Heightened empathy in mirror-sensory synaesthetes has mainly been reported on the Emotional Reactivity subscale of the Empathy Quotient (EQ) questionnaire. In mirror-sensory synaesthesia, stronger empathy is expected because synaesthetes experience on their own body any unpleasant sensation they observe on others: being more sensitive to other people's misfortunes, they would be more motivated to relieve others' suffering. Because of enhanced socio-cognitive abilities, atypical self–other representations have also been proposed as the main mechanism of mirror-sensory synaesthesia, with more inclusive representations of the ‘self’ facilitating the incorporation of others' experiences into the synaesthete's own body. It is, therefore, not surprising that mirror-sensory synaesthesia is related to enhanced empathy. Enhanced responses in the tactile mirror system in non-synaesthetes have been related to enhanced empathy ratings, suggesting that the more sensitive the tactile mirror system is, the more empathic individuals are. Observed pain is represented in the ‘pain matrix’, a system of both (somato)sensory and affective brain regions that reflect the sensory intensity and the affective impact of pain inflicted upon others, respectively. Normally, observed touch is subconsciously represented in this ‘tactile mirror system’ in somatosensory cortex to facilitate the understanding of touch in others. A proposed mechanism that may underlie mirror-sensory synaesthesia is hyperactivity in the somatosensory mirror system, causing observed touch or pain to be consciously perceived in synaesthetes. It is one of the most prevalent forms of synaesthesia, estimated to affect 1.6% of the general population. In mirror-sensory synaesthesia, people feel touch or pain on their own bodies when seeing someone else being touched or being in pain. This article is part of the discussion meeting issue ‘Bridging senses: novel insights from synaesthesia’. Our study demonstrates the subjective impact of mirror-sensory synaesthesia and its stimulating influence on prosocial behaviour. Mirror-sensory synaesthetes donated more money than non-synaesthetes, showing enhanced prosocial behaviour, and also scored higher on the Interpersonal Reactivity Index as a measure of empathy. Prosocial decision making was assessed with an economic game assessing altruism, in which participants had to divide money between themselves and a second player. However, there was no evidence for differential physiological or hormonal responses to arousing pictures. The subjective impact of positive and negative images was stronger in synaesthetes than in control participants the stronger the reported synaesthesia, the more extreme the picture ratings. Participants viewed arousing images depicting pain or touch we recorded subjective valence and arousal ratings, and physiological responses, hypothesizing more extreme reactions in synaesthetes. Mirror-sensory synaesthetes ( N = 18, all female), verified with a touch-interference paradigm, were compared with a similar number of age-matched control individuals (all female). We investigated whether the enhanced empathy of people with mirror-sensory synesthesia influences the experience of situations involving touch or pain and whether it affects their prosocial decision making. This type of synaesthesia has been associated with enhanced empathy. Mirror-sensory synaesthetes mirror the pain or touch that they observe in other people on their own bodies.
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