Measuring Mercy

The Fear Factor: How One Emotion Connects Altruists, Psychopaths, and Everyone In-Between
by Abigail Marsh
Basic Books
302 pages
978-1541697195

Two life-threatening events led neuroscientist Abigail Marsh to research the differences—and subsequently discover the surprising links—between psychopaths and altruists.

The first occurred when she was 19. Late one night, as she was driving along the freeway from Seattle to Tacoma, a dog suddenly ran in front of her car. She swerved to avoid it, the car spun around, and she ended up backward, facing oncoming traffic, with the engine seemingly dead. Stunned and stranded, she was astonished when a man tapped on her window and asked if he could help.

And he did: opening the hood of the car to start the engine, stepping into the driver’s seat to turn her car around to face the right direction, and making sure she was okay to drive herself home. They were strangers, and because they never exchanged names, he remained anonymous. But he’d quite possibly saved her life, and at the same time had risked his own by running across lanes of highway traffic to reach her.

The second incident took place amid an alcohol-fueled New Year’s Eve celebration in Las Vegas, when a man in the crowd started to grope her from behind. She turned to slap him away—but instead of leaving her alone, he began beating her in the face. Years later, she was left to ponder: how does it happen that one person unthinkingly goes to assist a stranger, while another just as automatically inflicts harm? Was there something in the wiring or structure of the human brain that could account for these extreme opposites of behavior?

Marsh has devoted her professional career, first as a researcher at the National Institute of Mental Health, and now as an associate professor of psychology and neuroscience at Georgetown, to pursuing an answer. She presents her findings in an engrossing book, The Fear Factor: How One Emotion Connects Altruists, Psychopaths, and Everyone In-Between.

In a nutshell, Marsh has developed a new framework for looking at and thinking about behavior at the extremes of good and evil. Her research has led her to conclude that these traits exist on a continuum that stretches from psychopathy at one end to extreme altruism on the other. This conceptualization is important because it provides a paradigm that can yield insight into the underpinnings of such behavior, and her detailed but accessible explanation of the neurobiological basis for both ends of the extremes, as well as her understanding of the positive influence of nurture, will also lead readers to reflect on human nature itself.

Marsh builds her case like a compelling mystery story, with each chapter revealing a new clue to the links between perceptions of fear in others and the capacity for care. She persuasively argues that recognizing fear in others is crucial to the capacity for empathy, and that the source of our ability to do that resides in the amygdala, the almond-shaped part of the brain that processes emotions.

To that end, she’s conducted numerous functional brain-scan studies that have demonstrated distinct differences in the size and activity patterns of the amygdala in extreme altruists, whose amygdalas light up when they sense another’s fear, as opposed to those in psychopaths, whose measurably smaller amygdalas don’t seem to respond at all. In her view, oxytocin—popularly if simplistically referred to as the love hormone—also plays an essential role, interacting with the amygdala to further sensitize our ability to recognize fear in others, and to compel us to respond to it.

Investigating why this “fear factor” exists, she cites research showing that evolution has hardwired not just humans, but many animals, to view fear in others as a signal of distress, and to reflexively respond with at least some modicum of compassion or empathy. Although there’s not yet sufficient evidence to decisively prove it, she hypothesizes that the reason that expressions of alarm in others alarm us is staring us right in the face: specifically, the face of a crying, fearful infant. It’s to ensure human survival: bawling babies trigger us to save them from harm. That helps explain why the face of fear at any age shares the same general expression of a needy baby—to trigger our instinct for compassion when we perceive someone in distress.

Such is the mechanism, according to Marsh, that accounts for what Shakespeare described as the quality of mercy. It’s a trait that can express itself across a continuum, from running across highway lanes to save a complete stranger to cold-hearted callousness. Why is this important? Viewed in this context, psychopathy represents a dysfunction in the workings of the oxytocin system, the amygdala, or both; while extreme altruists are, well, extremely tuned into both systems.

It’s eye-opening to think of psychopathy, which is found in between one to two percent of the population, as a developmental disorder, but “it does not emerge out of nowhere in adulthood,” she writes. “Essentially, without exception, all psychopathic adults first showed signs of psychopathy during adolescence or childhood.” But whether they were misclassified to begin with, or for other reasons, not all children with psychopathic traits go on to become psychopaths.

Marsh’s experiences screening teenagers with psychopathic traits before including them as subjects for her brain-scan studies is interesting in this sense. When she met Dylan, her first interviewee, she could barely believe that this outwardly friendly adolescent was the same individual who’d threatened his mother with a knife and whose violent tantrums had destroyed parts of their house and left the family in constant fear. Although he met the DSM-5 criteria for a conduct disorder diagnosis, in his telling, he wasn’t to blame for any of the incidents reported in his file; it was always someone else’s fault—no reason for him to apologize.

That lack of responsibility and remorse tipped Marsh off that Dylan wasn’t the genial youth he seemed to be in public. After she looked at his records again and interviewed his parents, his charm looked more like a tool for deception and manipulation—traits typically associated with psychopathic behavior. Her lesson: “using an interview alone to evaluate psychopathy is a bad idea.” By contrast, she interviewed another young man who met many of the same diagnostic criteria as Dylan but expressed remorse and responsibility for his actions. The fact that he cared about what he’d done and whom he’d harmed suggested that even after a neglectful upbringing, more caring for him from family and others could contribute to positive outcomes for his future.

Marsh shows her own compassion as she meets and interviews the parents of these troubled youths, many of whom “had tried literally every possible option to help their children . . . counselors, medication, special schools, social workers.” This brought home the conclusion that bad parenting by itself doesn’t cause psychopathy, as some people suggest. In fact, the siblings of children diagnosed with conduct disorders may not display those traits at all—a possible indication that a biological, not an environmental, factor is in play.

The bottom line, she writes, is that children with conduct disorders and oppositional defiant disorder are every bit in need of help as children with bipolar disorder or anxiety or autism. Successful potential interventions are unfortunately scarce, however, partly because so few studies have been conducted on youths with conduct disorders. So perhaps Marsh’s brain scans can provide hints as to ways to compensate for amygdala dysfunction.

On the opposite end of the continuum are extreme altruists. For her brain-scan studies, Marsh sought those who went beyond everyday good deeds and took great risks on behalf of people unknown to them, unprompted by any outside expectation to do so. In particular, she turned to people who chose to donate a kidney to strangers. Until 1999, despite the long list of patients awaiting kidney transplants, medical organizations universally refused to accept this type of kidney donation. These officials believed that no one would rationally decide to risk their well-being in an operation to benefit someone they didn’t even know; they must be crazy—as crazy, perhaps, as the heroes who’ve rushed into a burning building to rescue a stranger. Neither of these types of extreme altruists considers themselves heroic; they see their actions as natural and instinctive. They simply stepped up to a perceived need.

In fact, her emphasis on the capacity for human compassion, and not just cruelty, may be one of Marsh’s most important contributions. That point comes to the fore when she reassesses the message of Stanley Milgram’s infamous study on obedience to authority. In that study, volunteers were told to administer what they believed were increasingly powerful and painful electric shocks to a subject (actually an actor collaborating with Milgram). Even when the subject began screaming in pain (fake cries, because he wasn’t receiving shocks), many of the volunteers kept on hitting the shock button.

The conclusion most people have drawn from this, Marsh writes, is that humans are “uniformly callous and heartless, that within each of us lies a little Eichmann content to inflict terrible suffering on strangers.” But, in fact, she asserts, this isn’t what videos of the experiments show at all. Rather than being heartless, even those volunteers who continued administering shocks were visibly shaken and torn by what they were being asked to do. Moreover, according to Milgram himself, “at some point every participant either questioned the experiment or refused” the payment promised them.

Viewed this way, “Milgram actually demonstrated that compassion for a perfect stranger is powerful and common,” she writes. (Similarly, recent reevaluations of the Kitty Genovese case refute the common belief, which turns out to have been based on flawed reporting, that numerous bystanders callously remained silent as they witnessed her murder; instead, at least two people called the police, and one woman cradled the victim in her arms.)

In addition, Marsh writes, studies conducted by psychologist Daniel Batson that were similar to Milgram’s found “that when people are able to choose freely, most will opt to receive electrical shocks themselves rather than let a suffering stranger continue receiving them. Taken together, the real message of these studies is that, when given the opportunity, some people will behave callously or even aggressively toward a suffering stranger—but more people will not.”

Marsh devotes her last two chapters to championing ways to reinforce and enhance compassion through programs that promote caring for others, starting in childhood. These include the Buddhist meditations of compassion and loving-kindness as well as the cultivation of a sense of humility. We can do better in shaping where on the compassion continuum our children fall, she believes. Here’s hoping she’s right.