Last week we introduced Patient SM. 

By age four, a rare genetic disorder called Urbach-Wiethe disease had completely destroyed SM’s amygdala, rendering her unable to experience fear.

A life without fear might initially sound enviable. Yet, we learned it is anything but.

Fear, and all other basic emotions, are integral to understanding the world and making good decisions.

Reason and emotion are not separable. Without fear, SM cannot accurately make sense of the world.

More to SM’s Story

Patient SM’s inability to experience fear, while retaining normal brain function otherwise, makes her a unicorn. That alone would be sufficiently unique, but there is more to this strange story.

Not only is SM unable to experience fear herself, she is unable to recognize fear in others.

When presented with images of happy and fearful faces, SM is consistently unable to distinguish the two.

Why?

In their paper “A mechanism for impaired fear recognition after amygdala damage,” published in Nature in 2005, a team of researchers including renowned neuroscientist Antonio Damasio found the answer.

WYSIWYG

The team tracked SM’s eye movements as she looked at images of faces expressing the basic emotions:

• Happiness,
• Surprise,
• Anger,
• Disgust
• Sadness, and, of course...
• Fear.

Eye tracking technology picks up our visual “saccades,” the extremely rapid scanning movements our eyes make automatically and subconsciously. You’re doing it right now.

When looking at a face, the visual saccades of people with normal amygdala function subconsciously trace a predictable pattern. They make a triangle between the eyes and mouth.

SM’s visual saccades look very different. Her pattern is more random, pausing on the mouth or less informative features like the nose, but—importantly—rarely focusing on the eyes.

The Eyes Have It

This explains SM’s inability to recognize fear. More so than any of the other basic emotions, fear is expressed mostly with the eyes.

It also explains SM’s mostly normal recognition of happiness, surprise, sadness, and disgust, which can be identified by looking at the mouth.

Her ability to identify anger is not quite normal, but it is less impaired than fear, because anger involves both the eyes and mouth. While SM fails to notice the angry furrowed eyebrows, she compensates somewhat by looking at the scowling mouth.

SM’s emotional intelligence suffers, especially when negative emotions are involved, because she does not have an amygdala telling her where to look.

Implications

Let’s get right to the weirdness:

• The inability to feel fear makes it difficult or impossible to see that emotion in others.
• Without a functioning amygdala, our eyes are not properly directed to emotionally salient information (like fear on the face of another person, which we use for all sorts of things including gauging personal space).
• The fast-acting, subconscious part of our brain responsible for threat detection and rapid response moves our eyes around, deciding where we focus our visual attention.

What we see is determined, at least in part, by how we feel (or don’t feel), in the most literal sense.

Did you think you were consciously choosing what to look at?

Patient SM Meets Patient MS

SM resides on one extreme end of a spectrum. She has no functioning amygdala.

Let’s define the other extreme of that spectrum by imagining SM’s opposite. Let’s call him Patient MS.

• MS grew up poor, abused, and neglected.
• He began suffering from depression and anxiety as a teenager.
• At eighteen, in an attempt to bring some structure to his life, he joined the military, but he ended up on the front lines where he experienced the worst horrors of war.
• Upon returning home, he began to experience debilitating post-traumatic stress disorder.

While SM has no amygdala, and no fear, MS’s amygdala is on constant overdrive, hypervigilant to any potential threat, operating on a hair trigger. It has even grown physically larger.

MS’s emotional intelligence also suffers, but for the opposite reason.

How different are the worlds of SM and MS?

The Rest of Us

You almost certainly do not suffer from Urbach-Wiethe disease. There are only about 300 known cases in the medical literature.

And hopefully you do not find yourself on MS’s end of the spectrum, though, tragically, many people do.

Most of us reside somewhere in between. If SM’s amygdala response is a zero, and MS’s is 100, maybe you are a 30 and your coworker is a 70, both in the “normal” range.

Yet the two of you are still experiencing life quite differently. You are unlikely to look at any visual scene the same way. Your eyes literally will not lock onto the same things.

As a result, your emotional intelligence will vary. You will each have strengths and weaknesses, but probably not in the same areas.

What accounts for this difference?

Obviously genetics is a factor, but many things can alter the functioning, and even the physical size of the amygdala.

Here’s a short list of examples, in no particular order:

1. Anxiety
2. Depression
3. Autism
4. Childhood abuse and neglect
5. Trauma and PTSD
6. Sleep deprivation
7. Dementia and Alzheimer’s disease
8. Alcohol use and abuse
9. Drugs (legal and otherwise)
10. Chronic stress
11. Epilepsy
12. Bipolar disorder
13. Schizophrenia
14. Hormone fluctuations (including normal ones)
15. ADHD
16. Nutrition
17. Exercise or lack thereof
18. Mindfulness meditation (in a good way)
19. Cognitive behavior therapy (also in a good way)
20. Eye-movement desensitization and reprocessing, EMDR (isn’t it interesting that a treatment involving eye movement affects a brain structure that affects eye movement…)

The Same, But Different

At one level, our brains look very much the same. But in important ways, they are very different. We have been looking at variation in one small structure, the amygdala, but differences like this exist in every brain region.

We experience the same world differently because our brains are built differently.

The incredible sophistication of the prefrontal cortex, our complex emotions like empathy, resentment, regret, or pride, and our human emotional intelligence are built on primitive structures like the amygdala, and basic emotions like fear and disgust that evolved to keep us alive.

Understanding how our brains work and how they influence how we make sense of the world helps us understand ourselves and others better.

One More Lesson From SM

SM’s amygdala damage means that her eyes do not automatically seek emotional information in the eyes of others. Her impaired ability to recognize fear results from not instinctively knowing where to look, and it has made her life difficult in many ways.

Yet the neuroscientists working with her have found a cure. It is effective. It has no side effects, and it’s free. What is this miracle cure?

They told her where to look.

When neuroscientists gave SM explicit instructions to look to the eyes, her ability to recognize fear in others returned to normal.

It’s not natural or automatic for her. It requires effort, and recognizing fear will never be as easy for her as for those of us with a normally functioning amygdala, but it helps.

With some simple guidance, SM’s emotional intelligence got better. 

Sometimes it’s just a matter of knowing where and how to look.

Until next time,

Greg

Pssst! If you’d like some insight on where and how to look, check out our course, Emotional Intelligence Essentials, and get a clear picture of your emotional intelligence strengths and weaknesses with the EQ-i 2.0® assessment.