Self-Less Series Part 1: Do Yourself a Kindness

This is a series that will explore the many benefits of being Self-Less.  The first here examines the ways in which being compassionate is good for us.

If you feel you are burning out, practice compassion. When you are low, feeling tired and burdened by negative emotion, you might do yourself the kindness of being compassionate to someone else. 

That sounds crazy, doesn’t it?  Won’t that fatigue me more?  Surely it will further deplete my emotional resources.  Haven’t I heard of compassion fatigue? Well, yes, I have.  But we’ll get to that a bit later.

Let’s start with something I noticed in therapeutic practice.  From time to time I’d start the day a bit unhappy, concerned about the stressful things in my life.  But by the end of the day when I returned to the issues, they seemed to be less worrisome, less burdensome.  How come? Maybe to some extent my concerns paled in comparison to the suffering of my clients.  Maybe.  But I don’t think that’s it entirely.  Let’s see if we can unpack why this is so.

A great place to start is with arguably the world’s foremost expert on Compassion: The 14th Dali Lama who said:  If you want others to be happy, practice compassion. If you want to be happy, practice compassion.

Is there evidence that he’s right?  Well, it turns out there’s plenty. Compassionate people have reduced physiological responses to stress, less stress hormones released in the body and improved immune functioning. 

Compassionate feelings and actions also release oxytocin and the body’s natural opioids, relaxing our cardiovascular system and promoting human bonding. Recent evidence has emerged that being compassionate also stimulates our dopamine reward system. 

Not surprisingly therefore, the lives of those who are more compassionate are marked by greater physical health, increased resilience to adversity, improved happiness, better mental health, improved relationships and possibly even a longer life.

So, in retrospect my clients did me an enormous favour. There is a professional and ethical requirement as a therapist to put one’s own issues aside and be as present as possible to our clients, and of course to embody compassion.  Counselling is very unlikely to be successful without it.  And you can now see that embodying this state of compassion day after day was helping significantly to reduce my own suffering.

Now back to compassion fatigue.  I think this is actually a misnomer based on the confusion of empathy and compassion.  Compassion itself does not fatigue us!  This type of depletion is actually a type of empathy fatigue.  To understand this let’s start with a definition of compassion: it is ‘… a sensitivity to suffering in others (or self) with a commitment to alleviate it.’

We can see here that compassion begins with, but does not end with, empathy. And from initial feelings of empathy, I believe there are two possible subsequent pathways: compassion or empathic distress. 

Moving a step beyond and perhaps above empathy is compassion. It is other-centred and constituted by positive emotions, care, affection and kind actions. So, there is a psychological and bodily shift in this from suffering, to feelings of affection and kindness and it intends kind action.

On the other hand, empathy can turn into empathic distress if we over-identify with the other person’s suffering.  Such empathic distress is therefore self-centred, filled with negative feelings, and leads to behavioural withdrawal.  Sustained experience of empathic distress can and often does lead to burnout in the helping professions.

Is there evidence for these two divergent pathways?  I believe there is.  Brain scanning data show compassion increases activity in the areas of the brain involved in the dopamine reward system.  It facilitates oxytocin-related affiliation and bonding; and it enhances positive emotions in response to stressful situations. These positive emotions directly counteract our negative emotions. So, compassion does not fatigue — it rejuvenates our brain and body!

On the other hand, empathic distress that results from this over-identifying with others’ suffering increases activation in brain areas involved in the processing of threat or pain, such as the amygdala. If this is chronic it depletes dopamine levels, so we find it harder to experience interest and pleasure. Chronic depletion of dopamine is also implicated in burnout. 

Anyway, it appears what I discovered in private practice all those years ago was that compassion does not burn us out.  It is the failure to turn empathy into compassion that fatigues us.  We can definitely be too empathetic: I’d not be much use to an anxious client if I were to join them in their panic attack or to be weeping with my depressive clients! 

So, we need to demonstrate what I call optimal therapeutic distance: resonating enough with the suffering person’s emotion so we understand their experience; and not being so distant that we appear cold or aloof.  We can learn to tune in to our empathy to learn from it, and then dial it down in favour of compassion.  As a Canadian Veterinary Surgeon Trisha Dowling put it in a paper discussing these issues, ‘Compassion goes beyond feeling with the other to feeling for the other.’ 

And it then becomes obvious that the person who is suffering can then resonate with our positive feelings towards them. My compassion therefore becomes an antidote to their negative feelings. That is, embodying compassion is therapeutic in itself.

So, take a leaf out of the Dali Lama’s playbook and be on the lookout for people to be kind to.  And one more thing.  When you are next struggling with life, as we all do from time to time, you can also reach out to others for support.  Allow them to be compassionate to you.  In this way you will also be doing them a kindness!