Gaining Cognitive Empathy in Autism Spectrum Disorder

In this article, my goal is to show how someone with autism spectrum disorder (ASD) can attain a form of empathy known as cognitive empathy by using a theoretical framework for constructing emotions that I developed as part of a philosophical counseling modality known as logic-based therapy (LBT). Intriguingly, I discovered that the latter constructivist approach had such potential efficacy when someone with ASD, whom I was training to be an LBT practitioner, used it in this way.

Autism Spectrum Disorder

According to the Diagnostic and Statistical Manual of the American Psychiatric Association (2022), an essential feature of autism spectrum disorder is "persistent impairment in reciprocal social communication and social interaction." (p. 60). Deficits in reciprocal social-emotional communication involve the inability to identify and respond to the affective states of others in socially appropriate ways.

In essence, a person with ASD may not pick up on the social-emotional cues in a manner that people ordinarily do. Thus, the person with ASD might not pick up on my feeling down about a negative event in my life and, as a result, might respond in a manner that I find insensitive. On a neurological level, this is because there appears to be hypoactivation and dysconnectivity in the anterior insula cortex, which is a somatosensory part of the brain that is active during the emotional and social processing involved in (emotional) empathy (Caria & de Falco, 2015).

The question addressed here is whether a person with ASD can have a grasp of an emotional state without the need to process the experience through the insular cortex—that is, without having experienced the emotion themselves. Is there a sense in which a person with ASD can empathize with another without having the latter capacity?

A Performative (Speech Act) Approach to Emotions

One prominent set of theories of emotions is constructivist theories. These theories view emotions as constituted by exteroceptive (sensory) or interoceptive (bodily) perceptions that are organized and interpreted according to language. This constructivist, linguistic approach has been variously expressed in the literature on emotions (Schwarz-Friesel, 2015; Lindquist et al., 2015).

A version of a constructivist approach that I subscribe to derives from a philosophy of language first introduced in the 1960s by British philosopher J. L. Austin (1962) in a collection of lectures called How to Do Things with Words. According to Austin (1962), language can do more than simply report or describe events and objects in the world.

Instead, it can perform many different speech acts, such as commending, condemning, approving, disapproving, apologizing, denying, and applauding, among countless others. For example, in using the term “excellent,” I am, in common parlance, commending or recommending something, as in “The new café has an excellent wine list.”

In the case of emotions, I can construct my emotions using language that has the potential to express them. For example, in catastrophizing about an unwanted future possibility (“How horrible this would be if it were to happen!”), I express anxiety. In damning my life (“My whole life sucks!”), I express depression.

Notice how, in each emotive expression, we do not merely describe something. Instead, we perform a particular speech act that, in some way or other, rates or evaluates it. Philosopher Robert Solomon (1993), accordingly, defined emotions as value judgments. Monika Schwarz-Friesel (2015) insightfully referred to emotions as “the evaluative mental system within our cognitive apparatus.”

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LBT’s Theory of Emotions

In applying logic-based therapy (LBT), a highly philosophical form of rational-emotive behavior therapy that I developed, I employ a constructivist, linguistic approach that uses two elements to characterize emotions (Cohen, 2016):

(1) An intentional object (O), which is what the emotion is about

(2) A rating (R) of the intentional object or some aspect of it (a positive or negative evaluation)

For example, the intentional object of anxiety is a possible future state of affairs, such as the possibility of losing one’s job. Its rating is then “a strong negative rating of this possibility such that one perceives a need to ruminate about it.” For example, you catastrophize about this possibility by calling it “the worst thing that could happen.”

In the case of depression, the rating is a “strong, negative rating of this event or state of affairs on the basis of which one persistently, over a period of time, bleakly perceives one’s own existence as worthless or hopeless” (Cohen, 2016, p. 8). Thus, you may believe that you have been fired (O) and damn yourself for having been such a “total loser” (R).

Notice the emotional words that are used to perform the speech acts of catastrophizing and self-damnation: “the worst that could happen” and “total loser,” respectively. These words have a strong (potential) emotive force, which means they can be used to perform these speech acts. So individuals with ASD can experience, through language, the emotive force of what another is feeling instead of experiencing the affective state itself.

Here is a table that provides O + R characterizations of some common emotions (Cohen, 2016, p. 8). Notice how knowledge of both the object and its rating can uniquely identify the emotion and distinguish it from related emotions (for example, grieving versus depression).

Autism and the Construction of Other People’s Emotions

It had not occurred to me that this theory of emotions could be used by people with ASD to identify and respond to the emotions of others until an autistic client of mine whom I was training as a logic-based therapist disclosed to me that he had learned to use this theory to key into the emotions of others and thus to respond to them appropriately.

Interestingly, this client was a philosophy professor with a Ph.D. Apparently, he was a very popular instructor, being able to captivate a class in a large lecture hall with his profound and even humorous lectures.

However, in his one-on-one communications with students and others, he was challenged. LBT’s characterizations in terms of O + R appeared to help him grasp the core of emotional meaning in such personalized settings.

For example, here is a recreated conversation that the professor had with a student where he was able to find the student's O + R and key into her emotion:

1. Professor: What can I help you with?

2. Student: I know I failed the last exam.

3. Professor: This is not your usual work.

4. Student: I know. It has been hard to concentrate on your course. My boyfriend and I just broke up. We were together for two years, and I really thought... well, I really loved him.

5. Professor: So, you are not able to concentrate on your classwork because you broke up with your boyfriend whom you loved?

6. Student: Yes. He was everything to me. And now I have nothing without him.

7. Professor: So, you seem to be seeing your own existence without him as hopeless or bleak?

8. Student: Yes, that’s true.

9. Professor: I see. You must be very depressed about your boyfriend breaking up with you. And that makes it hard for you to see the point of doing the work in my class.

10. Student: Yes, exactly!

On line 5, the professor identifies the student’s intentional object (italicized). Then on line 7, the professor reflects on what the student tells him and checks to see if she is rating the aspect of the intentional object concerning her life after the breakup as being hopeless or bleak.

After the professor receives confirmation, on line 9, he concludes that the student’s O + R matches the definition of depression. In addition, given the student’s bleak outlook on her existence, he deduces that she sees no point in doing the work in his class.

On line 10, the student indicates that her feelings have been validated by the professor. This validation of the client’s feelings is what we would expect if the professor truly resonated with the student’s subjective world, that is, empathized with her. However, we know that the professor struggles to empathize with others. Nevertheless, the O + R approach permitted the professor to grasp the student’s emotion, albeit without experiencing it.

Cognitive Empathy

The professor now had cognitive empathy because he was able to translate the student’s emotions into words. This contrasts with emotional empathy, which involves the capacity to be affected (emotionally) by another’s emotions (Hepworth et al., 2017).

According to Perry and Shamay-Tsoory (2013), emotional empathy involves belief about what others feel, whereas cognitive empathy involves belief about what others believe. They maintain that people with ASD have trouble with the latter as well as with the former. However, the O + R approach permits the construction of what others think when they are experiencing an emotion, wherein the latter thoughts (the cognized O + R) comprise the (reportative and evaluative) acts that linguistically express what they feel.

Conclusion

Since this implication of my theory was one that I incidentally learned about from this client, it would not be reasonable to conclude that such a performative approach to developing cognitive empathy would work as well for other clients with ASD. After all, my client was an analytical philosopher who had spent many years studying linguistic analysis. So, any conclusion about the efficacy of this intervention to help people with ASD gain a form of empathy is tentative, awaiting further empirical investigation.