From Defensive Altruism to Pathological Altruism

Altruism is often regarded as a virtuous trait and it often is. However, for some people, their altruism can unwittingly become pathological and cause serious behavioral problems in them. What makes their altruism go awry and become pathological? This article attempts to provide a psychoanalytic insight into the nature of the problem. By examining how altruism works as an ego-defensive strategy, it is reasoned that the defensive altruism can make people mistake their underlying self-serving motivation for their true altruistic intention. As a result, such self-deception can make them much less likely to restrain themselves from being carried away by their self-serving motivation. It is possible that if such unconscious self-serving motivation is too strong, it may drive them to perform altruistic act blindly or in irrational ways.

Obviously, what is most baffling is that although such altruism is undesirable, the pathological altruists still sincerely believe that what they are doing is truly virtuous. They seem to be sane and rational. Yet they can totally lose control of their altruistic acts. What makes them so blind to their problematic altruistic performance? How can an inherent concern for others become so problematic that it is actually pathological?
Probably for the reason that altruism on the whole is so highly regarded, until recently, there was little scientific research on pathological altruism. Among those who did study it, Anna Freud (1937) used the term altruistic surrender to describe individuals who are unable to experience pleasure from the fulfillment of their own instinctual desire, yet can experience enormous pleasure from helping others fulfill the same desire. In 1984, McWilliams coined the term pathological altruism in a psychoanalytic paper on altruism. Then, Seelig and Rosof had a much more thorough psychoanalytic discussion of it in 2001. Meanwhile, from social selection perspective, Nesse (2007) ascribed abnormal extreme altruism to the manifestation of the handicap principle or runaway social selection (Zahavi, 1977). In 2011, much of the recent researches on the topic were pulled together by Oakley, Knafo, Madhavan, and Wilson (2011) in a comprehensive volume titled Pathological Altruism. The contributing authors gave a comprehensive diagnosis on pathological altruism from multiple angles, including psychology, psychiatry, genetics, neuroscience, evolutionary biology, and philosophy. Although it raised more questions than it answered, this comprehensive book has really shed light on the issue of pathological altruism.
In this article, defensive altruism, that is, altruism as an ego-defensive strategy, is first examined. Then, it is reasoned 782585S GOXXX10.1177/2158244018782585SAGE OpenSun research-article20182018 1 Vimgreen Pharmaceuticals, Hangzhou, China that pathological altruism is most likely an escalated form or extreme form of defensive altruism. This is followed with a discussion of the factors that determine whether an individual might be prone to pathological altruism. By taking a deep look of defensive altruism and providing a hopefully insightful interpretation of pathological altruism, this article not only helps make meaningful diagnosis of relevant psychological problems but also helps deepen the understanding of human mind and human nature in general.

Defensive Altruism
For the purpose of this discussion, it is helpful to briefly go over some of the main points of defense mechanisms. The ego defense mechanisms are unconscious psychological "strategies" to cope, deny, or distort reality. The goal is to prevent the self from seeing an identity-threatening truth and avoid experiencing the anxiety (Nesse, 1990). According to the psychoanalytic model of the mind, in essence, all defense mechanisms result from two conflicting psychological components, the "good-natured" superego that represents an individual's ideals and moral notions, and the "bad-natured" id that represents the individual's instinctual self-serving desires (Barnett, 2007;S. H. Cooper, 1989). The ego, which represents the individual both to oneself and to the outside world, has to minimize or eliminate the associated anxieties in the conflicting context between the id and the superego. As a result, the ego unknowingly uses ego defense mechanisms to distort the id impulses into acceptable forms, or simply repress the impulses. The ego defense theory allows us to deeply comprehend and appreciate many of the perplexing human behaviors (Turnbull & Solms, 2007).
The defensive altruism, or ego-defensive altruism, refers to an altruistic act in which there is an unconscious self-serving motivation underneath the altruist's conscious altruistic intention. Both the unconscious self-serving motivation and the conscious altruistic intention are essential components of defensive altruism. Or, it can be said that there exists a double motivation in defensive altruism. With regard to the underlying self-serving motivation in ego-defensive altruism, both the degree of its strength and the altruist's awareness of it vary considerably. An individual may be either entirely unaware of such a motivation or cognizant of it in fleeting moments now and then. For many people, the self-serving motivation may be merely kept from awareness.
It is worth noting here that the underlying self-serving motivation was not given enough weight before, and it was not paid due attention in previous researches on defensive altruism (Bowins, 2004;A. Freud, 1937;Seelig & Rosof, 2001;Vaillant, 1977Vaillant, , 2000. In fact, as will be shown in this article, the underlying self-serving motivation, which can be in many different forms, most likely plays a much more significant role in defensive altruism. Altruism, in the broadest definition, is defined as an act that benefits others (Rushton, 1981). In addition to defensive altruism, there are also, at least in theory, two other kinds of altruism. First, it is possible that people may perform altruistic acts out of pure care for others and solely for the benefit of others (Batson, 2011;Nagel, 1979). Second, people may also perform altruistic acts with full awareness that the goal is to benefit themselves in some tangible or intangible way as well, or to benefit themselves entirely (Maner et al., 2002;Mansbridge, 1990). Among the whole spectrum of altruism, which ranges from acts solely for the benefit of others to acts solely for the benefit of the self (Edwards, 1991;Jeffries, 2014;Krebs & Van Hesteren, 1994;Kurzban, Burton-Chellew, & West, 2015), so long as the altruists are fully aware of why they perform the altruistic act, it is not defensive altruism.
Among all the defense mechanisms, the ego-defensive altruism is a perfect one in the sense that it can make the id, the superego, and the ego all highly pleased. It is virtually the culmination of ego defense. According to the psychodynamic functions of the id, the ego, and the superego, it is conceivable that this is how defensive altruism actually works: First, the id strives to accomplish some self-serving purpose through the altruistic act-the id is capable of thought (Thompson, 2001) and cannot be limited to instinctual wishes (Eagle, 1987). However, the ego, which has repressed the self-serving desire unconsciously, is not aware of the self-serving motivation. Meanwhile, as the superego is by definition totally willing to perform the altruistic act, at least in some degree, while having difficulty seeing the self-serving motivation of the id, the ego can mistakenly believe that the altruistic driving force is purely from the superego. With such a cognitive distortion or self-deception in the mind, the id, the superego, and the ego can easily agree on the altruistic act. As a result, those who are motivated in such a way are much more likely to perform the altruistic act without hesitation. What's more, it allows them to act out their self-serving need, yet feel virtuous about what they are doing. They do not know that their self-serving motivation is hidden from their awareness. They do not know that they have mistaken its propelling force for their true altruistic aspiration.
As is known, the dual-process theory also believes that two different motivational cognitions, one conscious and one unconscious, can occur simultaneously in a person's mind (Gawronski & Bodenhausen, 2012;Sun, 2002). This is also consistent with the more general theory that the mind is composed of semi-independent modules (Carruthers, 2006;Sperber, 1994), and the modular or nonunitary nature of the mind can cause all kinds of self-deceptions (Kurzban, 2012;Von Hippel & Trivers, 2011).
All in all, the defensive altruism can essentially make people misunderstand themselves in a largely inverted way. It is not only because the self-serving motivation is repressed and cannot be easily seen by the ego, but because the altruistic act itself is very much in line with the altruistic intention of the superego. In many cases, the superego may also play an active role supporting the altruistic act. With the id and the superego aligned so closely with each other on the altruistic act, not only is the confused ego more likely to give the green light but also more likely to join in the effort. If no such altruistic intention exists within the superego, the ego is unlikely to get it wrong, and it is doubtful that the defensive altruism can still come to pass.
Nonetheless, in defensive altruism, as in all defense mechanisms, it is the id that provides the main energy. The superego, via the ego, primarily guides the direction (S. Freud, 1923Freud, /1990).

Pathological Altruism
For those performing ego-defensive altruistic acts, as their self-serving motivation assumes the appearance of their altruistic intention, in varying degrees, they are less likely to make out that they have to restrain themselves from being carried too far by their self-serving impulses (Cramer, 2006). Instead, they are more likely to believe that they can perform the altruistic act as much as they want without any concern, or the more they perform it, the better it is and the more virtuous they are. Consequently, if the underlying self-serving motivation is too strong, it may propel them to perform the altruistic act to excessive or extreme level, and it can cause foreseeable or unforeseeable problems one way or another (Rachlin, 2002;Turvey, 2011). In other words, those who have gone over the limit too much may unknowingly become pathological altruists.
As these altruists sincerely believe that they are purely altruistic, it is also difficult for them to see their irrational behavior. Their perception of what they are doing determines what they can and cannot see, although their perception is largely incorrect because of the cognitive distortion in their minds (Paulhus & John, 1998;Pronin, Gilovich, & Ross, 2004). Even when having clearly performed in a counterproductive way, instead of realizing that they are too self-interested and have acted to the detriment of the altruistic purpose, they may actually feel exceedingly virtuous and believe that they have performed rightfully and extraordinarily (Burton, 2011;Steele, 1988).
For the same reason, this also makes it difficult for them to correct their deleterious altruistic behavior. Pathological altruists are usually incapable of changing their behavior. Their ignorance of both their motivation and problem is most likely why their altruistic behavior often develops into a habitual maladaptive pattern. It is typical that they perform such altruistic deeds in persistent and inflexible ways (Berofsky, 2011;Turvey, 2011).
In addition, it is highly probable that such self-serving altruistic motivation is so strong that it can overpower all other self-interests that might hinder the altruistic performance. In other words, there is probably no way for pathological altruists to lessen or stop the performance on their own. That is most likely why pathological altruism is often associated with compulsiveness (Berofsky, 2011). There is a powerful inner force that drives pathological altruists to perform altruism beyond limit. Whereas normal people are largely free to choose their actions, pathological altruists are forced to act by a strong inner need. Whereas normal people can choose from a variety of strategies, pathological altruists are limited to a single strategy.
Obviously, the pathological altruists' distorted view of their altruism is not a matter of intellectual shortcoming, because the hidden self-serving altruistic motivation is completely out of their view. It prevents them from a sober, reflective examination of their inner drive. In addition, the real existence of true altruistic intention in their mind is also why pathological altruism can appear to be so genuine, to both oneself and others.
In principle, as a mature defense mechanism, the defensive altruism should make people do truly virtuous things that truly benefit others and society (Vaillant, 1977). But regrettably, while suitable use of defensive altruism helps improve social functioning and is beneficial to everyone, overuse of it can actually cause the opposite effect. In particular, for those preoccupied with a strong underlying selfserving motivation, it is probable that they may perform altruism to such an extreme degree that it actually becomes detrimental. In such cases, the adaptive defensive altruism has crossed the line and become pathological altruism.

Don Quixote
Now let us borrow a well-known figure from literature to illustrate the cause of pathological altruism. The most notable individual exhibiting such altruistic behavior in literature is probably Don Quixote, the main character in Miguel de Cervantes's famous novel titled Don Quixote de la Mancha. As Don Quixote has read too many knight novels and become obsessed with knighthood, chivalry, and joust, he decides to live his life in exactly the same way and, by doing so, save the world according to his vision.
Yet, as Don Quixote embraces the duties of knighthood and does everything according to the chivalric code, his adventure quickly evolves into a hilarious satire of purely imaginative knight-errantry laughed at by everyone. Even those Don Quixote has helped do not appreciate his help. In the end, after his final defeat, he is forced to swear to give up his knightly mission and never to attempt it again.
Obviously, it is a story that is not only laughable but also unsettling. How can a person so eager to do good for others behave in such a ludicrous way? Is it that he has so much virtue that has eventually driven him insane?
There is no doubt that Don Quixote really wants to do good for others. But, that is not the only thing that he sees in his knight-errantry. Other than seeing the benefit to others, he also sees the benefit to himself. By acting like a knightly man, he actually wants to satisfy a much larger desire, which is to see a glorious image of him and have a feeling of significance or superiority over others. After reading too many knight novels, he wants badly to become an extraordinary knight that everyone admires, and he wants badly to see and feel that he is a splendid figure. This is the real motivation behind his knight-errantry and altruistic quest.
However, Don Quixote does not know his real motivation. It is not that he knows what he does is only an instrumental means to achieve his self-serving goal, but still does it wholeheartedly anyway. Due to the distortion of his mind by ego-defensive altruism, he has no idea that what he does is mainly to satisfy his own need, and he has no idea that his conscious intention to do good for others is largely an expression of his unconscious motivation to boost his own ego. From the very beginning, he has mistaken his self-serving desire for his altruistic aspiration. He just knows and feels that what he is doing is highly virtuous. He fully believes that he has no other motive than helping others or doing good things. That is the main reason that he sees no need to rein in his altruistic performance. It is also the main reason that he does not feel embarrassed at all for what he is doing. Consequently, as his self-serving motivation is propelling him to perform whatever he deems is heroic, laudable, or admirable, Don Quixote has eventually been driven to the point of derangement.

A Real Example
Zhang Xun (or Chang Hsün, 709-757) was a brave general in the Tang Dynasty of China. Ever since his childhood, he had been known for being a role model for everyone around him, and he was frequently praised for his virtuous deeds. It was said that he was compelled by a strong sense of righteousness at all times, and his strong morals were always characteristic of him (Liu, 1945(Liu, /1975Ouyang & Song, 1060/2003).
Yet, while defending the city of Suiyang against rebel forces during the period called An-Shi Rebellion, he committed horrific atrocities against innocent people. It is hard to believe that such a righteous and virtuous man would resort to cannibalism on a massive scale to feed his troops day in and day out (Graff, 1995).
From the beginning of 757 to October of the same year, Zhang and his soldiers defended the city of Suiyang. Zhang was originally the magistrate of a local county when the rebel forces invaded the area. The situation prompted him to recruit a few thousand soldiers to fight the rebels, and he was able to repel rebel attacks again and again. However, after the city was under heavy siege for a long time, the loyalist forces' food supplies began to run out. By July, the soldiers in the city had fallen into a desperate state of food shortage. Soon afterward, when all of their warhorses had been killed and eaten, there was nothing else for them to eat (Liu, 1945(Liu, /1975Ouyang & Song, 1060/2003Sima, 1084Sima, /2012aSima, , 1084Sima, /2012bSima, , 1084Sima, /2012cSima, , 1084Sima, /2012d.
Faced with the dire situation, Zhang had to make a decision about his soldiers' fate. To everyone's surprise, he brought one of his wives out and gave a shocking speech to the soldiers. He said, You have been fighting hard to defend the city for our country, and you never hesitated throughout. Although you have been lacking food for months, your loyalty has never faltered. I regret that it is impossible for me to cut my own flesh to feed you. But why should I cherish her and keep her alive in such situation?
After these words, Zhang killed his wife in front of the soldiers and offered her flesh for them to eat.
Having shown that he was completely selfless, Zhang proceeded to create a horror on an unimaginable scale. To feed his soldiers, he ordered to eat the civilians within the city. First, they killed and ate women. After all the women were eaten, they ate the elderly men. Then, they began to eat children. Altogether, about 20,000 to 30,000 people were eaten. When the rebels finally seized the city, they found that no more than 400 people were left alive. Zhang was captured and put to death by the rebels (Graff, 1995;Liu, 1945Liu, /1975Ouyang & Song, 1060/2003Sima, 1084Sima, /2012aSima, , 1084Sima, /2012bSima, , 1084Sima, /2012cSima, , 1084Sima, /2012d.
How to explain that Zhang, a highly virtuous man who had always had strong moral values in his life, would kill so many innocent people and commit such a horrible crime? Is it really that Zhang was so loyal that he would do anything to fight for the emperor? Is it really that he was so selfless that he would kill his own family member to feed the soldiers? How could he eat people that he was supposed to protect?
An explanation of Zhang's horrible wrongdoing is that he had misunderstood himself completely. It was self-deception that led to it. Although he had firmly believed himself a highly virtuous man who always put others' interests first, he was actually also an extremely egoistic man beyond his conscious knowing. While he seemed to be fighting for the emperor, the country, or the people, he was also doing his utmost for himself. His self-serving motivation was to glorify himself. It was to show that he was the most righteous man, and to win praise for his unmatched virtue.
Here, it must be realized that in traditional Chinese culture, loyalty is a supreme moral requirement, especially when it comes to the emperor. It is the very best virtue and the greatest good. Whoever could do it at the maximum level would be seen as the most virtuous person and receive the highest praise. For Zhang, first, it is certain that he had completely accepted this prioritization of moral values and really wanted to be unswervingly loyal to the emperor. Second, for his own benefit, such as reputation, fame, popularity, social position, and pride, it is equally certain that he also wanted to project such an image and be seen as a role model in this regard. It is highly probable that such self-serving motivation was as strong as it could be in the bottom of his heart. As a result, such inner psyche would make Zhang pay more attention to what was most valued and praised in society. It would also make him think less about whether his virtuous deeds were indeed moral or noble. Consequently, even if he needed to kill thousands of innocent civilians, because it was in full accordance with the most important terms in the moral doctrine, to demonstrate that he was the most outstanding loyalist and most righteous man, in his own words, there was naturally no need to value human life.
Of course, due to the severe ego-defensive distortion of his mind, Zhang did not know his real motivation. He did not know that he was mainly trying to publicize his own virtue. In fact, not only was he unaware of his super strong egoistic motivation, but he had completely misunderstood it. As he indeed wanted to be a highly loyal man at the same time, it was easy for him to believe that what he was doing was entirely for a right cause. It is precisely because he had mistaken his selfserving motivation for his noble intention and saw no selfinterest at all that he was able to kill his family member and thousands of civilians ruthlessly. It is conceivable that he must have a very strong sense of righteousness while doing so. For him, not only had he upheld his loyal integrity, but he had done it at the utmost level. As for his killing of thousands of innocent civilians, he would not see it damaging to his image. He knew he would be highly honored and praised, not in spite of the killing, but on the contrary, owing to it.
Suppose Zhang could clearly see his egoistic motivation, would he still create the horror? For a man who valued virtue as much as he did, once realizing that it was mainly or actually a self-serving act, it is unlikely that he would still proceed ahead. He would not have let his altruistic deeds go unchecked.

Further Analysis
The psychoanalytic insight that pathological altruism is most likely an escalated form of defensive altruism also allows us to tell who might be more likely to exhibit such behaviors. With defensive altruism, although anyone can mistake one's self-serving motivation for one's altruistic intention, it is safe to say that not everyone does this on the same degree, and not everyone will inevitably become a pathological altruist. Then, what are the factors that determine whether an individual might be prone to pathological altruism? Who are those that might be more likely to exhibit such behaviors?
Given that defensive altruism ultimately results from two conflicting psychological components, the id and the superego, whether and how much an individual might "use" the defense mechanism and let it develop into pathological altruism should also be subject to the id and the superego in the mind. The altruistic dispositions of both the id and the superego are the most important factors-of course, as the final decision maker, the ego's role is important too.
For the id and the superego, their altruistic desires can both be quite strong, both be quite weak, or one is significantly stronger than the other. Of course, only the superego's altruistic desire is truly altruistic. The id's altruistic desire is actually self-serving and is impure altruism or altruistic egoism in essence (Andreoni, 1990;Selye, 1976). Depending on whether the altruistic desires of the id and the superego are strong or weak, and how competent the ego is at comprehending both oneself and the situation, whether and how much an individual would let ego-defensive altruism run its course should vary considerably from one to another.
To make the discussion easier, among the whole variety of altruism, only four representative types of altruism are discussed below. All other forms of altruism lie somewhere within the field framed by the four typical ones.
1. Neither the id nor the superego is particularly keen on the altruistic act. In such cases, due to the lack of internal driving force, the defensive altruism is unlikely to get up steam and function in a substantial way. It is also unlikely that these individuals will overexert themselves in their altruistic performances. 2. The id is particularly keen on the altruistic act, but the superego is somewhat indifferent. Then, as the superego's altruistic intention is not strong enough, the ego is unlikely to misbelieve that the altruistic driving force is from the superego. Besides, it is highly probable that the id's self-serving motivation is not even repressed enough for these individuals. In other words, most likely it is not the id, but the conscious part of the ego that is keen on the altruistic act. As a result, the defensive altruism is unlikely to come about either. If these individuals do decide to perform the altruistic act, in all likelihood they already know clearly that it is self-serving in nature. 3. The superego is particularly keen on the altruistic act, but the id does not have much interest. If so, due to the lack of driving force from the id, once again, the defensive altruism does not have the needed condition to run its course. Of course, this does not mean that these individuals will definitely not perform the altruistic act. What is certain is that they are unlikely to overexert themselves in the performance, given that the id lacks the eagerness to do so, or may even hinder the process, not to mention that the virtuous superego, by definition, can only make these altruists behave properly. 4. Both the id and the superego are particularly keen on the altruistic act. Then, with their desires so closely aligned on the altruistic act, unless the ego has somehow acquired the ability to prevent it from happening, the defensive altruism will almost certainly run the show and play a dominant role in the altruistic performance. The reason is that the id eagerly wants to accomplish some selfserving goal through the altruistic act and will do its best to push for such altruistic performance. Yet, due to the powerful influence of the superego on the ego, the id's self-serving altruistic desire is repressed the most in such cases. This makes it very hard for the ego to see the self-serving motivation in the mind. And to make it worse, because the superego aspires to the same altruistic performance, while having difficulty realizing that the id's self-serving motivation is a significant driving force or the actual driving force, the ego can easily believe that the altruistic driving force is purely from the superego. As a result, the ego is most likely to believe that there is no need to keep the altruistic performance in check, and the id's self-serving motivation can easily propel the altruistic performance to extreme level.
Here, a crucial element is that, in terms of the altruistic act itself, what the id wants to perform and what the superego wants to do are identical or very similar. Otherwise, the ego is unlikely to get confused, and it is unlikely that the defensive altruism can still function well. It is because the selfserving altruistic motivation is not only repressed, but identical or very similar to the conscious altruistic intention that these altruists can become so self-deceived and so blind to their altruist performance.
It should not be surprising that the self-serving motivation of the id can fit well with the true altruistic intention of the superego. For each individual, when the superego grows and becomes more virtuous under various influences from time to time, the id can also learn and, on the contrary, become more cunning at the same time. It is unlikely that the id is aloof or always aloof to all the factors that have a say on the superego. In the end, the id may acquire the ability to use the same virtue as a strategy for one's own advantage without one's conscious knowing. This makes it possible that the self-serving motivation of the id can fit perfectly well with the true altruistic intention of the superego.
According to the above analysis, only when people genuinely have strong altruistic intentions, do their unconscious self-serving motivations in the name of altruism or virtue have a chance to overuse defensive altruism. Although it sounds preposterous, it actually makes a lot of sense. It is true that, in principle, strong altruistic intentions should only make people do truly virtuous things. But, as various unconscious self-serving motivations are potentially able to "hijack" the true altruistic intentions, there is no guarantee that those with strong altruistic intentions will only do truly virtuous things (Carveth, 2015). Of course, if everything occurs on a reasonable level and only produces beneficial effects, it is a wonderful thing. However, if any underlying self-serving motivation is too strong and can make everything occur in an uncontrolled manner, such altruism can also become a serious problem. That is why the very zeal to do good for others and society is not necessarily always helpful.
Here, it is satisfying to see that true altruists are unlikely to display problematic behaviors in their altruistic activities. It is really unfortunate that some of those who also have true altruistic intentions may have a tendency to overuse defensive altruism and display maladaptive altruistic behaviors.

Conclusion
According to the discussions above, it is both the self-deception caused by defensive altruism and a strong self-serving motivation in the name of altruistic intention that are the causes of pathological altruism. The self-deception makes people feel good about what they are doing and let their altruistic deeds go unchecked. The strong self-serving motivation provides the energy to drive their altruism into warped, twisted, or whatever abnormal form.
It is clear that the above rational can adequately explain why and how pathological altruism occurs. Although it may look like a rather elementary analysis, it not only deepens the understanding of altruism but also deepens the understanding of human mind and human nature in general. It approves that a seemingly complicated problem may actually have a quite simple cause.
If the extreme defensive nature of pathological altruism is indeed correct, its psychotherapeutic value is significant. It helps make more insightful diagnosis of relevant psychological problems, and can potentially lead to more effective relief of symptoms and distress. It can also help people in general function more productively in these aspects. It can even help cultivate a more genuine and healthy society.
Toward that end, and for anyone to steer clear of pathological altruism, as it is apparent from the foregoing discussion, it is crucial to be aware of the self-serving altruistic motivations in one's own mind, especially for those having strong altruistic aspirations. This will help overcome the sleight of mind and make one play a supervising role of one's altruistic behavior (J. Cooper, 2007;Vazire & Wilson, 2012). As a result, the altruistic performance will be much more likely to be sensible. A true altruistic act should never become more of a problem.

Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.