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Although many studies have examined the neural basis of empathy, relatively little is known about how empathic processes are affected by different attentional conditions. Thus, we examined whether instructions to empathize might amplify responses in empathy-related regions and whether cognitive load would diminish the involvement of these regions. Thirty-two participants completed a functional magnetic resonance imaging session assessing empathic responses to individuals experiencing happy, sad, and anxious events. Stimuli were presented under three conditions: watching naturally, actively empathizing, and under cognitive load. Across analyses, we found evidence for a core set of neural regions that support empathic processes (dorsomedial prefrontal cortex, DMPFC; medial prefrontal cortex, MPFC; temporoparietal junction, TPJ; amygdala; ventral anterior insula, AI; and septal area, SA). Two key regions—the ventral AI and SA—were consistently active across all attentional conditions, suggesting that they are automatically engaged during empathy. In addition, watching vs. empathizing with targets was not markedly different and instead led to similar subjective and neural responses to others' emotional experiences. In contrast, cognitive load reduced the subjective experience of empathy and diminished neural responses in several regions related to empathy and social cognition (DMPFC, MPFC, TPJ, and amygdala). The results reveal how attention impacts empathic processes and provides insight into how empathy may unfold in everyday interactions.

The role of automaticity and attention in neural processes underlying empathy for happiness, sadness, and anxiety