Against Empathy: The Case for Rational Compassion
by Paul Bloom.
Ecco, 2016 ($26.99; 304 pages)
Most of us see empathy as a force for good. From an early age, adults tell children to imagine stepping into another's shoes to teach them respect and kindness. But in his new book, Yale University psychologist Bloom argues that empathy is actually a poor moral guide and that we may be better off with less of it.
To start, Bloom notes just how shortsighted, biased and irrational empathy can be. We sympathize more, for instance, with people who are similar to us or with whom we identify. Thus, our feelings do not always scale with the degree of someone's suffering: we typically feel much worse about a death in our own community than 100 deaths in some unfamiliar, distant land.
Thanks to this bias, empathy can even lead to violence, Bloom explains. Research shows that more empathetic people are more likely to endorse harsher punishments toward people they view as threats. “It is because of empathy that we often enact savage laws or enter into terrible wars; our feeling for the suffering of the few leads to disastrous consequence for the many,” he writes.
But simply having empathy for a wider range of people is not the solution. Constantly internalizing the suffering of others can lead to emotional burnout. Instead, Bloom asserts, we should rely on compassion. Compared with empathy—which involves actually sharing another's emotions—compassion reflects a more distanced form of caring and concern.
In fact, compassion and empathy look different in the brain. In one neuroimaging study, researchers trained participants either to imagine how someone else might feel (empathy) or to project loving thoughts toward them (compassion). They found that compassion training increased activity in the medial orbitofrontal cortex and ventral striatum, areas associated with love and reward; empathy training increased activity in the insula and anterior cingulate cortex, typically involved in registering another's pain. There were psychological differences as well: compassion led to positive emotions and greater motivation to help, but empathy brought unpleasant feelings, such as stress and sadness.
Bloom knows his negative take on empathy is controversial. Many psychologists and scholars criticize his point of view, insisting that empathy drives important social movements, among them advocacy for antislavery and gay rights. Bloom fires back that almost any strong feeling—anger or fear, for instance—can mobilize people for a good cause, but there are better ways to achieve the same outcome, such as deploying compassion. This book forces us to confront the uncomfortable, often ugly realities of human nature, but Bloom uses a conversational style and deeply personal examples to make it more palatable. By the end, it is hard not to agree that less empathy and more compassion are what our world desperately needs. —Diana Kwon
ADHD Nation: Children, Doctors, Big Pharma, and the Making of an American Epidemic
by Alan Schwarz.
Scribner, 2016 ($28; 352 pages)
During the 1940s chemist Leandro Panizzon tinkered with the molecular structure of amphetamine, a powerful stimulant in the central nervous system, in hopes of discovering a nonaddictive substance to increase his wife Rita's energy and focus on the tennis court. The drug he developed not only turned Rita into a tennis-playing machine but also kept her slim. She loved it so much he named it after her. In 1956 Ritalin was approved to treat narcolepsy, chronic fatigue, depression and erratic behavior in adults. By the 1960s a small group of clinicians had realized that the drug improved learning and focus in children diagnosed with a broad swath of emotional and behavioral issues. Others soon began investigating the underlying pathology in these children, which ultimately gave birth to attention-deficit/hyperactivity disorder (ADHD).
In ADHD Nation, Schwarz, an investigative reporter for the New York Times, traces the evolution of ADHD as one of the most widely diagnosed—and misdiagnosed—conditions in American medical history. He details how big drugmakers propelled ADHD into the national spotlight, conspiring with physicians, researchers, policy makers and educators to create, what he calls, the ADHD-industrial complex. In essence, pharmaceutical companies aggressively, and often misleadingly, marketed Ritalin and other stimulants to help fix “troubled” kids.
Researchers played their part by downplaying serious side effects, government officials by expanding health coverage and developing school policies to promote ADHD testing. In the 1990s schools received extra funding for each pupil diagnosed, and many administrators coerced parents into having their children tested and treated. The more attention ADHD received, the more children were diagnosed. “Of course, there was no way to disentangle which children were actually impaired by severe hyperactivity and distractibility ... and which were either questionable diagnoses or, at the most cynical end of the spectrum, labeled merely for money or extra services,” Schwarz writes.
These factors created an epidemic in the U.S., with 11 percent of all school-age children diagnosed with ADHD. When drug companies realized the potential to expand stimulant sales to adults, they devised a new market, to which Schwarz attributes the rising recreational use of ADHD drugs by students, professors, shift workers, doctors and others with demanding schedules.
Schwarz's book is an engaging, fast-paced exploration of what the father of ADHD research, psychologist Keith Conners, has called “a national disaster of dangerous proportions.” The book serves as an indictment of the ADHD epidemic but ultimately ends on a sobering, even hopeful note. Perhaps we can learn from our mistakes, Schwarz suggests, by reining in overtreatment and focusing research and resources on individuals who can actually benefit from ADHD therapies. —Moheb Costandi
The Perpetual Now: A Story of Amnesia, Memory, and Love
by Michael D. Lemonick
Doubleday, 2017 ($27.95; 304 pages)
In his latest (and seventh) book, Scientific American editor Lemonick introduces readers to Lonni Sue Johnson, an important new character in the ongoing quest to understand how our brain forms memories. In 2007, when Johnson was 57 years old, a viral infection ravaged her hippocampus. She survived, but the damage left her trapped—as the book's title attests—in the perpetual now: Johnson cannot remember what has happened more than five minutes ago nor anticipate what might come next.
Her fate is similar to that of Henry Molaison, one of neuroscience's most famous research subjects, who, until his death in 2008, was known in the literature as H.M. In 1953 a surgeon suctioned away most of his hippocampus in hopes of relieving his crippling epileptic fits. It worked—but also left him unable to recall specific events or commit new experiences to long-term memory. Scientists discovered, however, that H.M. could master new skills, even if he had no memory of practicing them.
In hundreds of tests over 40 years, they parsed H.M.'s memories into several broad categories—including declarative memories, or “knowing that,” and procedural memories, or “knowing how.” But as Lemonick notes, experiments with Johnson are revealing that some of “those distinctions may have been too crude to capture the subtleties of human memory.”
Compared with H.M., Johnson may offer an even greater research opportunity, thanks to her unusual range of talents. Before her illness, she was a successful artist, an amateur pilot and a gifted musician. “I think she might be the most interesting amnesic to have been studied in this level of detail,” cognitive scientist Michael McCloskey of Johns Hopkins University is quoted as saying. His team is one of several Lemonick interviews about working with Johnson.
Initially McCloskey and his colleagues, Barbara Landau and Emma Gregory, chose to plumb Johnson's once deep knowledge of art. In 2014 they showed her 70 paintings. Out of 60 famous works, she could name only two: Mona Lisa and The Last Supper. But she readily identified 10 of her own paintings and spotted others done in a similar style. “Whatever it is that allows her to recognize her own style,” Landau says in the book, “I don't think we know how to categorize that sort of memory.” Later tests showed that Johnson retains other memories—such as the rules for playing in a string quartet or how it feels to fly in a headwind—that appear to be part declarative and part procedural at the same time.
In his introduction, Lemonick asks, “If we have no memories of the experiences that made us, how can we know who we are?” Johnson seems to be largely unaware of what she has lost. What stands out in this sensitive portrait of her is just how many of her characteristic traits—an intense drive, an impulse to create art, a zany sense of fun—have survived. When Johnson's sister and late mother realized the extent of her injuries, they vowed to make something good of it. Thanks to their efforts, Johnson's remarkable brain is poised to help scientists rethink what we know about the workings of memory. —Kristin Ozelli
Suggestible You: The Curious Science of Your Brain’s Ability to Deceive, Transform, and Heal
by Erik Vance.
National Geographic, 2016 ($26; 288 pages)
Last fall my son woke up ill one morning. He moaned nonstop through our usual Friday pancake breakfast at the diner. But as soon as we were on our way to the doctor, his stomach pain subsided, and he fell asleep. What prompted the turnaround? Perhaps my son knew his doctor would make him feel better, so his brain unleashed a cascade of pain-fighting neurotransmitters in anticipation.
The fact is that our expectations can assuage a range of physical symptoms. In his new book Suggestible You, science writer Vance opens our innate mental medicine cabinet to look at the placebo effect—or what happens when a person receives a fake treatment and feels better just the same. In the past two decades scientists have discovered a surprising amount about why placebos influence the mind and body and how we can enhance our responses to them.
So how exactly do placebos work? Essentially, Vance says, our beliefs can increase levels of mood-enhancing and pain-soothing neurotransmitters, including dopamine, serotonin and endorphins. Just telling ourselves that doctors will provide relief can produce real improvement, regardless of what they prescribe. Scientists now know that certain conditions, such as Parkinson's disease, depression and irritable bowel syndrome, respond especially well to placebos, but others, including cancer and the flu, do not. Vance recommends that people use evidence-based medicine first, when possible, but then incorporate placebos to enhance outcomes.
Vance's exploration of the placebo effect is deeply personal. He grew up in the Christian Science religion, which practices self-healing and largely eschews health care. As an adult, though, he wanted to explain the mysterious cures he observed in his youth—such as his father's healed rotator cuff. For Vance, the placebo effect bridges the gap between faith and science.
His skill at weaving together the relevant research, anecdotes and his own experiences makes Suggestible You an enjoyable, quick read—one that relays many intriguing, if unexplained, discoveries: yellow pills, for instance, work best on depression, and bigger pills generally produce stronger effects.
In the end, Vance stresses that relief from painkillers and placebos are neurologically identical. “People experiencing a placebo effect aren't crazy or deluded or gullible,” he writes. “For decades the world has seen you as too easily influenced and pharmaceutical companies have been aggravated by you. But no longer. From here on out, call yourself what you are: talented.” —Meredith Knight