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Reply: Spontaneous versus deliberate vicarious representations: different routes to empathy in psychopathy and autism

Christian Keysers, Harma Meffert, Valeria Gazzola
DOI: http://dx.doi.org/10.1093/brain/awt376 e273 First published online: 5 February 2014

Sir, We thank Gillespie et al. (2014) for their letter. They summarize data that suggest that in autism, vicarious activations can be relatively normal under instructions explicitly encouraging vicarious processes, while being abnormal in conditions in which instructions do not. This points to an important opportunity to improve our understanding of empathy—both with regards to deficits in patients and individual differences in the normal population.

To date, the ‘cake’ called empathy has been cut in various ways. Some cut it in two pieces, cognitive versus emotional empathy (Baron-Cohen and Wheelwright, 2004), acknowledging that somewhat separate systems support the capacity to think what another is thinking (cognitive empathy) and to feel what another is feeling (emotional empathy). This has influenced our thinking about individual variability in empathy and psychiatric disorders, with some disorders, like autism, thought to be impaired more in cognitive empathy whereas others, like psychopathy, are impaired more in emotional empathy (Blair, 2005). Based on neuroscience, we have ‘cut’ empathy into four pieces: motor, emotional, tactile and cognitive empathy (Keysers and Gazzola, 2009). Mirror neurons in motor cortices and functional MRI activations in motor cortices during action observation suggest motor empathy: vicariously activating one’s own actions while witnessing the actions of others (Gallese et al., 1996; Gazzola and Keysers, 2009; Keysers, 2009; Caspers et al., 2010). Later, neuroimaging data showed that one also vicariously activate neural substrates involved in one’s own disgust (Wicker et al., 2003) and pain (Lamm et al., 2011) while witnessing the disgust or pain of others, suggesting emotional empathy. Somatosensory brain regions were also found to be vicariously active when viewing the tactile and haptic sensations of others, suggesting somatosensory empathy (Keysers et al., 2004, 2010; Gazzola and Keysers, 2009; Caspers et al., …

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