Compassion: the essential orientation

We humans engage in a wide range of behaviours, driven by many different motives. Unfortunately, many aspects of modern society tap into and stimulate our threat sensitive, competitive, self-focused and tribal impulses (Gilbert, 2018). You don't have to look very far to see this – just look at recent political campaigns in the UK and the US. 

'Compassionate motivation' on the other hand – endorsed by most religions for centuries – can help to counter the destructive effects of our more basic urges, and help redress many of the world's current problems (Ricard, 2015). But for humanity to fully unlock the power of compassion, we must first gain clarity about its nature. Where does it come from, and can we deliberately cultivate compassion? 

What is compassion?

There are several definitions of compassion, arising from different models and approaches. A dictionary definition might be 'sympathetic pity and concern for the sufferings or misfortunes of others'. But we can finesse this a little, in a way that emphasises the importance of compassion for our future (Gilbert & Choden, 2013).  

One scientific model views compassion as having evolved from the mammalian caregiving system which enabled parents to be sensitive to the distress and needs of their infant and work out how to best meet those needs and alleviate distress – for instance by protecting, feeding, comforting or rescuing. This new behavioural repertoire is underpinned and enabled by a range of neurophysiological and physiological adaptations, meaning that we are wired for advanced caring. 

Human compassion, though, differs from mammalian caring in important ways. About two million years ago our ancestors started to evolve new cognitive competencies including new types of self-awareness, ways to use language and reason, ways to think systemically and think in time (working out the impact of our behaviour on self and others years ahead), and a form of conscious awareness facilitating processes such as mindfulness (Gilbert, 2019b; Marsh, 2019). 

These competencies radically changed the way motives can be enacted and elaborated. For instance, our competitive motivation manifests itself in international sport, the fashion industry and aspects of our capitalist economic system, with its incentives to accumulate sometimes vast wealth, power and status (resulting in the massive inequalities in wealth we see around us). Meanwhile our caring motivation has morphed us into 'super-carers' – e.g. highly trained healthcare professionals, fire and rescue teams and international relief agencies. We campaign for social justice and for the improved wellbeing – not just those close to us but also of strangers, people on the other side of the planet, generations yet to be born and other species. We deliberately care for gardens, parks, oceans, rivers and rainforests. 

Yet whilst we may be super-carers, we are also super-cruel and callous. These same evolved competencies massively increase our capacity for harm, cruelty and viciousness. Just witness the Roman games, crucifixion as a punishment, the Holocaust, ethnic cleansing, and slavery, both ancient and modern. We are indeed a species of extremes (Marsh, 2018). What we need, to thrive in the future, is a better understanding of the contextual and personal conditions that bring out the best and worst in us (Sapolsky, 2017).

An evolved motivational system

Our motives – for avoiding harm, acquiring resources, securing status, developing friendships, joining groups, finding sexual partners, caring for children – are all underpinned by stimulus-response algorithms of the type: if A occurs, is felt or noticed … then do B. For example: if threat … then activate sympathetic nervous system and run or hide; if sexual opportunity …  then activate sexual arousal, approach and engage; if hungry … then go search for food. 

Once we understand compassion is an evolved motivational system growing from mammalian caring, we can infer that the neurologically supported stimulus-response algorithm which enables it is something like: if signal of distress … then engage and act to alleviate (the basic mammalian mother-infant caring algorithm). This has informed the widespread, evolutionary based definition of compassion as: 'a sensitivity to suffering of self and others, with a commitment to try to alleviate and prevent it' (Gilbert, 2017). 

Note the inclusion of prevention in this definition. It's about engaging and then acting, and Gilbert (2009) has outlined six trainable competencies for the engagement aspects of compassion and six for the action focused aspects (see Figure 1).

Figure 1 The motivation and competencies of compassion

Adapted by P. Gilbert From P. Gilbert (2009) The Compassionate Mind. With kind permission Little Brown

Whilst the engagement related competencies – being sensitive to signals of distress, being moved by them (sympathy), being able to tolerate our personal distress when engaging with suffering, having empathic understanding of the nature and causes of that distress, and being non-judgemental – are necessary for compassion, they are not sufficient. Indeed, it has even been suggested that engagement with distress alone may lead to burn-out (Ricard, 2015). So the six action focused competencies are just as necessary: paying attention to how to best be helpful, imagining helpful scenarios, reasoning about causes and solutions and problem-solving, behaving helpfully and sometimes courageously, and being sensitive to emotions and body states in oneself and others. (Even small changes in the behaviour of the compassionate actor can make a big difference. For instance, cancer patients randomised to an 'enhanced compassion' intervention in which oncologists added a few words to the start and end of the consultation had significantly reduced anxiety (Fogarty et al., 1999); and a pre-operative chat from an anaesthetist, designed to build the doctor-patient relationship, results in less need for pre-operative sedation and even a 50 per cent reduction in the need for post-op opiate pain medication (Egbert et al., 1963, 1964).)

Not a simple emotion

This 'motivational / competency' perspective helps us see that compassion is not a simple emotion. Compassion can be associated with a wide range of feelings depending on the context in which it unfolds. For instance, a firefighter arriving at a burning building might experience fear, manifest courage, feel a strong empathic connection to their team and experience strong positive feelings of achievement and satisfaction after the incident is over; an undercover journalist working to expose corporate wrongdoing may experience anger at the injustice of the wrongdoing alongside anxiety and paranoia about being discovered. 

This model also helps us see through the misconception that compassion is soft or weak – like pity, or just some kind of tenderness. We sometimes find this belief acts as a barrier to compassionate mind training or self-compassion exercises, so we might encourage people to get a picture of our rescue services in their mind, or historical figures such as Nelson Mandela or Emmeline Pankhurst who they might associate with compassion. Do they consider such people weak? 

Compassion is also sometimes confused with kindness in people's minds, but kind acts – such as remembering someone's birthday or doing someone a favour – are often associated with happiness and tend not require courage or engagement with suffering, whilst compassion always does (Gilbert et al., 2019). Whereas we are often told that 'kindness costs nothing', the engagement aspect means that compassion might… this could explain the classic 'Good Samaritan' study (Darley & Batson, 1973), in which the researchers got 90 per cent of students on their way to prepare a talk on the Good Samaritan to ignore a man slumped in an alleyway, simply by manipulating their sense of 'hurriness'. A competing motive (desire for achievement or threat of task failure) reduced compassionate responding.

What good is compassion?

The giving and receiving of compassion has major beneficial impacts on human physiology, including on the immune and cardiovascular systems, neurophysiological pathways and even epigenetic profiles (for reviews see Seppälä et al., 2017). Acting in a compassionate way also brings forth positive emotions in the person acting compassionately. For instance, two of us recently developed and tested a small compassionate mind training experience inside virtual reality for people with cancer. The positive feedback from patients testing the prototype system was one of the highlights of one of our professional careers. 

Then there's self-compassion. Research shows that people who are more compassionate towards themselves tend to experience better psychological health, reduced anxiety, rumination and perfectionism, lower levels fear of failure and depression, less struggle with unwanted thoughts and a greater willingness to accept negative emotions. They may also be better able to cope with adversity including academic failure, divorce, childhood maltreatment and chronic pain, and be more likely to look after themselves by making dietary changes, reducing smoking, becoming more active and seeking appropriate medical care. 

And there's more. People scoring high in self-compassion may have lower cortisol levels, increased heart-rate variability, and perhaps also experience more wellbeing, optimism, wisdom, curiosity, exploration, personal initiative, emotional intelligence, good relationship functioning and lower levels of self-harm and suicidal thoughts (see Seppälä et al., 2017 and Cleare et al., 2018, for reviews).

Too much compassion?

Can an individual suffer from being too compassionate? Perhaps, and in more than one way. Acting to alleviate suffering in others can expose the compassionate person to risk of harm – for instance, attempting to rescue someone from a burning car, or stepping in to protect someone from racial harassment. Some people may experience 'compassion fatigue', a significant reduction in feelings of empathy and care for others. Whether or not this syndrome is distinct from that of burnout is contested (Sinclair et al., 2017), and may be the result of similar causes (such as excessive work pressure combined with unsupportive environments and reduced self-care behaviour) and not excessive compassion per se. Indeed, some studies suggest that increasing self-compassion may be helpful in cases of burnout and compassion fatigue, including amongst psychologists (Eriksson, 2018). 

Can compassion be increased?

Something which separates humans from other animals is our ability to intentionally choose to improve our skills and functioning. And just as we can choose to get in better physical shape, so too we can choose to deliberately improve our psychological skills via mental training. 

Until recently compassion training was mainly derived from such contemplative traditions as Jainism and Buddhism, but the last 20 years has seen rapid growth in the scientific study of compassion focused interventions and practices and their impact on wellbeing, prosocial behaviour and neurophysiological systems (Goleman & Davidson, 2017). Whilst mainly offered within therapy settings, evidence-based approaches to the cultivation of compassion are also being adopted by coaching practitioners to help clients thrive and flourish (Passmore 2019; Passmore & Oades, 2015; Anstiss & Gilbert, 2014). 

Evidence from multiple teams shows that guided, intentional practice of compassion focused activities and exercises have significant impact on a range of psychological and physiological systems including the frontal cortex, amygdala sensitivity, heart rate variability and immune functioning. Studies also show that compassionate brain training alters activity levels in neural structures enabling and underpinning compassionate responding. 

But does compassionate mind training actually increase behaviour intended to benefit another? Several studies using a range of assessment measures (self-report, economic games and real-world experiments) show that it can. 

For example, Leiberg and colleagues found in a 2011 study that helping behaviour in a pro-social game increased in participants who received short term compassion training compared to the active control group. Crucially, how long a person had spent practising their compassion correlated with changes in the amount of help offered to strangers. Weng et al. (2013) found compassion training increased altruistic redistribution of funds to a victim encountered outside the training context, and that post-training prosocial behaviour was associated with altered activation in brain regions implicated in social cognition and emotional regulation. And a 2018 study led by Anne Bockler investigated three distinct mental trainings in a large scale nine-month intervention study, and found that only training in care and compassion boosted altruistically motivated behaviour. The researchers concluded that human pro-sociality, altruistic motivation and behaviour are malleable and can be altered through simple, short and non-costly daily mental practices that can be easily implemented in everyday life.

In education settings, a meta-analysis of 213 school-based social and emotional learning programmes involving over 250,000 kindergarten through to high school students (Durlak et al., 2011) found an 11 per cent improvement in social emotion skills, attitudes and behaviours compared to controls, whilst a meta-analysis of 45 studies involving close to 500,000 students (Goldberg et al., 2018) demonstrated small but significant improvements in social, emotional and behavioural adjustment including positive social behaviour.

In a must read for health professionals, Compassionomics: The revolutionary scientific evidence that care makes a difference, Anthony Trzeciak and Stephen Mazzarelli reviewed hundreds of studies to show that compassion delivers huge benefits for patients experiencing a wide range of conditions; that clinicians can be trained to manifest increased compassion in their work; and that such increases can lead to improved patient and healthcare system outcomes. 

All this leads us to…

8 Practical Steps for building compassion  

1. Learn about what compassion is, what it isn't, and its benefits to yourself and others.

2. Practice self-compassion. Recognise the inevitability of suffering, notice your own, and treat yourself with the same kindness, care and understanding you might treat another. 

3. Listen with more empathy. Imagine things from the other persons perspective and communicate this attempt at understanding.

4. Spend time during your day – perhaps during any mindfulness practice, or when travelling or working – silently wishing other people well, wishing them happiness and freedom from suffering.

5. In seated practice, cultivate feelings of compassion for things which are easy, for example, people you love, close friends and relatives, loved pets, etc. Then extend this 'circle of compassion' towards mere acquaintances and strangers. And then, perhaps, to people you actively dislike.

6. Increase your acts of kindness to others. Help people to do things that they cannot or might struggle to do for themselves. Try to be helpful, rather than harmful.

7. Try and shift from a self-focus to a systems-focus, recognising yourself as part of a much larger connected biological system in which co-operation commonly results in better outcomes.

8. Continuously hone your skills and abilities around noticing, approaching, alleviating and preventing suffering in yourself and others – such as non-judgement, empathy, distress tolerance, courage and technical helping skills.

So what?

Niko Tinbergen (1963) outlined four questions which must be answered to fully understand a product of evolution – including a psychological trait. What is its function? What is its physical mechanism? What is its history over generations? And how does it unfold over the lifetime of an individual? 

Over the last 20 years we have made great progress in answering each of these questions for the evolved motivation of compassion. We've also found evidence that it can be developed in individuals via training and therapy; and that this results in improved wellbeing and increased pro-social responding.

Attempts are underway to cultivate compassion in schools (Maratos et al., 2019, https://www.compassionschools.org/). In workplaces, organisations are beginning to explore the compassionate concept of being helpful not harmful, both in activities in the world and treatment of employees (Anstiss 2017; Dutton & Worline, 2017). Compassionate approaches are also being extended to cities (Ruez & Parekh, 2019) and political life (www.compassioninpolitics.com) where the focus is on creating helpful not harmful political and economic systems.

But one question remains unanswered. Can the human race cultivate compassion at sufficient scale and pace – at both individual and collective levels? We are embedded in a fast-changing world full of uncertainty and threat, technology advance, environmental challenge, political tribalism and extremism. Discovering how we can fasttrack the conditions for compassion is surely one of our species' greatest challenges, and one the most urgent tasks of psychological science.

- Tim Anstiss is a Faculty member, Centre for Coaching, Henley Business School and Founder at The Academy for Health Coaching

[email protected]

- Jonathan Passmore is a Fellow of the Society, a D.Occ.Psych, a professor of coaching and behavioural change, and Director of the Centre for Coaching, Henley Business School

[email protected]

- Paul Gilbert FBPsS, PhD, OBE is Professor of Clinical Psychology at the University of Derby

Founder of The Compassionate Mind Foundation

[email protected]

References 

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