How does the “double empathy problem” relate to autism in relationships? 

According to NHS guidance, autism affects how people communicate, understand others, and interpret the world around them. While older models described these differences as social “deficits”, newer research, particularly the double empathy problem theory, reframes them as reciprocal misunderstandings rather than one-sided difficulties. 

This concept offers a more balanced and compassionate understanding of how autistic and non-autistic people experience relationships. 

What is the double empathy problem? 

The double empathy problem was first introduced by autism researcher Dr Damian Milton, who argued that communication breakdowns between autistic and non-autistic people arise from differences in perspective, not deficits. Both groups can find it difficult to interpret each other’s social cues, emotional signals, or communication styles: creating a two-way challenge in understanding. 

A 2025 study published in the Journal of Autism and Developmental Disorders supports this idea, showing that when autistic people interact with one another, communication tends to be smoother and more intuitive. Difficulties are more likely when neurotypical expectations dominate, leading to mutual misunderstanding. 

In other words, the problem isn’t that autistic people lack empathy: it’s that empathy is expressed and interpreted differently depending on who’s involved in the interaction. 

How does this play out in relationships? 

In family or romantic relationships, differences in empathy and communication can be amplified. According to NICE guidance (CG142), autistic individuals may communicate more literally, express emotions directly, or need extra time to process complex emotional information. Meanwhile, non-autistic family members might rely on subtle tone, facial expressions, or unspoken cues: forms of communication that may be less clear to their autistic relatives. 

These mismatches can sometimes lead to feelings of frustration, rejection, or emotional distance, not because love or empathy is absent, but because the methods of expressing and recognising it differ. 

As the World Health Organization (WHO) explained, supporting mutual understanding rather than correction helps reduce conflict and strengthen connection. Families who reframe communication as bi-directional learning rather than one-sided teaching report better relationship outcomes and stronger emotional bonds. 

Breaking the cycle of misunderstanding 

The double empathy problem suggests that social understanding must go both ways. Instead of viewing autism as a communication impairment, it encourages both autistic and non-autistic people to adapt, listen, and respect each other’s perspectives. 

NICE recommendations and NHS guidance on communication and interaction emphasise that structured strategies can support this mutual adaptation: 

• Psychoeducation for both partners and family members, helping everyone understand autistic communication patterns. 

• Explicit emotional language saying “I’m tired and need quiet” rather than expecting others to infer it. 

• Predictable communication routines planning conversations during calm moments, not emotional peaks. 

• Sensory and environmental adjustments reduce background noise or visual distractions during discussions. 

These techniques promote empathy on both sides, improving trust, and reducing emotional exhaustion. 

The role of empathy and emotional resonance 

Contrary to common misconceptions, research shows that autistic people often experience empathy deeply: sometimes even more intensely than non-autistic individuals. However, this empathy may be conveyed through action rather than words, or through honesty rather than emotional performance. 

A 2024 review in (BMJ Open) found that family and partner-based psychoeducation help both sides recognise the intent behind each other’s emotional expressions. This understanding reduces misinterpretation and increases emotional closeness, particularly when both parties feel respected for their authentic communication styles. 

Building connection through shared understanding 

The double empathy problem encourages a shift from “fixing” communication differences to celebrating diversity in connection. According to NHS guidance, empathy grows when both people are curious, patient, and willing to clarify rather than assume. 

Simple strategies such as asking, “Would you like comfort or a solution?” Or clarifying intentions (“I’m quiet because I’m thinking, not because I’m upset”) can transform misunderstandings into meaningful understanding.  

Over time, families and couples who practise two-way empathy build stronger emotional bonds, rooted in acceptance and mutual respect. As NICE notes, this approach can enhance emotional wellbeing and reduce conflict within households. 

A new way of understanding autism and relationships 

The double empathy problem challenges outdated ideas of social “deficits” and invites us to see autism through a relational lens. Connection improves not when one person adapts completely, but when both sides learn from each other. 

By practising openness, patience, and respect, autistic and non-autistic people can build communication that feels natural, not forced: one where empathy flows both ways.