More on Empathy and Compassion

I’ve been blogging about the differences between empathy and compassion, and the pitfalls of empathy.

Recently, I’ve had conversations with several patients, many of whom also who work in the helping professions, to learn more about the appeal of empathy. Remember that empathy is the idea that you are suffering because the other person is suffering. As a result of this, one’s motivation is to “fix” the problems that are causing the other person to suffer so that one does not suffer — in this way, we want to relieve someone else’s suffering so that we also can be relieved of our suffering.

Based on my experiences working with others, it seems that the vast majority of people want to offer advice, change how other people think and feel, and force solutions for others who are suffering because they themselves want to feel better. This is a very interesting perspective on empathy. When I encounter individuals who are practicing this form of “helping,” I emphasize that empathy is actually driven by a warm, loving, and nurturing heart, and encourage empathic people to embrace, if not celebrate, those personality characteristics in themselves, while also inviting them to become more comfortable sitting with other people’s suffering and allowing other people to have their feelings as a way of holding space for the other person’s emotions and  honoring his or her experiences. I suggest that instead of trying to “fix” a problem for someone else that they simply validate the other person’s feelings by demonstrating understanding that the other person is suffering without trying to change how the person is feeling, what they are thinking, and how they are reacting. This approach, which is the defining feature of compassion (helping, but not fixing), is not only more effective for helping to relieve someone else’s suffering, but it also prevents burnout among those who are trying to help. Remember that compassion has a clear boundary of where you end and the other person begins. This boundary serves as a protective barrier for becoming fatigued by trying to help too much.

Are you practicing compassion (spirit of helping) or empathy (spirit of fixing) in your daily life?

Fall: A Season for Letting Go of What No Longer Serves You

With a change of seasons, we can learn from nature: Like the leaves that fall from the trees, Fall is a time to let go of those things that no longer serve us. This is borrowed from Native American lore.

May you be inspired by this metaphor in your own life. What can you let go off that is no longer serving you?

More on Empathy and Burnout

In an earlier blog entry, I described  some of the differences between empathy and compassion. In another blog entry, I outlined some of the pitfalls of empathy, to include burn out at work. This writing is devoted to describing how empathy can drive burnout among helping professionals.

It is a relief to know that I am not somehow shirking my humanity do not feel the pain of families were making end-of-life decisions for a loved one, or who are getting the news of a loved one staff, or people I am telling that they have a mental disorder. It is a nice idea but I can actively work to shut down my emotional response without losing my compassion.

The risks of empathy are perhaps the most obvious with therapists, who have to continually deal with people who are depressed, anxious, deluded, and often in severe emotional pain. There is a rich theoretical discussion among psychotherapists about the complex interpersonal relationships between therapist and their patients. But anyone who thinks that it’s important  for a therapist to feel depressed or anything else while dealing with the pastor anxious people is missing the point of therapy.

Actually, therapy would be an impossible job for many of us because of our inability to shut down our empathic responses. But good therapists are unusual in that regard.  For those of us who are clinical psychologists and other psychotherapists who practice from a place of empathy – – wherein the patient suffers and then in turn, we suffer – even a few hours of work can be exhausting.   On the other hand, those of us who practice psychotherapy from a place of compassion can often work long hours, with patients back-to-back, and this work does not feel draining, but rather exhilarating. We employ understanding and caring, not empathy.

I hope these blogs have been helpful to readers. If you or someone you know is experiencing burnout and works in a helping profession, please consider me a resource. I’ve aided many people in these fields to reflect, gain perspective, and actively learn skills they can develop to protect them from burning out.

 

Empathy Interefering with the Care of Others

Empathy has been named an “essential learning objective” by the American Association of Medical Colleges in there is a special focus on empathy training in medical schools. For the most part, empathy can be useful when it includes all sorts of good things and most of what goes into the name of empathy training in medical school is hard to object to, such as encouraging doctors to listen to patients, to take time with them, and to show respect. It’s only when we think about empathy in a more literal sense (I feel your pain)  that we run into problems.

If, while listening to the grieving mothers raw description of her son’s body at the scene of his death, I were to imagine my own son in his place, I would be incapacitated. My ability to attend to my patient’s psychological needs would be derailed by my own devastating sorrow. Similarly, if I was brought in by ambulance to my local emergency room and required immediate surgery to save my life, I would not want to the trauma surgeon on call to pause to empathize with my pain and suffering.

Similarly, research shows that patients prefer that doctors have compassion, which has boundaries within the empathic spectrum. The spirit of compassion (“let me help you”) allows the doctor to remain objective, calm, and centered. This in turn helps the patients feel safe, secure, and in good hands.

In my next entry, I’ll discuss more about how empathy leads to burnout among psychotherapists.

Empathy vs Compassion

A widely held belief is that we all benefit from having more empathy. The ability to put ourselves in other people’s shoes and our ability to imagine the suffering of others is often regarded as being at the core of humanity.

In recent years, a growing body of literature has found important differences between empathy and compassion. Today we know that empathy and compassion involve different neural pathways. Also, in the case of empathy, “you suffer and therefore I am suffering” whereas compassion occurs from a place of helping: “I’m sorry to hear you are suffering. I’ll try to help you.” With empathy, the boundary between people is blended, meaning it’s not clear where you end and the other person begins — therefore, I need to fix your pain because it’s causing me pain. On the other hand, for compassion there is a clear boundary: I am here and you are over there, and let’s see if I can help you.

That said, it’s not surprising that empathy is more strongly associated with burnout because of the suffering the helper feels when others are suffering; people coming from a place of compassion are not suffering because another person is suffering — they are just there to help if they can. We’ll explore this more in my next blog entry.

What Is This Thing Called Joy?

I recently read “The Book of Joy,” by his holiness the Dalai Lama and Archbishop Desmond Tutu. The question is, What is this thing called joy, and how is it possible that it can evoke such a wide range of feelings? Paul Ekman, famed emotions researcher and long-time friend of the Dalai Lama, has written that joy is associated with feelings as varied as:

  • pleasure – of the five senses
  • amusement – from a chuckle to a belly laugh
  • contentment – a calmer kind of satisfaction
  • excitement – in response to a novelty or challenge
  • relief – following upon further emotion, such as fear, anxiety or even pleasure
  • wonder – before something astonishing and admirable
  • ecstasy or bliss – transporting us outside ourselves
  • exultation – at having accomplished a difficult or daring task
  • radiant pride – when our children earn a special honor
  • unhealthy jubilation – relishing in someone else’s suffering
  • elevation  – from having witnessed an act of kindness, generosity, or compassion
  • gratitude – the appreciation of a selfless act of which one is the beneficiary
  • rejoicing – in someone else’s happiness
  • delight or enchantment – a shining kind of contentment
  • spiritual radiance – a serene joy born from deep well-being and benevolence

This helpful mapping of the kingdom of joy conveys its complexity and its subtlety.

For more on this topic, I invite you to explore the book, “The Book of Joy!”

Learning How to Be Your Own Best Friend

We all want to have our feelings validated. This is a great tool for being present with other people and demonstrating that we understand how the other person feels. You aren’t trying to fix the problem or tell the person that they shouldn’t feel that way. Instead, you witness their emotions and show them that you are listening, that their feelings matter, and that you understand. You might also share a similar experience you’ve had to help demonstrate that you understand how they might be feeling.

You can validate your own feelings, too! One of my favorite tools to teach people is how to be their own best friend by using this skill with themselves. Imagine that you had a very difficult day because something disappointing happened. You can be your own best friend by saying to yourself, “Disappointments are never easy. I know you feel angry about what happened and afraid that things won’t turn out as you hoped they would. Of course you feel that way about this situation. Today was hard for you. I have your back — I’m here for you. And I believe in you. You’ll get through this!”

Oftentimes people will respond to their own feelings by thinking “You shouldn’t feel this way,” or “This is silly! Just snap out of it! It’s no big deal!” You probably wouldn’t talk to your best friend that way, and you probably wouldn’t like it if someone said that to you when you expressed your feelings.

Most people are amazed by how difficult this is to do! It requires guided practice and patience for most people because it requires an advanced level of skillfulness.

Responding to Others’ Feelings

We all want to have our feelings validated. This is a great tool for being present with other people and demonstrating that we understand how the other person feels. You aren’t trying to fix the problem or tell the person that they shouldn’t feel that way. Instead, you witness their emotions and show them that you are listening, that their feelings matter, and that you understand. You might also share a similar experience you’ve had to help demonstrate that you understand how they might be feeling.

A good example of this is to imagine if you had recently lost a loved one or a beloved pet. You are probably feeling a great deal of sadness about the loss. If you expressed sadness to a friend, and the person replied to you by saying, “At least he lived a long life,” or “He’s in a better place now,” or “Be grateful for the memories you have,” then you might feel like the person is telling you not to feel sad — that you should feel grateful. It does not feel good to be told how to feel. Instead, you probably want them to validate your feelings and demonstrate empathy and understanding by saying something like, “I’m so sorry! Grief is very painful for me, too. I miss the person and have a great deal of sadness when someone I love dies. I’m here for you if you ever want to talk about it.”

Another example is when someone expresses anger to you. Suppose that someone says, “I can’t believe that you did this to me! How could you?” Disputing the facts can be perceived as telling the person that s/he should not feel that way. Saying, “But that’s not what happened” can lead to an argument because the person may feel like you are telling him/her that they shouldn’t be feeling that way. This is usually not effective, because the person’s feelings are being invalidated. Even if you don’t agree with how the person is feeling or the person’s perception of things, it is best that you not try to talk them out of feeling that way. A more effective way of responding to someone else’s anger is to say, “I understand that you feel angry right now. What I did seems unfair to you. I feel angry when I think I am being treated unfairly, too.” Demonstrating your empathy and understanding might be the best way to help resolve the problem.

Mindfulness and the Power of Now

The practice of mindfulness is based on the idea that life is best lived in the present moment. Mindfulness calls us to the be right here, right now.

There are several advantages of being in the present moment. We let go of sadness about the past and anxiety about the future because our attention and awareness is focused on The Now — what we emotions we feel in our hearts, the sensations we feel in our bodies, textures we feel from our touch, objects that we see, how food tastes, and what scents we smell. I say that it is like living life in Technocolor because we suddenly are aware of our environment and what lies within us. By practicing this mindfulness skill, known as observe and describe, we notice what is happening right now within us and around us. Research on mindfulness has shown that merely labeling what we feel, see, taste, and smell releases serotonin in our brains, and we begin feeling a sense of calm and well-being.

Practicing mindfulness skills strengthens that neural pathway in our brains — like doing reps lifting weights — so that being present in this moment becomes an automatic response. This helps us to experience the richness of life and also allows us to manage our feelings in the face of stressful situations.

Practicing Skills Outside of Psychotherapy Sessions

An important part of treatment is practicing the skills we learn during psychotherapy sessions during the times between sessions. Practicing skills is like doing repetitions with weights — this strengthens the neural pathways that make our new behaviors easier to do and more automatic.

When we’re in treatment together, I’ll ask you to report:

(1) What skill did you use?

(2) How did it change the outcome?

(3) What’s easy for you?

(4) What’s still a challenge?

We tend to practice skills that are easier and more automatic, and tend to practice the hard ones less often. You’ll have to consciously decide to attend to the skills that are harder for you. Sometimes skills you ate good at also have particular applications that are more challenging. For example, making boundaries with a co-worker might be easier for you while they may be more challenging with family members or friends. We will work together to identify what skills or applications are challenging and set goals for progress in those areas. The best goals are challenging, doable, measurable and important to you.

Three Methods for Working with Chaos

Today when I was reading, “When Things Fall Apart,” by Pema Chodron, I arrived at the chapter called “Three Methods for Working with Chaos,” and wanted to share this wisdom with my readers.

Pema recommends three very practical ways to work with chaos: no struggle, poison as medicine, and regarding everything that arises as the manifestation of wisdom.

First, we can train in letting go of the story lines. We can slow down enough to be present and let go of the multitude of judgments and schemes and just stop struggling.

Second, we can use every day of our lives to take a different attitude toward suffering. Instead of pushing it away, we can breath it in, with the wish that people everywhere could experience contentment in their hearts. In this way, we could transform pain into joy.

Third, we can acknowledge that suffering exists, that darkness exists — that there is chaos in here and chaos out there — and this is basic wisdom. As stated by Pema: Whether we regard our situation as heaven or as hell depends on our perception (p. 126).

Finally, we can just relax and lighten up! When we wake in the morning, we can dedicate our day to learning how to do this. We can cultivate our sense of humor and practice giving ourselves a break. Every time we sit down to meditate, we can think of it as training to lighten up, to have a sense or humor, and to relax.