Kidney Donor and Recipient

Abigail Marsh’s new book, The Fear Factor: How One Emotion Connects Altruists, Psychopaths and Everyone in Between, reads like a thriller: it is entertaining, easy to read, and page after page, throws light on two of the most fundamental traits of human beings: extreme selfishness and extreme altruism. While doing research for my book Altruism, I read over a hundred books and a thousand scientific articles. I wish that Marsh’s book had been available, since it offers a remarkable contribution to the understanding of the inner mechanisms of altruism.

Just think about this: Abigail Marsh discovered that psychopaths, the unrivaled champions of callous selfishness, are extremely bad at recognizing fear in other peoples’ faces. Even though they are good at identifying other emotions, such as anger, joy and even pain, they cannot describe what fear is nor do they experience much fear themselves.

When pressed to answer, one of the psychopaths finally said, “I don’t know what that expression is called. But I know that’s what people look like right before I stab them.” A thirteen-year-old girl with psychopathic tendencies answered Marsh’s question about fear with the comment: “Nothing scares me! #NOTHING.”

How can this be explained? Research by Abigail Marsh and other neuroscientists reveals that psychopaths’ brains are marked by a dysfunction in the structure called the amygdala that is responsible for essential social and emotional function. In psychopaths, the amygdala is not only under-responsive to images of people experiencing fear, but is also up to 20% smaller than average.

Marsh also wondered about people who are at the other end of the spectrum, extreme altruists: people filled with compassion, people who volunteer, for example, to donate one of their kidneys to a stranger. The answer is remarkable: extreme altruists surpass everyone in detecting expressions of fear in others and, while they do experience fear themselves, that does not stop them from acting in ways that are considered very courageous.

Since her initial discovery, several studies have confirmed that the ability to label other peoples’ fear predicts altruism better than gender, mood or how compassionate people claim to be. In addition, Abigail Marsh found that, among extreme altruists, the amygdala is physically larger than the average by about 8%. The significance of this fact held up even after finding something rather unexpected: the altruists’s brains are in general larger than those of the average person. (i)

So, why fear? The amygdala’s responses to fearful expressions doesn’t not seem to be a response to a threat or a danger, but rather a deep, atavistic form of empathy. Another remarkable connection made by Marsh helps to further clarify this process. When someone sees a baby’s face or comes into physical contact with a person dear to them, it triggers the brain release of a peptide called Oxytocin. Oxytocin makes us care for others, especially for people close to us. It is strongly present in the amygdala and might be instrumental in transforming the impulse to turn away form others’ fear and distress into the desire to care for them.

So, what does a baby’s face have to do with fear? Of all the expressions a human being can make, the one most resembling a baby is fear. Fearful eyes are wide and large, fearful brows are high and angels upward, while the mouth is rounded and low and the jaw is small and receding, just like a baby’s. So , it seems that when an altruistic person see someone in fear, he or she has the same reaction as seeing a baby in trouble, thus triggering the impulse to care and protect.

The release of Oxytocin seems the likely catalyst to this surge of empathy and caring. Although no current technology can directly measure the release of Oxytocin in the human brain, research has shown that administering it through a nasal spray not only increases caring and trusting behavior, but also increases accuracy in recognizing fear.

Marsh also confirms that extreme altruists are those who can extend their circle of care. Many people would be willing to give kidney to save their mother or a close relative. When asked why, the usual answer is: “Because she’s my Mom.”

One of the altruistic kidney donors asks, “Okay, you’d do it for your Mom. How about your sister or your brother. How about your best friend?” He then extends the circle further out, challenging us, “What if someone is going to die next week and you’re the only person who can save him?” For this altruist, “because someone is going to die” was just as obvious an explanation for donating his/her kidney to a stranger as “because she’s my Mom” is for everyone else.

Another heartwarming feature Marsh discovers in extraordinary altruists is their unshakable humility. They display a firm resistance to all efforts to elevate them with praise and labels like “hero.” A similar form of humility was noted by Samuel and Pearl Oliner (as well as Kristen Monroe [ii]) when they interviewed rescuers who risked their lives to save Jews from being sent to death camps by the Nazis. The urge to help others was “second nature” and had nothing sacrificial about it. They felt they responded with complete fidelity to themselves.

Now let’s pause for a moment: we also know from scientific research in the field of neuroplasticity, that any form of training leads to reconfiguring in the brain, at both the functional and structural levels. For the last twenty years an increasing body of research, such as conducted by Richard Davidson (iii) and his colleagues at the University of Madison, Wisconsin, has shown that training the mind through various meditation techniques can enhance our capacity for altruism and compassion. Abigail Marsh’s research suggests that specifically training in enhanced recognition of fear and suffering in others might increase this propensity for altruistic behavior.

Just as warmth inevitably occurs when we light a fire, true altruism naturally goes hand-in-hand with profound personal satisfaction. Authentic altruism does not require that we suffer when helping others. It does not lose its authenticity if accompanied by feelings of profound satisfaction. What’s more, the very notion of sacrifice is relative: what seems like a sacrifice to some is experienced as profound fulfillment by others. This also means that engaging in altruism reinforces itself — the gratification it incurs makes it more likely to be repeated.

In this current era one of our main challenges is how to reconcile the demands of the economy with the search for happiness and respect for the environment. These imperatives correspond to three time scales — short, middle and long term. Having more consideration for others is the only unifying concept that allows us to find our way through this maze of complex preoccupations and work together to build a better world. Altruism, therefore, should not be relegated to the realm of noble utopian thinking. We must have the clarity to acknowledge this and the audacity to say that altruism is not a luxury, but a necessity.


i Abigail A. Marsh, Sarah A. Stoycos, Kristin M. Brethel-Haurwitz, Paul Robinson, John W. VanMeter, and Elise M. Cardinale, “Neural and Cognitive Characteristics of Extraordinary Altruists,” Proceedings of the National Academy of Sciences of the United States of America 111, no. 42 (2014): 15036–15041.

ii Oliner, S. P., & Oliner, P. M. (1988). The Altruistic Personality: Rescuers of Jews in Nazi Europe. Macmillan. Monroe, K. R. (1996). The Heart of Altruism: Perceptions of a Common Humanity. Princeton University Press.

iii Lutz, A., Brefczynski-Lewis, J., Johnstone, T., & Davidson, R. J. (2008). Regulation of the neural circuitry of emotion by compassion meditation: effects of meditative expertise. PLoS One, 3(3), e1897.

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