Tuesday, January 28, 2014

Pathological Altruism

Pathological Altruism is the first book I have come across (thanks to an anonymous commenter on my blog) that deals broadly with a subject that has been near and dear to my heart. I have been writing about its manifestations in families for almost thirty years.

Pathological altruism is defined as actions designed by someone to help others at one’s own expense that, in the long run, harm not only the giver but the recipient as well. I first thought about it way back in 1985 as I was writing my first book, which was eventually published in 1988.

My ideas stemmed from the writings of family systems therapy pioneer Mara Selvini Palazzoli and her group in the book Paradox and Counterparadox. She described how children are willing to sacrifice their own well being in order to stabilize emotionally dysregulated parents and to preserve family homeostasis - the rules upon which family interactions are regulated and made predictable.

I noted that this sort of self-sacrifice led to a paradox, which I called the altruistic paradox. I got braver later on and re-named it with the moniker I originally had in mind, the Mother Theresa Paradox. Although the altruistic actions of family members would calm things down in the short haul, in the long run they would backfire. This happened for a number of reasons. 

First, such acting out would usually prevent family members from actually discussing mutual dilemmas and intrapsychic conflicts with one another in a way in which problems might be resolved.

Second, in cases in which parents would overly sacrifice themselves for their children in order to follow the homeostatic rules within the family of origin they themselves had grown up in, they would prevent their children from developing skills such as frustration tolerance that would allow their children to eventually function independently. The kids would never seem to grow up. I believe that refusing to grow up eventually becomes their choice and is also, in fact, a major act of self-sacrifice in a culture which values independence.

Third, an imbalance between giving and receiving in which the former is considered a virtue and the latter a vice creates a situation in which group members all become frustrated because no one is willing to receive what the others have to give!

The altruistic behavior within the group is described and explained by evolutionary biologists using the concept of kin selection.

The book Pathological Altruism is an edited collection that includes many different perspectives from a wide range of academics. Although I disagreed with many of the chapter authors, I am certainly delighted that this topic is being tackled, and I was indeed thrilled when the reader told me about the book's existence. As the editors of the book say in their introduction, perhaps pathological altruism has been so little discussed for pathologically altruistic reasons.

As the book illustrates, the concept of pathological altruism certainly can provide powerful answers to such questions as why some people become "co-dependent," why the most difficult patients to treat on a cancer ward are often former cancer ward nurses, and why some people seem to be victimized by criminals far more than the average Joe.

Some of the authors question whether pure altruism even exists – maybe all behavior is performed in order to make one's self feel better, not the other guy. If it does exist, how can we even know that it is pathological?

We can never be certain about the motives behind any human action, as people can be dishonest about that not only with others but with themselves. And maybe they sometimes do not understand their own motives, or they are under the sway of genetically determined processes over which they have no control. As Joseph Miller was quoted as saying, “It is orders of magnitude more difficult to study internal than external stimuli.”

In the book's discussions about making determinations of the motives behind the behavior of another person, one major omission is a pattern that I think is perhaps the most important. While many of the authors wrote about how apparently altruistic behavior can be used to mask covert or hidden selfish intentions, none of them discussed the opposite: how apparently selfish behavior can be used to mask covert or hidden altruistic intentions. For illustrations of how and why this happens, see my posts, The Language of Love from 4/17/10, and my two posts on dysfunctional family roles, Part I and Part II.

I did find much to admire in the writings of many of the authors, but in general I found that a lot of them make the same kinds of errors in thinking that I have brought up in this blog. For instance, they often have very simplistic understanding of what heritability means, or what the differences seen on fMRI scans between various people while doing certain tasks mean. They far overstate genetic influences on behavior.

On a related issue, as author Joachim I. Krueger points out in Chapter 30, there is a tendency of many of the authors to ignore social psychological influences, and think that a lot of the motivation behind pathologically altruistic behavior stems from one’s own internal predispositions rather than from being reactive to environmental contingencies.

These two errors come together in discussions by some of the authors of the "five factor" model for personality. These factors represent behavioral tendencies that may stem mostly from genetic predispositions. Someone may naturally be more agreeable than most others, for instance, and if all environments were the same in regards to the consequences of being agreeable, such a person would be more likely to be agreeable than someone without this genetic predisposition.

Of course, we all operate within many different environments, each of which is constantly subject to change due to the operation of a literally infinite number of variables. People who are agreeable, if they see that such behavior will lead to adverse consequences, will not be so likely to be agreeable than they would be if left purely to their own devices. When an fMRI scan is done, for instance, that is a measure of the brain’s reactivity within only one of a myriad of other contextual possibilities. In other words, context is everything.

Motivated people can easily defy their own natural inclinations when they see that it is in their or their family's interests to do so. In fact, if there's one thing I have learned in doing psychotherapy for close to 40 years, it is that people can construct a very complicated false self, as first discussed by psychoanalysts Jung and Winnecott, in which they completely submerge many of their own strong inclinations. 

In chapter 29 by Marc Hauser, he points out that from an evolutionary standpoint, it may be advantageous for a person to appear tougher, sexier, or more caring than they actually are. Primatologists have long known about the prevalence of and advantages of being able to deceive other members of one's own species. Hauser also talks about what I refer to as the Actor's Paradox: The act of deception is more convincing if the actors can convince themselves that they really are the character they are playing.

Paradoxically, the tendency of humans to use deception in the act of sacrificing oneself for the sake of their kin group may itself have a very powerful genetic component. This genetic tendency is probably far more powerful that any genetic influences on the five factors, if I had to guess.

The logical error of genetic determinism can be illustrated with an article that was cited by chapter 21 author John W. Traphagan (Freeman, J.B. et. al., “Culture shapes a mesolimbic response to signals of dominance and subordination that associates with behavior,” Neuroimage 47 (2009) 351-359). The brains of Japanese and Americans were scanned while the subjects reacted to photographs of people acting in dominant and subordinate ways, with the nationality of the subjects in the photographs being ambiguous. Statistically significant differences on the scans emerged.

It seems to me that it is highly unlikely that the distribution of genes creating each of the five factors of personality would be hugely different in Japanese or Americans, so this study shows that cultural training affects brain function during certain tasks. It probably does not reflect genetic differences to any significant degree. Of course, if this was a study done by psychiatrists, who always declare differences to be abnormalities, being Japanese would be called a disease!

Of course, it could be that the distribution of genes does vary markedly in different populations. But I doubt it. In Chapter 22, Joan Y. Chiao et. al. opine that empathy and altruism differ in different cultures because of such discrepancies in gene distribution. They chart different countries that vary on the balance between individuality versus collectivism within their cultures versus the percentage of different alleles (versions) of a gene that affects serotonin. 

Although a few seemingly highly collectivist cultures had significantly more of one allele than the other, in fact almost all of the countries had a very similar distribution. In fact, the USA and Brazil, rated vastly different on the individualism-collectivism scale (10% versus 70%), had almost exactly the same allele distribution. 

One wonders if perhaps there might be other more collectivist countries that were not included on the graph that would have been outliers in the opposite direction. This reminds me of a famous old study that showed heart attacks were more common in countries in which there was a higher fat intake in the average diet – a study which for some reason completely left out France. The French eat a lot of fat and have a relatively low incidence of heart attacks.

Some of the chapters in the book seemed to me to be overly academic or discuss arguments that seem to boil down to semantics. The book is probably not meant for lay readers. However, despite all of these reservations, the book has enough great stuff in it for me to recommend it to anyone with an interest in this fascinating subject.  


  1. Love reading your "stuff" ... some times to the point of tears ... healing ... maybe/ hopefully ... Always, cat.

  2. When I posted a link referencing the book Pathological Altruism on your blog, I never expected you to review it, and I'm once again impressed with your thoughtful and very thorough analysis. Thanks so much.

  3. I'm puzzled by the image on the book cover; what is the significance of a garlic head, its connection to Pathological Altruism?

    1. I was wondering the same thing. I'll have to ask Barbara Oakley next time I communicate with her.

  4. From Barbara Oakley, the first editor:

    Hidden on page xix, at the end of the Acknowledgments, is an explanation of the cover design:

    Lastly, we would like to thank Jeff Miller of faceoutstudio for his cover design. According to Jeff and Oxford editor Abby Gross, “The onion in the cover page illustrates how something rooted in what we think of as purity—the white, clearish center—could reverberate out or develop into something dark—the brown, crinkly outer layers. Layers within layers are also symbolic of human nature, from emotions to motives to behaviors and beyond that, the impact of behaviors outside of the self.” No editors could be happier with such beauty, originality, or insight, all wrapped into one seemingly simple image.”