A First-Rate Madness (11 page)

IN RECONSTRUCTION YEARS, an us-against-them mentality evolved in both North and South. The few leaders of unimpeachable stature, like Lee in the South and Sherman in the North, refused to risk their reputations to heal festering resentments. An exception was General James Longstreet, then a New Orleans–based Republican, who, after publicly expressing support for voting rights for blacks, was branded a “traitor” and a “scalawag” in an 1867 editorial in the
New Orleans Times,
which was widely reprinted throughout the South. The problems of Reconstruction seemed intractable, among them: How could black civil and voting rights be protected, while Southern white opinion was gradually directed toward incorporating the black minority into its civic life?

In the end, the Civil War replaced slavery with segregation. The nation would have to wait for another depressive leader to end another century of racism. Only the radically empathic politics of Martin Luther King's nonviolent resistance movement would complete that great task that remained. Lincoln had ended slavery legally; King would end it morally. The first had required military force; the second needed soul-force.

Love, agape, empathy
—whether in English, Greek, or modern jargon, human life entails this basic principle: dependence of everyone on everyone else, the existential equality of all persons. When depressed, one
knows
the truth of empathy—that our fundamental similarities make us feel similarly—more viscerally and painfully than normal people do. We've already seen the extent to which Lincoln and Sherman drew on their empathy. A few leaders, like Mahatma Gandhi and Martin Luther King Jr., who were intimately familiar with depression, made empathy the core of their political method. The
politics of radical empathy,
I believe, is the psychological underpinning of nonviolent resistance. Depression reveals the truth of empathy, and empathy, in turn, engenders unexpected powers of leadership.

Negative emotions like pain and suffering have generated more psychiatric interest than positive ones like empathy. Putting the self-help genre aside, serious works on empathy are rare. What little we know scientifically is of recent vintage. The very term didn't exist until the 1850s (originally to express how one appreciates a work of art, like a painting), and was applied to psychology in 1903 by the German physician Theodor Lipps.
Einfühlung
was the word he applied:
Ein
means “into,” and
Fühlung
means “feeling.” Thus empathy was
feeling into
another person's experience. Though this has been the usual interpretation, empathy can be equally interpreted to mean “one feeling,” reflecting not so much imagining oneself in another person's place but actually experiencing what the other person is experiencing. Though the concept of empathy originated in an aesthetic sensibility of beauty, Lipps adapted it to the realm of human suffering. Indeed, the English translation, made by 1910, captures this usage from Greek roots:
em
means “into,”
pathos
is “suffering”—“into suffering.” Ten years after Lipps, Karl Jaspers made empathy central to psychiatry, a revolutionary idea at the time. (Jaspers divided all mental illness into those conditions with which one could empathize, such as depression and anxiety, and those with which one could not empathize, like schizophrenia.) Jaspers's insight was ignored by psychoanalysis and behaviorism, the two strongest currents of twentieth-century psychology. In recent years, though, empathy has made a comeback, sparked from an unexpected quarter for such a touchy-feely concept: neuroscience.

 

 

THE NEUROBIOLOGY OF EMPATHY begins with the observation that only 3 percent of animals are monogamous. Besides humans, the only other monogamous primate species is the orangutan; chimpanzees, our closest evolutionary cousins, are highly polygamous. Researchers have long wondered about this disparity, and what might constitute the biological basis of monogamy. These questions led them to the biology of empathy.

The humble vole (genus
Microtus
) proved centrally important. The prairie vole (
Microtus ochrogaster
) is monogamous, but the montane vole (
Microtus montanus
) is polygamous. Thomas Insel and associates at the National Institute of Mental Health found that the brain hormone oxytocin affects the bonding and sexual habits of these rodents. The brain of the monogamous prairie vole contains many oxytocin receptors, especially in regions involving emotion processing. In contrast, the polygamous montane vole has few oxytocin receptors, and they occur in brain regions less involved with processing emotions. These neurological differences may produce changes in behavior: montane voles live by themselves; prairie voles live together as male/ female pairs. The only time montane voles briefly cohabit is immediately after the birth of babies, when the mother nurses and raises her offspring. During that period, oxytocin receptors markedly increase in the mother montane vole's brain.

Oxytocin is the sex hormone par excellence: its levels spike during sexual activity between voles. But oxytocin has broader social effects; it is a kind of glue that bonds living things together. If oxytocin is injected into prairie voles, they have sex. If researchers prevent them from having sex, and then give them a shot of oxytocin, the voles groom and snuggle each other. (These effects are less visible in the montane vole, because of its relatively few oxytocin receptors.) In mice, one can remove the entire oxytocin receptor gene experimentally, producing animals without any oxytocin receptors at all. In these poor creatures, social memory is absent: such a mouse can't recall another mouse it met before, and each mouse isolates itself from other mice. In humans, as in voles, oxytocin activity peaks during orgasm, and is high during childbirth and breastfeeding.

In short, oxytocin is something like a love drug that produces feelings of emotional attachment in socially significant moments—like sex or breastfeeding. Its constant presence is associated with sociability, its absence with isolation. One might well wonder whether people with great empathy naturally have lots of oxytocin receptors.

 

 

THE NEXT HINT about empathy came from studying macaques, long the subjects of research by Giacomo Rizzolatti and his associates at the University of Parma, Italy. The NIMH scientists discovered
how
empathy worked in the brain; the Italian scientists discovered
where
empathy worked in the brain. When a macaque moved his arm or leg, the motor cortex of its brain lit up as expected; the motor cortex oversees the body's movements. But a few other parts of the brain lit up as well: the insula, which is involved in processing emotions, and the anterior cingulate gyrus, a large collection of fibers at the center of the brain that unite its two hemispheres. This was interesting; why were these extra parts of the brain lighting up, even though they didn't control any muscle movement?

Even more interesting, the researchers discovered that when one of them moved his hand in view of the macaque, the monkey's insula and cingulate gyrus lit up,
but not the motor cortex
. Then one monkey was placed in front of another: monkey A moved his hand; in the brain of
monkey B, a different monkey,
again the insula and cingulate gyrus became active, but not the motor cortex. The brain acted
as if
the experimental monkey were moving his hand when in fact the monkey was only watching someone else moving his hand. These neurons “mirrored” the activity of another being. Similar research has since shown that some of the neurons that fire when one feels pain will also fire when he witnesses someone else in pain. Here is empathy itself, lighting up on a brain scan. Coining the term “mirror neuron system,” researchers found that 10 percent of the human brain is wired to turn on as if it is
doing
what it is only
observing
.

One-tenth of the brain is wired for empathy.

 

 

ALL OF THIS RESEARCH adds up to one conclusion: empathy is not a vague concept; it is a neurobiological fact. We are wired, literally, to feel the movements, emotions, and pain of others. So we should take empathy seriously, including its psychological effects. Psychologists divide empathy into different parts—cognitive, affective, motor, and sensory—distinctions that, though a bit abstract, are useful.
Cognitive
empathy means thinking another person's thoughts: I recognize that you have your own set of thoughts, and I try to understand what those thoughts are.
Affective
empathy involves feeling an emotion that another person feels: I am sad when I see that you're sad; one baby starts to cry, others follow suit.
Motor
empathy relates to moving the way another moves: the infant sees an adult smile, and she smiles.
Sensory
empathy means feeling a physical sensation that another person feels: you're in pain, and then I am; you're nauseated, and I feel it too. This experience happens sometimes during pregnancy, when the male partner can experience a woman's morning sickness, bloating, and even pain during contractions. Doctors call it pseudocyesis, or false pregnancy—the ultimate empathy.

There's a reason we're wired for empathy. We can't understand each other through words alone; we need to touch, to feel, to stroke each other emotionally and even physically. It is generally estimated that at least one-half of human communication is nonverbal. This is an incredible and underappreciated fact. No wonder emotionally charged emails and text messages are so easily misunderstood; they tell only half the story. Just as important as the content of one's message is the tone with which one delivers it, the expression on one's face, even one's posture. Without empathy, we can barely communicate with each other. Empathy is, it seems, central to the human (and rodent and primate) experience.

 

 

BESIDES BEING BORN with plenty of oxytocin receptors, how can one attain a high degree of empathy? One answer, I believe, is to be depressed. In one study, severely depressed patients had much higher scores on empathy scales than a college student control group; the more depressed patients were, the higher their empathy scores. This enhanced empathy was emotional, not cognitive; it reflected an actual sensation of sharing others' feelings, not merely an intellectual understanding of those feelings. This research suggests an important conclusion: when the depressive episode is over (and, short of suicide, all depressive periods end, usually within a year after they start), the intense experience of emotional identification with others might leave a lasting mental legacy. Emotional empathy, produced by the severe depressive episode, may prepare the mind for a long-term habit of appreciating others' points of view.

This is suggested by another study, in which patients with various psychiatric illnesses (depression, schizophrenia, personality and anxiety disorders) completed an empathy scale and measures of current or past suicidal thoughts or attempts. Various scales have been developed to measure empathy; they involve self-description of how often one appears to understand the emotions or thoughts of others. The Interpersonal Reactivity Index, used in this study, consists of twenty-eight questions that measure four behaviors: “perspective taking” or “the tendency to spontaneously adopt the psychological view of others in everyday life”; “empathic concern” or “the tendency to experience feelings of sympathy or compassion for unfortunate others”; “personal distress” or the “tendency to experience distress or discomfort in response to extreme distress in others”; and “fantasy” or “the tendency to imaginatively transpose oneself into fictional situations.” These patients were in standard outpatient treatment and had few if any symptoms of their disease at the time of the study. They then read a brief story about a woman who committed suicide by overdose. Researchers expected that those subjects who were or had been suicidal would sympathize with the woman in the story, but in fact those who had never been suicidal were more sympathetic. The exceptions were depressed subjects with past suicidality; they were especially sympathetic to the story.

This correlation between depression and empathy shouldn't surprise mental health professionals. Maybe nothing is more important than empathy in the daily work of the mental health specialist; nothing—not drugs or any specific psychotherapeutic technique. Subsequent studies have found that patients' ratings of their psychotherapists' empathy predict improvement for depression, even with treatments (like cognitive-behavioral therapy) that do not emphasize empathy.

Empathy seems central to the experience of depression, and just as central to its treatment. You are wired to experience it in your brain and in your body, and it thereby becomes central to your mental life. This is how things are for most of us, and perhaps more so for those who experience depression.

 

 

DEPRESSION DEEPENS our natural empathy, and produces someone for whom the inescapable web of interdependence (one of Martin Luther King's phrases) is a personal reality, not a fanciful wish. Depression cultivates empathic experience, ripens it, until, in a select few, it blooms into exemplary abilities.

Thus arises the empathic leader, a person sometimes so arresting that the rest of us become convinced he must be an otherworldly saint, a uniquely great soul, an anomalous event. He may be all those—but perhaps his secret is more prosaic: the common yet profound imprint of depression.

Mahatma Gandhi and Martin Luther King are the bookends of depressive activism, the innovators of a new politics of radical empathy that didn't exist before Gandhi and hasn't persisted after King. Though their countries and the world remain deeply influenced by their legacies, neither India nor the United States could now be said to exemplify the nonviolent ideals of these men. Their politics of radical empathy could not be maintained by leaders who lacked their vision—and their illness. They both attempted suicide as teenagers, endured at least one depressive episode in midlife, and suffered a very severe depressive episode in their final years, before they were killed. They each pushed the politics of empathy to its limits, and found their followers—the mass of normal humankind—unable to keep up with them.