MIndful Healthcare Summit – Grow Mindfulness

Can You 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:

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).
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”.
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.

Practical Mindfulness for Profound Effects

In the recent online Mindful Healthcare Summit, Jon Kabat-Zinn spoke about the profound effects of practical mindfulness. While the context he spoke about was the healthcare arena – doctors, nurses, allied health professionals and related roles – his comments have universal application because they relate to us as human beings and are built on the latest neuroscience findings.

Getting out of our heads

Jon describes us as “perpetually self-distracting” – we continuously distract ourselves from the task at hand through our thoughts which are incessantly active. Disruptive advertising in social media aid and abet this self-distraction to the point where mobile devices are now described as “weapons of mass distraction“.

Jon encourages us to be awake to the world around us – to the people and nature that surround us. He suggests we need to move out of the “thought realm” into the “awake realm”. He comments that when we are in the shower in the morning, we are more likely to be mentally at a meeting rather than aware of the sensation of the water on our skin. When we arrive at work, we are likely to be thinking about, and talking about, the traffic we encountered on the way.

He suggests that a very simple practical exercise when we wake up is to be consciously aware of our body – to “really wake up” and feel the sensation in our legs, our feet, our arms. He urges us not to start the day by getting lost in thought but to start by inhabiting our own body. When we do so, we open ourselves to the profound effects of being present in the moment, of being open to our capacity for focus and inner creativity.

Listening to others

Jon maintains that “listening is a huge part of mindfulness practice”. To truly listen, you need to be present to the other person – not lost in your own thoughts. When you attend to the other person through active listening, they “feel met, seen and encountered”. Jon draws on the work of Dr. Ron Epstein to support this assertion. Ron, the author of Attending: Medicine, Mindfulness and Humanity, established through his research and medical practice that “attending” achieved improved health outcomes for both the patient and the doctor.

Being fully present

Jon maintains that while meditation and other mindfulness practices build your awareness, the essence of mindfulness is to be fully present whatever you are doing. He argues that “the kindest thing you can do to yourself is to be present in the moment”. Jon reminds us that “tomorrow is uncertain, yesterday is over” so to live in the past or the future is self-defeating, disabling and potentially harmful to our health and well-being. He encourages us to meet each day (which is all that we have) with a clear intention – a commitment to make a positive and caring contribution to whatever is our life/work endeavour. This will have the profound effect of enhancing our own mental health and resilience, while creating an environment that is mentally healthy for others.

Tapping into our inner resources

Sometimes we can be so focused on the needs (or expectations) of others that we overlook the need for self-caring in the face of the stresses of life and work. He challenges us to befriend our self by tapping into our deep inner resources and “boundaryless awareness“. He contends from his own research and practice in Mindfulness-Based Stress Reduction (MBSR) that our bodies are “intrinsically and genetically self-healing” and that we are our own “deepest resource for health and well-being”. We need to access these healing inner resources through the practice of mindfulness in our daily life and work.

As we grow in mindfulness through mindful action in our life and work and mindfulness practices, we can tap our limitless inner resources, become increasingly self-healing, develop mentally healthy environments for others and achieve a higher level of fulfillment and happiness.

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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.