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Neurodiversity

"I Promise I'm Not Trying to Be Inconsiderate"

Neurodiversity, the double empathy problem, and misunderstandings.

Key points

  • Neurodivergent people are often misunderstood in social situations.
  • The 'double empathy problem' asserts that we are most likely to understand individuals of our own neurotype.
  • Appreciation for neurodiversity and differences in communication could help bridge this gap.

"Inconsiderate."

For a long time, I both despised that word and feared it applied to me. Not in a literal sense — I take great lengths to anticipate others' preferences. The trouble is, a lot of times what I anticipate doesn't match expectations. I enjoy going on jags about my topics of interest. Not everyone is interested. I find a TV droning in the background incredibly distracting to the conversation, so I turn it off. Someone else might prefer to watch. I've taken time to learn the neurotypical 'culture' and as time goes on I've felt more confident navigating this terrain.

Social Cognition

The construct of neurodiversity, that there are many ways of neurological set up, is becoming more and more accepted. Neurotypes include different patterns of processing information. The most common neurotype is neurotypical. Some diverge from this type such as autistic people, ADHDers, and those diagnosed with mental health conditions. While the term encompasses a wide variety of processing styles, they are all considered under the term neurodivergent.

In the past, a belief prevailed in psychiatry that neurodivergent people, particularly autistic people, struggle with theory of mind, the capacity to imagine another person's mental states which is a critical component of empathy. This led to significant, harmful conceptualizations and invalidation of neurodivergent communication. Autistic people routinely score more poorly on tests of social cognition such as the Reading the Mind in the Eyes test, a tool that shows pictures of eyes asking the test-taker to identify the emotion (Peñuelas-Calvo et al., 2019).

Still, an ignored reality about these tests is that the instruments focus on neurotypical social cognition. Neurodivergent people, by definition, are running on a different system of brain wiring. What works for us in terms of processing information is sometimes radically different from what might work for a neurotypical person. In his book, Unmasking Autism, Devon Price highlights the many processing differences in autism including a tendency toward bottom-up processing. While a neurotypical person will often rely more on top-down processing, allowing for intuition without too much focus on details, autistic people integrate information in a way that often requires a bit more thought and attention to detail.

As often as neurodivergent people "misread" neurotypical social cues so too do neurotypical people misunderstand neurodivergent social cues. Is it fair to utilize the same instruments to measure social cognition in neurodivergent individuals? Shall we create a neurodivergent social cognition test to administer to neurotypicals? Perhaps, there is space to explore this from a neurodiversity informed perspective.

The Double Empathy Problem

In 2012, an autistic psychologist shared the double empathy problem as an alternative way to view social cognition in people with autism. By the double empathy problem, what has been previously classified as a lack of empathy in neurodivergent people is a misunderstanding between the neurodivergent and neurotypical operating systems. (Milton et al., 2022). Neurodivergent people do not struggle with social cues, they struggle with reading neurotypical social cues. Similarly, neurotypical people often lack an understanding of neurodivergent social cues. Maybe even to a greater extent.

A study of eight autistic participants found that when paired with other autistic people, the participants' conversations went smoother (Williams et al., 2021). Similarly, a study that asked neurotypical people to identify the mental states of autistic and neurotypical people on video clips found that neurotypical people often struggled with relating the mental state of autistic people (Sheppard et al., 2016). Contrary to the postulate of lacking empathy, some have even suggested that neurodivergent people may excel in terms of empathy due to their constant need to 'translate' between others' processing style and their own.

Unfortunately, these misunderstandings often lead to neurodivergent people being seen as 'slow,' 'lacking credibility,' or even 'deceptive' (Lim et al, 2022).

What Can We Do?

Traditionally, interventions have focused on teaching neurodivergent people neurotypical social skills. Yet, many believe that this only instructs individuals to act more like someone of a different neurotype, to mask. Masking gets in the way of genuine communication and has negative impacts on neurodivergent self-worth and mental health.

Rather than invalidating neurodivergent experiences, it's time we recognize and appreciate these as different ways of moving through life.

An alternative might be to extend compassion. To seek to educate everyone on neurodivergent communication styles and the importance of suspending assumptions. Just as we encourage each other to seek to understand the needs and customs of other cultures, we could gain a lot as a society to embrace neurodiversity including appreciation for all communication styles.

References

Milton, D., Gurbuz, E., & López, B. (2022). The ‘double empathy problem’: Ten years on. Autism, 26(8), 1901-1903.

Peñuelas-Calvo, I., Sareen, A., Sevilla-Llewellyn-Jones, J., & Fernández-Berrocal, P. (2019). The “Reading the Mind in the Eyes” test in autism-spectrum disorders comparison with healthy controls: a systematic review and meta-analysis. Journal of Autism and Developmental Disorders, 49, 1048-1061.

Lim A., Young R. L., Brewer N. (2022). Autistic adults may Be erroneously perceived as deceptive and lacking credibility. Journal of Autism and Developmental Disorders, 52(2), 490–507.

Price, D. (2022). Unmasking Autism: Discovering the New Faces of Neurodiversity. Harmony Books

Sheppard, E., Pillai, D., Wong, G. T. L., Ropar, D., & Mitchell, P. (2016). How easy is it to read the minds of people with autism spectrum disorder?. Journal of autism and developmental disorders, 46, 1247-1254.

Williams, G. L., Wharton, T., & Jagoe, C. (2021). Mutual (mis) understanding: Reframing autistic pragmatic “impairments” using relevance theory. Frontiers in psychology, 12, 1277.

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