Human caregiving under safety and threat: The role of empathy and its endocrine regulation

Empathy is a core motivational driver of human caregiving, shaped by evolution to ensure the survival of dependent others. Human caregiving consists of two complementary components that are each supported by distinct neuroendocrine systems: nurturance, which flourishes under safety, and protection, which is activated in the face of threat. This review synthesizes current evidence on how empathy operates within these components, focusing on the endocrine regulation of caregiving and the adaptive shifts that occur along the safety-threat continuum. We highlight how oxytocin, testosterone, cortisol, and opioids modulate empathic processes to promote either nurturing, soothing care or rapid, protective responses. While these shifts are essential for flexible caregiving, severe or prolonged activation of the stress system, particularly in contexts of chronic adversity, can impair sensitivity and compassion, leading to maladaptive outcomes. We also discuss individual differences, such as sex and early life experiences, that shape the regulation of empathy in caregiving contexts. Understanding these dynamic interactions can inform interventions aimed at strengthening the quality of care, with relevance extending beyond the parent-child relationship to other caregiving domains.