The Double Empathy Problem: Denial of the Reality of Autism?

Sociologist and social psychologist, Damian Milton, via his ‘Double Empathy Problem’ theory, seems absolutely desperate to ‘prove’ that autism is not about ‘deficits in social interaction’, despite this being the key part of the diagnostic criteria.

The term ‘double empathy’ was coined back in 2012 and, on the surface, describes what was already a well known issue: autistic people find communicating with non-autistic people hard. The same can be said for non-autistic people, regarding communication with autistic people.

The issue with this line of thinking…

When someone tries to communicate with someone who is different to them, communication is difficult. This applies between non-autistic people too: people who think differently, and people from different backgrounds and cultures. However, it should also be noted that communication about interests is not generally a problem (irrespective of whether autism is involved or not), and there are people who can talk to a huge variety of people with no or little difficulty.

Milton frames his ‘double empathy’ concept relating to interpersonal communication as issues relating to personality, worldview, mindset, and culture (describing them as ‘different dispositional outlooks’, and ‘personal conceptual understandings’). This is not about empathy, though. Instead, it is about how different people think about and perceive the world, and about social norms, which is really about knowledge, including knowledge that different people have different views.

For this to work for autism, there has to be an underlying assumption that the ‘autistic community’ has its own culture. Nothing could be further from the truth. Autism is not a culture and groups of autistic people do not create their own culture. Even the term ‘autistic community’ is problematic. There are individuals diagnosed with a huge wide range of different ‘autisms’. The range of presentations of different autisms makes developing a community and culture impossible.

Ironically, Milton says autistic voices are made invisible while very effectively silencing all those with moderate and severe autism. His theory effectively ‘cancels’ those who do have very real and obvious deficits relating to social interaction and communication caused by cognitive barriers to learning social interaction.

What strikes me most of all is that, via his paper, Milton seems to dismiss the scientific literature as ‘ideology’. However, the scientific literature is based on evidence while Milton presents no evidence for his position. While Milton explains his reasoning behind ‘double’ in ‘double empathy problem’ (it affects both parties), he makes no attempt to explain what he means by ‘empathy’.

Milton’s paper is framed as about autism, but it isn’t. It denies of the reality of autism. While Milton can dress his ideas up with a fancy and inaccurate term, and flowery, jargon-heavy language, the reality of the presence of moderate and severe autism with very real deficits regarding communication, destroys his assumptions regarding autistic culture and community. In addition, cultural clashes and clashes due to different worldviews and mindsets are not about empathy.

No Two Autistic People Are the Same

Like many academics, Milton seems to treat autism as if it is homogeneous, when anyone who works with autistic people - autistic or not - can tell you it isn’t. Two autistic people can have very different ‘autisms’. These can be far more different that differences in culture, worldview, or mindset, leading to significant communications issues even between autistic people.

It is generally easier for a non-autistic person to adapt their communication to an autistic person because autistic communication tends to be simpler (without nuance and hidden meanings) - as long as the autistic person is reasonably articulate. Milton, however, positions it as an equal problem, but one the autistic person experiences regularly, while it is comparatively rare for the non autistic person. As for the difficulties of communicating with ‘non-verbal’ autistic people, this is not even mentioned.

Making Sense to Others - No Matter Their ‘Obvious Differences

If you watch a group of (obviously impaired) autistic people, you will find that these autistic people will seek out those autistic people whose autism is similar to theirs. This should not be surprising. When autisms are similar, people understand each other because they ‘tick’ in a similar way. They ‘make sense’ to each other in a way that other people, autistic or otherwise, don’t.

However, this observation, while obvious to me (and many other autistic people) seems much less obvious to the non-autistic people working with them. Let’s take a closer look at what’s at play.

I once knew someone who I understood well because her autism was similar to mine. However, she had severe learning disability, and to non-autistic people looking on, there were no similarities between us. But she made sense to me and I made some kind of sense to her, even though there was little communication because of the severity of her learning disability. This was impossible to explain to the non-autistic people around, though: they just could not see it.

Similarly, non-autistic people also tend to seek out people similar to them. We have found in workplaces that some people avoid other people because they don’t make sense to them. The most common cause (and one which causes the most frustration within businesses) is the difference between strategic and detail thinkers.

Communication Differences, Cultural Differences, and Empathy

I spent some time living in Khartoum in Sudan and it was impossible to describe what living in Europe was like to the people in Khartoum. It was equally difficult to describe what living in Khartoum was like to those living in Europe. There was just too little in common; the differences were too big.

Just to give one example: the idea that walking along the railway track is dangerous was ridiculous to the Sudanese: the only train they knew made a lot of noise and traveled slowly. There was therefore plenty of time for people (and goats) to get out of the way. The difference between living in Khartoum and Europe, then, isn’t an empathy thing, it’s a cultural, way of life and living environment thing.

Communication between people from very difficult cultures is, indeed, difficult. Social norms are different, as is humour. But this is not about empathy. It is about culture and social norms - and about knowledge, not empathy. Sharing empathy across cultures is not difficult and can create a point of contact. Pain of bereavement and joy of achieving after striving are the same across the world.

For Milton, the reason why people who are different from each other struggle to communicate effectively is to do with empathy. But in reality, empathy is a point of connection between people - even when there are significant differences and communication is extremely difficult. This means it can’t be issues to do with empathy per se that is causing the communication and social interaction difficulties.

Autistic people experience barriers that mean they cannot learn social interaction like everyone else. This is about barriers such as processing and sensory issues. These barriers can and often do cause problems with expressing empathy in socially expected ways, but difficulty with empathy is not the real issue. The real issues are to do with the mechanics of interpersonal interaction.

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