Introduction to Empathy: The brain, psychopaths and the empathy quotient test

We're going to focus a little on empathy specifically, but we don't want to be nit-picky about the term. Empathy occupies a specific scientific space, which we'll delve into with definitions and such, but when it comes to Better Humanhood, we're at least as interested in its relatives kindness and compassion.

We'll get more into this in a later post, but there's a school out there — well-laid out by Paul Bloom in Against Empathy — that argues against a reliance on empathy, but instead more of a systematized moral code that benefits more people through enforcing actions that result in kindnesses, rather than relying on what is actually empathy, the neuronal response.

What is empathy? Can we see it? What does it look like? What happens when it's missing? This introduction is the start of a series.

What is empathy? Can we see it? What does it look like? What happens when it's missing? #betterhumanhood Click To Tweet

"Empathy," writes Simon Baron-Cohen (cousin of comedian Sacha) in The Science of Evil, "is our ability to identify what someone else is thinking or feeling and to respond to their thoughts and feelings with an appropriate emotion" (p. 16).

Roman Krznaric describes it in Empathy: Why It Matters and How To Get It as "the art of stepping imaginatively into the shoes of another person, understanding their feelings and perspectives, and using that understanding to guide your actions" (p. x).

The word empathy derives from the Greek empatheiaem (in or into) and pathos (feeling). In The Empathy Exams, Leslie Jamison relates it to "a penetration, a kind of travel. It suggests you enter another person's pain as you'd enter another person's country" (p. 6).

It seems, then, that empathy requires:
(a) At least two people;
(b) the ability to recognize emotion in someone else (such as happiness or sadness); and
(c) the ability to determine what is hopefully a proper response.

Marco Iacoboni conducted some of the early experiments in empathy research, and was the first to discover empathetic connections in the brain. (You might remember that we went from thinking the brain was garbage to being shocked at how much we have yet to discover about the organ in our noggins.)

"Solid empirical evidence," he writes in Mirroring People, "suggests that our brains are capable of mirroring the deepest aspects of the minds of others" (p. 7).

'Our drive to imitate seems to be powerfully present at birth and never declines' -- @marcoiacoboni #betterhumanhood Click To Tweet

Iacoboni describes imitation as a basic human function. "Our drive to imitate," he notes, "seems to be powerfully present at birth and never declines" (p. 47). Toddlers who aren't yet speaking play imitation games; the more they do so, he finds, the more likely they are to be fluent speakers within one to two years.

In fact, Iacoboni writes, while Jean Piaget suggests that babies learn to imitate, Andrew Meltzoff suggests instead that babies learn by imitating. So, rather than babies developing the skill to imitate their parents, they are born with the innate skill to imitate, and by using that skill is how they actually learn.

It probably doesn't surpise you to learn that children are much better at imitating behavior, as well as the goals of others' behavior, than they are at paying attention to directions. For example, you can fail at doing a handstand, but a child can pick up what you're trying to do and take the steps to attempt to succeed at doing a handstand. However, they're not so good at following spoken instructions for doing a handstand.

How do we manage this early-in-life imitation, and how does it relate to empathy? "We are deeply connected at a basic, pre-reflective level," writes Iacoboni, but "we do not have to draw complex inferences or run complicated algorithms. Instead, we use mirror neurons" (pp. 268, 7).

Mirror neurons were first discovered using experiments involving grasping, and later we learned that perception and activity (such as seeing a graspable object versus actually grasping it) aren't done with separate sets of neurons. In other words, we don't have separate boxes" for those things — as far as our brains are concerned, thinking about grabbing a banana and actually grabbing it trigger the same neurons.

Iacoboni goes on to write about this in terms of pain. For people with normal brain function (more on that in a little bit), if we watch someone have a needle go through their hand, we inadvertently flinch in the part of our hand where the needle went through, even though it was going through someone else's hand.

This isn't a function of our hand, it's a function of our brain. "Our brain produces a full simulation — even the motor component — of the observed painful experiences of other people," Iacoboni writes (p. 124).

"Although we commonly think of pain as a fundamentally private experience," he continues, "our brain actually treats it as an experience shared with others" (p. 124).

Iacoboni identified the basic path empathetic feelings travel through brain via mirror neurons and the limbic system. Baron-Cohen reported a more detailed path, outlining ten specific parts of the brain. Among these are the medial prefrontal cortex, which is used for things like social information, perspective and comparison; the frontal operculum, which is responsible for language and encoding goals; and the amygdala, which handles fear, among other things. Along the way, neurons fire in parts of the brain that process pain, recognize gaze and emotional state, and judge intentions.

Now, if you're familiar with the case of Phineas Gage, the railroad worker who took a tamping rod through the skull and part of his brain and then toured the country for more than a decade until his death, you'll know that damage to different parts of the brain causes different things to go awry.

Of course, that was all new in 1848 and the only thing apparently wrong with Gage was that he was way too cranky to work with.

So what happens when part of the empathy path is damaged or otherwise compromised?

"We all live somewhere on on the empathy spectrum (from high to low)," Baron-Cohen writes (p. 10). This is true for all spectra, by the way, from empathy to autism to sexuality to blindness. That's what spectrums are — they put us on a sliding scale from, say, zero percent to 100 percent.

"People said to be evil or cruel are simply at one extreme of the empathy spectrum," he continues, noting that "unempathetic acts are simply the tail end of a bell curve, found in every population on the planet" (p. 15).

We noted above that neuroscientists have identified a path in the brain that signals travel in extending empathy to others. It might not surprise you, then, to discover that in people with low empathy, we find some damage or other irregularity along this path.

James Fallon (not to be confused with comedian Jimmy) has an interesting story we'll get to in a moment, but what he's found is that psychopaths all show a malfunction in the full path of the pattern. Other criminals (like impulse murderers) only have a malfunction in one or several parts along the path, often those parts that typically prevent impulsivity.

Interestingly, in brain scans, psychopaths and people with autism present similarly. So why aren't a large number of people with autism psychopathic murderers? Fallon:

"A dichotomy may exist between empathy, a fundamental connection with the pain of others and arising early in life, and 'theory of mind,' a more elaborate prefontal system that allows us to consider others' thoughts and beliefs, even if they are different from our own. People with autism lack theory of mind but not empathy, while people with psychopathy lack empathy but not theory of mind" (p. 55).

In his book The Psychopath Inside, Fallon details how he got into this research. A lawyer asked him to look at a brain scan of a convicted murderer ahead of his sentencing. Fallon found a defect in the impulse control regions, and the murderer was sentenced to life in prison instead of the death penalty.

He was brought in on a bunch of similar cases in subsequent years.

Some time later, he was asked if he would look at a bunch of brain scans of people known to be psychopaths to see if he could find a pattern. He agreed, but asked for a blind control: he wanted the psychopaths' brain scans mixed in with "normal" brain scans.

He found the pattern immediately.

Fallon was doing an unrelated Alzheimer's study and decided to have his brain and the brains of his wife and children scanned as a control (none was displaying signs of dementia). The brains of his wife and children looked perfectly normal, but his brain showed a familiar defect: it looked like that of psychopath.

Fallon's brother had done a lot of genealogical research on their family, and going back nearly a thousand years, there were impulse killers, serial killers and even tyrannical kings in their family tree.

Psychopathy is one of three "negative zero-empathy" condition Baron-Cohen describes, along with borderline and narcissism. Autism, in this case, would be a non-negative zero-empathy condition.

"Zero degrees of empathy," he writes, "means you have no awareness of how you come across to others, how to interact with others, or how to anticipate their feelings or reactions" (p. 43).

Early in life stress can lead to zero empathy, he notes, but "it takes more than a harsh environment to make a psychopath. There must be a genetic element" (p. 126).

Sounds like Fallon got lucky having a decent environment to grow up in. Or maybe potential victims got lucky.

Still, after finding out his brain appeared like that of a psychopath's, Fallon went around and asked friends and colleagues what they thought of him. At least one of them wanted nothing else to do with him ever. But on the kinder end of the scale, some of his friends pointed out that he never responded to party invitations until the last minute, holding out in case he got a better opportunity.

Fallon writes that he was defensive at first, but upon further reflection, his friends were correct.

"When our empathy is switched off, we are solely in the 'I' mode," writes Baron-Cohen. "In such a state we relate only to things or to people as if they were just things. Most of us are capable of doing this occasionally" (p. 7). That sounds pretty consistent with what Fallon's friends told him; just for him, natural empathy is generally turned off.

We're going to end this introduction to empathy with a look inward.

Baron-Cohen has developed an Empathy Quotient exam. I'll spare you the details (you can go take it if you want), but I score not much higher than someone with Asperger's or high-functioning autism.

You might recall that someone with autism has a brain that looks a lot like that of a psychopath, but we described that as a non-negative zero-empathy condition ("non-negative" is my term, by the way, to use in contrast with Baron-Cohen's "negative zero-empathy condition" description without using "positive").

But "empathy is not the sole route to developing a moral code and a moral conscience that leads a person to behave ethically," Baron-Cohen asserts (p. 95), and this includes people with high-functioning autism and those of us who are not far away from them on the EQ scale.

These people tend to systematize their moral code, and we'll discuss that in the next installment of this series.


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