My research into how emotion connects to intelligence led me to the vmPFC and Elliot’s case.
And question popped up… what would happen to a child with the same brain damage? Elliot was in his mid-to-late 30s when it happened. He already had decades of emotional memory, relationships, moral identity built up. He lost access to all of it, but it had existed at least.
So I started to research whether there were real cases with children and I found the VM case (Anderson et al., 1999 https://lnkd.in/dqSrw5fM). A child with early vmPFC damage. By age 9: normal IQ, no memory problems. But he lied constantly, manipulated others, showed no empathy, couldn’t learn from punishment, violated social rules with no remorse.
He could explain what’s “right” or “wrong.” But he didn’t feel it. Like reading a moral textbook without ever caring about the content.
And that’s what I see… If I think of emotion as an internal compass: Elliot lost his compass. The child never had the system to build a compass at all. His emotional learning wasn’t functional. Punishment didn’t register as something felt, so it could never become a guide.
But what about a person with antisocial personality disorder? (Not American Psycho! But a real condition according to the DSM, affecting about 1-3% of people). They have a compass. It’s just calibrated mostly toward their own gain. They can understand what others feel, they just aren’t moved by it in the same way. (despite the common misconception that people with antisocial disorder do not have empathy because they do, but its different). Same behavior on the outside. Completely different origins interestingly.
And I think we have to be careful not to confuse outcome with origin. The difference between these three is: loss, absence, and choice. Between someone who can’t feel, someone whose system never learned to, and someone who feels, but very much selectively.
Emotion is the foundation of how we build a self that cares. Without it, you can know every rule and still not be moved by any of them.