How We Feel Others' Pain and Why It Sometimes Fails
When you see a loved one wince in pain, feel a surge of anger when witnessing an injustice, or find yourself smiling at a stranger's joy, you're experiencing empathy—the remarkable human capacity to share and understand what others are feeling.
Connecting self and other
This invisible social bridge connects us, shapes our relationships, and forms the foundation of our moral societies. But what happens when this fundamental ability goes awry?
Neuroscientists have discovered that empathy isn't a single entity but a complex symphony of brain processes that can malfunction in different ways across psychiatric conditions. From the emotional detachment of psychopathy to the overwhelming absorption of others' emotions in burnout and depression, empathy disorders reveal how deeply our brains are wired for social connection 1 .
Empathy is not a simple, unified ability but rather a multidimensional construct involving both automatic emotional sharing and deliberate cognitive processing 1 .
Automatic, instinctive emotional responses
Deliberate, cognitive perspective-taking
The complexity of empathy creates what scientists call the "empathy paradox"—this ability can drive both helpful and hurtful behaviors 1 .
Compassionate Care
Manipulation
| Brain Region | Primary Function in Empathy | Associated Experience |
|---|---|---|
| Anterior Cingulate Cortex (ACC) | Processes affective aspects of pain and distress 3 | Feeling others' pain emotionally |
| Anterior Insula | Supports emotional resonance and sharing 3 | Visceral feeling of others' emotions |
| Medial Prefrontal Cortex | Enables mentalizing and perspective-taking 8 | Understanding others' viewpoints |
| Temporoparietal Junction | Distinguishes self from other | Recognizing others as separate individuals |
| Nucleus Accumbens | Processes rewarding aspects of care 3 | Warm feelings from helping others |
A groundbreaking 2025 study published in Nature Communications by Dr. Sehoon Keum's team at the Institute for Basic Science in South Korea overcame limitations using cutting-edge techniques in mouse models 5 .
| Research Question | Method Used | Key Finding |
|---|---|---|
| Which neurons encode empathic responses? | Calcium imaging of ACC | Specific neural ensembles activate during both direct pain and witnessing pain in others 5 |
| What type of pain information do these neurons represent? | Comparison of neural activity patterns | ACC activity during empathy resembles affective (emotional) rather than sensory pain processing 5 |
| Is the ACC-PAG pathway necessary for empathic behaviors? | Optogenetic inhibition | Silencing ACC-to-PAG pathway significantly reduced empathic freezing and pain avoidance 5 |
Critical pathway for transforming witnessed distress into felt emotion and action
ACC
PAG
Behavior
| Clinical Condition | Primary Empathy Deficit | Associated Neural Correlates |
|---|---|---|
| Psychopathy/Antisocial PD | Reduced affective empathy 1 4 | Decreased AI/ACC response to others' distress |
| Autism Spectrum Disorder | Challenges with cognitive empathy 1 | Reduced mentalizing network activity |
| Major Depressive Disorder | Mixed: Elevated distress, reduced care 8 | Altered ACC, IFG, and AI activity |
| Borderline Personality Disorder | Emotional over-identification 1 | Hyperactive limbic responses |
| Burnout & Compassion Fatigue | Reduced empathic care, elevated distress 3 6 | Diminished reward network activity |
Different psychiatric disorders feature characteristic empathy dysfunctions:
For decades, empathy was considered a fixed personality trait, but recent research reveals it's surprisingly malleable. A fascinating study from USC Dornsife demonstrated that empathy can be conditioned through emotional rewards 2 .
This "social twist on Pavlov's classic experiment" suggests that our social environments shape our empathic responses through basic learning mechanisms 2 .
For burnout and PTSD, interventions focus on strengthening prefrontal regulation of limbic reactivity.
For psychopathy, interventions target affective sharing networks through innovative approaches.
Cultivating empathic care while reducing empathic distress to prevent burnout.
Empathy stands as both our most noble gift and our most vulnerable vulnerability.
This remarkable capacity to feel with others binds our social world together, yet its dysfunctions reveal how deeply our wellbeing depends on neural systems that can falter in different ways. From the emotional detachment that characterizes psychopathy to the overwhelming absorption of others' suffering in burnout and depression, empathy disorders demonstrate the critical importance of balanced brain networks for healthy social functioning.
The emerging science of empathy offers more than just explanation—it provides a roadmap for intervention. By understanding the distinct neural circuits underlying affective sharing, cognitive perspective-taking, empathic care, and empathic distress, we can develop precisely targeted treatments for those struggling at both extremes of the empathic spectrum.
As research continues to unravel the complexities of the empathic brain, we move closer to a future where we can not only repair empathy when it breaks but nurture its healthy development—potentially building a more compassionate world grounded in the sophisticated neuroscience of human connection.