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Original Articles

Altered experience of emotion following bilateral amygdala damage

Pages 219-232 | Published online: 15 Jan 2007
 

Abstract

It has been well established that the amygdala is critical for processing various aspects of emotion, and in particular, for the perception of negative emotions such as fear. Perhaps the strongest evidence for this conclusion in humans comes from an extensive series of investigations in patient SM, an extremely rare neurological patient who has complete, focal bilateral amygdala damage. One question that has remained unanswered, however, is whether SM has a normal phenomenological experience of emotion, especially negative emotion. To explore this issue, we designed a study in which two experienced clinical psychologists conducted “blind” interviews of SM (the psychologists were not provided any background information regarding SM), with a special emphasis regarding the nature of her emotional experience. Both of them reached the conclusion that SM expressed a normal range of affect and emotion, and neither felt that SM warranted a DSM‐IV diagnosis. However, they both noted that SM was remarkably dispassionate when relating highly emotional and traumatic life experiences, and they noted that she did not seem to have a normal sense of distrust and “danger”. To the psychologists, SM came across as a “survivor”, as being “resilient” and even “heroic” in the way that she had dealt with adversity in her life. In the full light of SM's neurological and neuropsychological profile, however, these observations reflect the fact that SM is missing from the experiences in her life some of the deepest negative emotions, in a manner that parallels her defect in perceiving such emotions in external stimuli. These findings have interesting parallels with recent animal work (cf. Bauman, Lavenex, Mason, Capitanio, & Amaral, Citation2004a), and they provide valuable insights into the emotional life of an individual with complete bilateral amygdala damage.

Notes

Authors G.G. and M.K. contributed equally to this article.

We thank Dr. Tony Buchanan for his assistance in collecting some of the data reported in this study, and Ruth Henson for help with scheduling various assessments of the patient. Supported by Grant P01 NS19632 from NINDS, Grant R01 MH67681 from NIMH and the William T. Gimbel Discovery Fund.

An hour (55–60 minutes) is the typical length of a session in the psychologists’ practices. We deliberately conformed to this time‐frame, to keep the experiment as “ecologically valid” as possible.

We also debriefed SM following the interviews. Specifically the first author (D.T.) spoke with SM for about 45 minutes, explaining the general purpose of the investigation and the general impressions of the two psychologists who had interviewed her. She found the feedback unsurprising and, in many respects, flattering.

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