The neuroscience of extremes: Ruthless psychopathy to extraordinary generosity | Abigail Marsh

Key Concepts

Empathy, altruism, aggression, psychopathy, neurodevelopmental disorders, callousness, fearlessness, neurocognitive building blocks, amygdala, prefrontal cortex, oxytocin, genetics, environment, moral decision-making, hostile attribution bias, parent management training, "Mask of Sanity," reactive aggression, proactive aggression, social discounting task, effective altruism, honesty-humility, loving-kindness meditation.

Are We Wired to Care?

The speaker, a professor of psychology and neuroscience, discusses her research on the neural and cognitive basis of empathy and altruism. She challenges the pervasive belief that human nature is fundamentally selfish, citing her own life being saved by a stranger as evidence to the contrary. She argues that the brain must have neural processes that allow us to genuinely value other people's welfare.

To understand this better, she studies extreme populations:

• Extraordinary Altruists: People who give kidneys to strangers.
• Psychopaths: People who care significantly less about others.

The speaker explains the ethical challenges of studying altruism in a lab setting, as creating situations with real risks or costs is problematic. Instead, she takes a clinical approach, studying individuals who have demonstrated unusually caring or uncaring behavior in the real world. These individuals are then brought into the lab for cognitive tests and brain scans to identify differences in their brains, decision-making processes, and emotions.

The speaker argues that the existence of psychopathy is evidence against the idea that humans are fundamentally selfish. Psychopaths genuinely don't care about others, and if all people were inherently selfish, psychopathy wouldn't be a distinct disorder. She notes that psychopathy exists on a spectrum, suggesting the existence of "anti-psychopathic" individuals who care more than average.

Neuroscience literature supports the capacity for caring, with identified brain cells encoding the value of others' welfare. Psychological studies also show people volunteering to help others at a cost to themselves without obvious benefits.

The speaker emphasizes the importance of understanding human nature, as the belief that humans are fundamentally selfish erodes trust and leads to cynicism, undermining healthy societies. She suggests that trusting one another is more enjoyable and accurate than being cynical.

Pop culture often reinforces the idea of selfishness through popular characters like those in "The Wolf of Wall Street," "American Psycho," and "Wall Street." While these characters offer vicarious thrills, their popularity can distort our perception of reality, skewing our statistical calculator in the brain that estimates what the world and people are really like. The speaker argues that real-life interactions are overwhelmingly positive, but media portrayals can create a skewed and inaccurate representation of human nature.

Inside the Psychopathic Mind

Psychopathy is described as a constellation of personality traits, including:

• Mean, Callous Disposition: Lack of concern for others' welfare.
• Bold, Socially Dominant Personality.
• Disinhibited or Impulsive Behavior.

The speaker emphasizes that psychopathy exists on a continuum, with individuals ranging from extremely psychopathic to those with milder traits. She also mentions the possibility of an "anti-psychopathic" end of the spectrum, though research in this area is newer.

A key point is that psychopathic individuals don't always appear deranged or malign. They can be charming and kind, using these traits to manipulate others. This can contribute to the false perception that all niceness is driven by underlying selfishness.

Psychopathy is increasingly understood as a neurodevelopmental disorder, with symptoms emerging early in childhood due to differences in brain development. Genetic differences play a significant role, although there is no single "gene for psychopathy."

Early emerging differences in children at risk for psychopathy include:

• Fearless Temperament: Lack of fear in situations that would scare other children.
• Lack of Motivation by Social Rewards: Seeming cold, uninterested in affection, and not caring as much about parental happiness or pride.
• Reduced Emotional Contagion: Less likely to "catch" emotions like laughter.

These traits can lead to troublesome behaviors, such as risky actions and hurting others. Children at risk for psychopathy struggle to empathize with emotions they don't feel themselves, particularly fear. This makes it difficult for them to understand why others are afraid and more likely to cause fear without understanding the consequences.

Punishment is often ineffective because it relies on fear, which psychopathic individuals don't experience normally. This can lead to an upward spiral of callous, remorseless, and antisocial behavior.

The speaker stresses that clinicians and scientists avoid labeling children as psychopaths, using person-centered language instead. Many children with psychopathic traits do not go on to develop full-blown psychopathy, so labeling can be harmful.

Debunking Myths and Labels

The speaker clarifies the difference between "psychopath" and "sociopath." Psychopathy is a scientific and clinical term with a well-defined set of traits, while "sociopath" lacks a scientific definition and is not used in scientific literature. "Sociopath" is sometimes used to refer to someone diagnosed with antisocial personality disorder, but this is not accepted terminology.

She advocates for using only the term "psychopathy" to avoid confusion and the euphemism treadmill, where new, less stigmatized names are constantly sought for stigmatized disorders. This makes it harder for affected individuals and families to find information and treatment.

Antisocial personality disorder (ASPD) in the DSM has overlap with psychopathy, both referring to persistent antisocial behavior and lack of concern for others. However, psychopathy focuses more on personality and internal traits, while ASPD is more about external behaviors, particularly crime. Someone can be psychopathic without engaging in criminal behavior.

The speaker addresses common myths about psychopathy:

• Myth: It's extremely rare. Reality: Affects about 1% of adults, as common as schizophrenia or bipolar disorder.
• Myth: It's purely genetic or purely environmental. Reality: Results from a mix of genetic and environmental factors.
• Myth: It's exclusively seen in men. Reality: Men are more likely to have it, but women can also be psychopathic, often manifesting in emotional aggression.
• Myth: It's the same as violence or being a serial killer. Reality: Psychopathic individuals are more likely to be violent, but most are not.
• Myth: It's untreatable. Reality: Difficult to treat, but with the right approach, including medication and psychotherapy, individuals can learn new behaviors.

Effective treatments for adults include cognitive behavioral therapy. For children, parent management training is effective. The speaker recommends psychopathyis.org as a resource for information on effective treatments.

How We Can Treat Psychopathy

The speaker discusses Hervey Cleckley's work and his book "The Mask of Sanity," which describes how psychopathic individuals outwardly appear normal but have profound inner deficits in emotion and connection with others. This includes a lack of caring about others' welfare and an inability to love in the traditional sense.

Gary Ridgway, the Green River Killer, is cited as an example of extreme psychopathy, demonstrating a complete lack of regard for his victims. The unnerving aspect is how normal such individuals can appear to those around them.

Identifying psychopathy from a brief interaction is difficult. However, patterns of behavior can be indicative:

• Exploitation of Others: Lack of concern for others' welfare leads to stealing, lying, cheating, and fraud.
• Aggression: Both reactive (impulsive) and proactive (goal-oriented) aggression are common.

The speaker shares anecdotes from her research with psychopathic adolescents, illustrating their manipulative abilities and lack of remorse.

Family members of psychopathic individuals have a wide range of responses, from complete estrangement to strange loyalty. The speaker emphasizes the importance of balancing consequences for harmful actions with understanding that the individual didn't choose to have these traits.

Cognitive dissonance can make it difficult for those who have been manipulated by psychopathic individuals to acknowledge the fact. The ability of psychopathic individuals to lie and explain their behavior convincingly can be disarming.

The speaker summarizes the key traits of psychopathy:

• Callousness: Lack of concern for others' welfare.
• Boldness: Fearless core, lack of response to risk and threat.
• Exploitative and Deceptive: Lying, conning, stealing.
• Aggression: Emotional and physical harm to get what they want.

Early emerging differences in the brains of psychopathic individuals include:

• Fearless, Unemotional Disposition: Reduced experience of fear in threatening situations.
• Lack of Social Bonds: Reduced resonance with others' emotions, including laughter and yawning.

Recent research has identified neurocognitive building blocks of these deficits, particularly a deficit in experiencing fear.

The amygdala, a brain structure responsible for coordinating the experience of fear, is implicated. In psychopathic individuals, the amygdala tends to be smaller and less reactive to threats and the sight of others' fear. This disrupts the relay of information to other brain regions involved in fear responses.

The amygdala also sends information to the prefrontal cortex, which guides decision-making. In psychopathic individuals, this information is not making its way to the prefrontal cortex correctly, leading to decisions that are less based on empathy and the welfare of others. They tend to rely on the lateral prefrontal cortex, which applies rules to decision-making in a more rational way.

Other potential differences include fewer oxytocin receptors in the amygdala.

Genetics play a significant role in psychopathy, with estimates suggesting that about half of the population-level variance is due to genetic factors. However, there is no single "psychopathy gene."

Life experiences also play a crucial role, meaning that interventions can be effective. Psychopathy is not anyone's destiny.

The speaker emphasizes that people have different motivations for antisocial behavior. Some individuals are not restrained by conscience, empathy, or remorse and will continue to hurt others if it's useful for them, even if they have the option not to. However, they will respond to consequences.

Harsh punishments are not effective in deterring antisocial behavior, especially in psychopathic individuals. The best way to deter antisocial behavior is to ensure that people can't benefit from it.

Social media can increase the reward value of antisocial behavior by providing status points and attention. Policymakers could be more proactive in using social media posts to catch offenders and impose consequences.

Good parenting advice for children at risk for psychopathy boils down to:

• Building a strong base of affection and trust.
• Establishing clear rules and boundaries.
• Providing consistent and fast consequences when rules are broken, without being harsh.

The speaker recommends the book "1-2-3 Magic" as an example of how to put these principles into action.

Treating psychopathy in adults is difficult because they tend to be narcissistic and blame their problems on others. However, some individuals eventually realize that their own decision-making is the core of their problems. With the right information and treatment, they can learn to interact with others differently, in a non-instrumental way.

If someone close to you has psychopathic traits, the speaker advises against taking on the responsibility of fixing them. It's a problem that can only be fixed when the person themselves is ready. She advises caution in romantic relationships with psychopathic individuals unless they have taken the initiative to get treatment and improve. If you can't get out of a relationship with a psychopathic family member, protect yourself from exploitation.

The speaker notes that some members of her organization's board are themselves people with psychopathy who have gotten treatment and learned how to treat people better.

The Other Extreme - Extraordinary Altruism

On the other end of the spectrum from psychopathy are individuals who are "anti-psychopathic" and care more than average about others' welfare. These individuals are often extraordinarily altruistic, doing things to help others at real risk and cost to themselves.

Extraordinary altruism is not a clinical condition, but it is typified by traits that set altruists apart:

• Valuing the Welfare of Others: Genuinely unselfish.
• Opposite of Psychopathic Traits: More sensitive to others' fear.

Differences in the brain include a larger and more reactive amygdala, particularly in response to the sight of others' fear.

Humans are among the most altruistic species, spontaneously helping strangers to a degree not seen in other species. This is partly due to being an alloparental species, where offspring are cared for by all adults in the group.

The things that set an extraordinary altruist apart from typical people are:

• Having done something extraordinarily altruistic.
• Humility: Not thinking they're more special than anyone else.
• Belief in the Goodness of Others: Less likely to believe others can be truly evil.
• Sensitivity to Others' Distress: More likely to empathize with and recognize others' fear and pain.

Extraordinary altruists see the welfare of strangers as fundamentally important. In social discounting tasks, they don't show the same drop-off in willingness to share resources with people further out on the social axis.

The speaker mentions Mr. Beast, a YouTuber who has cured thousands of people's cataracts, as an example of someone who is apparently quite altruistic.

Genuinely altruistic people are often acting behind the scenes, without seeking accolades or praise. The speaker notes the number of actors who have rescued people from danger in real life.

Superheroes in movies and television shape the way we think of altruism. The speaker finds Ironman a more realistic depiction of an altruistic person than Superman, as he is more complex and multidimensional.

The speaker addresses the argument that there's no such thing as true altruism because it brings joy to those who help others. She argues that this is the best thing about altruism, as it makes people more likely to do it again. She quotes Matthieu Ricard, a Buddhist monk and neuroscientist, who said that the fact that helping others brings us joy is not contradictory to the idea of altruism; in fact, that's what it means to be altruistic.

The doctrine of double effect states that the morality of a behavior is a factor of not just its outcome, but its intended outcome. If the goal of helping others was to achieve happiness, then that's not very altruistic. However, if you help other people and given happiness as a foreseeable outcome of that behavior happens anyways, that doesn't take away from the goal of actually helping them.

The speaker rejects the puritanical idea that for something to be moral, it can't also be joyful. The fact that altruism brings us joy is a sign that we are a fundamentally social species, built to want to help those around us.

Effective altruism is a movement dedicated to helping people in more effective ways. The speaker agrees with this idea but disagrees with the belief that empathy must be suppressed in favor of rational decision-making. She argues that empathy is what gives us the motivation to help at all.

The speaker suggests that to best promote the goals of effective altruism, we need to cause people to value the needs of a wider range of people so that they will empathize for a wider range of people.

To assess how altruistic versus psychopathic you are, the speaker recommends:

• The TriPM: A self-report test of psychopathy available on the Psychopathy Is website.
• The HEXACO: A personality test that includes the honesty-humility trait, which captures the degree to which you believe that other people fundamentally matter versus are exploitable for your own good.

The speaker emphasizes that people's behavior generally reflects their values. When people do things that exploit and harm others, that is a reflection of their values. When people help others, that is a sign of their values, too.

In a study, the speaker found no evidence that very altruistic people are just using willpower to overcome selfishness. Instead, their generous choices reflect their greater valuation of other people's welfare.

Loving-kindness meditation training alone does not make people behave more generously. To make the average person respond more generously, we need to change their values, causing them to value other people's welfare more.

People can become more generous over time. When people are experiencing a high quality of life, they tend to become more generous.

The best evidence for how people can become more generous is by just starting. The speaker recommends starting with small, feasible ways to help others, as the experience of helping others becomes a self-reinforcing process.