Using brain scans, researchers have discovered that empathic care and empathic distress have distinct patterns of brain activity that remain remarkably consistent across individuals.

Writing in Neuron, researchers from the University of Colorado Boulder and colleagues describe how they developed brain markers that could predict the intensity of the two forms of empathy in volunteers as they listened to true accounts of human suffering.

They also found that the brain markers for empathic care and empathic distress link differently to eight other feelings.

In their study paper, the team explains how there has been much debate on the distinction between empathic distress and empathic care.

Some have argued that empathic distress - the negative feelings that arise in response to witnessing the suffering of others - is a deterrent because it leads to distress and avoidance. In contrast, empathic care elicits helpful behavior.

Others have put forward the case that empathic distress leads to burnout in the caring professions, whereas empathic care leads to fulfillment and "sustained functioning."

Brain studies have also suggested that empathic distress and empathic care involve different brain systems.

However, what remains unclear, note the researchers, is whether the two forms of empathy can be accurately mapped onto different patterns of brain activity, and, if so, whether the patterns can predict the two emotions in different people.

'Empathy is a distributed brain process'

Thus, the team decided to address these points by inviting 66 adult volunteers to listen to 24 true accounts of people in distressing situations as they underwent brain scans, and then rate their feelings.

The researchers suggest that their approach was "naturalistic" and more akin to what we might encounter in daily life than that used in studies that represent distressing situations to subjects by flashing static images on a screen.

One of the stories that the participants listened to gives an account of a young addict in a boarding school who receives help to recover from addiction and later helps others to do the same.

The volunteers listened to the accounts of distress in two sessions. In the first session, they sat inside a scanner as the researchers recorded their brain activity during the narratives using functional MRI.

For the second session, which took place outside the scanner, the participants listened to the stories again and rated their feelings of distress as they went along.

The researchers then correlated the patterns from the brain scans with the scores that the participants gave, pinpointing them to the same sections of the narratives.

The researchers found that during empathy, brain activity can be seen all over the brain. In the same way as that observed when the brain is processing signals from the senses, the activity is not confined just to one brain region.

Senior author Tor D. Wager, professor of neuroscience at the University of Colorado Boulder, remarks that, "The brain is not a modular system where there's a region that manages empathy. It's a distributed process."

Different brain patterns

Prof. Wager and colleagues did, however, find different patterns of activity for empathic care and empathic distress.

For example, brain activity for empathic care occurred in the medial orbitofrontal cortex and the ventromedial prefrontal cortex, which are regions that are linked to value and reward.

The patterns for empathic distress, on the other hand, showed activity in the "premotor cortex and the primary and secondary somatosensory cortices," regions that are linked to mirroring, in which we simulate or imagine another's thoughts and feelings.

The researchers were surprised to find that the patterns for empathic care and empathic distress did not differ much from person to person.

In fact, the team was able to use the distinct brain activity patterns - which they call brain markers - to predict empathic care and empathic distress states in volunteers who had not been scanned before.

First author Yoni Ashar, a graduate student in Prof. Wager's group, says, "There is a personal element to when a person might feel empathic care or distress, but when you're feeling them, you're activating similar brain regions and brain systems as someone else might."

Distinct emotional maps

The team also carried out an experiment to find out how the two forms of empathy might influence behavior. They asked the 66 volunteers to donate part of the payment they were given for taking part in the brain scan experiments to charity.

The researchers found that both empathic care and empathic distress were equally likely to be associated with giving to charity.

The team also carried out a separate set of experiments involving another group of 200 adult volunteers. This time, the group also listened to the stories of distress, but instead of undergoing brain scans and rating feelings of empathic care and distress, they scored their levels of anger, fear, surprise, positivity, negativity, happiness, sadness, and disgust.

Again, the researchers mapped the results from this experiment with the scores on empathic care and empathic distress obtained earlier, pinpointing them to each section of the narratives.

They found that empathic care was most strongly linked to both negative and positive feelings (for instance, both happiness and sadness, positivity and negativity), whereas empathic distress was most strongly associated with primarily negative emotions, such as anger, fear, sadness, and disgust.

Ashar says that these results suggest that "empathic care, or compassion, reflects a blend of both warmth and distress."

In a bid to help carers, nurses, and other helping professionals, the team is now evaluating a 4-week program of meditation designed to increase empathy in a way that favors empathic care but not empathic distress.
Feelings of empathy are virtues we want to cultivate personally and in society. Understanding these emotions could open the doors to increasing empathy and compassion in personal relationships and on a broader societal level. - Yoni Ashar