Can Your Experience Compassion Fatigue?

Kelly McGonigal in her presentation for the Mindful Healthcare Summit challenged the widely held belief that you cannot experience compassion fatigue. Many people contend that compassion fatigue does not occur because the heart is capable of endless kindness and love for others. Kelly maintains that motivation and goodness of heart are not sufficient to prevent the depression and burnout that can result from compassion fatigue. She asserts that compassion has to be supported by adequate self-care if it is to be sustained.

Compassion and the stress response

Kelly argues that compassion is like the stress response when viewed physiologically. Compassion floods the body with hormones such as dopamine and marshals the body’s energy to relieve the suffering of others. However, while this can be very energising and exciting in the short term, compassion takes its toll in the longer term both bodily and mentally, as we do not have endless physical and mental reserves.

The possibility of compassion fatigue can be increased where a helping professional or carer experiences vicarious trauma or moral distress – the latter being defined as being required to do things that clash with a person’s values or moral perspective, a frequently occurring ethical dilemma within the medical profession.

Compassion fatigue

Kelly suggests that compassion fatigue occurs when a person lacks the energy and resources to pursue their motivation to care in such way that it achieves personal satisfaction (activates the reward system). Outcomes achieved fall short of personal expectations and/or the expectations of others, despite the strength of the caring intention. The compassionate person feels exhausted and feels that the more they give the less they experience satisfaction – the gap between input of energy/time and the expected satisfaction increases, leading to burnout. The depletion of energy and satisfaction could be the result of factors outside the helper’s/carer’s control – such as structural blockages, breakdown in information exchange, overwork or under-resourcing.

Compassion needs nourishment

One of the issues that exacerbates the problem of compassion fatigue is the belief in the endless capacity of an individual to be compassionate through the goodness of their heart or the purity of their intentions. As a result of this false belief, helpers/carers fail to take the necessary actions to nourish themselves (and their compassionate action) and/or are reluctant to accept compassion extended to them by others.

Personal nourishment can take many forms – getting adequate sleep, meditation (especially self-compassion meditation), listening to relaxing/inspiring music, prayer (whatever form it takes) or drawing strength and healing from nature. It also requires an openness to receiving compassion from others – challenging false beliefs such as “no one else can do this”, “I will be seen to be weak if I accept help from others”, “I really shouldn’t pander to my own needs by having that short break or having a reasonable period for lunch”, “I can’t afford to become dependent on others for assistance”. Additionally, positive social connection– to offset the tendency to withdraw under extreme stress– is a critical source of self-nourishment.

As we grow in mindfulness through meditation our awareness of others’ suffering and our motivation to help are heightened. The capacity for compassionate action is not limitless and needs nourishment. Central to this nourishment is self-compassion.

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By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Understanding the Science of Compassion

In her presentation on The Science of Compassion during the Mindful Healthcare Summit, Kelly McGonigal highlighted the body-mind impact of compassion and compassion training. Over the past 10 years she has worked with the Stanford Center for Compassion and Altruism Research and Education in the capacities of researcher and educator. Kelly was a co-author of the Stanford Compassion Cultivation Training [CCT] and has undertaken research into its impacts on mind and body.

The mind-body effects of compassion training

The research undertaken by Kelly and her colleagues highlights the effects of compassion training on the mind and body. Kelly summarised these effects as follows:

  1. The process of compassion starts in the primitive part of the brain, the amygdala, which registers a form of “sympathetic stress”, experienced by the observing individual as sadness or suffering. At this stage a person can become overwhelmed, particularly where they become too identified with the person who they perceive as suffering in some way, e.g. through grief, chronic physical illness, relationship breakdown or mental illness. The person who is experiencing overwhelm may adopt flight behaviour by distancing themselves (mentally and/or physically).
  2. The next stage involves the pre-frontal cortex and other parts of the “midline structure of the brain”. Here the sympathetic sufferer, through a process of “social cognition”, can separate themselves from the perceived sufferer. They recognise the suffering of the “other” and understand that they have a relationship to that person (as part of humanity) but are quite distinct from that other person – they don’t take the suffering on-board or “own the suffering” of the other person. This ability to achieve separation mentally is critical for the balance and welfare of the observer and is foundational to their willingness and ability to act to relieve the suffering of others. Without this balance, the observer may experience what Richard Davidson described as “empathy fatigue”.
  3. When we actually take compassionate action to relieve the suffering of another, we experience the “reward system” – our brain releases dopamine which make us feel good, hopeful and courageous. It thus serves to strengthen our motivation to redress the suffering of others. It activates “the approach motivation system of the brain” – motivating us to act on environments that we experience as unjust or toxic.

As we grow in mindfulness through compassion meditation and compassion training, and take action to redress the suffering of others, we can experience an increasing capacity for compassionate action and strengthening motivation to act on unjust or toxic environments.

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By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Resilience is Not Endurance or Acceptance of a Toxic Situation

Resilience is very much about “bouncing back” from adversity or setbacks. Richard Davidson in his research has shown that resilience can be measured in terms of the rapidity with which the body returns to its “baseline” – measured in terms of level of cortisol and the level of activation of the amygdala. He maintains that resilience is not acceptance or endurance of a toxic environment that is unjust or inappropriate.

Resilience can be built through developing life skills that enable you to move beyond significant adverse life events. Richard and his colleagues have identified conscious ways to build resilience by using meditation and mindfulness practices focused on developing bodily awareness, social connection, personal insight and life purpose.

Resilience does not lead to acceptance of a toxic situation but rather builds motivation and skill to address the situation effectively. Mindfulness practices designed to build resilience also strengthen your capacity to manage stresses experienced within a toxic situation by increasing self-awareness, enhancing self-regulation, improving clarity and calmness and releasing creativity.

Resilience and compassion: building motivation and capacity for action

In the previous post, I discussed social connection as one way to build resilience and compassion meditation (loving-kindness meditation) as a way to develop social connection. Professor David DeSteno, renowned psychologist and author of The Truth About Trust, maintains that the ability to build social connections through compassion (through assisting those in need) makes us more resilient over the longer term. 

Kelly McGonigal, in her presentation on The Science of Compassion during the Mindful Healthcare Summit, maintained that compassion benefits everyone in a system – the person who shows compassion, the recipient, colleagues and witnesses (e.g. the hundreds of thousands of people who have witnessed the compassionate action by Mo Cheeks).

Kelly’s research and that of her colleagues suggests that people who undertake training in compassion (such as Compassion Cultivation Training [CCT] offered by Stanford University) become strong and resilient advocates for system change where people are suffering. She maintains that participants in CCT are more able to effectively change a toxic situation through their hope, courage, renewed energy and strong social connection. She suggests that this “very work of change is a form of compassion”. On reflection, compassion appeared to be the driver in an earlier reported case where participants used action learning to redress a toxic work environment.

As we grow in mindfulness through meditations designed to build resilience, we can increase our motivation and capacity to act effectively to change a toxic situation that is causing suffering for people. By building social connections through compassion, we not only strengthen our resilience, but also enhance our capacity to act effectively with hope and energy to address the suffering experienced within the toxic system.

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By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Being Mindful at Work

In the previous post, I wrote about mindfulness at work and identified some ways to be mindful while working.  Here, I want to take this further by suggesting some other strategies, again using the article by Shamash Alidina for my inspiration:

1.Slow down

In slowing down, we can become more aware of our inner thoughts and outer environment.  If you find yourself rushing from place to place, you can slow down and engage in some form of mindful walking.  Often we are rushing, not because of a deadline, but because this haste behaviour has become habituated.  You can pull yourself up in the act of rushing around and just take a few steps at a slower pace.  You might ask yourself, “Why am I in such a hurry?”  This mindful practice can start with your behaviour when getting to work, so that when at work you are already conscious of your hurrying behaviour and more able to “slow down to speed up”.

2.Treat stress as your friend

This approach seems counter-intuitive.  Most of what you read about stress is how harmful it is to your health.  Yet there is an optimum amount of stress that improves your health, energy and productivity.  Without sufficient challenge we suffer boredom and malaise; too much stress leads to “frazzle”.   Kelly McGonigal, in her TED talk, encourages you to “make stress your friend”.  Research shows that how you perceive stress can, in fact, influence the way stress impacts you.  If you have a positive perception of stress – you see your pounding heart as energising you and getting more oxygen to your brain – you are able progressively to reduce your physical response to stress and to increase your capacity to manage it.  So, in a lot of ways, it is “all in your head”.   Being mindful, you can get in touch with what is going on in your body, and instead of panicking, you can view this bodily response as “readiness for action”.

3.Develop a gratitude bias

We hear about the negativity bias of our brains, but it is possible to develop a “positivity bias”.  Kabat-Zinn suggests that you become what you pay attention to, e.g. you can become grateful, compassionate or empathetic by focusing on these aspects through mindfulness meditation.   Being mindful of what you have and expressing gratitude for these things “has a positive impact on your creativity, health, working relationships, and quality of work”.  Instead of focusing on the aspects of your job that you do not like, you could look at what you do have that you appreciate – expressing gratitude for the fact that you have a job, that you can make a difference, have a supportive boss, have colleagues who are collaborative or have highpoints in your day when you realise that you are doing something meaningful.  You can substitute a positivity bias for a negativity bias, by frequent and regular recall of what you appreciate in your work.

Your thoughts play a large role in how you experience the world and your associated mental health and mood.  As you grow in mindfulness through the practice of being mindful at work, your thoughts become more positive and your brain becomes “more efficient, focused, effective at communicating with others, and better at learning new skills”.

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Image source: courtesy of FirmBee on Pixabay

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Compassion and Neuroscience

In her presentation for the Mindfulness & Meditation Summit, Kelly McGonigal discussed The Neuroscience of Compassion.  Kelly is the author of The Science of Compassion and The Upside of Stress.

Kelly maintains that for compassion to be realised and sustained, the following six conditions must be present:

  1. awareness and recognition of suffering
  2. feeling of concern for, and connection to, the one who is suffering
  3. desire to relieve suffering
  4. belief that you can make a difference
  5. willingness to respond or take action
  6. warm glow/sense of satisfaction

She spoke about how compassion unfolds in the body, a mind-body state that has been verified by neuroscience.  Throughout her presentation she drew heavily on a neuroscience model of compassion developed by Ashar, Andrews-Hanna, Dimidjian & Wager (2016).  This systems-based model of the brain shows how the core functions of compassion are manifest in different parts of the brain, and each function can activate multiple parts of the brain simultaneously.

The three core functions identified in the neuroscience model of compassion are:

  1. Social cognition
  2. Visceral/emotional empathy
  3. Reward motivation

Social cognition has to do with the cognitive aspect of our social interactions – in other words, “how people process, store, and apply information about other people and social situations”.  Visceral/emotional empathy, on the other hand, is the emotional response generated in us when we connect with, or feel concern for, someone who is suffering.  Reward motivation relates to the personal, intrinsic satisfaction – warm inner glow – experienced when we are compassionate (which serves as a motivator of compassion).

Kelly maintains that all three brain functions have to be present, and effective, for sustainable compassion towards others and they need to be in balance.

For example, what potentially impedes effective social cognition is “dehumanization” of the observed individuals as a result of “unconscious bias” influencing our perception of others who differ in race, age or gender, or even in the sporting team they support.  Kelly reports, as did Dr. Richie Davidson, that meditation practices – such as loving-kindness and compassion meditation – can reduce such implicit bias and provide a more balanced social cognition that is not blind to the suffering and needs of a particular group.

Visceral/emotional empathy has to be balanced with reward motivation that can occur with compassionate action.  Kelly reports research that shows that if people are trained in empathetic meditation, without experiencing the reward component of compassion, they can potentially experience “empathetic distress”- a form of emotional overload resulting, in part, from too close an identification with the sufferer without the reward relief experienced through compassionate action.

This last imbalance resulting in “empathetic distress” has been observed in people in helping roles in difficult situations, e.g. war arenas.  Where helpers do not experience, or stop experiencing, the intrinsic rewards of compassionate action, they are prone to “burnout”.  Burnout occurs when we exhaust our reserve energies as a result of trying to close the gap between effort and intrinsic reward, in other words, we start working harder and harder for less and less positive outcome – we perceive that we are ceasing to make a difference.  Research has been shown that for sustainable compassionate action in these difficult arenas, helpers need to experience “reward motivation” – the intrinsic satisfaction sometimes experienced as  a warm inner glow.

Another important insight from neuroscience mentioned by Kelly is that we do not need to have self-compassion to be compassionate towards others.  Increasingly, compassion towards others is seen as an innate human capacity.  On the other hand, we seem to create all kinds of barriers to self-compassion such as fear, anxiety or anger.   Kelly maintains that the biggest barrier to self-compassion is the absence of the reward satisfaction when people feel the suffering of others, but do not experience the warm glow from taking action that makes a difference to someone’s suffering.

In summary, as we grow in mindfulness through loving-kindness and compassionate meditation, we can reduce our unconscious biases, free ourselves from the inertia of “empathetic distress” and open our minds and bodies to compassionate action resulting in reward motivation that will sustain that compassion over time.

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Image source: Courtesy of johnhain on Pixabay