neurogenesis provides a method that empathy can be taught through.

6. Conclusion

The experience of empathy is dependent on biological structures and systems in the brain, including the Mirror Neuron System, and the Amygdala. When these brain areas show a deficit or dysfunction, an individual’s experience of empathy will be severely altered and they will lack the ability to reciprocate the emotions of another. This suggests that empathy is not something that can be taught, but something that is a result of the activity of brain structures.

Although issues with biological structures within the brain can impact an individual’s experience of empathy, both the Mirror Neuron System and the Amygdala have the potential to be altered with psychotherapy. Deficits in the Mirror Neuron System are seen in children with ASD, and it is known that Cognitive Behavioural Therapy at a young age, can have a positive impact on this system, and ultimately enable a greater experience of empathy for children with ASD’s. The Amygdala, is a structure that can undergo neurogenesis, and can be grown and further developed.

The culmination of the studies presented in this paper suggest that empathy can be taught but only to some extent. Although there are biological structures that impact the experience of empathy, it is possible to alter and further develop these structures. This would indicate that while empathy cannot necessarily  be ‘taught’ there are certain ways, (Neurogenesis, Cognitive Behavioural Therapy to develop MNS) that empathy can be developed and improved in individuals.

7. References

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