The Neuroscience of Empathizing With Another Person's Pain

Observing American flags flying at half mast for the past week—to commemorate those who lost their lives in the deadliest mass shooting in U.S. history last weekend—speaks volumes about human beings' ability to empathize with others' pain.

Although the details of what motivated Omar Mateen to kill 49 people in the Pulse gay nightclub in Orlando Florida last Sunday remain murky . . . it seems that this was a targeted hate crime against members of the LGBT community. Despite the bigotry that fueled this mass murder, the outpouring of empathy from citizens across the country and our Commander-in-Chief, is heartwarming and reassuring.

As a gay person, I've lived through periods of institutionalized homophobia—especially at the beginning of the AIDS pandemic in the 1980s. During this period, there was often a lack of empathy regarding the decimation of those within my community by the HIV virus. We’ve come a long way towards achieving LGBT equality in the United States. Unfortunately, the “us" against “them” rhetoric towards other "out-groups" within the U.S. is alive and kicking in the 21st century.

Recently, news headlines have been filled with reports of violence and hate speech against members of various “out-groups" by those who identify with a different “in-group." What can we do to reverse the trends of intolerance and violence against marginalized groups of individuals who are collectively treated like second-class citizens? The latest neuroscientific research offers some valuable clues.

In this blog post, I’ve compiled findings from a variety of empirical studies that deconstruct the brain mechanics of Theory of Mind, which is basically the ability to put yourself in someone else’s shoes. Hopefully, these neuroscience-based findings can provide insights and actionable advice to increase empathy, loving-kindness, and pro-social behaviors for readers of all ages and walks of life.

Technically, theory of mind is a branch of cognitive science that investigates how we ascribe mental states to other people. One of the keys to theory of mind is the understanding and acceptance by an individual that other people have different beliefs, desires, and intentions from one's own.

Perceiving and Empathizing With Others' Pain Is a Cognitive Process

This week, a groundbreaking study was published which found that the ability to empathize with another person’s pain is rooted in cognitive neural processes that differ from the sensory processes used to perceive and experience one's own pain.

The June 2016 study, “Somatic and Vicarious Pain are Represented by Dissociable Multivariate Brain Patterns," by researchers at University of Colorado, Boulder, was published in the journal eLife.

Previous research on empathy has suggested that the same brain regions which allow someone to feel pain in his or her own body activate brain responses necessary to vicariously experience the pain of others. However, the latest research shows that empathizing with another person’s pain involves different neural circuitry than experiencing pain oneself.

In my opinion, this is both good and bad news. On the bright side, it shows that the neural constructs of empathy are never fixed and that compassion can be learned. However, on the flip side, these findings also suggest that sociopaths, and those who are incapable of practicing theory of mind, may have short-circuits in their neural mechanisms that make it practically impossible for them to empathize with others' pain.

"The research suggests that empathy is a deliberative process that requires taking another person's perspective rather than being an instinctive, automatic process," Tor Wager, senior author of the study and director of the Cognitive and Affective Neuroscience Laboratory at CU-Boulder said in a statement.

To test this hypothesis, Wager and colleagues at CU-Boulder compared patterns of brain activity in human volunteers as they experienced first-hand moderate pain directly (via heat, shock, or pressure) and then, as they watched images of others' hands or feet being injured in another experimental session.

While the volunteers watched images of pain being inflicted on others, they were asked to imagine that the injuries were happening to their own bodies. Interestingly, the researchers found that the brain patterns when the volunteers observed pain in others did not overlap with the brain patterns when the volunteers experienced pain themselves. Instead, while observing pain, the volunteers showed brain patterns consistent with mentalizing, which involves imagining another person's thoughts and intentions.

Neuroscience Shows How Our Friends and Family Become Ourselves

A 2013 study, "Familiarity Promotes the Blurring of Self and Other in the Neural Representation of Threat," found that humankind's profound capacity for empathy sets us apart from all other species. The researchers at University of Virginia found that most humans are hardwired to empathize with those close to them at a neural level.

Interestingly, the ability to put yourselves in another person’s shoes often depends on whether the person is a stranger or someone you know. According to researchers, the human brain puts strangers in one bin and people you know in another bin.

The researchers found that friends and family within your social network literally become entwined with your own sense of self at a neural level. "With familiarity, other people become part of ourselves," said James Coan, a psychology professor in University of Virginia's College of Arts & Sciences who used fMRI brain scans to identify that people closely correlate the emotions of people to whom they are emotionally attached.

Humans have evolved to have our self-identity interwoven into a neural tapestry with our loved ones. In a statement, Coan said, "Our self comes to include the people we feel close to. This likely is because humans need to have friends and allies who they can side with and see as being the same as themselves. And as people spend more time together, they become more similar.”

To test this hypothesis, Coan and colleagues conducted a study with 22 young adult participants who underwent fMRI scans of their brains during experiments to monitor brain activity while under threat of receiving mild electrical shocks to themselves versus a shock to a friend or a stranger.

The researchers found that regions of the brain responsible for threat response—the anterior insula, putamen and supramarginal gyrus—became active under threat of shock to the self and when a friend was threatened. In fact, when the threat of shock was to a friend, the brain activity of the participant was basically identical to the activity displayed under threat to the self. However, when the threat of shock was to a stranger, these brain areas showed minimal activity.

People Can Learn to Empathize With Outside Groups

Conflicts between people from different nationalities and cultures often stem from a lack of empathy or compassion for strangers in an outside group who are not viewed as comrades, friends, or family. However, another study—which dovetails perfectly with the research by Coan et al. at University of Virginia—found that empathy for strangers from outside groups can be enhanced simply by having a positive social interaction with someone who was previously perceived as a stranger.

The December 2015 study, “How Learning Shapes the Empathic Brain,” was published in the Proceedings of the National Academy of the United States of America. This study found that positive experiences with someone from another group trigger a learning effect in the brain, which increases empathy.

For this study, psychologist and neuroscientist Grit Hein teamed up with Philippe Tobler, Jan Engelmann, and Marius Vollberg to measure brain activity in participants who had positive social experiences both with a member of their own group (in-group member) compared with someone from a group of strangers (out-group member).

During the experiment, study participants expected to receive painful shocks to the backs of their hands. However, they were also told that a member of their own, or another group, could pay money to spare them the physical pain. Brain activity was measured when someone was observing pain being inflicted on a person from his or her own "in-group" or a stranger from an "out-group."

At the beginning of the study, a stranger's pain triggered weaker brain activation in the observer than if the pain was being inflicted on a member of someone's own group. However, after only a handful of positive experiences with an individual from the stranger's group, there were significant increases in empathic brain response when pain and suffering was inflicted on a new acquaintance from the out-group.

Not surprisingly, the stronger the positive experience with the stranger, the greater the increase in neuronal empathy. Positive social experiences, brain changes, and empathy appeared to grow in tandem. This speaks to the importance of avoiding situations that create unnecessary homogenization societally. Diversity benefits members of every sub-group, as well as the majority, within any given community.

In this study, the increased empathetic brain response for the out-group member was driven by a neuronal learning signal that develops simply through positive experiences of generosity and reciprocity with a stranger. In a statement, Hein concluded, "These results reveal that positive experiences with a stranger are transferred to other members of this group and increase the empathy for them."

Conclusions: Self-Forgiveness, Loving-Kindness, and the Empathic Brain

Of course, there are no easy solutions for encouraging the healthy development of theory of mind, or for teaching people how to be more empathetic. More research is needed to explore all the various factors that influence one's ability to adopt another's perspective and to empathize with someone else's pain.

That said, previous research has found that practicing a simple four-step process of loving-kindness meditation (LKM) benefits brain structure and functional connectivity. LKM also improves the tone of your vagus nerve, which is directly tied to the "tend-and-befriend" mechanisms of the parasympathetic nervous system.

LKM is a simple four-step process that only takes a few minutes each day. To practice LKM, all you need to do is systematically send empathy and loving-kindness to four categories of people:

1. Friends, family, and loved ones.
2. Strangers around the world and locally who are suffering.
3. Someone you know who has hurt, betrayed, or violated you.
4. Forgive yourself for any negativity or harm you’ve caused yourself or others.

Practicing LKM for just a few minutes every day can help re-wire and restructure the brain in ways that improve the levels of empathy we feel for friends, family, strangers, and ourselves.

Clearly, increasing empathy towards strangers and outside groups often takes a concerted effort. Hopefully, these insights on the neural basis of empathizing with someone else's pain will serve as a clarion call for all of us to make daily efforts to be more empathetic to the pain and suffering of strangers and those from so-called "out-groups."

To read more on this topic, check out my Psychology Today blog posts,

• "The Neuroscience of Empathy"
• "Your Brain Can Learn to Empathize With Outside Groups"
• "Why Are Some Neighborhoods Becoming Extremely Homogenized?"
• "The Neurobiology of Aggressive and Antisocial Behavior"
• "Can Reading a Fictional Story Make You More Empathetic?"
• "The Cerebellum Deeply Influences Our Thoughts and Behaviors"
• "The Neuroscience of Comforting Behavior in Times of Distress"
• "Mindfulness Training and the Compassionate Brain"

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