December 31, 2010

What Does The Woman Who Feels No Fear Feel?

I'm going to need another drink

An article in Current Biology.

A 44 year old woman named SM has a rare, autosomal recessive disorder that resulted in bilateral amygdalar damage and...

On no occasion did SM exhibit fear, and she never endorsed feeling more than minimal levels of fear... SM repeatedly demonstrated an absence of overt fear manifestations and an overall impoverished experience of fear. Despite her lack of fear, SM is able to exhibit other basic emotions and experience the respective feelings. The findings support the conclusion that the human amygdala plays a pivotal role in triggering a state of fear and that the absence of such a state precludes the experience of fear itself.

If you know anything about science, you know it loves to yell at people.  It also loves rules, some of which are arbitrary at best but good luck telling anyone, ordinary folk just say, "well, science said so" and the ones who should know better don't have time for your nonsense, they have to submit 50 page grant applications to a review committee comprised of a cabal of cronies or they won't make full professor.   /rant.

The rule for today is amygdala= fear.  So no amygdala means no fear.

SM, who lacks amygdalas, was Fear Factored with snakes and spiders;  they took her to a haunted house (though not a Japanese haunted house which doesn't so much scare you as destroy your soul forever);  they made her watch clips from horror movies.

But she wasn't scared.  She exhibited, and said she felt, no fear.


Don't hit up a brain surgeon quite yet.

SM not only can't feel fear, but is impaired "in recognizing fear in facial expressions, and in aspects of social behavior thought to be mediated by emotions related to fear."  Which seems consistent with the expected result of amygdalar damage.

But others noticed something interesting about patients with bilateral amygdalar damage, and by "patients" I mean the exact same patient as the one tested in the above article, "SM."  They found that she was indeed terrible at detecting fear in faces-- but it was because she didn't look at the eyes. When she was told to look at the eyes, she had no trouble detecting fear.

SM looks at the eyes.jpg
("SM eyes" means SM was told to look at the eyes)

This is borne out by other studies which find that the amygdala is primarily involved in fear detection when you are looking at the person's eyes.  Body positioning and gestures, fear displayed by the mouth-- the amygdala doesn't seem involved in processing fear from those cues.

So the incorrect interpretation is to say the amygdala is needed to perceive fear.  A more correct interpretation is that the amygdala is involved in fixating and processing information about emotions coming from cues from specific contexts such as the faces' eyes.  You can see why this interpretation doesn't make it to the internet.


What's going wrong is that one way associations are made into two way relationships.  It is true that the amygdala is routinely observed to be activated during conditioned fear responses, but that's not the same as saying that it is the amygdala that is necessary for experiencing fear.

On top of which the terms are ambiguous.  What's fear?   Another patient with the same disorder as SM had normal mood and affect, and I'll quickly point out that this man had no problem experiencing fear.  But guess what happened at age 38:  he developed panic attacks.  Missing two amygdalas did not help him, but 75mg of Effexor did.  Take that, anti-Pharma backlash.

Wired Magazine interviewed the Current Biology study's author:

"What that suggests to us is that perhaps the amygdala is acting at a very instinctual, unconscious level," says Feinstein.
Well, not exactly.  Another group had got hold of SM and this time flashed images of faces too fast to be detectable by the conscious mind.  Normal people are able to detect fearful faces more easily than, say, happy faces.  SM, lacking amygdalas, shouldn't show any difference-- but, in fact, fearful faces broke into her consciousness much more quickly than happy faces, and just as quickly as for normals.  So unconscious perception is intact despite the absence of amygdalas.


Though I've pointed out some inconsistencies in the studies of the amygdala-- not to mention the studies of SM-- the real "discovery" of these papers is this: all three of the "groups" I cited share at least one author.  

Unless we are positing these authors themselves suffer from some kind of brain lesion, we need a better explanation for the discrepancies.

It isn't that they are not aware of their own findings, but that we are not aware of them.  Unless you're motivated to look up everything any time you read anything, then each paper comes to you in a bubble.  If you take it and read it and learn it, you will almost always get it completely wrong.  It's worse if you're getting your science from the popular press, which is basically like reading only the 97th word in The Waste Land and then writing a synopsis.  "It's about canasta, I think."

Most real neuroscientists-- not psychiatrists or even neurologists- understand that the common paradigm of structure-phenotype is overly simplistic.

More generally, the brain doesn't so much process information as apply a set of built in solutions to every single piece of information.  It constantly learns and reorganizes, recognizes patterns and rebuilds.

In the case of the amygdala, it is involved in fear (conditioning), but it is more generally involved in making decisions based on incomplete information.  It helps reduce ambiguity through learning.   How the impairment of that facility manifests in an individual may be very different: SM feels no fear, the other guy gets panic attacks.  Some people gamble more; or take more risks; or don't learn from experience. Etc.  It's not just what's damaged; it's what each individual compensates with.

In other words, cutting out people's amygdalas is a terrible idea.

Feinstein says the new findings suggest that methods designed to safely and non-invasively turn off the amygdala might hold promise for those suffering from post-traumatic stress disorder (PTSD).

Which PTSD sufferers?  The ones who already have smaller amygdalas?  Don't hold your breath, and anyway, we already have something that does this: Valium.

This isn't to say that a specific structure isn't important, but it is to say that the other structures are just as important.


Here's the kind of question that should be primary, not secondary, to the investigation of SM: what would you expect her to feel instead of fear?  Think about this.  If the amygdala does fear and she doesn't have amygdalas, what do you expect to happen when there's a spider on her face?

Probably, you'd answer nothing.  You'd expect her just to sit there and stoic it as if it is all meaningless.  "Spider.  Hmm.  Tickles."

But what she actually felt was wonder.  And curiosity.  And excitement.

I could find no one else with amygdalar damage who had this compensatory (?) response.  She had the right amount of emotional energy, but she experienced it as excitement.  The spider didn't turn into a duck, it turned into a parachute jump.  Why?


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Because an up close look at... (Below threshold)

December 31, 2010 12:36 AM | Posted by Alex J.: | Reply

Because an up close look at a spider is something you don't often get? Everybody would feel wonder if it wasn't blotted out by the AIIIIIEEEEEE RUN!!!.

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I've always found fear/anxi... (Below threshold)

December 31, 2010 9:08 AM | Posted by AnAnon: | Reply

I've always found fear/anxiety and excitement to be very closely linked physiologically - they're basically the same physiological response with different stories/expectations attached. They feel very much the same on a purely physical level (butterflies, heightened alertness and the other aspects of a high adrenalin experience, which is what both are) - the big difference is the narrative we frame the biological experience within. Excitement is the expectation of something good happening, fear is the expectation of something bad happening. (It's a useful thing to know if you're a performer prone to stage fright, since it's not about getting rid of the adrenalin experience because that energy and focus helps with performance,it's about making the experience the more pleasurable one of excitement.) I don't doubt that there are many other neurochemicals involved in whether an experience is exciting or frightening but clearly the fear response is quite mutable and highly dependent upon (conscious and unconscious) narrative/past experience. (A good example of how fear response is changeable and related to narrative/experience is how desensitization treatments work to lessen fear).

I'd suggest that SM's excitement, curiosity and wonder probably isn't a compensatory response, rather the same adrenalin response but, for some reason, without the negative narrative about the future (meaning immediate future or the imminent now) or consequences. It sounds, from the description here, that she's experiencing excitement and new experiences somewhat like a child does, meaning that it comes without a narrative based upon prior negative (or positive) experience. That's if we trust the studies and/or self reporting at all, of course.

All in all, it sounds to me as if the physiological response is quite functional - it's something in the interpretation that's changed. It seems significant that one of the things noticed was that she didn't automatically look at other people's eyes so was missing the (narrative/information sharing) cues vis a vis other people's fear but interpreted them clearly when she was directed to look at the eyes.

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Same emotion, different int... (Below threshold)

December 31, 2010 10:38 AM | Posted by Beezle: | Reply

Same emotion, different interpretation?

I often try to trick myself into thinking anxiety is excitement. It's not hard to do, as long as I'm making the effort. As soon as I stop consciously trying to change the interpretation it goes back to being annoying old anxiety. Can someone give me a pill for that? Or a guided laser beam to the brain? I'd also like a pill for exercise while you're at it.

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Beezle - We tend to revert ... (Below threshold)

December 31, 2010 10:56 AM | Posted, in reply to Beezle's comment, by AnAnon: | Reply

Beezle - We tend to revert to old patterns/narratives/beliefs quite quickly and fears/anxiety are often learned responses to certain situations (including the unknown, which some people find exciting and others find terrifying). One generally needs to change the the connection between a certain state and an often unconscious belief - a sort of retraining of the body/mind. Often fears or anxieties are based in beliefs that are so ingrained that they're foundational to our narrative/world view (and sense of identity), this means we need to change that foundational/unconscious belief about the world to be able to make the conscious choice "stick". The process of cognitive therapy generally involves a lot of consciously "practicing" new thoughts/behaviors for quite a while before they start to become the new automatic go-to response.

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I am truly confused at this... (Below threshold)

December 31, 2010 3:07 PM | Posted by Anonymous: | Reply

I am truly confused at this... how can the same woman be seen by the same researcher but see totally different things? Is this a case of the anchor author not being directly involved in the research but gets to be on any papers that come out of his labs?

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This is really exciting!</p... (Below threshold)

December 31, 2010 3:49 PM | Posted by S. Schaeter: | Reply

This is really exciting!

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I have great difficulty rec... (Below threshold)

December 31, 2010 9:46 PM | Posted by Anonymous: | Reply

I have great difficulty recognizing emotion in others' faces and postures. Someone has to be trembling in panic or frothing in rage before I'll get it, and I also have a hard time telling when somebody likes me or not. Subtlety and irony are lost on me too. I've also been basically an outcast and a loner ever since I can remember (40+ years, I'm 47 now); sometimes it feels like my difficulty in assessing others' feelings is the cause of my social estrangement and sometimes it seems only natural that being alone most of the time means I'd have a hard time learning that stuff. I also have difficulty picking up things like satire and sarcasm in writing too.

In myself I've never had a problem experiencing and identifying emotion; I might not know what a state is called but I can rate it at points along a continuum or identify mixed states pretty easily. ("It's more of a medium anger thing but with a smidge of disgust thrown in.") I'm also aware of when I'm being sarcastic or satirical but it often doesn't come across to others in any medium without something like BLINK and BOLD tags.

Curiously enough, given what I've gleaned from the mass media, an "autistic spectrum disorder" has never been included in my myriad diagnoses, nor has anybody who might be expected to know suggested that I might have a major brain malfunction or malformation. I'm just clueless and thick.

Does this sound like Nature or Nurtue? If the latter, how would a middle-aged eccentric go about learning to figure other people out?

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You are almost certainly mi... (Below threshold)

January 1, 2011 4:12 AM | Posted, in reply to Anonymous's comment, by Anonymous: | Reply

You are almost certainly mildly autistic, assuming you are being 100% truthful (which you may not be, whether or not you realize it, you may be biasing your testimony to conform to your self diagnosis). Not understanding peoples emotions either in expression or written form is not normal and it seems biologically driven. Mental machinery are responsible for deciphering universally human facial cues like disgust, fear, elation/happiness/surprise. This is not something we can learn or unlearn, it is the mechanics of the brain and it is inborn, like the drive for thirst, food, sexual orientation/drive, breathing reflex and such. The brain has a special face recognition ability (i.e. special mental hardware which can detect and remember faces), and it also has an emotion recognition ability (mental hardware that can read universal emotions on people's faces).

This is how I can watch a music video in german, not understand anything being said in terms of words, but understand 100% what is going on by looking at the people's faces (elation, disgust, fear, surprise). This is how at work when I have a patient who speaks spanish I can communicate with them simply by using facial gestures and nonverbal cues. The brain is equipped to read other people's minds, because other people wear their minds on their faces... but you must have a normal brain to do it. Autistic people cannot do this, or can only do this after learning it the way we learn a language (it is not innate for them).

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Why? The other sid... (Below threshold)

January 1, 2011 7:31 AM | Posted by Whatever: | Reply


The other side of fear is excitement. The trait it self is neutral. It's all about how you utilize this trait.

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I can tell when a chick is... (Below threshold)

January 2, 2011 3:36 AM | Posted by Anonymous: | Reply

I can tell when a chick is faking horniness or orgasm but that's because I've watched a lot of porn. That's more "left-brained" though, right?

My usual form of "excitement" is a mild form of anger, which increases easily, and I seldom feel fear anymore. Cops and robbers just piss me off these days; it's easy to imagine getting shot for speaking my mind in an uninhibited fashion -- and I don't have to be drunk or high to do that either. (If you don't want to be told to suck my dick don't threaten me with a deadly weapon, it's as simple as that.)

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anonymous replying to anony... (Below threshold)

January 2, 2011 2:21 PM | Posted by vanveen: | Reply

anonymous replying to anonymous autistic:

i fear you did not detect the gist of TLP's article. read it again, keeping your gaze and inner monologue focussed solely on the words.

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I was not evne considering ... (Below threshold)

January 3, 2011 12:10 AM | Posted, in reply to vanveen's comment, by Anonymous: | Reply

I was not evne considering TLPs article and I understood that completely.

I was merely informing the autistic anon that he is very likely autistic, assuming he is not lying or malingering. It is entirely possible he is lying/malingering however as the anon mentioned he has a "Myriad of diagnoses", emotional/histroinic behavior is certainly a part of people who have personality disorders (and pretending to be autistic/convincing themselves they are autistic is in line with personality disordered behavior). It's hard to believe someone can have a "myriad of psychiatric diagnoses", yet be blatantly autistic and never diagnosed. This leads me to believe he is lying about his inability to understand/comprehend facial gestures and phrases of speech.

I have seen 3 mental health professionals in my life, and all three times I was given diagnoses which were roughly the same. I did not get a myriad of diagnoses. I would assume this would only occur when a person is extremely dramatic and manipulative and purposefully made it difficult for the professionals to accurately diagnose them (e.g. a borderline or histronic type).

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@12:10 AM: I've been diagn... (Below threshold)

January 4, 2011 1:48 PM | Posted, in reply to Anonymous's comment, by Anonymous: | Reply

@12:10 AM: I've been diagnosed as schizoaffective, schizotypal, paranoid schizophrenic, major depressive and bipolar, based on which behavioral, thought and emotional patterns were more prominent at the time; I also think a lot has to do with which diagnoses were more in vogue at the time. The only clinician to call me Borderline was a psychologist who suggested letting him buttfuck me would help me, so I tend to discount that also. That's not to say I'm precluded from any Axis Two labels, but that it's not what they focus on.

And I still can't read people for toffee. That so few of you are worth much effort has little to do with that; it seems a major part of the problem is mine, as lots of misanthropes can tell what others are thinking and feeling. Some even make a good bit of money at it, say by working as "mental health practitioners" -- whether or not they prescribe "sexual healing."

Oh, and fuck you. I read English well enough to know when I've been blatantly insulted.

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I would go for amygdalectom... (Below threshold)

January 5, 2011 11:56 AM | Posted by bob: | Reply

I would go for amygdalectomy any time of the month

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With summer approaching, we... (Below threshold)

January 11, 2011 5:14 AM | Posted by Basketball jerseys: | Reply

With summer approaching, we have to begin our work of looking for new clothes, shoes and even hair styles. NBA jerseys are the best choice for wearing in summers. NBA is a magic word that associates with numerous dreams. We are not only interested in the games themselves but the NBA jerseys, shirts and shorts that the players are wearing. Why not to buy a cheap NBA jersey on the

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Fear is a curious thing. To... (Below threshold)

January 12, 2011 3:10 AM | Posted by ZSum: | Reply

Fear is a curious thing. To me it has always been sort of a trip. You know the feeling, when there's only a tunnel, towards or away and you feel like vomiting. Then you just go. There's a memory of things happening, you happening, but no clear memory of a concious thought. The rush is amazing, you survived! You feel powerful. You feel alive. It lasts many days. The simple things look beautiful, food tastes great and you feel grateful of every breath.

You feel need to be in it, but you really don't want to.

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Possibly because in our psy... (Below threshold)

March 10, 2011 11:42 AM | Posted by Susan: | Reply

Possibly because in our psyche, excitement is opposing fear. Who was it that said, 'You feel the most alive when near death?" This would be the neurological basis for why we 'feel' that if we take away the danger or risk in an experience, it would be purely thrilling.

I hate flying- when we take off, that first 15 minutes, man I'm scared shitless. But also, exhilarated. I continue to be exhilarated for the rest of the ride, to the point that landing is *both* disappointing as well as nerve-wracking, simultaneously. God this post was fascinating. As always.

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I hate flying- when we take... (Below threshold)

April 9, 2011 4:37 AM | Posted by Monster Energy Hats: | Reply

I hate flying- when we take off, that first 15 minutes, man I'm scared shitless. But also, exhilarated. I continue to be exhilarated for the rest of the ride, to the point that landing is *both* disappointing as well as nerve-wracking, simultaneously. God this post was fascinating. As always.

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Why did someone just cut an... (Below threshold)

May 5, 2011 3:54 AM | Posted by SUSAN: | Reply

Why did someone just cut and paste the last part of my comment? Was it confusing?

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gray boots ON SALE!... (Below threshold)

August 8, 2011 11:11 PM | Posted by | Reply

gray boots ON SALE!

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The real question is, IS th... (Below threshold)

April 24, 2012 5:05 AM | Posted by Anonymous: | Reply

The real question is, IS the 97th word of The Waste Land - canasta?

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You should check out emotio... (Below threshold)

May 22, 2012 11:45 AM | Posted, in reply to Anonymous's comment, by Anonymous: | Reply

You should check out emotional lability.

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You should check out emotio... (Below threshold)

May 22, 2012 11:47 AM | Posted, in reply to Anonymous's comment, by Anonymous: | Reply

You should check out emotional lability.

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Me again. Emotional labilit... (Below threshold)

May 22, 2012 11:53 AM | Posted, in reply to Anonymous's comment, by Anonymous: | Reply

Me again. Emotional lability to the guy/girl on the "myraid of diagnoses" side of the arguement above.

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In response to multiple ano... (Below threshold)

May 22, 2012 2:04 PM | Posted, in reply to Anonymous's comment, by Jay: | Reply

In response to multiple anonymous commenters (or a single anonymous commenter with severe dissociative disorder):

I had the usual Asperger's problems until college, mainly flat affect, social cluelessness, and a lack of interest in other people generally. Around my sophomore year of college, I made a conscious effort to begin using facial expressions. At first it looked really odd, I'm told, but I gradually got better at it. I also learned a little about reading faces. Some comics, especially manga, helped, because the style was highly expressive but also very simple (I recommend the works of Rumiko Takahashi for this purpose).

Now I'm quite a bit better. Still, it's a learned skill. When I get busy or distracted, I tend to revert to my old mannerisms.

I still don't find most people interesting, which is still a problem, because they can usually tell.

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I wonder why this one has s... (Below threshold)

March 31, 2014 4:36 PM | Posted by GhostOctopus: | Reply

I wonder why this one has so few comments compared to others; it might be my favorite so far. It's a shame you don't have a category for the ones which are actually a big instructional lesson, though I guess maybe that would defeat the purpose.

Also, maybe this has been talked about before on here but the titles of the posts in this blog are fantastic.

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