*This post was originally published on The Neuroethics Blog.
by Georgina Campelia
Georgina Campelia is currently a Ph.D. Candidate in Philosophy at the Graduate Center, CUNY, working under the supervision of Virginia Held. Her dissertation, “Virtue’s Web: The Virtue of Empathic Attunement and the Need for a Relational Foundation,” develops an account of empathic attunement, defends its status as a virtue, and sketches a relational ontology of virtue that would better accommodate the relationality of this and other important virtues.
More broadly, Georgina’s research focuses on ethics and feminist theory, with particular interests in virtue ethics, care ethics, empathy, the interdependence of ethics and epistemology, and interrelational conceptions of persons. Georgina’s work extends this theoretical work to neuroethics and medical ethics, where much of her research concerns using virtue ethics and care ethics to guide patient care, establishing structures to enable and encourage empathy, and creating greater awareness of the relational constitution of patient identity and medical decisions.
Georgina is currently an affiliate instructor at the Montefiore Einstein Center for Bioethics, where she teaches in their Certificate and Masters Programs. She also serves on the Steering Committee at the New York Society for Women and Philosophy (NYSWIP) and is a co-organizer of SWIPshop (a workshop for feminist philosophy).
As the lack of empathy in the world has become particularly apparent and troubling in light of the resistance to offering asylum for Muslim refugees (see this recent article from The Guardian), perhaps it makes sense that the study of empathy is booming (Coplan, 2014; Decety, 2012; de Waal, 2009). Philosophers question and defend its moral worth (Bloom, 2014), psychologists and primatologists consider its nature and origin (Hoffman, 2000; Waal, 2012), and neuroscientists explore its metaphysical structure (Singer, 2009; Zaki & Ochsner, 2012). Empathy offers a distinctive ground for interdisciplinary work and, yet, little has been done to advance cross-field communication. While some popular work offers broadly incorporated perspectives (de Waal, 2009), and there are some anthologies that include multiple disciplines (Coplan & Goldie, 2014; Decety, 2012), there is room for more robustly integrated research.
|Image of a baby macaque imitating facial expressions courtesy of Wikimedia.
Experiments on mirror neurons began with the objective of understanding goal-directed movement and action-imitation using monkeys (Pellegrino, Fadiga, Fogassi, Gallese, & Rizzolatti, 1992). Di Pellegrino et al. found that many of the same neurons that were active when the monkey performed an action (e.g. grasping a piece of food) were also active when the monkey observed an experimenter performing the same movement. The fact that there were motor neurons that were active when a monkey merely observed another’s action seemed to strongly suggest some kind of empathic mechanism.
The discussion around mirror neurons continues to evolve (see a response from Catmur et al. here and special AJOB Neuroscience issue edited by Jean Decety here), but communication across disciplines is still lacking. This is especially true of philosophy and neuroscience. On the one hand, the philosophy of empathy largely neglects the findings of experiments that study mirror neurons or the general networks of brain activity that reflect some kind of mirroring the other or feeling with the other (Coplan & Goldie, 2014; Slote, 2007). To ignore these findings is to ignore our own physicality and, potentially, to imply that empathy is merely ‘substantial,’ ‘non-physical,’ ‘mental’ (i.e. not real). One reason for unease here rests on how such assumptions maintain the dualisms and binaries that many feminists have sought to resist. If empathy is ‘merely’ mental, emotional, feminine, it is all too easy to discount its epistemic, moral and metaphysical import. On the other hand, much work in neuroscience and cognitive science seems to proceed with a notion of ‘empathy’ that is not fully analyzed and rarely questioned (Singer & Lamm, 2009; Zaki & Ochsner, 2012). Why think that some affective resonance in witnessing a partner’s pain (Singer, Seymour, et al. 2004) is a matter of empathy rather than sympathy or compassion? Does it not pain me to see a refugee tripped by a camera-person even though I can’t possibly know how that feels (i.e. empathize)? How are we to differentiate this form of affective resonance from actually understanding how another feels (i.e. empathizing)? This vagueness holds many dangers, including the epistemic and moral injustices that arise in conflating empathy with sympathy and other forms of affective responsiveness. The assumption that fMRI imaging proves empathic understanding (i.e knowing how another feels) (Singer, Seymour, et al. 2004) when it could be sympathy or compassion instead (merely feeling badly for another), could be used to justify the false assumptions of empathy that deepen marginalization and dehumanization, e.g. a politician’s claim to understand (and empathize with) the plight of a Syrian refugee while denying asylum. As Singer and Lamm’s more recent evaluation of the current status of the social neuroscience of empathy suggests, there is reason to proceed with caution and make efforts to enhance differentiation (Singer & Lamm 2009).
Further, there is work on both sides that is guilty of overly extoling or too quickly dismissing the connections between mirror neurons/systems, empathy, and moral value. For instance, Jesse Prinz argues that empathy is “not necessary” for morality (Prinz 2011), which is a far cry from it having no role in morality (or even a substantial role depending on the definition of empathy). Similarly, critiques of mirror neurons in cognitive science sometimes neglect the space between mirror neurons as the basis of action theory and mirror neurons as completely devoid of import to cognition (see Gregory Hickock’s recent book review from AJOB Neuroscience here). The pitfalls on all sides are troublesome, but all the more reason to find means of reflective integration. In particular, I have found that work in neuroscience on mirror neurons may help to challenge atomistic views of the self. Studies of mirror neurons and mirror systems suggest that, at least at times, self and other are not easily divisible. In empathizing (or otherwise affectively mirroring), we engage with others in ways that are more integrative of feelings, perspectives, and subjective experiences, i.e. more deeply relational.
|Children shown images of painful accidents have activation
of some pain circuits in the brain. Image courtesy of Wikimedia
As suggested above, multiple studies have found that “vicariously experiencing pain activates part of the neural network that is also activated when we are in pain ourselves” (Singer & Lamm, 2009, p. 85). In one such experiment, Singer et al. (2004) studied the reactions of participants to a partner experiencing pain by using fMRI to measure patterns of neural activation. As Singer & Lamm conclude, “The results suggest that parts of the so-called pain matrix (Derbyshire, 2000)… were activated when participants experienced pain themselves as well as when they saw a signal indicating that their loved one would experience pain” (Singer & Lamm, 2009, p. 85), also formerly discussed on the blog here.
First, while this work does not conclusively demonstrate empathy, it does support the claim that we can ‘feel-with’ (Code, 1995). In other words, when we observe another in pain, can mirror the person’s affective state (at least to some degree), thus engaging in some level of empathic resonance (even if we cannot fully understand how the other feels). While much work must be done regarding the methods by which we achieve such mirroring and what that mirroring amounts to (e.g., could it be that we are only projecting ourselves into the experience of the other?), we certainly and at the very least see a minimal level of interconnected brain states. Rather than avoidance, neglect, or detached perception, connections reliably develop between experiential states. This is not to say that we feel the other’s emotion, but we can and do feel-with the other to some extent or another.
Second, this research presents a picture of the self that does not only externally react or respond to others, does not only cognitively consider the experiences of others and then respond (as in theory-theory of mind) (Baren-Cohen, 2011; Zahavi & Overgaard, 2012), but rather possesses an internal experiential state that regularly emotionally engages with and reflects the experiences of others. This fits with phenomenological and psychological claims about empathy’s role in development and day-to-day interactions with others (Code, 1995; Hoffman, 2000; Keysers, 2011; Slote, 2007; de Waal, 2009). If, as these accounts suggest, we are so continuously and deeply affected by the emotional experiences of others, then we have some reason to conclude that the self is developed in relation to others and persistently connected to the experiences of others as many feminist theorists have contended (Bartky, 1997; Code, 1995; Fricker, 2007; Held, 2006; Kittay, 1999; Nedelsky, 2011; Tietjens Meyers, 1997; Whitbeck, 1983).
This is not to say that all mental states are so connected, or even mental states beyond the experience of pain; we simply do not yet know. Further, while there is a significant degree of overlap, there is also a significant degree of distinction in the two neurological processes (self-experience and vicarious experience), and we still know very little about the specific functions of the relevant brain areas (nevermind individual neurons and networks). However, these studies suggest a greater degree of affective interconnection than originally supposed by a vast amount of neurological, psychological and philosophical literature.
Ultimately, if we are more deeply relational selves, then the relations we hold with others matter to who we are and to our moral responsibility . For instance, according to most ethical theories, a politician who spouts anti-Muslim views could be responsible for psychological harm and maybe, with some stretching, for physical harm that results from others acting on those views. But a relational view of the self and a relational ethics will offer something different. In addition to the harming of other individuals, the politician could be responsible for forming uncaring relationships. In particular, perhaps we can say that the fault lies in the failure to develop empathic connections with those who need them most. In this way, the wrongdoing of the opposition to accepting refugees can be said to be a failure of empathic engagement. The politician does not really try to understand how the refugees feel and, therefore, does not take the subjective experience of the refugee seriously. This is a substantial form of disrespect and dehumanization that is only available once we take relationality and empathy seriously.
Now, as some philosophers have argued, one might say that the politician’s stereotypes obstruct empathy (Prinz, 2011) and that empathy is or becomes impossible (Goldie, 2014). Without the ‘is’ we cannot get the ‘ought’ claim off the ground. However, neuroscience largely suggests that stereotypes do not necessarily prevent empathy. Positive stereotypes can enhance empathy (Jussim, Harber, Crawford, Cain, & Cohen, 2005; Lewis & Hodges, 2012). And even the research that suggests that empathy is affected by in-group and out-group biases fails to demonstrate that these biases are immovable or impossible to overcome (De Dreu, Greer, Van Kleef, Shalvi, & Handgraaf, 2010; Lewis & Hodges, 2012). Thus, any obstruction to empathy that stereotypes might provide does not necessarily excuse empathic failure. In fact, given the relational view above, it calls all such dimensions of empathic relationships into the bounds of individual responsibility.
So, while the main question here is an ontological one and, therefore, largely leaves open questions about if, when and how we should engage empathically with others, it does lead us toward new dimensions of responsibility and wrongdoing. These are dimensions of our ethical lives that dig into our psychological relations with others and plunge us into broader ethical concerns. Can a human rights framework of justice ultimately succeed if it obligates tolerance but not empathic or otherwise caring relations? Similarly, might a strong handed focus on the principle of autonomy ultimately steer medicine deeper into the abyss of consumerism and liability rather than into structures of caring and affectively engaged relations? Ultimately, it will be a reflective integration of philosophy and neuroscience, not a reduction to one or the other, that leads us to ask these very important questions and gets us on the track of providing more comprehensive answers.
 Here, I do not make any claim that a relational account of the self is holistic or collectivist as it is in some Eastern Philosophy (Chan, 1999). Further, taking relationality seriously does not entail that we are mere nodes of relations (as in some postmodern sociology, e.g. (Taylor, 2001)). Nor does it entail a loss of individuality or individual responsibility, as relations can still be embodied.
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