The mental health field is constantly evolving. At PLOS Mental Health we think it is important to provide a platform for mental health professionals, researchers, advocates and community members to explore together. This is why we are starting this new blog series ‘PLOS Mental Health Conversations’ and for the first blog of this series, we hear from Ayesha Qahash, who explains the need for, and details of, a new framework for empathy differences, namely, Empathy Spectrum Disorder. What is Empathy Spectrum Disorder (ESD)? This makes it difficult to talk openly about the costs of empathy, emotional burnout, blurred boundaries, or even strategic manipulation, without shame or judgment.