Empathy vs. compassion. Wait, aren’t they the same thing? In the medical world, we use these two words interchangeably to mean concern for the patient’s suffering. But recent neuroscience research tells us that there are two distinct but related states when it comes to feeling for another’s pain. The first state, we will call empathy, is the more commonly felt reaction when we encounter another’s suffering. That is when we understand the other’s predicament then share his feelings. For example, when we encounter a young patient with a possible terminal diagnosis, we feel for them and say “I feel so bad for him”, that’s empathy.
WHAT IS COMPASSION?
So then, what is compassion? Compassion goes one step further. When we see someone in distress, we feel their pain as if it were our own, then commit and strive to lessen their pain. This step of commitment is what distinguishes compassion from the commonly felt empathy and shows a different brain activation pattern in fMRI scans. As physicians, this doesn't necessarily mean that we are committing to find a cure to their physical ailment no matter what. Yes, we do the best we can in our situation, so if we are in the ER, we treat our patients the best we can within our context. But more importantly, the commitment is an attitude of openness to truly seeing the other person’s humanity and wishing them well without turning away from their suffering. From this place of compassion, we are able to interact and decide on how to act and provide the most compassionate treatment and recommendations based on true understanding.
THERE'S NO SUCH THING AS COMPASSION FATIGUE
Recently, there has been a lot of talk in the medical world about “compassion fatigue.” Out of the few conferences I’ve been to in the past year, all of them had at least one lecture about the high levels of fatigue and burnout among physicians. Given our new understanding of the two different brain activation patterns in empathy and compassion, what we are really talking about is “empathy fatigue.” From the beautiful collaboration between science and spirituality in recent years where some of these brain imaging research studies were performed on Buddhist monks who were trained in compassion through meditative practices, we now know that the true compassion state is non-fatiguable and can be trained, while untrained empathy can lead to empathic distress and decreased helping behavior.
TRAIN YOUR COMPASSION MUSCLE
So the good news is, training in compassion has been shown to reverse the negative effects of empathic distress. One of the most tried-and-true way of training in compassion is through meditative practice. In the controlled setting of seated meditation, away from the real-time interactions, we practice giving our compassion, blessing and unconditional love to others. In this adapted version, we will practice giving our compassion to the people we cross paths with in our work as physicians.
Guided Compassion Meditation for physicians (10 minutes)
To begin, find a comfortable seat where you can fully relax and not be disturbed for 10 minutes.
- Klimecki, O., Leiberg, S., Ricard, M., Singer, T. Differential pattern of functional brain plasticity after compassion and empathy training. Soc Cogn Affect Neurosci (2013)doi: 10.1093.
- Halifax, J. (in preparation). Understanding and Cultivating Compassion in Clinical Settings - The A.B.I.D.E Compassion Model. In Singer, T. & Bolz, M. (Ed.), Compassion: Bridging Practice and Science (E-Book)
- Halifax J: A heuristic model of enactive compassion. Curr Opin Support Palliat Care; Jun;6(2):228-35 PMID: 22469669
- Leiberg S, Klimecki O, Singer T. Short-term compassion training increases prosocial behavior in a newly developed prosocial game. PLoS One, 6:e17798; Doi:10.1371/journal.pone.0017798.
- Marsh, A.A. (2012). Empathy and compassion: A cognitiveneuroscience perspective. In J. Decety (Ed.), Empathy: From bench to bedside (pp. 191-205). Cambridge, MA: MIT Press.