How do you think autistic people deal with hyper-empathy? originally appeared on Quora: the place to gain and share knowledge, empowering people to learn from others and better understand the world.
Answer by Nicole Gravagna, PhD neuroscientist, on Quora:
The anterior cingulate cortex (ACC) is a part of the brain that is important to processing social-emotional pain [1]. The ACC might also be a clue to solving social challenges like those experienced by people with autism, social anxiety, and even addiction.
Yes, surprisingly enough, the social behaviors associated with autism might be related to the social behaviors associated with addiction. Fortunately, there’s some great (and easy) solutions on the horizon.
We are learning all of this brand new information about autism, addiction, and the brain through fMRI data collected over the last 15 years. Finally, we have enough data to look back over it all and draw some new conclusions through meta analysis studies.
People with autism have smaller, thinner ACCs than the average person [2]. In brain-speak, thickness and density measures can mean that the brain region is stronger or weaker. A thin ACC could mean a weak ACC. So, when you see that ACCs are thin in autism, you might decide that the thin ACC is causing autism. Not so fast! The data seem to suggest that the behaviors of autism (and not the physiological basis of autism) cause a person to have a thin ACC. Keep reading! We can see more of the ACC puzzle by looking at people with addictions.
ACC cheat sheet:
- A thin ACC seems to contribute to a more intense experience of social pain.
- A thick ACC seems to be protective so that the person doesn’t experience social pain as easily.
Consider the brain of a person who has been suffering from an addiction. When a person suffers from an addiction, it can be an on-again-off-again experience. They recover, they fall off the wagon, they recover, fall off the wagon, perhaps ad infinitum. Scientists see that the thinning of the ACC seems to track with the amount of time that the person has been indulging in their addiction. When the person abstains from their addiction for a few weeks, the ACC plumps back up again [3]. When they descend into addiction behaviors, the ACC gets thinner.
You read that right. The ACC changes thickness pretty quickly. The brain acts more like a muscle than scientists used to believe. The thickness of the brain changes in different regions in direct response to the activities that we do in our lives.
So, what we are starting to see is that when a person indulges a self-soothing behavior like an addiction, they lose density in their ACC. Self-soothing behaviors, then, may lead to an increased intensity of social pain. Self-soothing behaviors could be as simple as sticking to a rigid schedule (or diet) to feel in control, or self-soothing behaviors can be as serious as street drug abuse. The ACC doesn’t seem to distinguish between these behaviors.
If you have autism, or know someone who has autism, you know that people with autism tend to have a backpack full of self-soothing behaviors that help them cope with life. It might be the case that those self-soothing behaviors are helping in the short term, and actually making it harder to cope in social situations over the longer term.
It might be true that people with autism have a higher sensitivity to social pain, which leads to a more pronounced use of self-soothing behaviors, which leads to an increase in the sensitivity to social pain, which leads to increased use of self-soothing behaviors. You see where this is going.
It looks like people with autism are more susceptible to fall on the painful side of a natural feedback loop that we all experience.
Feedback loop cheat sheet:
- Regularly soothing social pain results in a lower pain threshold.
- Regularly facing social pain and coming out unscathed results in a higher pain threshold.
Here’s a positive angle to this whole thing. Scientists see ACC thickness increases in people who begin meditation or mindfulness practices [4], even for those with addictions and autism [5]. If we extrapolate these findings, it looks like it might be fairly easy to create therapeutic programs for people who suffer from social pain.
The future looks bright for alleviating social pain, social anxiety [6], empathy pain, and the social challenges of autism. We will learn a lot more about the ACC over the next few years. Scientists are beginning to take this work out of the laboratory and into real-life applications to test efficacy.
Footnotes
[1] https://www.ncbi.nlm.nih.gov/pmc...
[2] The anterior cingulate cortex in autism: heterogeneity of qualitative and quantitative cytoarchitectonic features suggests possible subgroups.
[3] Dissociated Grey Matter Changes with Prolonged Addiction and Extended Abstinence in Cocaine Users
[4] Neural mechanisms of mindfulness meditation - Wikipedia
[5] Meditation as a Potential Therapy for Autism: A Review
[6] Anxious? Activate your anterior cingulate cortex with a little meditation
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