
A woman who can't feel fear - tacon
http://www.washingtonpost.com/news/speaking-of-science/wp/2015/01/20/meet-the-woman-who-cant-feel-fear/
======
gwern
This reminds me of discussions of pain asymbolia or not being able to feel
pain (diabetes, leprosy): it's a crippling and dangerous problem.

Fear, pain, guilty - the gifts no one appreciates.

~~~
SafariDevelop
By lumping them all together, you are implying that fear is a gift. The NPR
podcast on the other hand suggests otherwise. SM describes herself to be happy
9 out of 10 times, and she has no past trauma. Sounds like being fearless is
in fact the under-appreciated gift.

~~~
vidarh
I think you miss the point. She describes herself to be happy 9 out of 10
times because she is also unable to notice the real dangers that fear is there
to help us handle. While it may be great to not feel afraid, as the article
points out it also leads her to risky behaviour that most healthy persons
would avoid.

~~~
jdimov
That's because most healthy people are wrong. There are no risks or dangers
worth fearing.

~~~
vidarh
If you want to stay alive that is blatantly false.

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dewarrn1
I've had the privilege of working with the patient described in the podcast.
She's unique in any sense of the word.

~~~
SafariDevelop
Excellent! Could you say something about her emotional life? In the podcast,
she described herself to be happy 9 out of 10 times. I wonder if she
experiences love. And if she does, does she also experience grief? What about
fear-based emotions (such as separation anxiety)?

~~~
dewarrn1
First, I should point out the original work of Ralph Adolphs, the Damasios,
and Dan Tranel on this case [0]. It's a short, important paper that started
this whole line of investigation based on the single extraordinary case of SM.

In my interactions with her, SM was uniformly happy, and it's my impression
that she's like that in everyday life as well. A former labmate, Justin
Feinstein, wrote an interesting paper based in part on observing her in real-
world settings [1]. He didn't observe fear in any of a variety of potentially
frightening contexts — she generally confronts such contexts with laughter or
wonder.

Regarding love, she's deeply attached to her family. I distinctly remember
stopping when we walked past the hospital chapel so that she could pray for
members of her family. I can't say as much about grief, but she never seemed
anxious in any of the time that we spent together, and she certainly never got
angry or even upset.

[0][http://www.ncbi.nlm.nih.gov/pubmed/7990957](http://www.ncbi.nlm.nih.gov/pubmed/7990957)

[1][http://www.ncbi.nlm.nih.gov/pubmed/21167712](http://www.ncbi.nlm.nih.gov/pubmed/21167712)

~~~
SafariDevelop
Thank you. I find it interesting that you describe her to be "uniformly happy"
yet your former lab mate, Justin Feinstein (along with Adolphs, Damasio,
Tranel), uses "adverse consequences of living life without the amygdala" to
describe her.

And when he (they) concluded the paper by writing "[SM's] behavior, time and
time again, leads her back to the very situations she should be avoiding,
highlighting the indispensable role that the amygdala plays in promoting
survival by compelling the organism away from danger." were they thinking of
the experimental situations (snakes, haunt houses) in mind or real world
situations? I ask because for someone living in a "poverty-stricken area
replete with crime, drugs, and danger" at the age of 44 being held at
knifepoint/ gunpoint 4 times seems par for the course.

Even so, what evidence is there that SM went back to the very situations she
should be avoiding in _real life_ (i.e., not experimental situations of poking
snakes and monsters). For example, did she go back to the situation that put
herself at knifepoint (the incident which she handled fearlessly by saying "go
ahead and cut me")?

I can't help but think that the authors are bringing their own bias (that
fear-response is essential in modern times) when concluding as that. I'm not a
neuroscientist, but I'm very interested in the topic of fear.

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robotresearcher
Seems like after every popular science radio show / podcast, a raft of
'articles' appear that are just cribbed summaries of the show.

Either there's just not enough material out there, or writers are very lazy,
or these are essentially promos for the original show. In any case, if you
consume science journalism with any appetite, this is pretty frustrating.

How about writing a new story, people?!

------
ggambetta
I wonder whether she has done truly awesome things with her life. One of these
pieces of advice you hear often regarding your true vocation goes something
like _what would you do if you had no fear?_.

Well, she literally hasn't. So is she an Olympic champion who fights crime
during the night and writes amazing novels during the day and commutes to work
swimming together with a school of piranhas, or has she led a relatively
normal life? She can follow her passion with no fear of failure or success or
whatever!

I'm genuinely curious to find scientific evidence about whether fear is the
only thing holding us back or there are other factors.

~~~
egeozcan
I think what they really mean by fear, in those advice, is actually "learned
helplessness". You refrain from applying that great position you've always
dreamed of, because you "fear" that being rejected would crush your dreams.
This is a complex thought. What this woman lacks, as I understand, is
something more elementary.

~~~
SafariDevelop
Isn't the "complex thought" of "learned helplessness" actually based on the
elementary "fear" instinct? That is: no fear, no learned helplessness (only
intelligent appraisal).

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simula67
What would stop a person like this from killing herself if she is truly
depressed ?

What stops her from killing herself out of curiosity ?

Would she make a better or worse soldier ?

I wish this woman did an AMA.

~~~
berberous
I wonder if you can be truly depressed if you don't fear anything? Or does her
lack of fear not encompass anxiety?

~~~
Coding_Cat
>I wonder if you can be truly depressed if you don't fear anything?

I would say yes, often times depression manifests itself not as a feeling of
fear or dread but as apathy. See for example Hugh Laurie's personal life [1,2]
or Nine Inch Nails' Everyday is Exactly the Same[3] which captures that exact
feeling. Or of course the wonderful Hyperbole and a Half's account of
depression[4], especially the second part makes the point that depression at
its worst is a void. No positive feelings, but also no negative ones.

Now I made myself sad^H^H^H apathetic going through those sources. Why does
Trent Reznor have to be so good at projecting?

As for the anxiety bit (anxiety and depression are to completely different
things), the article mentions her response to having her blood-co2 levels
elevated, which seems to me to be a standard anxiety response. A feeling of
restlessness and dread.

[1]
[http://en.wikipedia.org/wiki/Hugh_Laurie#Personal_Life](http://en.wikipedia.org/wiki/Hugh_Laurie#Personal_Life)
[2]
[http://www.dailymail.co.uk/tvshowbiz/article-2316880/Playing...](http://www.dailymail.co.uk/tvshowbiz/article-2316880/Playing-
House-nightmare-says-Hugh-Laurie-250-000-episode.html) (I know, I know, Daily
mail but the quotes are worth it)
[3][https://www.youtube.com/watch?v=-Aj9_8t1eQc](https://www.youtube.com/watch?v=-Aj9_8t1eQc)
[4] [http://hyperboleandahalf.blogspot.nl/2011/10/adventures-
in-d...](http://hyperboleandahalf.blogspot.nl/2011/10/adventures-in-
depression.html)

------
cheshire137
This didn't feel like much of an article. I'm super interested in hearing her
responses to the interview questions, but the article just kind of stops!

------
Davesjoshin
Reminds me of this podcast from earlier this week..
[http://www.npr.org/programs/invisibilia/](http://www.npr.org/programs/invisibilia/)

~~~
jonathanwallace
That's exactly what they reference in the first couple of paragraphs.

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golemotron
This sounds a lot like sociopathy. I've read that sociopaths are not scared
like normal people are in frightening situations. Maybe dysfunction of the
amygdala is part of that too.

~~~
blisterpeanuts
I've read that sociopathy may be related to a dysfunction of the brain's
ability to sympathize with others. Perhaps it's a combination of the two.

Who knows, it might have conferred a survival advantage in our distant past--
bands of nomadic hominids might have had to kill and even eat each other at
times.

~~~
tjradcliffe
Sociopathy is more likely related to mate competition than cannibalism, which
is almost never practised for food, but rather for its ritual significance.
Cannibalism was fairly widely and routinely practised in pre-political states
--to the extent that in Polynesia there is a prion disease that appears to
have evolved with cannibalism as a vector--but even amongst peoples where it
was practised, in times of starvation people would mostly starve rather than
eat each other.

A number of early European explorers (including Champlain, if memory serves)
describe ritual cannibalism--generally the consumption of prisoners, who were
first tortured to death in that holistic and natural way First Peoples had--
but also describe people starving to death in times of want without resorting
to it.

In the case of this woman, her amygdalae have been damaged by Urbach-Wieth
disease, which according to the article is extremely rare.

That said, it is likely that there is a wide distribution of various types of
emotional response in the populace due to variations in neurological
capability.

~~~
cbd1984
> pre-political states

How is this not a contradiction in terms? Non-political humans seem
impossible.

