A rare neurological condition, mirror-touch synaesthesia has often been dismissed as fanciful. But for those living with the condition, the symptoms are all too real.
By Olivia Miossec
“Don’t judge someone until you’ve walked a mile in their shoes”
This sentence illustrates perfectly what empathy is. It is not observing someone’s emotion from a safe distance; it is transposing and experiencing those feelings within yourself. We are self-centred beings and empathy is the tool we need to survive and thrive in our hyper-social world. It allows us to automatically and unconsciously ask the questions, “What if it were me?” and, “How would that make me feel?”. On a more basic level, empathy involves mirroring the actions and feelings of those around us. When someone falls, we tend to wince. When Jenny dies, we cry alongside Forrest. Mirroring provides us with the tool to understand others and act accordingly. It is therefore essential to our social functioning. A lack of it prevents us from connecting with others, pushing us towards the margins of society. An example is individuals diagnosed with Autism Spectrum Disorder (ASD), though of course there are exceptions within that category. Yet, how about too much of a good thing? Can connecting with others be a vulnerability in itself? Indeed, there are individuals who can sense the physical, and to some extent the emotional, feelings of those around them at incapacitating levels. The condition is known as mirror-touch synaesthesia, and it is arguably as alienating and isolating as its counterpart.
Mirroring is caring: a neurological substrate for emotional empathy The first time I read about someone suffering from mirror-touch synaesthesia (MTS), her story sounded completely implausible. If those around her received a hug, she felt the warm embrace herself. If someone tumbled to the ground, searing pain travelled through her. It sounds other worldly. Yet, there is a scientific basis for it: mirror neurons. These special neurons were first discovered in the 1990s by an Italian research group led by Rizzoli. They were looking at the firing of single neurons in monkeys when reaching for different objects. By accident, they discovered that a specific neuron would fire when the monkey reached for a peanut as well as when the monkey watched another reach for a peanut. A monkey-see, monkey-do type of neuron.
In humans, investigating single neuron activity in the brain would be an invasive, and thus impossible, procedure. However, activity in specific brain regions can be measured using fMRI scans. This has allowed the identification of mirror systems. How do mirror systems work? For example, if someone strokes your arm, the ‘arm area’ of your somatosensory cortex will be activated. Now, if you observed someone else’s arm being stroked, on television or on the street, that same exact region will also be activated (Blakemore, 2005). So now both you, and the person being stroked, have the same regions activated. You are mirroring them. The old adage “put yourself in someone’s shoes” should be revised. You are “putting yourself in someone’s brain”!
Mirroring does not however limit itself to the physical. Emotions can be shared too. Research by Schulte-Ruther et al (2007) revealed that both the insula and limbic system, known to process emotionally salient stimuli, are activated when both imitating and observing facial expressions. Thus, we are able to translate others’ expressions into our own emotions. Our ability to empathize may therefore rely on these shared affective neural systems, from physical to emotional sensations. “Their experience” becomes “our experience”. A form of google translate for the ‘human experience’. It would however be an oversimplification to qualify mirror-systems as the entire biological basis for such a complex and multi-dimensional trait as empathy. Empathy can be cognitive, involving “perspective taking” and an understanding of other’s thoughts, or it can be a more visceral emotional empathy, feeling alongside others. It is in the latter case that mirror-systems play a role.
Mirror-touch synaesthesia: a gift or a curse? What happens when our mirror systems perform too well? In normal individuals, our relevant mirror systems become activated when observing sensations experienced by others. But the main distinction with MTS sufferers lies in the degree to which that system is activated. In normal individuals, our brain regions are less active when we observe a sensation than when experience it. This thus creates a distinction between our ‘self’ and the others. It lets us wince, but not double over, when we watch someone get punched in the gut. We experience the shadow of a feeling. In MTS individuals, the mirror systems are overactive. In fMRI studies initiated by Blakemore (2005), but also Banissy and Ward, have revealed that MTS participants showed higher activity in somatosensory regions than controls when watching movies clips of faces being stroked. This supports the threshold theory of MTS. According to this, over-activation of the relevant regions in MTS is strong enough to reach the threshold of conscious experience, where we appropriate the feeling of others as our own.
One could initially see this condition as empowering in a world where we constantly implore for more empathy. If someone breaks their leg, or loses a parent, we feel we can truly empathize and “be there” for them when we have ourselves experienced it in our past. Mirror-touch synaesthetes may have the advantage of being able to create these conscious experiences out of thin air. Banissy & Ward (2011) support this by showing that MTS individuals tend to display greater gray matter volume in areas of the brain associated with social cognition and empathy. On the other hand, decreased tempoparietal junction gray matter volume is also observed. This is the area which allows us to distinguish our own self from others. MTS is a poisoned chalice. In absorbing the feelings of all those around them, MTS individuals become one with their surroundings, progressively losing their identity, the sum of all their conscious experiences. Whilst they can manage their best to lessen their own physical and emotional pain through the choices they make, the behaviour of others, to which they are so emotionally reactive to, is out of their reach. The only solution can then be to retreat from the social world, a similar predicament to their opposite counterpart, ASD individuals.
Embracing empathic diversity Beyond simple curiosity, this neuropsychological condition, which touches around 1.6% of the population, can teach us a lot about the rest of the 98.4% (Banissy et al, 2009). Emotional empathy may be a spectrum, and the level of mirror system activation its measuring scale. Indeed, according to Gazzola et al (2006), the level of empathy and emotional insight individuals possess correlates with the level of brain activation in their mirror systems. This is important to consider in that whilst the individuals may read facial expressions or recognize social cues with higher ease, they may also share the emotional reactivity endured by MTS sufferers. They may respond more intensely and involuntarily to external stimulus.
Another consideration is how much all our experiences, physical or emotional, are created by our brains. These are of course stimuli-driven, but conditions such as MTS underline how subjective our own responses to these stimuli are. Maybe more interestingly, they reveal how much of the nature of these responses rely on the individuality and performance of our brain circuits. Without disregarding the socio-cultural component, there is a large biological basis that dictates our place in the empathy spectrum. Society expects us to balance the right level of empathy and indifference to succeed as well as preserve our mental wellbeing. However, some of us allocated to the left side of the spectrum, the extreme form being ASD, may find social situations to be foreign and challenging territories. Those of us allocated to the right side of the scale, the extreme form being MTS, maybe be constantly exposed and overwhelmed to the contagious emotions of others.
So, don’t judge someone until you’ve felt the world through their mirror neuron system. Though bear in mind that swapping shoes is a much easier task than swapping brains. •