One of the most important findings of modern brain research was the discovery of mirror neurons. First observed in monkeys, these are neurons in the motor cortex which fire to produce an action but which are also seen to fire at a much lower level when the subject observes the action carried out by another actor. In people as in monkeys, it seems that seeing someone else perform an act is reflected in the mirror neurons of the cortex. 

Empathy is another type of mirroring, and has been linked with mirror neuron activity. Indeed, here there is a difference between the sexes: women averagely show greater mirror neuron response than men in accordance with their overall tendency to be more empathic. Deficits in mirror neuron activity have also been found in autism, in line with the parallel finding that autistics have deficits in empathy.

Initial studies also reported lower mirror neuron response in schizophrenics. This is exactly what you might have expected because feeling empathy for someone implies accurate and appropriate reflection of that person’s feelings and emotional state. Both autistics and schizophrenics symptomatically misread people’s minds, so finding similar deficits in mirror neuron response in both groups hardly seemed surprising.

But however that may be, the case of the schizophrenics appeared to refute the imprinted brain theory and its distinctive diametric model of mental illness. This proposes that autism is characterized by deficits in mentalistic skills like feeling empathy, but that psychoses such as schizophrenia represent the opposite: so-called hyper-mentalism understood as a pathological over-development of mentalistic skills, which would have to include empathizing. Or at least, the neurological basis of empathizing, because clearly, empathizing taken to excess cannot be truly empathic if the definition of empathy is accurate reflection of the other person’s feelings. 

But now a new study, brought to my attention by my colleague Bernard Crespi, suggests that the initial findings may have been incorrect. According to the new study, “subjects with active psychosis were found to have greater … mirror neuron activity, which correlated to greater psychotic symptoms.” The authors point out that this finding translates to nearly 20 percent greater mirror neuron activity in actively psychotic subjects compared to healthy participants, and that this degree of mirror neuron activity was directly correlated with the severity of their psychotic symptoms, despite the fact that many of them were taking anti-psychotic medications at the time. 

The authors also point out that their “findings … are consistent with the view of Abu-Akel (2003), who suggested that patients with active psychosis have greater empathy and ToM” [theory-of-mind] abilities...” They certainly are, and are of course even more consistent with the diametric model of autistic hypo-mentalism versus psychotic hyper-mentalism peculiar to the imprinted brain theory, which Ahmad Abu Akel so brilliantly anticipated.

Indeed, they confirm the diametric model’s implication that even if high-level “hyper-empathizing” does not make much sense for the reason already explained, low-level hyper-activation of neural systems fundamental to mentalistic skills like empathizing does. Just as psychotics can amplify awareness of gaze into delusions of being watched or spied on, so their hyper-active mirror neurons might provide the neural substrate for them to amplify their reflection of others’ negative responses to them into delusions of persecution—or positive ones into erotomania (the delusion that others are in love with you).

Clearly, more studies are needed to resolve this issue, but just as previous ones have confirmed the predictions of the diametric model where measures of pre-frontal cortical activity are concerned, so I expect future studies to corroborate the findings reported here. As ever, time will tell, but a bigger study with un-medicated subjects would be most telling of all.

(With thanks and acknowledgment to Bernard Crespi.)

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