Far from perfect, but it is such a detailed TOC that just reading it gives you a good idea of the content of the book. It should set your brains to work.
PART I THE PSYCHOLOGY OF PATHOLOGICAL ALTRUISM... 1
CHAPTER 1 PATHOLOGICAL ALTRUISM—AN INTRODUCTION 3
Barbara Oakley, Ariel Knafo, and Michael McGrath
• Pathological altruism might be thought of as any behavior or personal tendency in which either the stated aim or the implied motivation is to promote the welfare of another. But, instead of overall beneficial outcomes, the "altruism" instead has irrational (from the point of view of an outside observer) and substantial negative consequences to the other or even to the self.
• Many harmful deeds—from codependency to suicide martyrdom to genocide—are committed with the altruistic intention to help companions or one's own in-group. Thus, it is worthwhile to study how well-meaning altruism can shade into pathology.
• Studies of pathological altruism provide for a more nuanced and sophisticated understanding of altruism.
CHAPTER 2 EMPATHY-BASED PATHOGENIC GUILT, PATHOLOGICAL
ALTRUISM, AND PSYCHOPATHOLOGY 10
Lynn E. 0' Connor, Jack W Berry, Thomas B. Lewis, and David J. Stiver
• Empathic reactions to pain or distress in others are instantaneous and begin the path to both normal and pathological altruism. These reactions move quickly to implicit empathy-based guilt, linked to a belief that one should try to relieve the suffering of others.
• Empathic guilt is further linked to evaluations of fairness, equality, and the equitable distributions of resources.
• Survivor guilt (inequity guilt) is a specific form of empathic guilt that tends to become pathogenic when based on a false belief that one's own success, happiness, or well-being is a source of unhappiness for others, simply by comparison. People with high survivor guilt may falsely Alieve they are "cheaters!'
• Pathogenic guilt leads to pathological altruism. In pathological altruism, the altruistic behavior helps no one and potentially harms the altruist, the recipient of the altruism, or both.
. Empathic concern and empathic guilt are evolved psychological mechanisms sustaining mammalian group cohesion. Altruism may fail to favor fitness at the level of the individual in within-group competition, while increasing fitness at the level of the group in between-group competition.
rEs 3 A CONTEXTUAL 13LHAVIORAL APPROACH
rO PATHOLOGICAL ALTRUISM 31
.oger Vilardaga and Steven C. Hayes
n the same way that the process of natural evolution selects features of the human ,pecies, the cultural environment selects for patterns of behaviors during the lifetime of in individual or a group.
one particular form of human behavior, language, is of great survival value. But language 11s° amplifies the way we experience both the positive and negative aspects of the world. [his can reinforce behaviors that are damaging for individuals and groups.
;ome behaviors that may play a role in pathological altruism are experiential avoidance, I conceptualized self, perspective-taking, and values-based action.
acceptance and commitment therapy and relational frame theory lay forth a scientific ramework and provide tools to modify such behaviors, which points to their potential itility to reduce pathological altruism.
'ER 4 CODEPENDENCY AND PATHOLOGICAL ALTRUISM 49
vlichael McGrath and Barbara Oakley
:odependency is an inability to tolerate a perceived negative affect in others that
!ads to a dysfunctional empathic response.
:odependency likely shares roots with pathological altruism.
here are evolutionary, genetic, and neurobiological components to the expression
nd propagation of codependent behaviors.
r II PSYCHIATRIC IMPLICATIONS OF
PATHOLOGICAL ALTRUISM
ER 5 SELF-ADDICTION AND SELF-RIGHTEOUSNESS 77
>avid Brin
he word, "addiction" appears to limit our perception of a wider realm—general thavioral reinforcement within the human brain. If neurochemical processes reinforce ;ood" habits such as love, loyalty, joy in music onskill, then addiction should be studied a larger context.
'a mental state causes pleasurable reinforcement, there will be a tendency to return to . Meditation, adoration, gambling, rage, and indignation might all, at times, be "mental Idictions."
his more general view of reinforcement suggests potential ways to reduce or eliminate addiction, as well as self-induced rage.
4f-righteousness and indignation may sometimes be as much about chemical !ed as valid concerns about unfair actions. Among other outcomes, this may cause tathologically altruistic" behavior.
:oderate-progressives who seek problem-solving pragmatism may get a boost if it were .oved that dogmatic self-righteousness is often an "addiction."
• 1111 1 1%1 I .1, 1.4 personalii‘ .111 he u11cd11111<x 1111C all1.11,11Vt.,Intl 111.11•111i11,11VC
.111.1111s111 4111111P.M
• 111 All 1i Sliggl'•IS 111.1trIldtill.11)11Ve is a Lomponent of dependent personality
• t ase studies illustrate how maladaptive altruism, combined with differing levels of may impact treatment.
HAPTER 7 THE RELEVANCE OF PATHOLOGICAL ALTRUISM
TO EATING DISORDERS 94
Rachel Bachner-Melman
• Individuals with eating disorders tend to sacrifice their own needs and interests and devote themselves instead to helping and serving others.
• Selflessness and concern for appropriateness, concepts linked to pathological altruism, have been shown to characterize women with eating disorders.
• Developmental, interpersonal, family, cultural, genetic, personality, and social factors no doubt combine to make pathological altruism a characteristic of people who develop eating disorders.
IlAPTER 8 ANIMAL HOARDING: HOW THE SEMBLANCE
OF A BENEVOLENT MISSION BECOMES ACTUALIZED
AS EGOISM AND CRUELTY 107
Jane N. Nathanson and Gary J. Patronek
• In animal hoarding, animals are used to support the hoarder's own emotional needs with respect to intimacy, self-esteem, control, identity, and fear of abandonment.
• Self- versus other-centeredness in animal hoarding reflects a lack of empathy and often leaves the true needs of animals unmet.
• Precipitating factors for animal hoarding likely include failure to develop functional attachment styles during childhood as a result of caregiver unavailability, neglect, or abuse.
• A hoarder's feeling of being a savior of animals is not the same as actually saving those animals. Although believing they are animals' saviors, rescuer hoarders fail to provide for the animals' basic life requirements.
CHAPTER 9 EVERYONE'S FRIEND? THE CASE OF
WILLIAMS SYNDROME 116
Deborah M. Riby, Vicki Bruce, and Ali Jawaid
• Williams syndrome illustrates how atypical development can affect social functioning.
• Individuals with the disorder are often referred to as caring, empathetic, and hypersociable.
• The Williams syndrome style of social engagement occurs alongside high levels of anxiety and social vulnerability in adults.
75
• Itilicving 1A,11 ymi dic ,tt iii Autitlicis 11.-A Hut ,ynunyinous with oiling in
anothei's Iwsl inleicsl. It is a belief, not a fact.
• Moral judgments, su(h as "good intentions," arise out of basic biological drives, not out of inherent goodness or evilness.
• Justifications of behavior such as "I'm just trying to help:' should be used with great restraint and viewed with great skepticism.
CHAPTER 11 ALTRUISM AND SUFFERING IN THE CONTEXT
OF CANCER: IMPLICATIONS OF A RELATIONAL PARADIGM
Madeline Li and Gary Rodin
• Individuals who disavow their own need for support maybe vulnerable to distress in the context of medical illness, both as patients themselves and as caregivers to others.
• The term "pathological altruism" has heuristic appeal, but is problematic in the context of life-threatening illness in that:
• The term "pathology" in this circumstance implies a categorical external judgment of behavior and motivation, based on an arbitrary threshold that does not necessarily account for the social or relational context or the degree of suffering of the other.
• The concept of altruism implies a dichotomy, often false, between the interests of self and those of the other.
o Humans are relationally organized, such that acts of caregiving, particularly toward family members or loved ones, are often intrinsically rewarding and therefore not purely altruistic.
• The multiple determinants of altruism in the cancer caregiving context challenge us to develop a new nosology of such behavior and concern, informed by biological, social, and psychodynamic theory.
CHAPTER 12 CONSIDERING PATHOLOGICAL ALTRUISM IN THE LAW FROM THERAPEUTIC JURISPRUDENCE
AND NEUROSCIENCE PERSPECTIVES
Michael L. Perlin
• Therapeutic jurisprudence and neuroimaging are valuable tools when considering the treatment of pathological altruism in the law, in cases of organ donations to strangers and cases raising "cultural defenses."
• Therapeutic jurisprudence gives us a benchmark by which we can assess whether the pathological altruist (if, indeed, the altruist is pathological) has sacrificed her dignity to do the putatively pathologically altruistic act, an assessment process that can also illuminate whether the underlying behavior is irrational, harmful to others, or self-harming.
• Neuroimaging gives us new tools to potentially assess whether the pathological altruist is a rational moral agent in doing such acts.
CHAPTER 13 PATHOLOGICAL ALTRUISM: VICTIMS AND
MOTIVATIONAL TYPES 177
Brent E. Turvey
• rairmiugit.ti itisiii ri. 1..1111.1 III itss... LUl,uI (vim I Immo1 ncttilvtin, I11 with it Hie
.H11 111\1 may lie thy VII 11111, !ill 1 I11111/(1, III 1.'01
• P.Ii11,111,y,11 ,II .1l1 111r,111 may be \ 'rm.(' as .1 mailibaation 11t ,i)g11111Ve ths1()1 11111111
i, Illy 114)111 , LI1C1111‘411, 111 (ICVC I01)111C111.11 M
,1( 1111g .II(C
ui «)kit
• Vallhdogically altruistic behavior can be classified into fOur major types: protective, fIcfensive, masochistic, and malignant, each having both psychotic and nonpsychotik incarnations.
CHAPTER 14 DOES NO GOOD DEED GO UNPUNISHED?
THE VICTIMOLOGY OF ALTRUISM IVI
Robert J. Homant and Daniel B. Kennedy
. Pathological altruism can be briefly summarized as altruism that:
• is unnecessary or uncalled for
• has consequences that cause the actor to complain, yet the actor-continues doing It anyway
• is motivated by values or needs within the altruist that are irrational or are symptol Os of psychological disturbance
o is of no real benefit to anyone, and a reasonable person would have foreseen this
• The higher the level of altruistic behavior reported by subjects, the higher their level of criminal victimization.
• Self-reported altruism has been found to be a significant predictor of both property and personal crime victimization.
• The relationship between altruism and victimization has been found to be especially due to risky altruism, which in turn is correlated with the basic personality trait of Sensation Seeking.
CHAPTER 15 SUICIDE ATTACK MARTYRDOMS: TEMPERAMENT
AND MINDSET OF ALTRUISTIC WARRIORS 207
Adolf Toberia
• Suicide attacks are a combative tactic arising from a lethal, nonpathological altruism in some warfare contexts.
• Altruism is the only widely agreed upon temperamental attributes of suicide attackers.
• Strong altruistic dispositions are increasingly being found to have underlying biological mediators.
• Understanding the neurocognitive underpinnings of willingness to commit extreme altruistic acts may help us understand suicide attacks.
CHAPTER 16 GENOCIDE: FROM PATHOLOGICAL ALTRUISM
TO PATHOLOGICAL OBEDIENCE 225
Augustine Brannigan
• Low self-control, which is a major covariate of criminal behavior, appears early in life and is relatively stable over the life course.
• Levels of self-control may vary across historical periods asitiople become more sensitive to socially intrusive behavior.
• The perplexing levels of obedience in major genocides do not reflect deficiencies in self-control but suggest the oversocialization of the internal executive function by external social hierarchies.
l'AIII(11()(,1( AI ( I 1t111111)1 I ll
A Ittilltm
138
156
AND l'Al1101W.11 Al Al 114lIISM 21;
( oil N1,1,111.1‘,Iii mid 11.111.11,i( /oldtv
• \ It, 11i..111 .111,I .1 piwrilul 11141b111/C 1111,111(1.1i tiliti
1111111.1101.111.111 ttiti III 11111,01x1V.itt t1 0.11100..
• A111101101 t ,t111i.11 t t 00010i1 been helpful 101 litany count! lcs..1 Loge numbei 11l alii ur,lk, nun stiategiL , lul rlgn oil programs owl the past sevei al decades have tailed win selling the very situation they were meant to help. Many other humanitarian programs have also been ineffective at enormous cost.
• Altruistic efforts for social improvements must be guided, not purely by emotion, but with a well thought-out objective strategy and endpoint.
• Neuroscience is allowing us to understand how default emotional approaches to helping others can backfire and cripple otherwise noble intentions.
• Public policies and interventions that have incorporated smart, strategic, and tempered altruism may be effective in alleviating poverty and stimulating economic development.
• There may be value in recruiting a new breed of non-traditional talent that is capable of reframing the way development assistance is carried out.
CHAPTER 18 WAS GANDHI A "PATHOLOGICAL ALTRUIST"? 246
Arun Gandhi
• Finding Truth was Gandhi's ultimate objective.
• Nonviolence is a key means for obtaining Truth.
• Nonviolence can, on occasion, become a pathologically altruistic enterprise, unnecessarily hurting others, and it cannot be dogmatically followed if the greater good of Truth is to be attained.
CHAPTER 19 A CONTRARIAN PERSPECTIVE ON ALTRUISM:
THE DANGERS OF FIRST CONTACT David Brin
• Much of what is called "altruistic" behavior in nature can have self-serving, kinship, or game-based roots that we should not ignore simply out of aesthetic Puritanism.
• Unselfish altruism can emerge out of satiability, satiation, empathy, and sympathy, as well as cultural and individual values. Although sometimes implemented in ways that are ill-conceived or pathological, this trait is viewed as a high feature of intelligence.
• Occasionally, altruism between species seems to be unleashed by full bellies and sympathy, (sometinvs) along with enlightened self-interest in the long-term survival of an entire world.
• Modern Western society disavows the notion that ideas are inherently dangerous or toxic, or that an elite should guide gullible masses toward correct thinking. However, virtually every other culture held the older, prevalent belief in "toxic memes:' As yet, there is no decisive proof supporting one side over the other.
• Western assumptions color the "search for extra-terrestrial intelligence" (SETI), just as previous "first-contact" events were driven by cultural assumptions of past eras. Especially pervasive—and unwarranted—is the belief that all advanced civilizations will automatically be altruistic.
net tietokky
• I .1111111SM tall he 110111111 Is Illy Vicky 111.11 WC 'MC itithr.11it It. "tilt P.01
111.1i .1117111..111 cg0isls 'whey(' Ohl( we haVc0itit 1.111011..1titly
.11H1111.11 twoli P.11“1 .1 vullic.
• l'.\.,11.,14,y,.11(Tgui," deny that there are altruists. Since all' instil is chaiat totted by I1 ut11llun tat he~i limn outcome, and there are people who act with the intention to help at I lieu own expelise, psychological egoism seems clearly false.
• Since a conscious intention to help can conceal an unconscious motivation to harm, one can redefine psychological egoism more plausibly as the view that no one is really motivated to sacrifice his or her own interests to help others.
•it 1 he psychological egoist is right and there are no altruists, how can there be pathological altruists?
I' rst answer: Pathological types have some common characteristics—compulsiveness, destructiveness, ignorance of motivation.
Second answer: More importantly, the pathological altruist's altruistic intention is an essential expression of his self-regarding motivation. He must intend to help in order to serve his own destructive needs.
CHAPTER 21 ALTRUISM, PATHOLOGY, AND CULTURE 272
John W. Traphagan
• Altruism and pathology are concepts that do not necessarily translate well from one culture to another; this raises questions for how biological and cultural aspects of these concepts influence behavior.
• Certain features of altruistic behavior may be relatively consistent across different cultures, but nuances of meaning vary, necessarily implying that deviation from the "norm" will vary as well.
• Pathological altruism is behavior that deviates from norms of action that shape concepts of altruism in particular cultures, but those acts themselves have no moral value and are not necessarily parallel from one culture to another.
PART IV CULTURAL AND EVOLUTIONARY DIMENSIONS
OF PATHOLOGICAL ALTRUISM 289
CHAPTER 22 CULTURE—GENE COEVOLUTION OF
EMPATHY AND ALTRUISM 291
Joan Y. Chiao, Katherine D. Blizinsky, Vani A. Mathur, and Bobby K. Cheon
• Western and East Asian cultures vary in individualism and collectivism, or cultural values that influence how people think about themselves in relation to others.
• Cultural differences in social behavior are associated with cultural differences in allelic frequency of serotonin transporter-linked polymorphic region v (5-HTTLPR) variants.
• Culture-gene coevolution between individualism-collectivism and the 5-HTTLPR may influence brain regions associated with empathy and altruism.
CHAPTER 23 THE MESSIANIC EFFECT OF PATHOLOGICAL ALTRUISM .... 300 Jorge M. Pacheco and Francisco C. Santos
• Without additional mechanisms, cooperation is not an evolutionarily viable behavior, as the tragedy of the commons often emerges as the final doomsday scenario.
251
11,1%Iiii
• 1111 I toili !Mkt 11111111.di I‘, ',mg I.\ tilt I, nll,lnnuns of
d and it al (hal I. id it, di it., non
• A slilglc 111c cvoluUunaly advantage ul tido I”ls,
letillig li) t (00114.1,1tolti.
I leme, they genet ate a iney.talik effect, whit.h spreads through the entire community.
• Pathological altruists catalyse social cohesion, as their presence benefits the entire community even when defection remains as the single rational option and individuals act in their own selfish interest.
:HAPTER 24 BATTERED WOMEN, HAPPY GENES: THERE IS NO SUCH
THING AS ALTRUISM, PATHOLOGICAL OR OTHERWISE 311
Satoshi Kanazawa
• Psychologically altruistic acts may not necessarily be evolutionarily altruistic.
• Battered women and their violent mates have more sons than others.
• Therefore, battered women's decision to stay with their abusers may be psychologically altruistic, but evolutionarily self-interested, as they gain the genetic benefit of producing violent sons.
DART V THE DEVELOPMENT AND UNDERLYING BRAIN
PROCESSES OF PATHOLOGICAL ALTRUISM 319
HAPTER 25 EMPATHY, GUILT, AND DEPRESSION: WHEN CARING
FOR OTHERS BECOMES COSTLY TO CHILDREN
Carolyn Zahn-Waxler and Carol Van Hulle
• Empathy emerges early in life and often motivates caring, prosocial actions toward others. This leads to social competence and healthy emotional development.
• Children's empathy can lead to pathogenic guilt, anxiety, and a sense of personal failure when early family environments require too much of them.
• Parental depression contributes to pathogenic guilt in children which, in turn, creates conditions conducive to risk for developing depression.
• Genetic and environmental factors combine to determine why some children, especially girls, are likely to develop empathy-based pathogenic guilt and depression.
II
whichInv,ulvrrInliit I of rvvn slung ry%Ieliilillug alongside di§ ll', tilt les in empathy
I iiirailiiiing•Sysit minor Ihr,u% rit,h,r, that sonie intIR Owls will have
Jlihcuhlcs NylitCniliing• iniao even a silting di lye these
hyper-einpathizet-s" may it ape clinical notice.
CHAPTER 27 SEDUCTION SUPER-RESPONDERS AND HYPER-TRUSTERS:
THE BIOLOGY OF AFFILIATIVE BEHAVIOR
Karol M. Pessin 349
• People are social animals who go to great lengths to belong—a need that may be rooted in biology. This behavior and biology directed toward social belonging may result in
heightened altruism toward some and diminished empathy toward others.
• Whether altruism is pathological depends on its context, as empathy may be selective toward particular individuals or one's own in-group, at the expense of other individuals or groups.
• Oxytocin and vasopressin systems, structurally flexible and capable of rapid changes, appear to be key in understanding social behaviors in rapidly changing human societies.
• A "seduction super-response" maybe rooted in biological systems for how receptive one is to social signals, such as vocalizing. Similarly, impaired sensitivity to social signals may lead to "hyper-trust" in failing to detect social threats.
• More broadly, social signals are transmitted through groups; a seduction super-response or undue hyper-trust may be a response to social contagions involving neurosensory or chemosensory means yet to be discovered.
(HAPTER 28 EMPATHIC DISTRESS FATIGUE RATHER THAN COMPASSION FATIGUE? INTEGRATING FINDINGS FROM EMPATHY RESEARCH
IN PSYCHOLOGY AND SOCIAL NEUROSCIENCE 368
Olga Klimecki and Tania Singer
• Compassion fatigue is introduced as a form of pathological altruism since it is altruistically motivated and gives rise to symptoms of burnout.
• Empirical findings are discussed that dissociate different forms of vicarious responses.
• We conclude that the term compassion fatigue should be replaced by the term empathic distress fatigue.
PART VI SYNTHESIS OF VIEWS ON
PATHOLOGICAL ALTRUISM 385
321
HAPTER 26 AUTISM, EMPATHIZING-SYSTEMIZING (E-S) THEORY,
AND PATHOLOGICAL ALTRUISM 345
Simon Baron-Cohen
• Empathy involves two very different neural processes: affective (feeling an emotion appropriate in response to another person's thoughts and feelings), and cognitive (also called Theory of Mind—that is, being able to imagine someone else's thoughts or feelings).
• The ability to empathize forms one pole of a personality-related dimension—the opposite pole is the ability to systemize. (Put briefly, systemizing is the drive to create and understand systems, for example, the mechanical system of an old-fashioned dock).
• On average, empathizing is stronger in females, whereas systemizing is stronger in males.
CHAPTER 29 HELL'S ANGELS: A RUNAWAY MODEL OF
PATHOLOGICAL ALTRUISM 387
Marc D. Hauser
• Pathological altruism emerges as a by-product of a runaway process of selection for in-group favoritism and self-deception.
• In-group favoritism coupled with self-deception or denial of the other, leads to pathological commitment to one group's ideology, coupled with out-group antagonism that can lead to mass genocides.
• Self-sacrifice and martyrdom represent the ultimate forms of pathological altruism, at least from the perspective of the victims. From the perspective of the pathological altruist's group (e.g., religion), however, it is divine altruism, revered, and adaptive for the martyr's faith.
( it/twit ALIRUI`,M (.UNI MAI)
Joachim I. Krueger
• Personality-based approaches to pathologi( al alti typological or dimensional, with distinct implications liar the question of hoW pathologiL al altruism is propagated.
• In a mixed population of individuals with different social preferences, altruists do poorly. They may not see it that way, however, which makes their behavior pathological.
• In a Volunteer's Dilemma, altruists suffer when interacting with other altruists.
• When interpersonal dilemmas are nested within intergroup dilemmas, the meaning of altruism is contingent on perspective.
• Evolution has favored parochial morality (altruism), leaving us with the intractable problem of how to satisfy the local group and the general population at the same time.
CHAPTER 31 PATHOLOGY, EVOLUTION, AND ALTRUISM 406
David Sloan Wilson
• The concept of a pathological adaptation might seem like a contradiction of terms, but traits that count as adaptive in the evolutionary sense can be harmful to others and even to oneself over the long term.
• When altruism is defined in terms of behavioral consequences, it is inherently vulnerable to exploitation by selfishness and evolves only when altruists manage to confine their interactions with each other. Even when altruism evolves because it is more successful than selfishness, on average, some altruists still encounter selfish individuals and are harmed by their own behavior.
• Social environments are pathological when they are structured to make altruists vulnerable to exploitation. Much can be done to create social environments that favor altruism as a successful behavioral strategy.
• Altruism at one level of a multitiered hierarchy (e.g., within groups) can be used for selfish purposes at higher levels (e.g., between-group conflict). The costs and benefits of altruism are repeated at all levels.
• When altruism is defined in psychological terms, it can be regarded as a proximate mechanism for motivating altruistic behavior. Just as there are many ways to skin a cat, there are many proximate mechanisms for motivating altruistic behavior that can be expected to vary among individuals and cultures.
• The analysis of pathological altruism in this volume should be extended to other traits associated with morality and group-level functional organization.
195