© Illustration by Yael Bogen
This is a story about a woman who is not afraid of anything. Not snakes, not horror movies, and not walking alone in the dark. As someone who lives in a not-so-nice suburb in the United States, S.M. (as she is known, to protect her identity), has wound up in quite a few scary and even traumatic situations: One day she was assaulted in her home and almost killed, another time she had a knife held to her throat while she was walking alone through a park at night, and on other occasions she encountered people who threatened her life. But all of this did not lead S.M. to become anxiety-ridden or even frightened. Quite the contrary.
Psychologists who have met her describe a vivacious woman, very friendly − one of those survivor types who arouse our admiration because of their capacity to endure in the face of life's calamities. But S.M. is no hero. It's not that she succeeds in overcoming fear by enlisting hidden inner resources: S.M. simply does not know how to be afraid.
Scientists in the United States have been monitoring her for years and documenting her behavior. When they took her to an exotic pet store − the sort that displays giant lizards, pythons and hairy spiders − she approached the snakes and tried to pet the biggest and most dangerous ones as though they were kittens. When they placed a snake (nonpoisonous) in her arms, she inquisitively petted its scales and touched its darting tongue, and when she saw a hairy and horrible-looking tarantula, she reached out to pet it despite being warned repeatedly that its bite is fatal.
At a movie theater they showed her horror films, and while others in the audience fearfully shrank into their seats, S.M. seemed highly amused and occasionally responded with bursts of enthusiasm. For "dessert," they took her on a tour through the spooky maze of an amusement park haunted house, where people emerged pale and breathless after a skeleton laid a hand on their shoulder and monsters breathed damply on them. S.M. burst out laughing and tried to touch one of the monsters. The monster (a staff member) got a real scare.
Ostensibly we are talking about a cool person who deserves our admiration. But no: S.M. is brain-damaged, in an area called the amygdala. This area (actually two areas, one on each side of the brain) is part of our so-called emotional brain, which is responsible for the feelings we experience, especially fear. When we encounter something that poses a threat to us − for example, when we see a snake pop out at us or when we hear a loud explosion − the amygdala is activated and sends fear through us; this warns us against the pain or danger awaiting us.
With the help of links to other areas of the brain, it motivates us to act in response to the threat: to fight it or flee from it. A burst of adrenalin washes over us and our heart rate goes up, breathing accelerates and the blood vessels dilate (that is why we perspire). All of this gets the muscles in gear to deal with the danger. However, S.M.'s body does not produce this range of reactions because her brain lacks the amygdala. A rare childhood disease destroyed that part of her brain, and with it the ability to feel fear.
In a society such as Israel, which reveres dauntless generals; in a security reality that attempts to nurture hardened, fearless warriors, but winds up producing dozens of post-traumatized people a year − in other words, people who in fact never stop being afraid − it is interesting to examine the story of this woman, who outwardly looks like a hero, a fighter, but in fact suffers from a brain defect.
The amygdala and post-trauma
"In a way, it is a miracle that this woman is alive," says Dr. Inbal Kivenson-Baron of the education department at Haifa University, who studies fear and its implications for personality traits, "because without fear it is almost impossible to survive. Fear is a basic emotion that appeared very early in evolution because it enables us to recognize dangers that threaten us, and thanks to it we can beware of them. The fact that S.M. has encountered a large number of violent incidents in her life is apparently not coincidental. Another person would have refrained, for example, from walking alone in a park at night, certainly after having experienced a frightening incident, and thereby protected himself from further injury.
But S.M., whose amygdala is damaged, cannot feel fear and accordingly also cannot remember the experience of fear so as to learn from it. That is why she returns to places that have already proven themselves to be dangerous and is attacked each time anew."
S.M. is a rare and extreme case of a woman who doesn't know what fear is because of a totally inactive amygdala. At the other extreme are the post-traumatized − those whose amygdala is extremely aroused and active on a regular basis, as seen in MRI scans. For this reason they cannot rid themselves of fear they experienced in the past, even if months or years have gone by since the frightening incident.
Just how central the amygdala is in creating post-trauma may be learned from a fascinating study conducted among Vietnam War veterans. American researchers found that soldiers who suffered a brain injury in the amygdala region did not develop post-trauma when compared to other soldiers who were injured in other areas of the brain or who sustained no brain injury at all.
Ironically, and in a sort of surprise twist to the plot of life, it seems that the injury to their amygdala wound up protecting those soldiers from the constant fear inherent in the post-traumatic condition.
What goes on in the middle range, between the two extremes? It turns out that there are major differences between people in terms of the amygdala's activity in their brains and their propensity for experiencing fear. In Israel, with its plentiful history of wars and unrest, many studies of post-traumatic individuals are carried out, with the object of alleviating their suffering. Less attention is being paid to people who are closer to S.M. on the scale − i.e., people who are relatively impervious to fear. The question of whether resistance to fear, or to sensitivity, has pathological ramifications, is receiving even less attention.
This is precisely the question that interests Dr. Kivenson-Baron. In the course of working with at-risk children and adolescents, she came across children with antisocial tendencies, which are manifested as exploitation of others, a lack of empathy and the absence of guilt. She noticed that these were often "fearless" children: Nothing scares or deters them. She decided to look into the possibility of a connection between these two phenomena: antisocial tendencies and fearlessness.
"Every child has a temperament that reflects his innate traits, which are inherent even before his character forms over the course of his life," Kivenson-Baron says. "One of the components of temperament has to do with the tendency to approach or retreat from new stimuli; to be curious about people and phenomena or be deterred by them and become reclusive. Generally, we all maintain a certain balance between these opposing systems: the inquisitive system that pushes us forward to meet new challenges, and on the other hand the fear system that holds us back. Most of the psychological and sociological studies conducted in the world deal with children who are ruled by the fear system: the shy, the scared, and the socially delayed. [Researchers] try to understand what causes these children to be so sensitive and how they can be helped. I was interested in the other end of the scale − the fearless children."
Under the guidance of Prof. Ofra Meisels, Kivenson-Baron conducted research on preschool children aged 3-4, and diagnosed some who had been described by their teachers and parents as "children who are not afraid of anything." Whereas, for example, most children at these ages exhibit to one extent or another fear of climbing trees or high playground equipment, freeze at the sound of a firecracker, and scream in fright at the sight of a scurrying cockroach − the fearless children were not only unafraid of these things, but were actually drawn to them. In general, they were described by parents and teachers as being attracted to dangerous situations.
"On the face of it, there is no problem here," Kivenson-Baron says. "These are curious children, inquisitive, and even remarkably sociable because they have no reluctance to meeting new people."
In actuality, fearlessness can be an indication of a problematic brain structure and of a profound emotional and social problem. It turns out that not only do these children not feel fear, but they also cannot recognize that feeling in others. Kivenson-Baron gave the children a test that is customarily administered to fearless adults with a barely active or completely inactive amygdala (as in S.M.'s case). In it, subjects are shown pictures of people whose faces express various emotions − joy, anger, sadness and so on − and are asked to identify the emotional state of the person in the picture. Fearless people easily identify expressions of joy, surprise, anger and disgust, but have great difficulty recognizing expressions of fear. In some cases they also have difficulty recognizing sadness. This is also what happened in the cases of the fearless children Kivenson-Baron tested: They had a hard time recognizing a fearful expression in others, and even when asked specifically, "Is the man in the picture in danger?" − they had trouble deciding.
The fact that people whose fear system is atrophied also have trouble recognizing fear and sadness in others is intriguing because it demonstrates the ancient claim that a man cannot know his fellow man if he does not know himself. But beyond the philosophical insight, this discovery has important social and moral implications.
Kivenson-Baron: "Fearless people do not recognize in others emotions that express distress, and hence are impaired in their emotional grasp of the world. A lack of understanding of this kind indicates insensitivity toward others and an inability to feel empathy, things which might lead to antisocial behaviors such as aggression and exploitation."
And indeed, Kivenson-Baron found that in contrast to other children their age, the fearless children tended to ignore the loud crying of a baby outside the room, looked on with equanimity as their mother hurt her finger, and remained utterly indifferent to friends in distress.
Another characteristic of the fearless children, in contrast to other kids, was that they did not tend to get upset about bad things they had done and did not feel guilty or remorseful afterward.
"The callousness that characterizes the fearless children and their inability to recognize another's distress attest to an impaired moral development and an underdeveloped conscience," Kivenson-Baron says. "It would seem, then, that there is a connection between fearlessness and inability to identify with the other and an underdeveloped conscience. The connecting point for all of these is reduced activity in the amygdala."
Moral brain
Is this so? Is there really a connection between a dormant amygdala, on the one hand, and fearlessness and deficient moral development, on the other? There is a close connection, if you ask Dr. James Blair of the U.S. National Institute of Mental Health, one of the world's leading brain researchers, who studies the connection between brain structure and a violent criminal personality.
"A fearless temperament," he says, "might lead to a criminal path in life and even psychopathy, because there is a biological connection between the fear system and the development of a conscience and morals."
At issue is not fear that stems from rational thoughts about the future consequences of our actions and about the punishments awaiting us should we behave in an unacceptable manner. The fear Blair is referring to dictates the development of our conscience in a far more primal and instinctual manner. It is located in the depths of our emotional brain and derives directly from the activity of the amygdala.
Blair and his colleagues scanned the brains of teenage boys with antisocial personality traits. We're not talking about mean loners or children who put a frog in the teacher's bag. Rather, teenage boys who employ extreme violence to attain their goals, do so with manifest cool-headedness and do not regret it later or suffer pangs of conscience.
Such was the case, for example, in 1994 when Arbel Aloni and Moshe Ben-Ivgy, both 14 years old at the time, held a revolver to the head of Netanya taxi driver Derek Roth and pulled the trigger. One bullet, and then another and another − a total of six bullets fired with a steady hand, coolly and for no apparent reason, and not accompanied later by any pangs of conscience. Brain scans of teens of this type, which Blair performed, found that their neurological activity was very different from that of normative boys of the same age: The amygdala of the first group of teens was characterized by an especially low level of activity, and the same was true for a certain area at the front of the brain.
Brain scans of psychopaths also reveal differences in the level of their amygdala activity and of that same area at the front of the brain, as compared to ordinary, normative people. Psychopaths are people who perpetrate crimes "in cold blood" − in other words, without emotional involvement. They are known for their extreme lack of empathy and complete absence of guilt or remorse. We know them from the movies: characters such as Hannibal Lecter and Buffalo Bill in The Silence of the Lambs, Anton Chigurh in No Country for Old Men, and Alex in A Clockwork Orange. In reality we are talking about people like Charles Manson, who was responsible for a series of particularly brutal murders (among them the murder of Sharon Tate, Roman Polanski's wife), or Charles Whitman, who used four rifles and a handgun to shoot dozens of people after murdering his wife and mother the previous day (see below).
"There is a direct connection between the activity of the amygdala and deficient moral conduct because of the decisive role that the amygdala plays in the emotional system of fear," Blair explains. "Its centrality is due to its being responsible not only for the experience of fear but also for recognizing it in other people. As social creatures we learn what are good and bad behaviors by deciphering the facial expressions of others who react to these behaviors.
"If as a child I hit you and you cry or become frightened, my amygdala switches on and recognizes the miserable look on your face. The identification I feel at the sight of that expression teaches me that I did something wrong. Likewise, when I see another person doing something bad to someone else, my amygdala signals me, by deciphering the victim's facial expression, that here was a case of bad behavior that must not be repeated. The frightened or sad looks on another's face are negative reinforcements for behaviors that are to be avoided, precisely as an electric shock is a negative reinforcement that teaches us to be careful and refrain from doing whatever caused us to receive the shock. The facial expressions of a person who is in distress function as negative feedback that teaches us to avoid repeating those same actions that caused that expression."
Blair contends that learning that relies on facial expressions is particularly important in children, since that is how they learn the first basis for distinguishing between good and bad, especially when it comes to social conduct and interpersonal relations. The learning takes place because of the immediate association between the behavior and the expression it elicits in the other, and it is more effective that teaching by means of punishments (for example, spanking a child's bottom or withholding a gift), where there is a greater time lapse between the action and the feedback.
In people whose amygdala activity is low, such as the teenage boys with antisocial personality traits and the adult psychopaths, this whole system is defective. Their fear system is faulty both in terms of their personal sense of fear and in terms of recognizing fear and distress on another's face. When a person fails to recognize the victim's distress as negative feedback and does not feel empathy toward him, he is not deterred by the actions that caused this distress and does not refrain from perpetrating them.
You could say that the amygdala, according to Blair, is not only part of our emotional brain, but is also a kind of moral brain. "The amygdala is the center through which we initially learn the distinction between good and bad," he says, "and it is the basis for the development of the conscience and morals. In this regard, the amygdala is one of our moral centers. However, a moral system that entails thought, judgment, and planning apparently derives from activity in other parts of the brain, for example in the front part of the cerebral cortex, which 'speaks' with the amygdala and regulates its activity. It is interesting that in this frontal area as well you find differences in brain activity between psychopathic and normative people, and it seems that complex moral decisions are reached through interaction between these two areas while adjusting for the stimuli the cerebral cortex receives from the amygdala."
In fact, the differences between the brains of criminals and psychopaths and those of normative people, as revealed in brain scans, are so impressive that there are scientists who claim that on the basis of such scans, they can determine to a great degree of likelihood who among a group of children will grow up to be a psychopathic criminal and who will not.
Such a claim is naturally off-putting because of the deterministic approach it entails, and it also raises complex moral and legal issues regarding a society's ability to bring to trial and punish a person whose brain anatomy and physiology supposedly dictated his morally deficient behavior.
Do the children in Kivenson-Baron's study have no choice but to grow up to become insensitive criminals? And, by the same token, are we doomed to send our children to serve under the command of fearless generals, whose bravery is perhaps dictated to them by a brain structure that is insensitive to fear? Is everyone whose brain exhibits reduced activity in the amygdala compelled toward aggressive behavior? There is reason to believe that the answers to these questions are complicated.
When I spoke with Justin Feinstein, the lead author in the case study of S.M. at the University of Iowa, he was adamant that she does not exhibit any criminal tendencies whatsoever and is actually very empathetic toward those around her. Just recently, he said, she gave her last $10 to a homeless man so he could buy himself a winter coat. Thus, the absence of an amygdala and the presence of fearlessness may be prerequisites for developing a psychopathic personality, but they do not suffice.
As brain research advances and science discovers more about how behaviors are dictated by biological factors, and to what extent we can affect them, the question of free will and responsibility will doubtless increasingly preoccupy society. Science will go on searching and updating, discovering and tweaking its findings. And most of us will continue to maneuver between Rabbi Nachman of Braslav's recommendation, "the most important thing is not to fear at all" − and the declaration in Proverbs: "Happy is the man that feareth always."
Well, it is neither this way nor that, but somewhere in between. As usual.
The writer has a Ph.D. in molecular biology and is the author of "Darwin on the Tel Aviv Freeway" (Keter, 2007).
Criminal mind 1
On May 20, 1998, a 15-year-old American named Kip Kinkel walked into his house in Springfield, Oregon, aimed a gun he had in his possession at his father's head and pulled the trigger. A few hours later Kinkel's mother came home and, after helping her to bring in the groceries, he shot her too, crying out: "Mom, I love you." Kinkel sat all night beside his parents' bodies, which he had covered with sheets, and in the morning got into their car, drove over to his high school carrying three guns he had taken from his house, and went on a shooting spree, hitting 25 students at random before he was stopped. A brain scan revealed that activity in Kinkel's amygdala was demonstrably lower than normal; the same applied to a certain area at the front of his brain.
Criminal mind 2
On August 1, 1966, Charles Whitman, a student at the University of Texas and a former U.S. Marine, climbed up to the observation deck of the campus administration tower and shot indiscriminately at people walking below. Sixteen people were killed and 32 were wounded before Whitman was shot and killed by a police officer. It turned out that a short while before the massacre, Whitman had gone to his mother's house and murdered her; afterward he went to his own home and murdered his wife in her sleep. He left a letter requesting that an autopsy be performed on his body and that his brain be examined, having apparently sensed that it had betrayed him in some way. An autopsy of Whitman's brain found a cancerous tumor in the amygdala.
Learning to fear
The amygdala, it turns out, is important not only for experiencing fear, but also for learning it. Here is an experiment that demonstrates this: Test subjects are shown a series of pictures of people, for a few seconds. Toward the end of the presentation of several pictures, subjects are given an electric shock that causes them pain. Most people learn, over time, to fear the pictures of the people that "caused them pain." When they recognize these pictures (but not the other pictures), their amygdalas switch on and send signals to their bodies that stimulate sweating, increased heart rate and so forth.
In real life this response would enable them to flee or fight the person who "hurt" them. By contrast, people whose amygdala activity is low, like psychopaths, view all the pictures with equal indifference. Their amygdalas do not react even when faced with the people who "caused" them pain; they view them with equanimity without having learned a thing.
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