In the year 1965, at an undisclosed location in the United States, a little girl was born with an extraordinarily rare genetic disorder called Urbach-Wiethe disease.

Unbeknownst to anyone, by around her fourth birthday, the disease had completely destroyed her amygdala, that pair of almond-shaped brain regions well known for its role in rapid threat detection and response.

An MRI of her brain shows only black emptiness where the amygdala should be.

She has lived completely without fear ever since.

That little girl, now nearly sixty, is known only as Patient SM, and she is to neuroscience as identical twins separated at birth are to genetics research.

Patient SM is a unicorn.

Learning from Unicorns

The amygdala is rightly associated with our most primitive fight or flight reactions, but its role is actually much broader. The amygdala is central to memory formation, decision-making, and emotional response, and Patient SM doesn’t have one.

A near-perfect natural experiment, SM’s disease completely destroyed both of her amygdalae, yet spared the rest of her brain. 

SM has a normal IQ, and is described as outgoing and friendly. She experiences, recognizes, and expresses other emotions normally, but fear is almost entirely absent.

SM does not startle at horror movies or haunted houses. Instead, she responds with curiosity and excitement. She picks up snakes and spiders without hesitation, despite claiming to not like them.

In her thirties, she was attacked by a man with a knife late at night who threatened to kill her. Taken aback by her fearlessness, he let her go.

SM did not run. She walked away, and returned to the same park the next day, unafraid.

Literally Fearless

What must it be like to live completely free of fear? 

Remember, we’re not just talking about primal fears like spiders and snakes and men with knives.

We’re talking about fear of failure, fear of rejection, fear of interpersonal conflict, and fear of shame and humiliation, the pervasive fears that elevate our cortisol levels and cause us to suffer chronically at home and at work.

All of them, gone. Forever.

So, if I offered you a red pill that would magically neutralize all fear like Urbach-Wiethe disease did for SM, would you take it? And what would happen if you did?

Would it be a fear-free nirvana?

If It Sounds Too Good to Be True…

There must be a catch, you might be thinking, and you’d be right. Patient SM’s life has not been easy.

Her lack of fear makes her uniquely vulnerable to danger, and in one of nature’s coldly dispassionate ironies, the woman who feels no fear lives in precisely the environment where an intact sense of fear is needed most.

SM has lived in neighborhoods with high rates of drug use, crime, and violence. She has been exploited and victimized on many occasions.

Yet, even had she been born into affluence and safety, SM’s inability to experience fear is an enormous liability. It is not only her physical safety that is jeopardized. Her social interactions and decision-making are greatly impaired.

It is this observation that leads us to insights that are generalizable to “normal” people.

Beyond Unicorns

Isolated as she is on the long tail of human variation, SM stands apart from the endless confounders present in “normal” people.

To the benefit of us all, SM is a generous spirit, and has patiently participated in studies with the world’s preeminent neuroscientists for decades.

A case like SM’s helps us answer questions that would otherwise be unanswerable.

For example, what happens when we remove a basic emotional capacity like fear?

The answer is certainly not nirvana.

Rather, it results in significant impairment, not only when there is threat to life and limb, but in our basic, everyday ability to function.

Consider the following:

• SM cannot accurately gauge risk, whether it be entering a bad neighborhood or a bad contract, because she doesn't feel the anticipatory fear of bad consequences.
• Because she lacks fear, she is bold and uninhibited, yet she cannot recognize negative social cues and thus struggles to form relationships or keep jobs.
• Oddly, she is a “close talker,” for those of you who get the Seinfeld reference. Apparently fear has something to do with gauging personal space. The brain is weird.
• She cannot process the emotional content of music, especially music that is sad or scary.
• She does not learn from past experiences that were dangerous, either physically or emotionally.

What this shows us is that, without fear, SM’s understanding of the world is incomplete at a very fundamental level.

An Essential Ingredient

Fear informs a thousand subtle choices per day, as do all the other basic emotions.

All of us, whether at home or at work, want the ability to make good decisions, communicate effectively, have healthy relationships, collaborate with others, and engage in positive social interactions.

It is hopefully obvious to you that all of those capabilities originate in your brain, and therefore understanding how it works, including all its complex capacities, quirks, and biases, is pretty important.

(That’s why I keep writing about all this brain and emotion stuff! Plus, I think it’s cool.)

Unicorns like SM help us see that sensory perception, thoughts, emotions, and actions do not exist in isolation.

They are all woven together in an amazing, complex, cohesive fabric. Any one element cannot be understood in isolation from the whole, and vice versa.

(Have I mentioned that “Retexo” is a weaving metaphor?)

SM shows us that the ability to experience, understand, and regulate emotions is a prerequisite for the most basic human functioning, and that eliminating even the most unpleasant emotions, the ones we’d rather not feel, would leave us greatly diminished.

Thank You, Patient SM, Whoever You Are

Edge cases like Patient SM provide unique insight into that strange gray organ on which our entire life experience, including our business success, depends.

This week we explored how SM’s inability to recognize fear in herself affects her ability to make sense of the world.

Next week, we will explore the strange and fascinating finding that SM cannot recognize fear in others, either. And we will answer a question with pretty incredible implications: why?

In the meantime, if you’d like to learn more about how understanding and regulating emotion is essential to sound decision-making, check out our online Emotional Intelligence Essentials course.

Until next time,
Greg