The Pathological Altruist

[Elijah]

I know this isn't going to be an easy subject, but I found this fascinating.

I once posed a hypothetical question to a friend about a discussion we were having along the same vein...I asked if you were on a ship with 2,000 people on board but only had enough life rafts to hold 1,000, would you save the 1,000 or would you attempt to overload the life rafts and in the end, no one survives?

She was immediately emotional and no longer wanted to finish the discussion.

I think this is how we, as a society, have come to operate...we want X, but have no logical way to make X happen. And no one wants to make the hard decisions, so we just ignore realities and think about kittens.

So there it is...My take on things, for whatever it's worth.

I am interested in how others feel about this? (Please read the article below before responding)





The Pathological Altruist Gives Till Someone Hurts
By NATALIE ANGIER
Published: October 3, 2011

Some years ago, Dr. Robert A. Burton was the neurologist on call at a San Francisco hospital when a high-profile colleague from the oncology department asked him to perform a spinal tap on an elderly patient with advanced metastatic cancer. The patient had seemed a little fuzzy-headed that morning, and the oncologist wanted to check for meningitis or another infection that might be treatable with antibiotics.

Dr. Burton hesitated. Spinal taps are painful. The patient’s overall prognosis was beyond dire. Why go after an ancillary infection? But the oncologist, known for his uncompromising and aggressive approach to treatment, insisted.

“For him, there was no such thing as excessive,” Dr. Burton said in a telephone interview. “For him, there was always hope.”

On entering the patient’s room with spinal tap tray portentously agleam, Dr. Burton encountered the patient’s family members. They begged him not to proceed. The frail, bedridden patient begged him not to proceed. Dr. Burton conveyed their pleas to the oncologist, but the oncologist continued to lobby for a spinal tap, and the exhausted family finally gave in.

As Dr. Burton had feared, the procedure proved painful and difficult to administer. It revealed nothing of diagnostic importance. And it left the patient with a grinding spinal-tap headache that lasted for days, until the man fell into a coma and died of his malignancy.

Dr. Burton had admired his oncology colleague (now deceased), yet he also saw how the doctor’s zeal to heal could border on fanaticism, and how his determination to help his patients at all costs could perversely end up hurting them.

“If you’re supremely confident of your skills, and if you’re certain that what you’re doing is for the good of your patients,” he said, “it can be very difficult to know on your own when you’re veering into dangerous territory.”

The author of “On Being Certain” and the coming “A Skeptic’s Guide to the Mind,” Dr. Burton is a contributor to a scholarly yet surprisingly sprightly volume called “Pathological Altruism,” to be published this fall by Oxford University Press. And he says his colleague’s behavior is a good example of that catchily contradictory term, just beginning to make the rounds through the psychological sciences.

As the new book makes clear, pathological altruism is not limited to showcase acts of self-sacrifice, like donating a kidney or a part of one’s liver to a total stranger. The book is the first comprehensive treatment of the idea that when ostensibly generous “how can I help you?” behavior is taken to extremes, misapplied or stridently rhapsodized, it can become unhelpful, unproductive and even destructive.

Selflessness gone awry may play a role in a broad variety of disorders, including anorexia and animal hoarding, women who put up with abusive partners and men who abide alcoholic ones.

Because a certain degree of selfless behavior is essential to the smooth performance of any human group, selflessness run amok can crop up in political contexts. It fosters the exhilarating sensation of righteous indignation, the belief in the purity of your team and your cause and the perfidiousness of all competing teams and causes.

David Brin, a physicist and science fiction writer, argues in one chapter that sanctimony can be as physically addictive as any recreational drug, and as destabilizing. “A relentless addiction to indignation may be one of the chief drivers of obstinate dogmatism,” he writes. “It may be the ultimate propellant behind the current ‘culture war.’ ” Not to mention an epidemic of blogorrhea, newspaper-induced hypertension and the use of a hot, steeped beverage as one’s political mascot.

Barbara Oakley, an associate professor of engineering at Oakland University in Michigan and an editor of the new volume, said in an interview that when she first began talking about its theme at medical or social science conferences, “people looked at me as though I’d just grown goat horns. They said, ‘But altruism by definition can never be pathological.’ ”

To Dr. Oakley, the resistance was telling. “It epitomized the idea ‘I know how to do the right thing, and when I decide to do the right thing it can never be called pathological,’ ” she said.

Indeed, the study of altruism, generosity and other affiliative behaviors has lately been quite fashionable in academia, partly as a counterweight to the harsher, selfish-gene renderings of Darwinism, and partly on the financing bounty of organizations like the John Templeton Foundation. Many researchers point out that human beings are a spectacularly cooperative species, far surpassing other animals in the willingness to work closely and amicably with non-kin. Our altruistic impulse, they say, is no mere crown jewel of humanity; it is the bedrock on which we stand.

Yet given her professional background, Dr. Oakley couldn’t help doubting altruism’s exalted reputation. “I’m not looking at altruism as a sacred thing from on high,” she said. “I’m looking at it as an engineer.”

And by the first rule of engineering, she said, “there is no such thing as a free lunch; there are always trade-offs.” If you increase order in one place, you must decrease it somewhere else.

Moreover, the laws of thermodynamics dictate that the transfer of energy will itself exact a tax, which means that the overall disorder churned up by the transaction will be slightly greater than the new orderliness created. None of which is to argue against good deeds, Dr. Oakley said, but rather to adopt a bit of an engineer’s mind-set, and be prepared for energy losses and your own limitations.

Train nurses to be highly empathetic and, yes, their patients will love them. But studies show that empathetic nurses burn out and leave the profession more quickly than do their peers who remain aloof. Give generously to Child A, and Child B will immediately howl foul, while quiet Child C will grow up and write nasty novels about you. “Pathologies of altruism,” as Dr. Oakley put it, “are bound to arise.”

Rachel Bachner-Melman, a clinical psychologist at Hadassah University Medical Center in Jerusalem who specializes in eating disorders, has seen the impact of extreme selflessness on the anorexic young women who populate her ward.

“They are terribly sensitive to the needs of those around them,” she said in an interview. “They know who needs to be pushed in a wheelchair, who needs a word of encouragement, who needs to be fed.”

Yet the spectral empaths will express no desires of their own. “They try to hide their needs or deny their needs or pretend their needs don’t exist,” Dr. Bachner-Melman went on. “They barely feel they have the right to exist themselves.” They apologize for themselves, for the hated, hollow self, by giving, ceaselessly giving.

In therapy they are reminded that to give requires that first one must have. “It’s like in an airplane,” Dr. Bachner-Melman said. “The parents must put on the oxygen mask first, not because they’re more important, but if the parents can’t breathe, they can’t help the child.”

Denial and mental compartmentalization also characterize people who stay in abusive relationships, who persuade themselves that with enough self-sacrifice and fluttering indulgence their beloved batterer or drunken spouse will reform. Extreme sensory denial defines the practice of animal hoarding, in which people keep far more pets than they can care for — dozens, scores, hundreds of cats, rodents, ferrets, turtles.

The hoarders may otherwise be high-functioning individuals, says Dr. Gary J. Patronek, a clinical assistant professor at the veterinary school of Tufts University and founder of the Hoarding of Animals Research Consortium. “We’ve seen teachers, nurses, public officials, even veterinarians,” he said in an interview. “They live a double life.”

At work, they behave responsibly and know the importance of good hygiene. They go home and enter another world, one of squalor and chaos, of overwhelming stench and undernourished animals, of pets that have died for lack of care.

Yet the hoarders notice none of this. “You walk in, you can’t breathe, there are dead and dying animals present, but the person is unable to see it,” Dr. Patronek said. Cat carcasses may alternate with food in the refrigerator, “but in the person’s mind it’s happy and wonderful, it’s a peaceable kingdom.”

Hoarders may think of themselves as animal saviors, rescuing pets from the jaws of the pound; yet they are not remotely capable of caring for the animal throngs, and they soon give up trying. “It’s a very focal, delusional behavior,” Dr. Patronek said. And it can be all the more difficult to treat for wearing the trappings of selflessness and love.

(Taken from the Science section of The New York Times)

[Dutch Leonard]

David Brin, a physicist and science fiction writer, argues in one chapter that sanctimony can be as physically addictive as any recreational drug, and as destabilizing. “A relentless addiction to indignation may be one of the chief drivers of obstinate dogmatism,” he writes. “It may be the ultimate propellant behind the current ‘culture war.’ ” Not to mention an epidemic of blogorrhea, newspaper-induced hypertension and the use of a hot, steeped beverage as one’s political mascot.

This is a fascinating article and explains a lot about people whose lives have one main theme.

But if the "hot steeped beverage as a political mascot" is a veiled reference to the Tea Party, then I have to set everyone straight. They take their name from the Boston Tea Party, where tea was dumped in the harbor, which is a terrible waste of tea. I love tea. A lot. I will not stand for it to be wasted or disrespected. The Tea Partiers should be referred to as Tea Baggers, which refers to a preposterous and juvenile act that involves placing one person's testicles on another person's face or head, or a type of oral sex where the testicles are taken into the mouth.

And I totally know what to do with the limited life boats. I wouldn't let the Tea Baggers on them.

But I guess that makes me a lot less like an altruist and a little more like a mass murderer and therefore vastly unqualified to comment on this topic, but most of mass murderers tend to be sanctimonious and probably started out altruistic.

[EnderD_503]

Originally Posted by ElijahRene

[FONT="Trebuchet MS"]I know this isn't going to be an easy subject, but I found this fascinating.

I once posed a hypothetical question to a friend about a discussion we were having along the same vein...I asked if you were on a ship with 2,000 people on board but only had enough life rafts to hold 1,000, would you save the 1,000 or would you attempt to overload the life rafts and in the end, no one survives?

She was immediately emotional and no longer wanted to finish the discussion.

I think this is how we, as a society, have come to operate...we want X, but have no logical way to make X happen. And no one wants to make the hard decisions, so we just ignore realities and think about kittens.

So there it is...My take on things, for whatever it's worth.

I am interested in how others feel about this? (Please read the article below before responding)

I'm not sure what else to contribute other than I agree with much of what the article had to say. On the one hand, I'm tempted to say that those with what seems to be a pathological need to be altruistic are a product of a time when a great deal of the Western world is middle class and lives in relative comfort. Helping those they perceive as disadvantaged or in need to help, in that case, might arguably come from their own feelings of worthlessness. Giving as a kind of "feel good" that is simultaneously selfless and selfish.

On the other hand, I think that kind of pathological altruism may also be a symptom of any person in any era and of any class, with a lower sense of self worth for whatever reason, and compensates through helping other excessively instead of addressing their own misfortune. Or perhaps someone who, for whatever reason, has difficulties with dealing with what's on their own plate, so instead opt to help others. I suppose it's always easier to try to help others than deal with things happening in your own life that you don't want to face. Except for eventually you have to deal with your problems, instead of burying yourself in other peoples' misfortunes.

It's kind of a tough call though, I'd imagine. On the one hand you can just say some people are more sensitive to the needs of others. On the other hand, I think too much of anything can be a sign of serious problems or (mental) health issues.

As far as you question over the life raft...so basically you're asking us, if we were on the Titanic, what would we do? Hehe, honestly, though, I think it's a tough call if you haven't been in the situation. Kind of like those questions that ask you: "Could you ever kill another human being"? The only way you can know is when you're faced with that immediate situation. That said, if I could take a guess at my own reactions without having been there, I'd say I agree with the analogy made in the article about the parents putting on oxygen masks before helping their child/not trying to "help" to the point of doing more harm than good. If you can save 1000 people, it's "better" than your misguided "help" causing the deaths of 2000...especially if you know there's no way to make 2000 people fit onto a certain number of rafts.

Then again, I guess in those situations people will always ask themselves what more they could have done to help when tragedy strikes. I don't think that's an odd reaction. But there's a difference between that and what the article described, imo. *shrug*

[tapu]

Originally Posted by ElijahRene

I think this is how we, as a society, have come to operate...we want X, but have no logical way to make X happen. And no one wants to make the hard decisions, so we just ignore realities and think about kittens.

Your remark above and the anecdote in the article regarding medical care capture where we are with medicine today. And with who pays for medicine today, which of course leads into the thorny matters regarding medical insurance and coverage for all.

Basically, people want 21st century medicine at 1960s prices. But really there is just no way to pull the stops out for everyone's treatment. Talk about hard decisions. I think those decisions will be forced, and soon. But how will we decide who gets advanced treatment? And if medically you don't qualify for it, will we let you buy it?

As for the lifeboat thing, I'd stick to the 1000. Unless I was number 1001.

Good topic, ElijahRenee. Thank you. --the tapu

[Slater]

I think it is an interesting proposition, but the article, and possibly the book it is named after, badly misuses the word altruism. Few of the examples cited come anywhere near actual altruism. I think the article would be better called "Unhelpful Helping" or something like that. For instance, the anecdote with the oncologist looks a lot more like hubris than altruism. Basically that example amounts to a doctor who was so arrogant that he ignored his patients, their families, his colleagues and medical science in favor of his own inflated notions of his abilities. There is not a sniff of altruism in there.

Based on the article I'm not persuaded that pathological altruism is actually much of a phenomenon at all. Unhelpful helping, or whatever? Definitely. And also I think ElijahRene's initial point about people being unwilling to make hard decisions, unwilling often to even acknowledge that hard decisions need to be made, is a valid one and I think it would be interesting to try to unpack that and see where it comes from. I just don't think the article sheds any light on it.

Some of this stems from the relatively smooth lives of (especially) the middle class and above portions of our society. We expect things to work because they usually do. We expect to be protected because we usually are. Most of us don't face life-or-death choices all that often so we may be slow to really recognize or accept when we are facing one.

I also think part of it is that we have become a culture that expects miracles. I think odds-defying occurances are over-emphasized and perhaps spun by the media to make them seem even more miraculous than they are.

So the person who tries to cram 2000 people into lifeboats for 1000 may believe it will be okay because manufacturers often put artifically low limits on their products to guard against liability. Or they think they heard of this time when a rubber raft was way over capacity but it made it from Cuba to Florida, or whatever.

It think it is a different phenomenon than the unhelpful helping, though at times they may cross paths.

[AtLast]

Originally Posted by tapu

Your remark above and the anecdote in the article regarding medical care capture where we are with medicine today. And with who pays for medicine today, which of course leads into the thorny matters regarding medical insurance and coverage for all.

Basically, people want 21st century medicine at 1960s prices. But really there is just no way to pull the stops out for everyone's treatment. Talk about hard decisions. I think those decisions will be forced, and soon. But how will we decide who gets advanced treatment? And if medically you don't qualify for it, will we let you buy it?

As for the lifeboat thing, I'd stick to the 1000. Unless I was number 1001.

Good topic, ElijahRenee. Thank you. --the tapu

I agree with most of what you are saying. And yes, we need to understand just how expensive medical care is. However, so much is inflated by public entity health care provider corporations that not only want to gain a profit on the services, but also for their stockholders. This is over and above what the actual costs are. Yes, a corporation has to cover all od its costs including wages and benefits for its employees, but CEO's of some of our healthcare providers in the US take home 5-7 million in salary plus bonuses of a couple of million. Above that, millions go into dividends to stockholders.

One very good reason to get heathcare under a single-payer, public structure. And the very core of why these corporations have many lobbyists working for them in Washington DC.

The other side to this has to do with technological advances that are really quite phenomenal. But, also are costly from the the idea of a bright scientist through clinical trials, actually building the machines (ie., scanners), training those who can run them up to clinics and hospitals being able to afford them.

[SoNotHer]

I once posed a hypothetical question to a friend about a discussion we were having along the same vein...I asked if you were on a ship with 2,000 people on board but only had enough life rafts to hold 1,000, would you save the 1,000 or would you attempt to overload the life rafts and in the end, no one survives?

It's a Hobson's Choice that speaks more to rational vs. emotion-based thought processes. Altruism could in fact inform either of these, leading one person to let drown 2K in overloaded life boats or destroy a thousand to save a thousand. The impetus for both actions, however, can be altruistic.

I think this is how we, as a society, have come to operate...we want X, but have no logical way to make X happen.

The desire exists before the means. It always has. Visionaries and artists have long understood this. The architect imagines, draws and then orchestrates the three dimensional realization.

And no one wants to make the hard decisions, so we just ignore realities and think about kittens.

I don't know about "no one," but lets agree upon not enough. I don't disagree that we are overwhelmingly more attracted to images and discussions of celebrity makeovers and "baby bumps," for example, than images and discussions of ocean acidification and the loss of coral reef systems, but perhaps those "hard decisions" need to begin on a personal level. As someone once told me, you can control what you can control, and you have to let the rest go. The personal level seems like the most accessible place to begin the shift I sense you are suggesting from thought to action.

What connection did you see to this line of thinking and the article's discussion of the new trajectory in academia to study "altruism" and its manifestations in human behavior and the laws of thermodynamics and cause/effect?

[Dutch Leonard]

Originally Posted by SoNotHer

What connection did you see to this line of thinking and the article's discussion of the new trajectory in academia to study "altruism" and its manifestations in human behavior and the laws of thermodynamics and cause/effect?

Think of thermodynamics in these terms:

You can't win.

You can't break even.

You can't get out of the game.

Someone who wants to save everyone and everything ultimately destroys what they wanted to save in the first place. Same for the crazy cat lady and the spinal tap ordering doctor.

[Amber2010]

As far as you question over the life raft...so basically you're asking us, if we were on the Titanic, what would we do? Hehe, honestly, though, I think it's a tough call if you haven't been in the situation. Kind of like those questions that ask you: "

I will have to agree I think you have to be in the situation to really know what you are going to do. I know I have never done that but feel that in the heat of the moment I would probably just start piling the "first come" ones in and get the boats down as soon as possible and pray for help from the calls that went out for the rest. I think I am somone who just keeps moving and takes the conseqences when they come. Kind of like a burning building and you can't save all the poeple but you save the ones that you can get to and pray you are doing the right thing but keep moving because if you stop to think about it half will be dead.

[SoNotHer]

Originally Posted by Dutch Leonard

Think of thermodynamics in these terms: You can't win. You can't break even. You can't get out of the game.

Someone who wants to save everyone and everything ultimately destroys what they wanted to save in the first place. Same for the crazy cat lady and the spinal tap ordering doctor.

I am familiar with the laws of thermodynamics and the concept of entropy. I am trying to understand the specific connection being made and conclusions being drawn here between altruism, thermodynamics and the lifeboat question.

[tapu]

Originally Posted by SoNotHer

I am familiar with the laws of thermodynamics and the concept of entropy. I am trying to understand the specific connection being made and conclusions being drawn here between altruism, thermodynamics and the lifeboat question.

Let me try: You can't win for losin'. The good you may do is always canceled out by the bad that is collateral.

I'm working with the terms as defined in the article; point of fact, I agree with you that altruism is used as jargon here, apparently, and not in its customary sense.

[SoNotHer]

[QUOTE=tapu;433197]Let me try: You can't win for losin'. The good you may do is always canceled out by the bad that is collateral."

Quite a leap it makes then. I saw a more gently and beautifully laid (yes, please do 'leap" on that entendre) argument in Tom Stoppard's play, Arcadia. Highly recommended.

And yes, I think jargon is a poor substitute for "The Real Thing," to play off of another Stoppard title.

[tapu]

[quote=SoNotHer;433206]

Originally Posted by tapu

Let me try: You can't win for losin'. The good you may do is always canceled out by the bad that is collateral."

Quite a leap it makes then. I saw a more gently and beautifully laid (yes, please do 'leap" on that entendre) argument in Tom Stoppard's play, Arcadia. Highly recommended.

And yes, I think jargon is a poor substitute for "The Real Thing," to play off of another Stoppard title.

Did she just come on to me...?

[SoNotHer]

[quote=tapu;433214]

Originally Posted by SoNotHer

Did she just come on to me...?

No. But I did inject humor and word play into the discussion.

[tapu]

[quote=SoNotHer;433217]

Originally Posted by tapu

No. But I did inject humor and word play into the discussion.

Got it.

Joking aside:

Can you explain how it is "quite a leap" to say that altruism (here = its products, i'm thinking) can lead (inadvertently, of course) to bad that cancels out that good?


Sorry, I know Stoppard only by name so that may be the source of misunderstanding that leads to my question above.

[SoNotHer]

[quote=tapu;433219]

Originally Posted by SoNotHer

Got it. Joking aside:

Can you explain how it "quite a leap" saying that altruism (assigned a value of good) can lead (inadvertently, which I think is the claim) to bad that cancels out that good?

Since I need to leave for work, I'll pass the onus to you to explain how the triangulation or yoking together of these three things is a natural and inevitable conclusion and not a leap.

[tapu]

Got it.
.
.
.

[Dutch Leonard]

http://mic.sgmjournals.org/content/150/8/2751.abstract

[dreadgeek]

Originally Posted by SoNotHer

[I]

What connection did you see to this line of thinking and the article's discussion of the new trajectory in academia to study "altruism" and its manifestations in human behavior and the laws of thermodynamics and cause/effect?

Please forgive the large snip of some really good stuff. I wanted to address this question specifically, though, because it is one of my little intellectual obsessions. Selfishness is easy to explain. Darwinian theory would predict that each organism is going full-out to look after its own interests. Altruism is an interesting puzzle and interesting puzzles are where science becomes something of an adventure. Why would altruism evolve?

Altruism evolved because while genes may be pseudo-selfish the world that the bodies these genes make is so complex that it actually pays to cooperate. Despite what we might expect from a very straight-forward reading of Darwinian theory, Nature continues to prove she is more clever than we are. How this gets booted up is through the fact of parents and offspring. Offspring have a cost but they also are an investment in the future. When a female is pregnant the nutrients that go into her offspring are not available for *her*. However, the payoff for her genes is that she passes them on into the future. Thus is altruism booted up. If parents *consistently* did what was solely in their own direct interest then their offspring would die off and the planet would be sterile. If, on the other hand, parents *never* pursued their own self-interest then they could be exploited not only by their own offspring but by their neighbors. Nature has to find an equilibrium between these two extremes and has to do it in a completely blind and haphazard fashion. This is why altruism is interesting.

The relationship between thermodynamics is that despite what we might wish about the world, there are always costs. Always. This means that when we look at the world and either try to explain why it works the way it does or try to envision how it might be improved upon, we must always ask ourselves the cost of things. Costs here do not mean money. Costs here is a synonym for consequences. The other day, my wife was talking about a situation when she was a child that is a perfect illustration. When she was a girl, she had an opportunity to skip two whole grades. This would have put her in the same grade as her elder brother. Her mother did not want to make her brother feel bad so she did not let her skip the grades. Either choice had potentially negative consequences; in one, her brother is, perhaps, humiliated by his little sister proving to be smarter than him. The other is her being held back. Her mother would've preferred solution where she got to skip two grades where both children got what they needed but that was not the situation she was presented with.

This is not about the wrongness of her decision in not letting her daughter jump two grades. Rather, it is to illustrate that there were no *possible* worlds, given the initial conditions, where her mother could have made a decision where there was not even the risk of cost. (In other words, it may have turned out to be the case that her brother might have been fine with his little sister skipping grades and this would actually provide the best possible outcome but the calculations her mother made was not knowing *how* things would work out so she was dealing with the potential cost-benefit.) Too often we ignore these types of considerations or try to dismiss them with hand-waving. But this is, in fact, where the nitty gritty work gets done *and* it is humbling because in trying to solve these kinds of problems one brushes right up against the limits of one's own abilities to grasp things.

I do not think we should look to the natural world for our morality, necessarily. Nature is horribly cruel and wasteful and has tortures that are the stuff of horror movies that various organisms use as a way of feeding themselves or propagating. But I think we *can* and *should* look to Nature for an understanding of ourselves and of the world we inhabit. Not so that we can learn what we should do, but so we can have some kind of ideas about what we can do. I would love for every adult in America to have a grounding in the kinds of trade-offs nature makes because all of the living things we see around us and we ourselves are the results of those trade-offs. That means I would love for every American adult to understand Darwinian theory because it gives people the tools to really start to be amazed at how Nature does things and why our world is so wonderful while, at the same time, training the mind to begin asking cost-questions. I would also love every American adult to understand the second law of thermodynamics because, again, it trains the mind to seek out and understand costs.

Cheers
Aj

[tapu]

Nice, AJ.


Hey, I read a book called Why Things Bite Back: The Science of Unintended Consequences. Informative and entertaining. A bit outdated by copyright but still generally applicable and extendable to current issues.