She says that personality is "extremely heritable," but also that one's personality might diverge from its genetic fate (if I may use that term) by circumstances and experiences. However, later she comments that altruistic persons, or "X-altruists" as she calls them, are "compelled" to act as they do.
X-altruists are compelled to good, even when doing so makes no sense and brings harm upon them. The cannot tolerate injustice, and go to extreme lengths to help those who have been wronged, regardless of their personal relationship to them. Now, I am not speaking of the guy who helps an old lady cross the street. I am speaking of the guy who throws himself in front of a speeding bus to push the old lady out of the way, killing himself in the process. The average, kind, thoughtful person does not take these kinds of extreme personal risks on a regular basis.
She qualifies her statement by saying that these extreme acts of altruism resulting in a personal sacrifice happen infrequently, that the "average thoughtful person does not take these kinds of extreme personal risks on a regular basis." Well, perhaps extreme events do not happen on a "regular basis." I mean, how often does one see an old lady about to be run down by a speeding bus, or something similar?
According to this therapist's way of thinking, there's very little difference between a sociopath and an "X-altruist." They both are impulsive, like novelty in their lives, and have a tendency to break rules. However, the distinction between the two is that "X-altruists" behave from external motivations, i.e. a concern for others and the common good, and sociopaths behave from internal motivations, i.e. selfishness and/or greed. "X-altruists" have "too much empathy" which causes them to put themselves in harm's way and break rules to help others. However, she points out, we are supposed to be law-abiding citizens and questions the good of breaking rules in order to save another person, and comes just short of calling a caring person a criminal. I wonder if that little old lady about to be hit by that speeding bus would consider her savior a criminal? Thank goodness Tod Beamer broke the airline's rule to stay in his seat on that infamous flight back in 2001!