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Journal of Child & Adolescent Mental

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Zero degrees of empathy: A new

theory of human cruelty
a b
Lynda Albertyn
a
Child, Adolescent and Family Unit , Charlotte Maxeke
Johannesburg Academic Hospital
b
Division of Psychiatry, Medical School , The University of
Witwatersrand , South Africa
Published online: 26 Oct 2012.

To cite this article: Lynda Albertyn (2012) Zero degrees of empathy: A new theory
of human cruelty, Journal of Child & Adolescent Mental Health, 24:2, 173-175, DOI:
10.2989/17280583.2012.735509

To link to this article: http://dx.doi.org/10.2989/17280583.2012.735509

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 Journal of Child & Adolescent Mental Health 2012, 24(2): 173–175 Copyright © NISC Pty Ltd
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MENTAL HEALTH
ISSN 1728-0583 EISSN 1728-0591
http://dx.doi.org/10.2989/17280583.2012.735509

Book Review

Zero degrees of empathy: A new theory of human cruelty

Simon Baron-Cohen

2011, Allen Lane, Penguin Books

190 pages
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Hardcover, ISBN 978-0-713-99791-0

This very readable book by Professor Baron-Cohen is aimed at a lay audience and is an attempt
to explain why certain people seem to lack empathy and can therefore engage in cruel and
horrible actions. He defines “evil” as a lack of empathy and attempts to uncover the roots of
empathy development and explain where the development of empathy goes wrong.
It is a valuable book for child and adolescent psychiatrists as his theory is embedded in attach-
ment theory and makes valuable links between attachment difficulty and disorders with later
psychopathy. It also raises ethical questions about behaving in humane, empathic ways all the
time.
The central question tackled by the book is a cry echoed by humanists globally: “how can
humans treat other people as objects?” How can the Nazis have done what they did, how can
people blow themselves up along with hundreds of other innocent bystanders’, how can adoles-
cent school children shoot their fellow pupils? This book goes some way in explaining these
phenomena in a rational and logical way. However, I am not sure if it answers every question
about evil acts and evil doers.
Baron-Cohen describes an “empathy bell curve” in normal populations, with people at the high
end having extreme amounts of empathy (one of whom he describes is our own Desmond Tutu)
and those at the bottom end, those with zero degrees of empathy being the kinds of villains who
murder, torture and rape. This bell curve was the outcome of their studies using their Empathy
Quotient administered to thousands of people. He argues that the deficiency of using a self-report
questionnaire, especially in people who lack self-insight, is negated by the scale of numbers
being interviewed.
He defines lack of empathy as a form of extreme selfishness with only the self in mind. Having
empathy involves a duality of mind, in which the “other” is also held in the mind alongside the self.
Two stages of empathy have been defined: the first is of recognition of the other and the other’s
thoughts and feelings, and the second stage is a response that is appropriate to the situation.
All of us have temporary losses of empathy e.g. if over-tired, preoccupied or overly stressed,
which may result in unempathic actions. We may fail to notice the distress in others and so fail
to respond. This is more of a trait. Baron-Cohen is interested in failure of empathy as a fixed,
permanent state.
The book has an excellent chapter which summarises most of the neurologic and imaging work
that has examined various areas of the brain in people who lack empathy. The author concludes
that 10 areas of the brain make up the “empathy circuit”. Damage or disruption to any area may
affect the ability to feel empathy. Each area encompasses a different aspect of empathy. There
is the area of self-awareness and emotional valence in the medial prefrontal cortex; the area of
social judgement in the orbitofrontal cortex; the language areas for intentions and goals in the

Journal of Child & Adolescent Mental Health is co-published by NISC (Pty) Ltd and Routledge, Taylor & Francis Group
 174 Albertyn

frontal operculum; the emotional recognition area of the inferior frontal gyrus; the pain area for
recognising one’s own and others’ pain in the caudate anterior cingulate cortex, bodily awareness
in the anterior insula; judgement of intentions and beliefs in the right temperoparietal junction;
observation of biological motion in the posterior superior temporal sulcus; touch and identifica-
tion of other’s distress in the somatosensory cortex; mirror neurons in the inferior parietal lobule;
and finally, the most important area of all, the amygdala where emotional learning and regulation
takes place.
Three personality types make up the people with zero empathy: extreme narcissists, extreme
borderline personality disorders and the psychopaths among the antisocial personality disorders.
Each type has a case study or two describing the sort of interactions and background of each
case. All of them have childhoods characterised by neglect, coldness, lack of nurture and often
abuse. Baron-Cohen argues that there is fairly robust physical evidence showing abnormalities
in various areas of the empathy circuit in people with these disorders. Smaller amygdalae have
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been found in abused children.

The important factors in childhood that lead to lack of empathy are neglect, abuse, parental
rejection (which in turn leads to child rage) and attachment difficulties. There is an excellent
summing up of Bowlby’s theories. Baron-Cohen calls secure attachment the “internal pot of
gold” that parents give to their children, which enables resilience to develop and ensures that
their children grow up with the ability to empathise with others. He also looks at animal experi-
ments like Harlow’s monkeys raised without maternal affection or care which led to an aggressive
interpretation of threat of neutral stimuli and becoming a harsh, abusive parent later.
The issue of certain sadists enjoying the pain of others is examined. One hypothesis is that
there is some evidence to suggest that there is hypersensitivity of the reward circuits in psycho-
paths so that they obtain pleasure when others are hurt. Other studies have shown decreased
amygdala activity.
One of the more fascinating areas, that is evidently under-researched, is that of narcissists who
become serial killers. The book hypothesises that their childhoods are often characterised by
early emotional abuse, but also excessive admiration, praise and overindulgence with unrealistic
feedback being given.
Baron-Cohen describes those on the autistic spectrum as having positive zero empathy, while
the psychopathic group have negative zero empathy. This is a useful distinction to make in that
people on the autistic spectrum are often blunt to the point of rudeness, cannot read others’
intentions and struggle to make sense that others have separate minds, yet do not have the
maliciousness and intent to hurt that psychopaths have. People on the autistic spectrum also
have better systematising ability, occasionally to a high order in the case of savants. This often
leads to the rigidity seen in autistic people, who live their lives with strict, unchangeable rules,
resulting in very “black and white” ideas about morality. Both groups lack the affective element
of empathy, but only those on the autistic spectrum lack the cognitive “recognition” aspect of
empathy.
The chapter on the genetics of zero empathy is interesting. Parent behaviour is not the
complete picture and sufficient evidence exists from twin, adoptive and genetic studies to
support the idea that genes influence behaviour. However, the author feels that this is more of
an epigenetic phenomenon than entirely genetic (i.e. the effect of the environment on vulner-
able individuals) one. Several genes have been implicated ranging from those responsible for the
production of serotonin and oxytocin to those producing the sex hormones. Work has been done
on the sex hormones because of the significant difference in empathy levels between males and
females, with females always scoring higher than males on the Empathy Quotient scale.
The end of the book is not as strong as the beginning and is especially weak on treatment
of those with zero empathy. The suggestion that empathy disorders become a separate DSM
diagnosis opens up the possibility that most dangerous criminals would fall under the category
of being mentally ill. He also fails to explain why we get more empathic as we get older.
Baron-Cohen also tends to be an optimist in his belief that empathy can be earned in later life,
given the right conditions.
 Journal of Child & Adolescent Mental Health 2012, 24(2): 173–175 175

Apart from the book being an enjoyable and entertaining read, there are also useful self-report
questionnaires in the index measuring empathy quotients in adults and children. The reference
section is also useful for professionals.

Lynda Albertyn
Head, Child, Adolescent and Family Unit, Charlotte Maxeke Johannesburg Academic Hospital,
Principal Specialist Psychiatrist, Division of Psychiatry, Medical School, The University of
Witwatersrand, South Africa
email: [email protected]
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