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Consider Compassion as Featured by Illinois Psychiatric Society
This article appeared in the December 2023 issue of the Illinois Psychiatric Society “Mind Matters” Newsletter. Here is a link to the original article. It was authored by Luke Lammers, currently a fourth-year medical student at the Chicago College of Osteopathic Medicine.
Compassion. As physicians, we have all heard this word ad nauseum. I have not personally been on a medical school admissions committee, but I’d guess that for those who have, the word “compassion” has crossed their screens thousands of times, embedded in hopeful medical students’ personal statements. For many, the word is devoid of flavor. It may even come with a bitter aftertaste. I hope that this article will help to restore some of the original savory flavor that the word used to connote for you, and hopefully allow you to appreciate the more subtle notes and complexities that this indulgence has to offer.
My school’s Wellness Committee recently put on a one-hour Compassion Workshop, hosted by The Compassion Institute. During this event, we learned about Compassion, how it differs from empathy, why it is a worthwhile goal, and ways to foster compassion both in our life and our future practice. But first, what is compassion? Compassion can be a difficult word to define; it is not necessarily a concrete notion. In fact, it is closer to a feeling than anything else. How do you begin to define a feeling? The only way to truly define it is to feel it for yourself. Otherwise, it would be like trying to imagine a new color. I can tell you all its properties, but you will never truly comprehend it without seeing it for yourself. So, if you will, indulge me for a moment. Close your eyes, notice your breathing, and think back to a time where you felt compassion shine through. Whether it be a time that you showed compassion to another, when someone showed you compassion, or when you graciously showed yourself compassion. What did that feel like? When we did this activity during our event, we came up with some things like “selflessness” and “it brings people together.” This rings true when you analyze the etymology of the word. In Latin, “pati” is “to suffer” and “com” is “with.” So, compassion literally means “to suffer with.” Our speaker, Dr. Mansouri, expanded on this definition and broke compassion down into four parts. First, it is to become aware of someone’s suffering. Second, to feel a sense of concern and care for the person. Third, it is the desire to see change in the person’s circumstances. Finally, there comes the piece that is difficult to nail down, and I like how Dr. Mansouri put it, the “warm glow” that we feel after witnessing compassion. As doctors, we are in the unique position to be the conduit for change and relief from suffering in our patients’ lives, further emphasizing the importance of compassion as a centerpiece of our practice.
Before this compassion training, I essentially used “empathy” and “compassion” synonymously. It is specifically the last two pieces of the compassion definition that differentiates the two. Empathy is to feel someone else’s pain. While this can be a noble goal, in a profession like medicine it can quickly lead to burnout or “empathic suffering.” Compassion, on the other hand, is feeling their emotions and then holding their hand and hoping for a change. It is to realize that suffering connects us to every human being that has ever lived. To recognize this, sit with it, and exist in it. Where empathy can sometimes be a black hole, leading us down into a spiral of negative feelings and anxiety, compassion is a burning sun, providing warmth and energy to the human spirit.
Let’s now analyze how compassion can affect us and how we can implement it in our daily lives. One study analyzed how Emergency Department provider compassion scores, as measured by the Consultation and Relational Empathy (CARE) measure, affected PTSD symptoms in patients one month after a serious medical trauma. They found that every one-point increase in CARE measure lowered the odds of the patient developing PTSD symptoms by 7%1. There are many more studies investigating the link between provider compassion and patient outcomes, which I do not have room to review in this article, but are very interesting, nonetheless.
So how do we integrate compassion into our daily lives and medical practices? A great place to start is with compassion meditation. Simply put, you first enter the meditative state by sitting and quietly focusing on your breath. Then, in your mind’s eye, imagine someone that you love suffering. Focus on the feeling of wanting to change their situation and focus on that. Start there. Once you have done this for multiple meditation sessions, branch out to a neutral person. The barista who gives you your coffee, the clerk at the gas station, etc. Finally, extend this practice to those who you do not necessarily like. While this practice will begin to build your compassion, it is also important to bring the lessons that you learn into your daily life. This can be done with simple techniques to remind yourself about compassion throughout the day. Change your password to something that reminds you to be compassionate. Some utilize “doorknob meditation,” in which they take a moment before going into a patient’s room, as they touch the doorknob, to remember compassion. These are just a few of the many techniques that you can employ to integrate compassion into your practice
Many may say that they do not have time to begin this compassion practice. However, it can actually save time by honing your listening skills, thus improving history taking skills. Furthermore, it will energize you in your practice, and create more space for you to enjoy the opportunity to be a medium of change and improvement in your patient’s lives. As one of my classmates astutely observed, “we do not have time to NOT be compassionate.” I’d like to conclude with a quote by Edward Livingston Trudeau that was shared with us by Dr. Mansouri about what it means to be a doctor: “To cure sometimes, to relieve often, to comfort always.” So, go forth and comfort.
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