Enhancing Virtues: Caring (part 3)

In this series:

Practicing Empathy

Walking in Other People’s Shoes In terms of practices, there are a number of perspective-taking exercises that have been linked to improvements in empathy. For instance, reading fiction, especially romances and thrillers[1], has been shown to improve cognitive empathy because it exercises our capacity for taking the perspectives of other people.[2] When stories are from a first person perspective they encourage identification with the protagonist, which helps create empathy across cultural boundaries.[3] This effect is also being demonstrated in the use of avatars in virtual reality. In one study white women who used black avatars in VR became less racially biased[4], and in another subjects who were given avatars that could fly like a superhero were more likely to engage in prosocial behavior.[5]

On the other hand first person identification has troubling implications for the effects of first person shooter games on shaping the moral sensibilities of children. A recent meta-analysis of 98 studies of video game effects with almost 40,000 participants found that violent video games do increase aggressive thoughts, emotions and behaviors, while prosocial video games boosted prosocial thoughts, emotions and behaviors, and reduce aggression.[6]

The expansion of literacy and our virtual, real-time connection to the faces and perspectives of people around the world also supports increasing empathy. Although the technoskeptics claim that digital distraction is impairing our face-to-face relationships and capacity for empathy - and there is some evidence that we are paying too much attention to screens and not enough to one another [7] - there is also ample evidence that digital connection is at least a complement to connection, caring and compassionate action. In 2011, the Pew Internet & American Life Project found for instance that people who use Facebook have more “close, core ties in their overall social network compared with other internet users.”[8] Texting and social media allow us to maintain larger social networks, staying connected with people we never meet.

Compassion Meditation Another practice that is receiving increasing attention for enhancing empathy is compassion meditation. In Buddhist compassion meditation one first generates feelings of compassion for oneself, then for loved ones, then for neutral people, then for people you dislike, and then for all living beings. People who practice compassion meditation are found to have increased activity and volume in brain regions associated with emotional regulation and thinking about others.[9] [10] Compassion meditation improves accuracy at reading the emotions of others,[11] and encourages prosocial behavior.[12] [13]

Empathy Games Exocortical aids are also being used to enhance empathy. Computer-based methods for teaching children and adults with autism accuracy in recognizing emotions in faces and other cognitive empathy skills have been in successful use for a decade.[14] Social gaming designers have been making computer games like Darfur is Dying, a web-based simulation in which students take the role of a Sudanese, and confront kidnapping, rape and genocide. The Empathy App aims to create a decentralized counseling network by connecting “trained empathizers” with people in need of empathy.

Eventually brain-machine interfaces will allow the monitoring and manipulation of empathy with real-time neurofeedback. In a recent Brazilian experiment research subjects in fMRI scanners were given neurofeedback cues for the level of activity in areas of the brain associated with affiliative emotions, and were able to increase those signatures by reflecting on feelings of tenderness and affection.[15] As advances are made in the use of artificial intelligence to detect human emotion we can imagine digital personal assistants able to provide even greater insight into the feelings of others. Once we have nano-neural brain-machine interfaces, and some kind of translational language to communicate emotions and experiences, direct brain-to-brain sharing of experience would allow the most profound form of perspective-taking.

Empathy-Boosting Therapies

The pharmaceutical options for the enhancement of empathy have however been the focus of most of the moral enhancement debate. Given the links of oxytocin, serotonin and testosterone to empathy and prosocial behavior it is tempting to think that simply boosting oxytocin and serotonin, and tamping down excessive testosterone, using drugs and gene therapy would have a universally beneficial effect.

One drug that boosts empathy and prosocial behavior, apparently by boosting serotonin and oxytocin, is the psychedelic stimulant MDMA or Ecstasy.[16] [17] In one study researchers gave groups either MDMA, methylphenidate (Ritalin) or a placebo and measured their emotional empathy, facial emotion recognition and moral judgments. [18] MDMA boosted the subjects’ oxytocin, their capacity for emotional recognition, and their sense of closeness, openness and trust, while methylphenidate and the placebo had no effect on these traits.

But these chemicals don’t have the same effects in everyone. Oxytocin can reduce feelings of trust in people prone to anxiety and social phobia.[19] Testosterone may increase cooperation for those with low T, and decrease it for those with high T. As we better understand the roles these chemicals play we will undoubtedly develop diagnostic protocols for who can become more optimally empathetic from boosting or suppressing them with drugs and gene therapy.

Too Much Empathy?

Unfortunately, the effects of these chemicals do not easily align with the virtues of universal compassion or fairness. MDMA not only enhances identification of positive emotions in others, it also suppresses the recognition of other people’s negative emotions.[20] That may be good for trusting and liking other people, but not recognizing other people’s negative emotions doesn’t equate to a high level of empathy. Oxytocin administration boosts trust in people that you consider to be in your in-group, or with whom you share some common experience, but it increases suspicion of strangers and outsiders.[21] [22] That effect would not necessarily be a problem if they were being used in targeted therapies to increase marital or parental trust and bonding, as Savulescu, Sandberg and Liao have proposed.[23] [24] Reducing your positive feelings towards outsiders might be an acceptable trade-off if you were trying save a marriage or bond better with an infant. But universally boosting oxytocin might in fact increase xenophobia and racism.

Empathy can also impair our capacity for justice and consequentialist action. Emotional empathy reduces the willingness to sacrifice individuals for the good of the many, as in the classic trolley experiments, or to be honest when the truth hurts. Empathy makes us respond more to humanitarian crises when there are individuals to identify with - e.g. a baby in a well - than when they impact tens of thousands of people. Perversely, psychopaths find it easier to make consequentialist judgments, to benefit the many at the expense of the few, precisely because they are less swayed by empathy.[25] Serotonin increases sensitivity to others’ distress, but that can make us less willing to punish others to enforce important social rules.

Too much empathy can also be harmful to oneself, [26] as Paul Bloom argues in his recent provocative article “Against Empathy.”[27] In Buddhism there are four mental states recommended for the cultivation of compassion: benevolence (metta), compassion for other people’s suffering (karuna), joy at other people’s accomplishments (mudita) and equanimity (upekkha). Developing equanimity alongside empathy is key, since developing too much compassion and empathy can cause sympathetic distress. One reason that women are more subject to depression may be their tendency to care about more people and more strongly than men.[28][29] One reason that liberals are consistently found to be less happy than conservatives is because they are more distressed by the problems of society. People in caregiving professions who don’t learn detachment from empathy are prone to burnout. Boosting oxytocin in those already very sensitive can lead to emotional distress.[30]

But people with more executive control and emotional self-regulation are less prone to being distressed by empathy,[31] and people can be trained to be mindfully empathetic in a way that does not lead to distress or burnout. Mindfulness meditation has been successfully used to reduce empathic burnout with physicians and medical students.[32] Practicing compassion meditation also reduces empathic distress, as compared to empathy training which increases distress.[33]

So again, as with all the virtues, we return to the need for empathy to be tempered and balanced by the other moral capabilities. Ensuring that enhancement with empathy chemicals and technologies is morally beneficial requires shaping their influences with mindfulness, intelligence and moral reasoning within an overall program of character education.

References

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[2] Kid DC, Castano E. Reading Literary Fiction Improves Theory of Mind. Science. 2013; Oct 18: 342:377-380.

[3] Kaufman GF, Libby LK. Changing beliefs and behavior through experience-taking. Journal of Personality and Social Psychology. 2012; 103(1): 1-19.

[4] Peck TC, et al. Putting yourself in the skin of a black avatar reduces implicit racial bias. Consciousness and Cognition. 2013; 22: 779–787.

[5] Rosenberg RS, et al. Virtual Superheroes: Using Superpowers in Virtual Reality to Encourage Prosocial Behavior. PLoS ONE. 2013; 8(1): e55003. doi:10.1371/journal.pone.0055003

[6] Greitmeyer T, Mugge DO. Video Games Do Affect Social Outcomes: A Meta-Analytic Review of the Effects of Violent and Prosocial Video Game Play. Personality and Social Psychology Bulletin. 2014; 40(5) 578-589.

[7] Uhls YT, et al. Five days at outdoor education camp without screens improves preteen skills with nonverbal emotion cues. Computers in Human Behavior. 2014; 39: 387–392.

[8] Hampton KN, et al. Social networking sites and our lives. Pew Research Center’s Internet & American Life Project. 2011. http://pewinternet.org/Reports/2011/Technology-and-social-networks.aspx

[9] Weng HY, et al. Compassion Training Alters Altruism and Neural Responses to Suffering. Psychological Science. 2013; doi:10.1177/0956797612469537

[10] Klimecki OM, et al. Functional Neural Plasticity and Associated Changes in Positive Affect After Compassion Training. Cerebral Cortex. 2012; doi:10.1093/cercor/bhs142

[11] Mascaro JS, Rilling JK, Negi LT, Raison CL. Compassion meditation enhances empathic accuracy and related neural activity. Social Cognitive and Affective Neuroscience. 2013; 8, 48-55.

[12] Leiberg S, Klimecki O, Singer T. Short-Term Compassion Training Increases Prosocial Behavior in a Newly Developed Prosocial Game. PLoS ONE. 2011; 6(3): e17798. doi:10.1371/journal.pone.0017798

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[14] Grynszpan O, Weiss PL, Perez-Diaz F, Gal E. Innovative technology-based interventions for autism spectrum disorders: A meta-analysis. Autism. 2014; 18(4): 346-361.

[15] Moll J, et al. Voluntary Enhancement of Neural Signatures of Affiliative Emotion Using fMRI Neurofeedback. PLoS ONE. 2014; 9(5): e97343. doi:10.1371/journal.pone.0097343

[16] Hysek CM, et al. MDMA enhances emotional empathy and prosocial behavior. Social Cognitive and Affective Neuroscience. 2013; doi:10.1093/scan/nst161

[17] Kuypers KPC, et al. No Evidence that MDMA-Induced Enhancement of Emotional Empathy Is Related to Peripheral Oxytocin Levels or 5-HT1a Receptor Activation. PLoS ONE. 2014; 9(6): doi:10.1371/journal.pone.0100719

[18] Scmid Y, et al. Differential effects of MDMA and methylphenidate on social cognition. Journal of Psychopharmacology. 2014. 28(9) 847-856.

[19] Yong E. Dark side of the love hormone. New Scientist. 2012.; Feb 8: http://www.newscientist.com/article/mg21328512.100-dark-side-of-the-love-hormone.html

[20] Wardle MC, de Wit H. MDMA alters emotional processing and facilitates positive social interaction. Psychopharmacology. 2014; DOI 10.1007/s00213-014-3570-x

[21] De Dreu CKW, et al. Oxytocin promotes human ethnocentrism. PNAS. 2010; www.pnas.org/cgi/doi/10.1073/pnas.1015316108

[22] De Dreu CKW, et al. The Neuropeptide Oxytocin Regulates Parochial Altruism in Intergroup Conflict Among Humans. Science. 2010; 328(5984): 1408-1411. DOI: 10.1126/science.1189047

[23] Savulescu J, Sandberg A. Neuroenhancement of Love and Marriage: The Chemicals Between Us. Neuroethics. 2008; 1: 31-44.

[24] Liao SM. Parental Love Pills: Some Ethical Considerations. Bioethics. 2011; 25(9): 489-494.

[25] Paytas T. Sometimes Psychopaths get it Right: A Utilitarian Response to ‘The Mismeasure of Morals’. Utilitas. 2014; 26(2): 178-191.

[26] Oakley B, Knafo A, Madhavan G, Wilson DS. Pathological Altruism. 2011. Oxford University Press.

[27] Bloom P. Against Empathy. Boston Review. 2014: http://www.bostonreview.net/forum/paul-bloom-against-empathy

[28] Gleichgerrcht E, Decety J. Empathy in Clinical Practice: How Individual Dispositions, Gender, and Experience Moderate Empathic Concern, Burnout, and Emotional Distress in Physicians. PLOS One. 2013; DOI: 10.1371/journal.pone.0061526

[29] Purvanova R, Muros JP. Gender differences in burnout: A meta-analysis. Journal of Vocational Behavior. 2010; 77(2): 168–185.

[30] Yong E. Dark side of the love hormone. New Scientist. 2012.; Feb 8: http://www.newscientist.com/article/mg21328512.100-dark-side-of-the-love-hormone.html

[31] Thoma P, et al. Cognitive and affective empathy in depression linked to executive control. Psychiatry Research. 2011; 189(3): 373–378.

[32] Regehr C, et al. Interventions to Reduce the Consequences of Stress in Physicians: A Review and Meta-Analysis. Journal of Nervous & Mental Disease. 2014; 202(5):353-359. doi: 10.1097/NMD.0000000000000130

[33] Klimecki OM, Leiberg S, Ricard M, Singer T. Differential pattern of functional brain plasticity after compassion and empathy training. Social Cognitive and Affective Neuroscience. 2014; 9: 873-879.