Empathy and thinking styles

See Lexicon – Empathy for the general definition and forms of empathy.

Three types of empathy

Science classically distinguishes three forms of empathy:

• Cognitive empathy — understanding what the other person thinks or feels; putting yourself in their shoes.
• Affective empathy — emotionally resonating; feeling the other person's emotion yourself.
• Warm concern (empathic concern) — the motivation to help. Singer and Klimecki (2014) distinguish this from personal distress: being drawn into another person's pain.¹

Contextual empathy

There is a fourth element that we call contextual empathy here. It is not a separate fourth type, but a regulator: it determines whether the three classical forms are deployed appropriately at the right moment.

Cognitively understanding that someone is crying is different from sensing that silence now means more than comforting. Melloni, Lopez, and Ibanez (2014) therefore describe empathy as a process strongly guided by context.² Heyers and colleagues (2025) provided recent empirical support for this: empathy demonstrably varies with context.³

This distinction is also reflected in the brain. Affective empathy relies on the insula and mid-cingulate cortex (core of the salience network). Cognitive empathy relies on other regions involved in inner representation.⁴ Contextual empathy thus connects directly to the network that determines which signal matters right now.

"Contextual empathy" is not yet an established scientific term. We present it as a conceptual tool that connects with existing findings, not as an established category.

Low-contextual thinking

• Limited cognitive empathy → difficulty correctly assessing the other person's situation and intentions.
• Emotional reactions are therefore less attuned and often reflexive → more of sympathy than full-fledged empathy.
• Vulnerability: misunderstandings more quickly, emotional escalations, fragile basic trust.

High-contextual thinking

• Strong cognitive empathy → can take perspective and frame the other person's emotions.
• Emotional empathy is better attuned to the context → response feels appropriate and supportive for the other person.
• Vulnerability: overload due to too much change of perspective, tendency to overresponsibility.

Hyper-empathy: two opposite things under one word

Anyone who says "I feel too much", or calls themselves hyper-empathic, is describing one of two patterns that, seen through context sensitivity, are each other's opposite. The difference lies not in how hard the emotion comes in, but in what goes back out: is the response attuned to the environment, or must the environment adapt to the person?

• High-contextual. Someone senses processes, tensions and unspoken problems sharply, and knows how best to respond in this situation. The response fits. The price comes afterwards: taking on too many tasks, difficulty saying no, exhaustion. See High-contextuals as helpers.
• Low-contextual. Everything comes in unfiltered and goes back out just as unfiltered. The response is not attuned to the situation; the environment has to adapt to the person. Peter Vermeulen speaks here of sympathy rather than empathy — the form also seen in young children.¹⁰

Vermeulen points out that this second pattern is easily mistaken from the outside for empathy. Someone recognises a feeling and responds appropriately — but because they recognise a situation they have been through themselves, not because they put themselves in the other person's position. He calls this an encyclopaedia of scenarios: as long as the other person feels what this person once felt, the response fits; faced with something they have never been through, it falls away.¹⁰ Putting both patterns under one label loses exactly what matters in support: the first group needs boundaries, the second attunement.

Empathy and exhaustion in care professions

It is tempting to think that more empathy is always better. That is not straightforwardly true. Holas and colleagues (2024) studied Polish care workers during the COVID-19 pandemic.⁵ In that study, warm concern was not protective — it was even associated with more exhaustion. Personal distress in particular proved strongly linked to burnout.

Zhou (2025) confirms, based on a broader literature, that the relationship between empathy and burnout is not linear.⁶ It depends on the type of empathy. "More is better" therefore does not apply here.

Empathy and psychopathology

In clinical practice, empathy profiles are sometimes described for certain disorders. These are working hypotheses and heuristics, not established empirical profiles:

• In some profiles, strong emotional empathy is seen without sufficient cognitive integration, causing emotions to become overwhelming.
• In other profiles, there is understanding of what the other person is thinking, but little emotional resonance.

For a more careful discussion, see personality disorders.

The double empathy problem

Damian Milton (2012) formulated the double empathy problem: the empathic mismatch between autistic and non-autistic people works both ways.⁷ It is therefore not a one-sided autistic deficit. The concept has become popular in the autism community.

Caution is warranted, however. Livingston, Hargitai, and Shah (2025) analyzed the scientific basis and conclude that the concept rests on a notably weak chain of reasoning and is often confused with other concepts.⁸ We therefore mention the idea, but advise against basing policy or clinical decisions on it until the evidence is stronger.

Finally, a measurement note: questionnaires for empathy do not all measure the same thing. de Lima and Osório (2021) found that different instruments agree only moderately with each other.⁹ An empathy score therefore also depends on the instrument used.

References

1. Singer, T., & Klimecki, O. M. (2014). Empathy and compassion. Current Biology, 24(18), R875–R878. doi:10.1016/j.cub.2014.06.054
2. Melloni, M., Lopez, V., & Ibanez, A. (2014). Empathy and contextual social cognition. Cognitive, Affective, & Behavioral Neuroscience, 14(1), 407–425. doi:10.3758/s13415-013-0205-3
3. Heyers, K., Schrödter, R., Pfeifer, L. S., Ocklenburg, S., Güntürkün, O., & Stockhorst, U. (2025). (State) empathy: how context matters. Frontiers in Psychology, 16, 1525517. doi:10.3389/fpsyg.2025.1525517 — PubMed 40040661
4. Arioli, M., & Canessa, N. (2019). Neural processing of social interaction: Coordinate-based meta-analytic evidence from human neuroimaging studies. Human Brain Mapping, 40(13), 3712–3737. doi:10.1002/hbm.24627
5. Holas, P., Gambin, M., Wojtkowiak, N., Kmita, G., & Łojek, E. (2024). Relationship of burnout with empathy dimensions in healthcare workers in Poland during the COVID-19 pandemic. Health Psychology Report, 13(2), 156–169. doi:10.5114/hpr/188097 — PubMed 40487480
6. Zhou, H. (2025). Relationship between empathy and burnout as well as potential affecting and mediating factors from the perspective of clinical nurses: a systematic review. BMC Nursing, 24(1), 38. doi:10.1186/s12912-025-02701-0 — PubMed 39794782
7. Milton, D. E. M. (2012). On the ontological status of autism: the 'double empathy problem'. Disability & Society, 27(6), 883–887. doi:10.1080/09687599.2012.710008
8. Livingston, L. A., Hargitai, L. D., & Shah, P. (2025). The double empathy problem: A derivation chain analysis and cautionary note. Psychological Review, 132(3), 744–757. doi:10.1037/rev0000468 — PubMed 38829337
9. de Lima, F. F., & Osório, F. de L. (2021). Empathy: Assessment Instruments and Psychometric Quality — A Systematic Review With Meta-Analysis. Frontiers in Psychology, 12, 781346. doi:10.3389/fpsyg.2021.781346 — PubMed 34899531
10. Vermeulen, P. (2005). Een gesloten boek. Autisme en emoties (fully revised edition), chapter 5 "Empathie — Inleven". Acco, Leuven. ISBN 9789033459092; e-book ISBN 9789033496400.