"in adults the anterior cingulate cortex activates when they see someone hurt. Ditto for the amygdala and insula, especially in instances of intentional harm--there is anger and disgust. PFC regions including the (emotional) vmPFC are on board. Observing physical pain (e.g., a finger being poked with a needle) produces a concrete, vicarious pattern: there is activation of the periaqueductal gray (PAG), a region central to your own pain perception, in parts of the sensory cortex receiving sensation from your own fingers, and in motor neurons that command your own fingers to move.fn3 You clench your fingers. Work by Jean Decety of the University of Chicago shows that when seven-year-olds watch someone in pain, activation is greatest in the more concrete regions--the PAG and the sensory and motor cortices--with PAG activity coupled to the minimal vmPFC activation there is. In older kids the vmPFC is coupled to increasingly activated limbic structures.13 And by adolescence the stronger vmPFC activation is coupled to ToM regions. What's happening? Empathy is shifting from the concrete world of "Her finger must hurt, I'm suddenly conscious of my own finger" to ToM-ish focusing on the pokee's emotions and experience."