Psychopathy versus altruism: the neuroscience of caring about others (w/ Abigail Marsh) (Transcript)

Please note the following transcript may not exactly match the final audio, as minor edits or adjustments could be made during production.

Chris Duffy: You are listening to How to Be a Better Human. I'm your host, Chris Duffy. What makes us care about other people? What makes us hurt them? These are really big questions and they're questions that today's guest, Abigail Marsh has been studying as a psychologist, as a neuroscientist, and as a professor. By looking at the brains and the behaviors of extraordinary altruists, people who are willing to undergo surgery to give an organ to strangers, to someone who they've never met and will never meet.

And then on the other hand, she also looks at psychopathic individuals, people who may struggle to feel empathy for others who may act violently by studying this full spectrum of humanity. Abigail's trying to get to the bottom of where empathy comes from. Why do we care for or not care for others? Her interest in what makes people act in such extreme ways, both positive and negative.

It started with a terrifying experience in her own life, and here is a clip from her TED Talk where she's talking about it.

Abigail Marsh: There's a man out there somewhere who looks a little bit like the actor, Idris Elba, or at least he did 20 years ago. I don't know anything else about him except that he once saved my life by putting his own life in danger.

I was 19 years old and driving back to my home in Tacoma, Washington, down the Interstate five freeway when a little dog darted out in front of my car. And I did exactly what you're not supposed to do, which is swerve to avoid it. And I discovered why you're not supposed to do that. I hit the dog anyways, and that sent the car into a fish tail and then a spin across the freeway.

And so finally it wound up in the fast lane of the freeway facing backward into oncoming traffic. And then the engine died. And I was sure in that moment that I was about to die too, but I didn't because of the actions of that one brave man who must have made the decision within a fraction of a second of seeing my stranded car.

So pull over and run across four lanes of freeway traffic in the dark. To save my life. And then after he got my car working again and got me back to safety and made sure I was gonna be all right, he drove off again, never even told me his name, and I'm pretty sure I forgot to say thank you. So before I go any further, I really wanna take a moment to stop and say thank you to that stranger.

Hi, I am Abigail Marsh. I'm a professor of Psychology and Neuroscience at Georgetown University. I'm the author of the book, the Fear Factor, and the co-founder of the Society for the Prevention of Disorders of Aggression.

Chris Duffy: You've been really interested in studying altruism and what makes people altruistic.

Let's just start by what is the definition that you use for altruism?

Abigail Marsh: So altruism is any behavior that is aimed at benefiting another person approving their welfare. If you're a biologist, you don't really care about the intention. You do care about the outcome, and that you pay some sort of a cost for the behavior.

If you're psychologist, you mostly care about what the goal of the behavior was.

Chris Duffy: You study altruism. You study what makes people do extraordinary acts of, of kindness or generosity for other people, but you also study it from the flip side, which is what makes people not care about other people. What makes people not willing to do generous or caring acts?

Abigail Marsh: Exactly. Uh, I see them as either ends of a single continuum that's defined by how much people intrinsically care about other people's welfare, but from a scientific perspective as well, if you wanna understand a phenomenon, it's really useful to try to study people who are missing whatever it is you're interested in.

So if you're interested in memory, it's interesting to study people with amnesia. So, because I'm interested in what allows people to care about others' welfare, it's really intrinsically interesting to study people who really don't seem to have the capacity to care about other people intrinsically, for example, people with psychopathy.

So yes, that's who I study as well.

Chris Duffy: You talk in the book several times about how people who do something that is incredibly altruistic in an example that you give is people who donate a kidney to someone that they don't know and probably will never meet. So they, they go through a, a painful and quite serious surgery to help someone else.

Without any personal connection at all, that those people often really insist that there is nothing special about them, that they are just the same as everyone else.

Abigail Marsh: Absolutely. I met the first altruistic kidney donors who came in to do our research, was very honored to meet them and so excited, and it was amazing how obvious it was right from the get go that any kind of fawning or flattery was just.

Horribly uncomfortable. It was not something they were looking for essentially to a person. Every single altruistic kidney donor I've ever worked with, that's true of, and other kinds of altruists as well, like heroic rescuers, they're not looking for that and it's even further than not wanting flattery.

They really insist, like I, I'm just the same as you. And I initially thought that was just a funny kind of bug. But now I think it's a feature. I think it's actually essential because if you are going to take a big risk or you know, expend your own resources or energy to help a total stranger, you can't believe that you're more important than they are because otherwise you should be the one who has all the stuff.

Right. Only if you truly believe that you're not more important than anybody else, does it make sense for you to give up your own stuff to help somebody else out there, no matter who it is? So I think actually humility and altruism are intrinsically related.

Chris Duffy: What are some of the other key pieces to altruism? Humility is obviously one of them.

Abigail Marsh: The most obvious one that people ask about is empathy, and there is a relationship between empathy and altruism, but it's not as simple as I used to think. People who are altruistic do not appear to be more empathic across the board. So for example, they don't empathize any better with other people's pain.

For example, we've put them in the scanner and used a device that bangs on their thumbnail really hard.

Chris Duffy: Terrible device. Hate that device. Yes.

Abigail Marsh: It's called we, we call it a thumb smasher, colloquially, but we try not to call that. Yeah.

Chris Duffy: What's the technical term now? I'm really fascinated. What's, how do you like say a thumb smasher in scientific language?

Abigail Marsh: Pneumatic pressure. Pain device.

Chris Duffy: Pneumatic pressure. Pain device. Okay. Wow. Also like nightmare term.

Abigail Marsh: Yes. And I, I hasten to add that everybody gets to control their own level of pain. We are not doing anything and nobody has consented to. And then while they're still in the scanner, they watch over a real-time feed as a stranger has the same pressure, pain applied to their thumbnail.

And what we found is that the altruistic kidney donors do show more empathy with a stranger's pain. So their brain looks very similar when they're experiencing the pain and watching somebody else experience pain. It's, it's literally kind of the neural equivalent of trying to put yourself in somebody else's shoes, mapping their experiences onto your own.

But what was neat is that when we told everybody in the study, the altruist and the typical adults. To try to empathize. They all did it equally well. There was no difference. And so what that means is that it's not that the alvis necessarily can empathize better, but they do empathize and the reason seems to be.

That they genuinely care about other people's welfare more, and we have lots of data points that that's true. And I think that's interesting because what it means is that most people, and we know this can empathize just fine, right? Most people don't need to be taught how to empathize. It's actually pretty natural if the person on the other end is somebody you intrinsically care about.

Right. If it's somebody very close to you, somebody who's similar to you, somebody who shares your values, but then that empathy goes away when the other person is not somebody we intrinsically care about. So what this means is that Ultras somehow have developed the ability to genuinely care about everybody.

Like truly everybody. Maybe not to exactly the same degree, but even if you're a perfect stranger, they've never met before, they already care that you are not suffering, that you are. Well, and that's really the core, right? And that's the thing. We don't quite know where it comes from, but it clearly does, uh, exist.

One of the ingredients to developing that ability, interestingly, seems to be having a high level of wellbeing. So not necessarily being happy all the time, but feeling like you're flourishing, feeling like you have what you need in life. And in general, we see that at a societal level when people have higher levels of wellbeing, when they feel like they're flourishing, they have what they need in life, they're more likely to be altruistic towards strangers.

Hmm. So that's a good thing because it means that we don't have to choose between those two outcomes.

Chris Duffy: Yeah, I mean certainly even just in my own personal life, right? I know it's a lot easier to be generous and to be the best version of myself if I've got a good night's sleep and I'm not hungry or thirsty, right?

I mean, the amount of arguments that I've had with people that I love that ultimately boiled down to like, you need a snack is extremely high. Yes, exactly. And that's the smallest level of this, I think. Yeah. But. If higher levels of wellbeing translate towards more altruism, caring for more people, why is it that there seem to be, at this moment in our society, a group of people who have more than they could ever possibly need?

And yet don't feel the need to use their wealth to give to other people the state of being a billionaire. Maybe there are exceptions, but like, yeah, you have the ability to, without, without almost any effect in your own personal life, transform the lives of other people. And very few people actually use it in that way.

So my question is, does that have to do some something with like who we actually have compassion for? Like where our circle is, are those people really generous to their children? But then when they see someone who is suffering on the street, they just don't think of them as, as being in that same category?

How, how do you explain that?

Abigail Marsh: Yeah, this is a really great and complicated question and there's, I think I've done several prongs to the answer. One is that whenever you're talking about a group of people and the relationship between variables, so higher wellbeing, higher altruism, we're just talking about averages.

Hmm. So there's always gonna be exceptions to that rule. And one of the things I always hasten to add, because it could sound like what I'm saying, is Oh, so people who are poor aren't kind. And I am absolutely not saying that. And you know, hopefully anybody who's ever been a person in the world understands that that's not true.

However, it is true that as people have more sort of. Sources and wherewithal. They are more and more generous, especially towards strangers on average with big exceptions, you know, wherever you are on that continuum. But the next piece of the puzzle is that. It's always, it's intrinsically hard to talk about billionaires, right?

Because there just aren't that many of them. You know, it's a tiny fraction of the population. Nobody's ever done a study,

Chris Duffy: But it's also a tiny fraction of the population who donate their kidneys.

Abigail Marsh: True. But what I love to do, the study of billionaires, I would, but what I should mention is that there are, it's, it's important not to make too many.

Too many assumptions about exemplars. The types of exemplars that come to mind tend to be extreme and of course salient. And so things that are happening right now in the world result in different billionaire exemplars being brought to mind than maybe 10 years ago when we might have thought of Warren Buffet or Bill Gates.

A hundred years ago when we might have thought of Carnegie, you know, any one exemplar could tell a totally different story. So I would say the evidence tends to be billionaires aside because we don't have data on that. Okay. But it does tend to be that as people move up the wellbeing. Ladder, which is not exactly the same thing as wealth, but there's a little bit of overlap.

They do tend to give proportionately more of what they have in terms of resources to others. They do. And again, there's lots of exceptions. It's not linear. However, it is statistically predictable. However, it's also true that there's a relationship between the desire for money and status and power and callousness.

So. It probably also depends on a little bit on how you came to be somebody with such high levels of wellbeing, whether we'll see the typical pattern or not. If you're somebody who came to acquire a lot of resources, you know, through the fact that you just happened to be a brilliant person in the right place at the right time, developed a technology that makes you know people's lives better and sold tremendously well, there's no reason to expect that. You wouldn't be somebody who feels immense gratitude for what you've done or in your life, how successful you've been, how lucky you've been, and then we'll pass it along. And that does happen a lot.

But you know, there are other people for whom. Wealth and power were the result of the fact that all they've ever cared about is amassing wealth and power that tends to be associated with more callous and psychopathic traits. No question. Those are the things that highly psychopathic people tend to be driven by is status and resources and pleasure.

And so if those were the causal forces behind your. Success. We might expect to see a different pattern when you achieve the success that you hope for. And the other thing is to the extent that people's interest is in sort of relative status, that's a moving target, right? There's, it's never enough if really what you want is to have more than the other guy, because your social circle and your basis for comparison just keeps changing.

And so that's certainly a pattern that we see sometimes too.

Chris Duffy: But then you also are researching something that is like. A deep and profound, maybe the moral question of our time, which is like, who do you care about and how do you care for them?

Abigail Marsh: I do think personally, there is no more important question in the world than what makes people care about others and what causes them to harm them.

Chris Duffy: What makes people care about others? What makes people harm others? We are going to dive into these very important questions in just a moment with Abigail Marsh, but first, a quick break.

And we are back. Abigail, I've heard you say that you have three key questions that you address and focus on in your research empathy. How do people understand what others think and feel? Altruism. What drives us to help other people, and then psychopathy and, and aggression. What prevents us from harming them?

What prevents us from harming others? Tell me about that.

Abigail Marsh: Luckily, many things for most of us, so aggression is any behavior that's aimed at harming another person. Or could be an animal, I suppose, and that's really important. Aggression has to be intentional. There was a period in time where I feel like a lot of things were getting labeled violence and aggression.

Oh, and I should, uh, clarify. Violence is physically harming somebody else. So there's social aggression, emotional aggression, you know, bullying, ostracism, malicious gossip, those sorts of things. But physically harming somebody else with the intention of harming them is violence. And there was a period in time, I think, when it was pretty common to call a lot of unintentional behavior that caused somebody else to be upset or, you know, feel wounded, aggression and mm-hmm.

But from a scientific perspective, that's not true. It has to be intentional. And aggression is, you know, deep in our bones. Right. Just like altruism. Is it, it, you know, we see these same behavior in mice. And rats and monkeys and horses and dogs. You know, there's nothing unique to humans about aggression and it's not completely learned.

And I think anybody who's had a small child knows that small children sometimes bite and kick and scratch and pull hair that behaviors that they have not watched anybody else engage in. The reason that we aggress, uh, is. Complex, the sort of most, I don't know, more like acceptable kinds of aggression or aggression and self-defense or in defense of somebody else.

Hmm. And so that is often true. You know, it's the standard fight or flight response. If I think I'm gonna get hurt, I will respond aggressively to defend myself, no big deal. The kinds of aggression we worry about more from a moral perspective and certainly from a legal and social perspective, are aggression.

That's a response to not getting what you want. So this is relates to the frustration aggression hypothesis, which is that when your efforts to achieve a goal through other means are frustrated, aggression might be the next way you try to achieve those goals. So there is a relationship between aggression and situations of need or desire that aren't being met.

The worst kind of aggression from a moral perspective, what's called instrumental aggression. So this is, I'm not even mad. Right. I'm not, nobody's done anything to me. Mm. I just want something. I haven't necessarily even been frustrated in my attempts to get it, but I perceive that aggression will be the most effective way to get what I want.

Right? So, I, I, I want some money. You have some, and if I have to hit you over the head with a bat or threaten to do so, to get your money, you know, I will. And that kind of, you know, very cold, calculated, deliberate aggression is rare, luckily. And it's really only associated with one particular psychological disorder, which is psychopathy.

Chris Duffy: I feel like we have, at least in the United States, there's kind of like a, a very interesting, complex cultural obsession with psychopathy and, and psychopathic people. There's a whole very popular strand of entertainment that is just, you know, true crime stories or, or what makes people do that. And, and you actually work with the real people, not the characters of this.

Yes. Um. My question for you is like how much is this hidden versus how much is this something where you definitely would know if you met them?

Abigail Marsh: Everybody listening, you've included, knows somebody with psychopathy. I promise you. One to 2% of the population of US adults is, has clinical levels of psychopathy.

Most of them are not in prison or a psychiatric institution and are good at masking what they're really like. So there is no question that we all know people with psychopathy.

Chris Duffy: So the reason I think that I haven't met someone who has this is because I am, I have a false idea in my head that's like, this would be the person who, you know, out of nowhere takes a hammer and just attacks me.

Abigail Marsh: Luckily, no, usually not. Okay. And this actually comes back to your prior question of what keeps us from acting aggressively. So even people with psychopathy don't act aggressively most of the time. And the reason is that because what marks a good society is that in general, pro-social behaviors are rewarded and anti-social behaviors are punished.

Like you have to have that be true to have a good society. If you are primarily rewarded by engaging in antisocial behavior, like you get good things by doing bad things, you're gonna do more bad things. That's as fundamental a law in psychology as there is. And so society is set up so that aggression is generally punished.

It's stigmatized. Mm-hmm. That's good, right? You will have fewer friends and fewer people will want to be with you if you are aggressive, especially in a sort of random or unjustified way, because there are laws and structures set up to make sure that that is not how people get resources. It's just by being bigger and tougher and meaner than the people around them.

And so for the most part, society is set up to prevent aggression. Now. You know, again, there are gonna be situations when people perceive that they can get away with being aggressive, if that's what will get them what they want. And then for most people, they aren't aggressive in those situations. A because they have, uh, a fully developed conscience.

They have a sense of remorse and guilt when they hurt people. And so that prevents them from doing it in the future. Guilt and remorse or very good. Pro-social emotions, and they also have a sense of empathy. So they, they, they can simulate what the experience of the other person would be if they hurt them and recognize that experiences like pain and fear that the other person would likely experience are bad.

And most of us care about other people's welfare, and so we're just intrinsically motivated not to hurt them. So people with psychopathy live in the same society, right? They know all the rules and all the benefits from doing the good thing, but what they don't have is the ability to experience remorse or guilt.

So those aren't stopping them from behaving aggressively. They also don't genuinely care about other people's welfare at all. True psychopathy means that other people's welfare is just not motivating to you. Doesn't mean you can't be a good person, right? You can still develop a moral code even without that.

And I know many people with psychopathy for whom that's true. However, uh, many people with psychopathy also have trouble regulating their impulses. Sometimes all the breaks fail and you end up acting aggressively, uh, when that's true.

Chris Duffy: I work in podcasting. I'm also a comedian. These are places where I know that by virtue of the, the fields, I encounter a lot of delusional self-aggrandizing people, right?

Like that, those, those pieces. And I'm not saying that I'm not one of them, but like those, those pieces of, you know, psychology, those are definitely like overrepresented in the, in the fields of entertainment and comedy, right? People who think like, everyone should listen to me and I should be on stage while people are silent.

Since a lot of what's happening with psychopathic individuals is they're responding to rewards and consequences rather than some sort of intrinsic sense inside of themself of what it would mean to care about other people. Um, are there then fields where psychopaths are overrepresented because they reward those traits more than others?

Abigail Marsh: This is a good question. Uh, I don't think we have a great. Like rock solid sense of whether this is true. There have been some studies looking at, um, you know, certain fields of business, for example, where there's a very kind of high risk, high reward endeavors where you can make a lot of money, but there's a lot of risk you have to take to get it.

That is the kind of setting that would attract people who are psychopathic because they're not deterred by risk. One of the critical components of a psychopathic personality is being relatively fearless. Not learning from punishment or from being hurt. And so you're more likely to do things that other people would avoid because it's risky.

And there's some evidence that maybe especially fields of business that have that very high risk, high reward combination have higher levels of people with psychopathy. There's some evidence that certainly, uh, the entertainment field may be filled with people who are higher in narcissism.

Chris Duffy: I can confirm.

I'm, I don't have a PhD, but I'll tell you, it doesn't take, it doesn't take years of research to say that that is true.

Abigail Marsh: I was gonna say this did not take a lot of study out my writing either.

Chris Duffy: That's one. That's one where they're like, yep, we can just accept that to the peer review journal right now. We don't have to.

We don't even have to send it out. Publish it.

Abigail Marsh: Journal of the clinically obvious, yes, and narcissism is not the same thing as psychopathy, but they do overlap and so it wouldn't be impossible to imagine that there might be higher levels of psychopathy as well. But this, again, not conflating psychopathy with violence or serial killers or anything like that.

Most people with psychopathy are nothing even close to being a violent serial killer. They're just people who want what they want and they're not terribly motivated by guilt or remorse or care about other people.

Chris Duffy: I've noticed that you don't use the word psychopath. You say people with psychopathy or psychopathic individuals.

Can, can you talk a little bit about that choice?

Abigail Marsh: Yeah, thanks so much for asking. As I mentioned in, uh, my introduction, I'm the co-founder of an organization called the Society for the Prevention of Disorders of Aggression. Uh, it's the only organization in the world aimed at trying to help people who have disorders of aggression like psychopathy.

And one of the really important goals of the organization is just to reinforce that disorders of aggression, meaning psychological disorders. For which a primary feature is engaging in aggressive behavior are psychological disorders. They have every hallmark of psychological disorders, including the fact that they're pretty strongly heritable.

So there's a strong genetic component. They're associated with different patterns of brain development. And it's not that people choose to have these conditions. They can choose not to have them, right? You can absolutely choose a course of treatment that will cause you to not act this way anymore, and that's important to remember, but it's a disorder.

And psychology has stopped referring to people as their disorders. For many years now, we don't, it used to be commonplace to call people with anorexia anorexics, right. Or as people with, you know, depression, depressives defining them as their disorder. And it's interesting how psychopathy has sort of not been caught up under that umbrella, but even by many psychologists, they're still called people psychopaths.

But I, I think that's dehumanizing. I understand why people don't experience compassion for people with psychopathy. You know, I, I get it, but they're still human beings. They didn't choose to have the disorder that they have, and they can be treated. And I think many of them actually really would like to be treated and be able to live a much more typical flourishing life.

And so the first step is just remembering their people and that they have psychopathy, they're not psychopaths. So it's a word I try to avoid.

Chris Duffy: We're gonna take another quick break and then we will be right back.

And we are back. We're talking with Abigail Marsh about her research into altruism and psychopathy. What are some of the smaller, maybe less dramatic traits of psychopathy that we might notice in a loved one or even in ourselves?

Abigail Marsh: I'm gonna tell you, first of all, it is hard because again, almost everybody I've ever talked to who has psychopathy says that they spend a lot of time masking.

They've figured out sort of what are the best ways to act to get what you want at a given situation. Oftentimes the best way to act is to be really nice, like really nice. And so people with psychopathy can be wonderful friends and they can be fantastic people to spend time with because they've learned that by being really nice and fun and a good person to hang out with.

That's a good way to get what they want later down the road. That's not necessarily bad, as long as the thing that they want is not something that it's bad to want. But I will say that there are some clues that you can look for. One of which, again, is an unusually fearless temperament.  So people with psychopathy, it's not that they're unemotional across the board, but they don't seem to be afraid of risks the same way that other people are, that they just don't seem to be deterred by the possible risks 'cause their behavior, including punishment.

So they're more likely to do things that most of us would be like, oh my gosh, aren't we gonna get in trouble? And they're like, oh, maybe we will. I don't care. And then you're also looking for a pattern of behavior that seems to exploit other people across contexts. So the big mistake people make is saying, well, I don't like that person.

They must be a psychopath. Uh-huh, maybe they don't like you either, and they're a really nice person in every other setting, and you think they're psychopathic because you, and they have a bad relationship. That's not the same thing at all. You're looking for a pattern of exploitative behavior, again, across situations.

So this is a person who doesn't seem to have any great relationships where like. They and the other person really are mutually supportive and loving.

Right?

Abigail Marsh: It's just like kind of a lot of shallow relationships or relationships based on kind of mutual benefits rather than kind of long standing ties.

Like they, they may not have like long time best friends that just like to hang out together. They have a lot of colleagues who are, you know. Together for mostly beneficial reasons. You also sometimes will look for people who different people think very different things of, so some people will say like, that person is not trustworthy at all.

They are, you know, I've seen them lie. I've seen them manipulate people and other people are like, oh, you actually kidding meet them. The nicest person in the world and. When you get enough of that variation across different people's opinions of someone, it means that they're masking some of the time, or that they're chameleon, like switching the way that they present themselves, depending on the situation that they're in.

And there's more than one reason somebody could do that, but it is at least correlated with being more psychopathic.

Chris Duffy: Let's say you're a parent. There's someone who's listening to, they're a parent. They heard what you just said. Yeah. And they're like, wow, that actually does ring true for my kid. Yep. I love my kid.

I want to give them the best life. Yep. What, what practically can they do?

Abigail Marsh: Yeah.

Chris Duffy: Since, like you said, there's only one organization in the whole world that, uh, is doing this.

Abigail Marsh: So yes, a subset of parents out there have kids that they're worried about for behavioral reasons. They think, you know, my kid really does not respond to punishment at all.

Like, and I'm not talking about harsh punishment. I'm talking about like timeouts and getting your iPad taken away and. You know, the normal things that parents do to restrain behavior and the, the kid just does not respond. They are very defiant. They don't seem to care if they hurt other people. They lie a lot.

Uh, maybe they steal things when nobody's looking and, and it, it's behavior. It happens at home, at school. It happens in so many settings that there doesn't seem to be like a particular trigger for it. It's like a more of a personality trait. This has cause for concern. You should not let this low. You should not just hope this goes away.

Um. It is. It could be a sign that the child has what's called callous une emotional traits, which are sort of the child precursor to psychopathy. And the first thing you should do is set up an appointment with your kid's doctor. If the child has a social worker, that's also good and you should ask specifically that they be assessed for.

The official diagnoses are oppositional defiant disorder or ODD conduct disorder. In kids and then callous on emotional traits. And they may be like, what? Or they may say, well, we don't, you know, we don't believe in those diagnoses, which a lot of clinicians will say they think they're too stigmatizing.

They think that kids are just misunderstood when they act out. And really what's the problem is anxiety. This happens all the time. And the problem with that attitude is that if you, a kid actually has. Disruptive behavior disorder, like conduct disorder. The treatments that will help them are not the same treatments that will help kids with, you know, anxiety or depression or these other disorders.

Those are different treatment patterns, and so you really have to get the right diagnosis. To get the right treatment. And there are treatments that work, but so few kids get them that they've developed the reputation of being untreatable. But if they're not untreatable, it's just they're not, they're not getting treated.

Um, 'cause a lot of clinicians really, um, struggle to work with these populations. They may not know the treatments that work. You gotta say, look, I wanna, I wanna know the real deal. These are what I want you to assess for. They're standard assessments for them. They can always go to our website if they're looking for one of the standard assessments, we provide them for free.

It's disorders of aggression.org. And then, uh, if the kid comes back, is having troubling levels of these different traits. The best treatment by mile is these parent focused treatments. So these are. The treatments that the parent that, that a therapist trains the parent to deliver to the child. Why this is always the best kind of treatment for kids.

By the way, having a therapist work with a young child directly is not nearly as helpful as having the therapist work with the parent. And the reason is that, you know, kids aren't able to deliver their own therapy, right? Most therapy is aimed at helping the person sort of learn to regulate and develop insight and those sorts of things into their behaviors.

But young kids can't do that. The best treatments. Are the ones where the therapist teaches the parent how to better manage the kid at home, and parents oftentimes don't wanna do this. They're like, oh, I'm busy. You know, can't you just, you know, I'll send you the kid. They'll come back fine. The answer is no.

If you really actually want the problem to go away, you need to work with a therapist. And so really what a therapist will do, hopefully in an ideal world, is use one of the tested forms of treatment that work. One of the best ones is called PCIT or Parent Child Interaction Therapy. The therapist will.

Coach the parent on how to sort of manage the child's behavior in such a way that the child is only reinforced for doing the right behavior and never gets the reinforcement that they're looking for from the wrong behavior. It's not punishment focused. 'cause again, if your kid is at risk for psychopathy, they're not gonna respond to punishment.

That's one of the problems with, with working with kids like this, but you, you can make sure that they only get the reinforcements that they care about, whatever those reinforcements are by doing the right thing and not doing the wrong thing. And they'll also focus on being much more kind of warm and sort of loving with your child than might even seem natural.

Mm-hmm. And this is a weird thing for some parents because a lot of kids who are like this don't seem to want that level of warmth and affection. They kind of resist it and it's partly 'cause they're not as sensitive to it. And so you actually have to up it even more than you think you need to for it to kind of sink in.

And building that really warm positive relationship with them is so important for the rest of it to take hold. And that's really hard to do. There's no reason a parent should ever figure out how to do this on their own. It's complicated, but it, it, it really does. It's not gonna work miracles, but it absolutely can help.

I really admire teachers who are so good at working with these kids. 'cause it is hard, right? You have to resist the natural tendency to be grumpy and cold with these kids because they frustrate you all the time, right? Mm-hmm. You have to amp up the affection and the warmth. But not be a pushover. Right?

This is the mistake some people make. They're like, oh, they need the most love. Don't be too hard on 'em. You know? Yeah. When they mess up, it's like, no, no, no, no, no, no. Like you have to have very high standards and there must be consequences when they misbehave. That has to be true, because otherwise they will run rough shot over you and they will just learn like, oh, I can do whatever I want, and people will just give more and more benefits.

I've seen teachers do that too, and it just drives me bananas because the kids are just learning how to manipulate people. So coupling that those high standards and high expectations with genuine warmth and love and affection is the secret sauce. It's very, it's a very difficult balance to strike, but it can, people can learn to do it.

Chris Duffy: But what if you're, you are an adult. Yeah. And you have this feeling that actually some of the. Ways that you're describing psychopathy and those challenges, that actually sounds a little bit like me. Mm-hmm. But if someone is thinking that, what can they do for themselves?

Abigail Marsh: You know, one of our, the members of my organization's board, Emmy Thomas, uh, had that discovery when she was talking to an office mate in her twenties, just telling her office mate about herself.

And the office mate said, you know, have you ever considered the possibility that you could be psychopathic?

Interesting.

Abigail Marsh: And she was like, no. And then she looked it up and she was like, oh yeah, actually I think I am. And that was the beginning of her getting better. The insight is a huge step in the right direction.

Many people with psychopathy do not have insight that they are the cause of their problems, that the reason that you keep losing your job and that friends keep abandoning you, and people are always mad at you and you keep ending up in trouble. It's not other people's fault, you know? Or you know, maybe sometimes it is, but like if it keeps happening to you, in the words of Taylor Swift, you might.

Maybe you need to think I'm the problem. It's me. And the thing to remember is that this is a set, a, a, a pattern of behaviors that I guess could qualify as a form of neurodivergence. I mean, you know, there's a million different ways to be neurodivergent. This is one of them.  But it is important to get better because there's no way to live a healthy, flourishing life with these traits if you cannot learn to change your behaviors, but you can learn to change your behaviors.

It's just about building different habits, different mental habits and different behavioral habits, and. The most effective way to do that is, again, with a psychotherapist, not a psychotherapist who's gonna do kind of wooly insight based therapy or art therapy, or all these different kinds of therapy that have no scientific basis.

There's also some called schema therapy and transference therapy, but what they're really trying to do is help you develop different. Sort of frameworks for understanding yourself, your relationships with other people and, and what other people are like, and sort of what a good relationship with other people is, and then also helping you learn new habits, new ways of interacting with people.

That will lead to positive sort of mutually adaptive relationships that will help you flourish rather than unproductive relationships that will end up in a lot of misery for everybody. And so, and again, these are just habits of mind and habits of behavior that can be learned. I a hundred percent believe this.

I've seen it happen too many times.

Chris Duffy: One thing in this conversation that's really striking me is that a lot of the advice you're giving, if a thing keeps happening over and over, you're probably the problem that you can use therapy to work out these behaviors. This is actually great advice for anyone listening, not just people with psychopathy.

And speaking of that, speaking of things that anyone who is listening might relate to, I was really struck by how in your book, the Fear Factor, it reframes the way that we think about fear, because I think for many people who are. Thinking about fear, they, they would say it's a negative emotion and that they would be better off if they didn't have fear in their lives.

But you make a very compelling case in the book that that is completely wrong. That to not have fear would be incredibly damaging for us as humans, especially the kind of humans that we want to be.

Abigail Marsh: So we call fear a negative emotion 'cause it's unpleasant in the moment when we're feeling it. You know, that's, that's pretty obvious.

But things that are unpleasant in the moment when we're feeling them are not necessarily bad. We know that this is true about lots of things, right? About exercise, for example, you know about a lot of kinds of hard work. Fear is just as useful and valuable as these things, and the obvious reason, obviously is it keeps us alive.

Fear is one of the oldest emotions, you know, every creature in the world from like Caterpillars to sea slugs has some variation of. Fear to keep it from, you know, ending up dead from, uh, an avoidable threat. But fear has more subtle benefits as well, one of which is that it gives us the ability to understand fear and other people around us.

We can't empathize with emotions that we don't feel, and so the same networks in our brain that give us the ability to experience fear can help us understand it and others  And the capacity to understand and resonate with other people's fears seems to drive a lot of the most beautiful forms of altruism.

So that seems to be one thing that really separates very altruistic people from others, is that they have a much stronger empathic response to other people's fear, in particular, for reasons that are not. A hundred percent clear, like why is it fear in particular? But they really do, and that seems to motivate them to help when they see a need.

And then by contrast, people who are psychopathic because they are relatively fearless, temperamentally, they don't seem to be able to resonate with other people's fear. They, they struggle to even recognize it. I have a good friend. In the UK who was testing people who were psychopathic in a prison for their ability to recognize images of facial expressions that conveyed different emotions.

And one prisoner she was testing who was psychopathic missed every single fearful facial expression. Like every one she showed him. He didn't know what it was, which is pretty bad, even for somebody who was psychopathic. And then he got to the very last one and he said. You know, I don't know what that expression is called, but I know that's what people look like right before you stab them.

And so I think fear is one of those emotional experiences that sort of binds us together and keeps us looking out for one another's welfare, not just our own as well.

Chris Duffy: I think for a lot of people. If you hear the story about the guy who doesn't recognize fear but has stabbed people and recognizes that face as that, and then you also think about the person who like runs into a burning building so she can save a grandmother.

I think a lot of people would say the person who ran into the burning building is good, and the person who stabs someone is bad. I'm curious, how do you feel, or how do you think about drawing those kinds of moral lines on people?

Abigail Marsh: So obviously saving somebody's life is a good thing to do, and harming an innocent person to meet your own desires is not, but people are complicated, obviously.

I'm sure if any of us were defined by the worst thing that we've ever done, there are people in the world who would call us bad. And it's so important to remember that almost everybody is the protagonist in their own life story. Morality is really all about how we balance our own needs with the needs of the people around us who you know, we depend on and who depend on us.

And so I do believe that an important part of being a better person is. Learning that the other people around you have value too, right? And to put more weight on what matters to them on what they're thinking when you act and a little less weight on yourself. Seeing yourself as, you know, part of the larger fabric rather than as the star of the show.

'cause we know that that way lies, narcissism. It's not that there's such things as like static, good and bad people, but there are certainly people who do more good things and more bad things, and I think it's within reach for all of us to try to move toward the better end of that spectrum.

Chris Duffy: So what do you now think is one of the most effective ways to boost altruism?

Abigail Marsh: So the ways that we know, like in the world altruism increases, the first one is impossible to do Okay. On any kind of real scale, which is increasing wellbeing. Right. I mean that's, and it's, again, it's not just momentary happiness, it's like your sense of life satisfaction. Hmm. And so that's a policy issue, right?

That's, that's up to governments. If you, you know, have better social policies that increase, you know, wellbeing of your whole society, altruism will almost certainly increase as a follow on. Amazing. Right? So it's a solution, but it's not, it's not a sort of individual person level solution. The other, the unethical way of increasing altruism, the short term is increasing, uh, stress.

Like acute stress. Interesting. Yeah. Interestingly, at least if in the context of general high levels of wellbeing, when people are under acute stress, they also seem to become more altruistic, interestingly, which is. The opposite of what a lot of people think. People often think like, oh, in times of disaster, people turn on each other.

But no. Right after the Covid pandemic, there's this organization that's been keeping track of pro-social behavior all around the world for, I don't know, almost 20 years now. And they found a big spike in altruistic behavior right after the pandemic. And we remember that right where, you know, people really were, it was so stressful and so scary at the beginning, and people were just like, I just wanna do something.

To be helpful. People were lining up to volunteer for Covid Challenge trials to be deliberately injected with covid to help test vaccines and treatments, you know, the mask making and helping support the medical providers. I mean, that and that stuff is pretty typical, interestingly. So that's pretty cool.

But again, not a good way to, to induce altruism, uh, on it from an ethical perspective. Mm-hmm. Probably the best way to do it, durably is sort of like what I was talking about when it comes to reducing. Psychopathy. It's building better habits. Habits, both of mind and habits of behavior that. Change the way that you think about other people and the way that you sort of habitually respond to people.

There are behaviors like gratitude journaling. We know that like expressions of gratitude are a really good way to induce humility and induce pro-social emotions. You just have to actually start behaving like the person you wanna be too many times. I think we assume that the desires and the sort of internal traits come first and the behavior comes.

But it's usually the other way around, right? Once you've started treating people nicely and seeing like, oh, this kind of feels good and it seems to make my life better, and I, I'm enjoying my life more, and those rewards make you wanna do it more,

Chris Duffy: I think that's just about a perfect place to end on. You have to act like the person you want to be.

You start with the behaviors, and then the internal change can follow, whether it is habits of mind or how you're living your life. We can become more altruistic, more caring people. Thank you so much, Abigail. This was an inspiration and a pleasure getting to talk to you. I, I'm so grateful for you to make time to be on the show.

Thank you. This was fantastic.

Abigail Marsh: Well, thank you so much. I really enjoyed myself.

Chris Duffy: That is it for this episode of How to Be a Better Human. Thank you so much to today's guest, Abigail Marsh. Her book is called The Fear Factor, and you can find more information about her research@abigailmarsh.com. I am your host, Chris Duffy. And you can find more information from me, including my weekly newsletter and other projects@chrisduffycomedy.com.

How to Be a Better Human is put together by an extraordinarily empathic team of individuals. On the TED side, we've got Daniella Balarezo, Banban Cheng, Cloe Shasha Brooks, Valentina Bojanini, Lanie Lott, Michelle Quint, Antonia Le, and Joseph DeBrine. This episode was fact checked by Julia Dickerson and Matheus Salles, who have no mercy for falsehoods on the PRX side.

They make me sound like a better person than I am. Morgan Flannery, Noor Gill, Patrick Grant, and Jocelyn Gonzalez. Thanks again to you for listening. Please share this episode with a friend or a family member who you think would enjoy it, who you think would get something out of it. Word of mouth is the number one way we get to new listeners.

We will be back next week with even more How to be A Better Human. Thank you so much for listening and take care.