The Double Empathy Problem

Autism, which is referred to as Autism Spectrum Disorder as defined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision, is a neurodevelopmental difference that can manifest as differences in communication, emotional expression, sensory processing, behaviors, and support needs.

Historically, the medical model has conceptualized Autistic traits as inferior to neurotypical tendencies and indicative of “deficits” that need to be fixed. However, in recent years the neurodiversity movement has increasingly asserted that “different” does not equal “less,” and Autistic people’s experiences are equally valid to their neurotypical peers.

Dr. Damian Milton, an Autistic academic, developed the theory of “double empathy” to conceptualize the communication and interpretation disconnect experienced when neurotypicals incorrectly interpret Autistic people’s experiences and emotions. Below, we explain Double Empathy, the differences in neurotypes and communication styles, and how understanding this theory can improve communication between people of different neurotypes.

The Double Empathy Problem: What Is It?

In basic terms, the double empathy problem is a theory that posits that people with different experiences and perceptions will have more difficulty empathizing and communicating with each other compared to people who are more similar to each other. When we find someone more relatable, we have an easier time feeling empathy for them. When we do not find those commonalities, we struggle to experience the same level of empathy.

False Beliefs of Autistic People and Their Communication Styles

“Previously, the assumption was that we Autistics lacked the theory of mind or the ability to recognize social cues,” says Stephanie Cartwright-Karlsson, LICSW, “This made it easy for neuronormative people to assume that communication difficulties were solely our “fault.”

However, the double empathy problem highlights that it’s not that Autistic people have inherent communication challenges, but that neurotypical/neurodivergent communication is difficult because we’re trying to communicate across neurotypes.

“Autistic and non-Autistic people have vastly different experiences of the world,” Dr. Alex Fox, PsyD, says. “With such different perspectives and frames of reference, interactions aren’t going to have the same ease or automaticity. I liken it more to a language barrier than a deficiency on the part of Autistic folks, as previous theories have emphasized. And, like a language barrier, it can be bridged with effort and a willingness to learn—on both sides.”

Real Stories of Communication Breakdown

There is a breakdown in communication and empathy when we assume that one way of being is “right,” and every other way is “wrong.”

Brian G., an Autistic adult, says Autistic people are expected to accommodate neurotypical communication styles. “I have spent my life coping with misunderstandings on both sides. Every manager I had told me to listen more and talk less in meetings,” he says. “People always said I came across as a know-it-all. I was fine as the presenter in a lecture or presentation setting where I was expected to know it all. In personal communications, people said I came across as loud and bossy. I learned to get my point across by asking leading questions so someone else would come up with the answer.”

Placing the burden of adapting on the Autistic person can be exhausting. Autistic adult Nonya B. says she doesn’t “bother talking or asking. Most people just want to talk anyway [and] not engaging lets them think a conversation occurred.”

Masha S., an Autistic adult shares a similar experience: “I often don’t feel safe when talking to neurotypical people (or people I assume are neurotypical). I am aware that I might offend them without meaning to, I notice they respond as if I’m being funny or odd when I am not aware what I’m doing to cause that reaction.”

Origins and Development of the Double Empathy Problem

Dr. Damian Milton, an Autistic researcher and social psychologist, coined the term “double empathy problem” in 2012. Dr. Milton identified the tendency to assume Autistic communication deficits rather than acknowledging reciprocal breakdowns of communication between Autistic and non-Autistic people.

According to Dr. Milton, this assumption has led to stigma and negative perceptions of Autistic people, including the assumption that Autistics do not have theory of mind because they do not express emotions in neurotypical ways.

In Dr. Milton’s words: “the ‘double empathy problem’ refers to a breakdown in mutual understanding (that can happen between any two people) and hence a problem for both parties to contend with, yet more likely to occur when people of very differing dispositions attempt to interact. Within the context of exchanges between Autistic and non-Autistic people however, the locus of the problem has traditionally been seen to reside in the brain of the Autistic person.”

The Double Empathy Theory Gives Autistic People Autonomy

The belief that Autistic people do not have a true sense of identity is not new. In fact, Ole Ivar Lovaas, the psychologist who developed Applied Behavioral Analysis, once said: “you start pretty much from scratch when you work with an Autistic child. You have a person in the physical sense—they have hair, a nose, and a mouth—but they are not people in the psychological sense.” This mindset dehumanizes Autistic people and has been used as an excuse to strip autonomy from Autistics.

Core Concepts

The double empathy problem seeks to reframe communication difficulties that many Autistic people experience. It asks us to think about communication as a two-way street, where both parties—NT and ND people—make efforts to find an effective middle ground rather than assuming that one side is fundamentally flawed.

“Because [ND people] experience challenges in communicating, we may believe that we have deficits instead of recognizing the issue is the interplay between NT and ND communication styles,” Stephanie Cartwright-Karlsson, LICSW, explains. “I think it also harms Autistic people because our experiences are never centered.”

All Communication Styles Are Valid

It additionally challenges the notion that common methods of communication are superior. Different communication styles are valid even if they are not compatible with each other. And when we accept that different communication methods are equally valid, we can accommodate both parties instead of insisting that one side accommodate the other. It allows reciprocal efforts for clarification.

“I think it would be amazing if non-Autistic people could go so far as to decenter themselves,” says Cartwright-Karlsson. “For instance, instead of saying ‘I don’t understand what you’re trying to say,’ they could say ‘I think I am having a hard time understanding, could you offer another example?’”

Finally, the double empathy problem demonstrates that Autistic people are human beings regardless of communication style. It contradicts the idea that an Autistic mind is broken and requires fixing.

Implications of Double Empathy

Dr. Milton’s introducing of a specific term for this concept has allowed for more education and awareness about Autistic communication tendencies and neurotype. Autistic advocates use the concept to express that Autistic people do, in fact, have theory of mind.

“Despite the likelihood that these difficulties in understanding come from both sides, the burden almost always falls on the Autistic person to ‘appropriately’ perform in social interactions,” he says. “For high-masking individuals, this can be exhausting. For others, it can seem insurmountable.”

Without increased education and understanding on the part of non-Autistic people, it is unlikely that this will change. Autistic people will continue to suffer fatigue, burnout, and social and employment setbacks until there is a wider understanding of these differences.”

Although the double empathy problem is used to convey how Autistic communication tendencies differ from that of non-Autistics, it does not mean that two people with the same neurotype will communicate without issue. Miscommunication, misunderstanding, and breakdown of understanding and empathy can occur between any people who are interacting with each other.

Autistics can and do miscommunicate with each other, and non-Autistics can and do miscommunicate with each other. Double empathy simply refers to the tendency for breakdowns to occur more frequently between people who do not share a neurotype.

Criticism of Double Empathy

Some critics of the double empathy problem note that it simplifies the concepts of communication and empathy. As with many things, interpersonal interactions are highly complex and cannot be boiled down into simple, easy-to-digest concepts.

However, like other explanations of human experience developed for public consumption, double empathy attempts to simplify a difficult concept in a way that more people will be able to comprehend. Many concepts (for example, spoon theory) are overly simple when we truly consider all implications and angles of the idea.

Some Autistic people find that the concept of double empathy does not resonate with them. The notion that Autistic communication styles are different but not a deficit is sometimes criticized as downplaying the experiences of Autistic people who do feel that they struggle with communication. These experiences are valid and should be acknowledged.

Conclusion

The double empathy problem can assist in understanding and conceptualizing Autistic experiences with communication and social interaction. It reframes breakdowns that tend to occur between Autistic and non-Autistic people from a “deficit” on the Autistic person’s part to a difference that can be accommodated.

While imperfect, the double empathy problem helps fight stigma and harmful misconceptions about Autistic experiences. You can learn more about Dr. Milton and his work on his website.