The Empathy Continuum and a spot of armchair self-diagnosis – Part 1

Lee Evans, during his UK stand-up tour, BIG.

Profiling the central characters for my next novel has directed research into the fascinating subject of empathy and the hugely varied personality traits / disorders which can arise from our relative positions on what I’m now seeing as an empathy continuum. Not only is this providing useful material for the book, it has also sparked some introspection, illuminating and perhaps connecting a number of physiological peculiarities from which I’ve suffered over the years.

So at the risk of revealing a little more about myself than I might otherwise, I thought I’d share with you a little of the arm-chair self-diagnosis in which I’ve been indulging recently. While none of the following symptoms have ever led me to seek medical attention, they have nonetheless caused varying degrees of irritation, embarrassment and curiosity:

  • Symptom No.1
    From as early as I can remember, I’ve had a level of squeamishness, or put another way, sensitivity to observing pain, which has seemed greater than that of those around me. Most of us cringe, at least to some extent, when confronted with gratuitous violence, whether in movies or in real life, but for me these scenes can produce such intense feelings of nausea that I have to leave the room or movie theatre. As a result, I generally avoid horror movies. Another manifestation, which amuses my two daughters enormously, is my inevitable yet uncontrollable twitching and jerking during fight scenes. Funniest of all (in their minds), is when I happen to be holding a drink at the moment of some unexpected, shocking event in a movie – a trait to which many a stained shirt can testify.
    While the degree of my affliction is nothing compared to some of those described in this New Scientist article, it would seem to place me somewhere towards the higher end of the empathy continuum.
  • Symptom No.2
    I always used to dread shots of local anaesthetic at the dentist. While I imagine there are few of us who enjoy injections of any sort, every time I was administered local anaesthetic into my mouth or gums, I would almost immediately turn white as a sheet and start to feel nauseated. On one such occasion however, about twelve years ago, my dentist, on observing this, suggested that I might be having an adverse reaction to the adrenaline in the shot. Although you may not be aware of this, adrenaline, for its property as a vasoconstrictor, is typically added to local anaesthetics in order to constrict the capillaries, thereby prolonging and localizing the analgesic effect – presumably since the reduced blood flow cannot wash away the active component quite so quickly.
  • Symptom No.3
    This is a bizarre one: a sneeze reflex triggered by sexual thoughts. I hasten to add, for those who know me – lest they jump to false conclusions – that I do also suffer from occasional hay fever and allergies. So my sneezing in your presence doesn’t necessarily mean that I have anything other than platonic feelings for you.
    Anyway, like the character Peter, in my novel Connected, I had previously imagined this to be an uncanny coincidence. Then a few years ago, I happened across this article in the Guardian, revealing that it is in fact a known condition, probably due to some kind of hereditary short-circuit in the autonomic nervous system.
  • Symptom No.4
    The final and perhaps most inconvenient of my minor abnormalities is what I’ve come to regard as a hair-trigger thermostat / stress response system. Its effect is to precipitate occasional bouts of extreme perspiration triggered by seemingly minor increases in ambient temperature, stress, heart rate, or combinations thereof. These then become self-reinforcing in a kind of positive feedback loop, in which self-consciousness of my sweating can potentially escalate the situation until I am literally awash.
    Throughout my career, I have spent a good deal of time creating and delivering technology and business presentations, occasionally to audiences of several hundred. Although while on stage I’m barely conscious of elevated stress levels, I invariably start to sweat profusely (think Lee Evans during his stand-up routines) in all but the chilliest of auditoriums. Typically it will start five to ten minutes into my speech, upon which I will remove my jacket, make some feeble joke about the need for guttering on my forehead (stolen from Lee Evans by the way) and continue. A few minutes later, following copious brow mopping, it stops, after which I’ll be fine for the rest of my time on stage.

I have long suspected that this fourth symptom, like symptom No.3, has something to do with my autonomic nervous system, since this is the involuntary control system which regulates many of our bodily functions including heart rate, respiratory rate, digestion, perspiration and arousal. Now, the autonomic nervous system further comprises at least two complementary sub-systems: the sympathetic and parasympathetic, the latter acting as a kind of damper to the former. According to Wikipedia:

[the sympathetic nervous system] is perhaps best known for mediating the neuronal and hormonal stress response commonly known as the fight-or-flight response. This response is also known as sympatho-adrenal response of the body…

The word “adrenal” here, refers to the secretion of adrenaline, which as we all know is a key part of our “fight-or-flight” response. So symptoms 3 and 4 appear to have a common factor, which is involvement of the autonomic nervous system, and since the release of adrenaline plays a key part in the activation of this system, it doesn’t seem unreasonable  that symptom 2 is also linked in some way.
In part 2 of this essay, I will try to explain what all of this has to do with empathy.

What about you? Do you know of anyone afflicted by some of these things? Are you a doctor or medical researcher into any of these areas? If so, I’d love to hear from you, either in the form of comments below, or via email to

Thanks for reading!

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Author, musician, science nut, & IT marketing pro. My first novel, CONNECTED, is a mystery thriller with a touch of speculative science & philosophy.

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  1. Simon,

    I actually work for a company that has an iPhone app that measures heart rate variability (which is the measure of these two branches of the nervous system). If you have an iPhone and are interested, email me and I’ll give you some more information on how you can strap yourself up and see what’s really going on in your autonomic nervous system.

    Very interesting and well written article!

  2. Simon, there is an interesting series of articles you should take a look at in Slate. It is called Blogging the Human Genome. All of the articles are worth a glance, but number 16 talks specifically about (amongst other things) the fact that the sneeze reflex gets cross-wired in some people and can pop up in reaction to lots of stuff, including looking at the sun. “The sunlight-sneeze link, called the photic sneeze reflex, isn’t even that uncommon, affecting around one-quarter of all people, according to some studies.” You can find this article at .
    It has links to the other entries.

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