Autism Spectrum Disorder, Cluster B Personality Pathology, & Empathy

This video answers the questions: What is the relationship between Autism Spectrum Disorder (ASD) and empathy? Is the lack of empathy different when comparing ASD and Cluster B Personality Pathology (antisocial, borderline, narcissistic, and histrionic personality disorders)
Is empathy assessed different for each group?

Empathy in Autism Spectrum Disorder
Irene E. Harmsen
Journal of Autism and Developmental Disorders

Does Theory of Mind Training Enhance Empathy in Autism?
Annaleena Holopainen, Daniëlle M. J. de Veld, Elske Hoddenbach1, Sander Begeer
Journal of Autism and Developmental Disorders (2019) 49:3965–3972

Dudas, R. B., Lovejoy, C., Cassidy, S., Allison, C., Smith, P., & Baron-Cohen, S. (2017). The overlap between autistic spectrum conditions and borderline personality disorder. PLoS ONE, 12(9), 1–13.

Strunz, S., Westphal, L., Ritter, K., Heuser, I., Dziobek, I., & Roepke, S. (2015). Personality Pathology of Adults With Autism Spectrum Disorder Without Accompanying Intellectual Impairment in Comparison to Adults With Personality Disorders. Journal of Autism and Developmental Disorders, 45(12), 4026–4038.

Support Dr. Grande on Patreon:

[NTraveller]

My ex-wife and my parents are narcissists and my son is an asperger. Their empathy abilities differ greatly. My son, being 4-year-old is much more emotionally mature than my wife. He often fails to notice other people's emotions, but once he does, he really lives into it, and really feels for other people. My parents and my ex-wife observe other people's emotions with sadistic interest, they don't get infected with emotions, they watch them emotionlessly as if they were some lizards...

[kilumbata]

I used to date a guy with asperger, he told me right from the beginning that he had issues with empathy as well as reading social situations, so he might act inappropriately in certain situations, particularly concerning grief and sadness.

A bit into the relationship, a guy I worked with got in an accident and died. I told my then-boyfriend what had happened, , he was completely carefree and he essentially reacted the same way he would have, if I had told him I'd gotten a new blanket for Christmas. Instead of getting frustrated as I would have if we hadn't talked about it beforehand, I told him that it was very hard for me, and that I needed something different from him.

He immediately changed his behavior without questioning it or making excuses.

To this day that is still my greatest example of why it's important to talk openly about these things both before they become relevant and when they do.

[dimitrifeher]

Having autism is both a bless and a curse. I'm 19 years old. It's been a month since i discovered i had aspergers. Suddenly everything started to make sense to me. The lack of empathy is true. I keep a distance from others all the time but it's not something I want. I enjoy my private time, I love being alone for some time, that relax me a lot. But I *do* want to have a relationship with someone. The hardest part for me (and probably most of us) is how to approach people. When talking to someone I'm afraid they might leave me, get bored or judge me. I *need* to know what I'm supposed to say, I'm not trying to be rude, I just want to make the person feel comfortable around me, since being out in public on large crowds or with strangers it's _hella_ exhausting for me. Loneliness is good for us. But all the time it gets pretty bad. We just need someone to understand us and accpet us by who we are since there is no cure to it. *AND THANKFULLY THERE ISN'T* . A good analogy to this is: I'm a balloon floating in the air that needs a helping hand to not get lost, and don't try to bring me to the ground, I wasn't made for that, both of we can help each other and be happy in that way. =)

[TheJilayne]

Really glad to see Dr. Grande do this video. I am a mature woman who has just been diagnosed with ASD this past fall and so many things finally make sense. I spent many, many years going to mental health professionals and never getting an answer that fit. My Mother was diagnosed with Borderline Personality Disorder. She is now in her 80s but we think she might actually be ASD as well. Apparently this is a common misdiagnosis for women on the spectrum. Would love to see more videos on ASD from Dr. Grande.

[nextpage]

That is so true that people with cluster B disorders are not able to self-report their thoughts and actions.
My mom considers herself to be one of the kindest and helpful(lest?) people on Earth but everyone runs from her because what we see is that she is manipulative and never tells her truth. There are always secret agendas and secret anger in her. So ... she thinks of her as of a victim. And - she never stops to think why ALL the people run away from her. For her it's like some witch-hunt. She does not see that she is the reason why people stay away.

[XXTHETHMANXX]

I have asbergers I have found that I feel empathy but sometimes don't know how to express it.

[michelleduval]

I'm autistic woman. I do prefer call myself 'autistic' over aspie. I was recently diagnosed with ASD (some months ago in age 26). And I thought about empathy a lot. I remember many autistic people said they have a high level of empathy (some of them may not have this level of empathy) and... I feel that. There was explanation that autistic people may be overwhelmed by emotion of other people in this same room with them (for example, a waiting room in doctor office). And this is what I experience. I have a high level of emotional empathy and I have a problems with cognitive empathy. I would be like 'this person is angry! WHY? They are probably angry at me!'. I won't realize that this person doesn't like the song which is playing right now or they are angry at something else. Also, I have a high level of compassion too towards my family, friends, and my cats (pets in general). My compassion is so high, I can't even say if it's my emotions or somebody's else. Anyway, I'm an autistic woman. I'm not sure if it's the same for men. Plus, I feel like people in our community are different and each person's experience unique. I can't say if many aspies/autistic people feel the same or not

[fullscorpion]

I have come to believe that I am on the spectrum. I believe that I did not get diagnosed because of the traumatic home environment I grew up in. I was diagnosed DID, but I rejected this later once I realized no hidden memories were ever coming to surface other than the ones I didn't ever forget. I'm in my fourties and have only been able to maintain one job longterm, and that was a software developer/data analyst where autistic behaviors seem to be tolerated more. I could shut the world out and just code. I could leave work early and code at home once my headache started. I have always been overly sensitive to noise, lights, sounds, smells and all sensory input to the point of getting a migraines once I've reached my limit. I cannot maintain relationships and I have given up on the idea. I have always felt overwhelmed and broken and my health is reflecting my internal struggles. I feel overwhelming empathy, but it's always too late after the fact when I've gotten away from the situation and I can process what happened. The only creatures I always feel comfortable with are dogs and horses. Their communication is always honest and upfront, and they always allow you to fail and learn from failure whereas people give up so quickly.

[JemyM]

In my experience, a person with Asperger care a lot, they just have difficulties to see social cues.
A cluster B see a lot of social cues, they just don't care or feel themselves entitled to not care.

For a person with Asperger you just need to ask questions and communicate with them verbally.
For a person with cluster B the communication doesn't help. They don't care, and may take your attempt to talk with them as an excuse to attack you or fake more misunderstandings.

Befriend a person with Asperger, and you have a solid, loyal friend for life, despite their eccentrics.
Befriend a person with Cluster B, and you will eventually find out you weren't friends at all.

A person with Asperger will read the lines, and nothing in between.
A person with Cluster B will actively add things between the lines and ignore the lines themselves.

A person with Asperger is usually exactly what they say they are. They are extremely predictable. Its like interacting with a solid rock.
A person with Cluster B are almost never where you expect them to be. Its like interacting with a gas cloud.

A person with Aspergers are often attacked due to misinterpretions.
A person with cluster B often attack people due to misinterpretions.

A person with Asperger will (annoyed) correct you on rigid factual information and insist until you "get it", but is very unlikely to ever block or unfriend you on social media. They criticise you to make you a better person.
A person with Cluster B will (annoyed) leave you for made up reasons and insist you are an awful person for not getting it right before they told you about it, and they are very likely to block or unfriend you on social media. They criticise you to push you down.

A person with Asperger will lecture you for hours on their special interest.
A person with Cluster B will fake having your special interest.

[Adara]

Could you do more videos about empathy, please? It would be interesting to hear your analysis as to why certain individuals innately are HSP or empathic by nature, and why some individuals develop more empathy as they grow older via environmental factors or 'nurture.' Also, it would be helpful to understand more about the absence of empathy in certain personality disorders and how these differ in their expression.

[Bar_Bar]

Can you do one on ADD and CPTSD when it comes to attention and focus, how are they different in this area and how do you recognize each other?? Please!

[deedlessdeity]

I think this was part of one of my rather complex questions, and I am so thankful for scratching at this.
Many autists, including myself, get accused of narcissism, usually in Gaslighting environments set up by Cluster-Bs. A friend of mine is currently going through the same, being accused as a forward defense (projection) by her abuser (the clearly oedipal & narcissistic stepmother). And as I have seen with other autists, including myself, they tend really take this accusation to heart and introspect, seek feverishly where this might be true and often find false positive answers, reduce any self-preservatory behaviours they mistake for selfishness even more and thus subject themselves to those psychological abusers even more. It is surely not for all cases and strands of autism, but I have observed this trend among a significant number of the high functioning types I know.

My follow-up question in this general topic is implied in the previous paragraph and was surely asked in some poor way before. For obvious contextual reasons here, I try to state it again:
Is there a predator/prey dynamic between certain personality types and especially disorders? Especially in relation to Cluster-B and the emotionally immature/naive non-Cluster-B individuals? Autists might also fall into this category as they tend to not easily pick up on liars, unless confronted directly with the reality checks. Also on this notion, it seems to me that Gaslighting affects Autists maybe not harder, but faster (thus seeming harder in effect over time) than non-Autists. My assumption would be that this is due to our prevalence to deal in raw factual information first and other aspects of communication secondary or tertiary. Continued Gaslighting thus triggers an ever more sore response with frantic reality checks about the given (false) information and accusations, wearing the mind down extremely fast.
I could elaborate and meander more, but I think my question is already getting lost.

Thank you for this piece, as I stated in the beginning. I was, for maybe understandable reasons, scared of the content at first, thus did not watch it right away as I should have and my exitement wanted me to when I got the notification. Either way, these are quite personal topics; whether regarding me directly or the people I had to deal with up until this point in my life. More knowledge, understanding, processing, gives more control and structure and stability back though, and thus must always be sought.

[jshir]

Sometimes our “lack of empathy” simply means that we disagree engage a different opinion from a neurotypical. Otherwise we often do understand or care what they think

[laetitialalila]

Thank you, Dr. Grande, for making these videos! They are fascinating and informative. I also love your voice, it calms my hyperactive sympathetic system down. 😊

[MatthewC]

I have autism/Asperger's and I actually am very empathetic when I understand how someone's feeling, it's just that a lot of the time I don't understand what the social situation is, how to put myself in other people's shoes, or I otherwise don't express my empathy appropriately. My grandfather was almost definitely Cluster B (he was diagnosed with BPD, but he in all likelihood was clinically a narcissist as well, but he never sought mental health as he didn't think there was anything wrong with him and there wasn't a lot of awareness around mental health in his generation), and he was the opposite- he would understand the social situation completely, but he wouldn't care how other people thought and often use the situation to manipulate people. His biological father (he was adopted) in all likelihood was a sociopath/ASPD as well.

[jenlovesthisstuff]

Could you please do a video on a relationship of a daughter with ASD and a mother with cluster B personality (covert narcissism) ?

[luanads]

From my 20 to my 30 I was diagnosed with bipolar, on my 30 they changed my diagnose to borderline, then I was diagnosed with borderline traits, now I'm seeing a new psychologist, she does not rule out the borderline traits, but she believes I might be in the spectrum. All I wanted was a definitive diagnose. I feel that not having a closure on that keeps me hostage of exploring my full potencial. It's like telling someone they might have diabetes, but you can't be sure, should they eat chocolate, shouldn't they?! Should they have insuline or not... :/

[Celestein]

I am autistic (late diagnosis) and my own experience is that we typically have very strong empathy. However our issues around acceptable and expected social cues impede the comfortable expression of our emotions. I explain it as being like a foreign language or culture: A person can express rich, warm emotions but if you don't know their language, it may be completely lost- even sound hostile and scary- because you don't understand the same nuances and meaning. Autistic people do not 'lack' emotions, we express and process them in ways that are foreign to and difficult to interpret by non-autistics. Many autistic people become avoidant and reclusive from receiving frequent negative reactions from people when they express themselves freely, not because they fundamentally dislike people and connection. Being constantly misunderstood and treated as 'weird' by the wider society is stressful and alienating and would make anyone prefer to be a hermit.

[Desertphile]

Thank you for covering these topics. In the past I have left comments to your videos regarding autism and how ASD relates to the personality disorders you have mentioned--- for example, I noted that I am well below clinical / diagnostic level for any known personality disorder, yet I behave in at least a dozen assorted personality disorder behaviors and I assume it is due to being born autistic. In your videos I intellectually winced a few times when you have mentioned diagnostic criteria for personality disorders that are common autistic behaviors and not *ONLY* a personality disorder marker.

[Sanslife]

Layered is a good look on you, Dr. Grande!

I find the structured assessment really interesting. I struggled with empathy deficits growing up, and I think this very formal way of explaining the components of an empathic response really would've helped a younger me.

One thing I'd like to point out is that moving from category IV to V is partially a function of relevant life experience. It's really hard to know what emotion to mirror if you've never experienced something. Unfortunately, a lot of people actively hide painful experiences from children, so it can be really confusing to try and learn from observation. Fortunately, fiction can help stand in for some of this experience.