Harnessing Compassion for Inclusivity

Compassion and Healthcare

Compassion is the urge to do something about the suffering of others. As such, it is central to providing healthcare, and research is confirming a key feature of compassion. As with learning to speak a language or make music, it is a human skill. Compassion is a capacity that can be developed through training and experience, and it can be expanded to include wider circles of others. Further, expanded compassion is not only a goal of quality healthcare but also central to understanding and promoting healthy diversity and inclusion.

Compassion science has received much attention in the last decade, especially in healthcare. Drs. Trzeciak and Mazzarelli published Compassionomics in 2019, a meta-analysis of over 200 studies on compassion in healthcare, concluding definitively: “Compassion matters not only in meaningful ways but also in measurable ways” and that compassion “belongs in the domain of evidence-based medicine.” The concluding chapter is titled simply: “Compassion as an Antidote to Burnout.”

CBCT® (Cognitively Based Compassion Training) offers a comprehensive method for training compassion that draws on the ancient lojong tradition of Indo-Tibetan Buddhism. Its approach is supported by current scientific research in fields such as evolutionary biology, psychology, and neuroscience. Since 2014 CBCT has been offered each semester to Emory School of Medicine faculty, staff and learners. A randomized control study by professor Jennifer Mascaro (family and preventive medicine) found that CBCT significantly correlated with increased compassion and decreases in loneliness and depression in second-year medical students. CBCT has also become the basis for a thriving training and research program for Emory’s hospital chaplains called Compassion-Centered Spiritual Health, demonstrating that people of any – or no – faith tradition can engage its methods with success.

CBCT was the first compassion training designed for scientific research. Since 2004 studies have shown that CBCT may improve multiple measures of mental health, including depression, loneliness, hopefulness and self-compassion. It may help decrease the levels of inflammation and cortisol in the body, physiological markers associated with stress, as well as strengthen the neural correlates of compassion in response to pain and suffering. Improved behavioral outcomes such as empathic accuracy and decreased PTSD symptomology have also been observed. The program today remains at the vanguard of this growing field with multiple research projects including two multi-site, multi-year programs funded by the US National Institute of Health.

In CBCT we cultivate compassion through meditation, mental exercises to explore and train qualities such as kindness and empathy and to familiarize ourselves with the various skills and perspectives that generate and sustain such qualities. CBCT is based on an integrative model that offers practices in eight modules, each designed to strengthen a particular skill or insight that supports compassion.

Emory’s Compassion Center is based on the premise that training compassion can promote flourishing on individual, societal and systems levels, and contributes to a healthier and more ethical world for all. All are welcome to explore this with us.

Day 1: Connecting to a Moment of Nurturance

When we feel safer and more cared for, it opens the door to possibility. Connecting with a personal experience of receiving kindness calms body and mind. This creates space for us to extend care and kindness to others and, by connecting to the value of nurturance, we become more motivated to be a greater source of it for others. It is important to recognize that we all come from diverse backgrounds and have different experiences, so the way we understand nurturance may be different. For some, nurturance may have come from a caregiving individual while for others, the moment of nurturance that elicits feelings of calm and contentment is through an experience like being in nature, sharing a moment with a pet or reading a book. Through connecting to a moment of nurturance, we are better able to access the feelings of safety that give us the strength to train and sustain a more inclusive compassion for all.

Day 2: Cultivating Self-Compassion

Self-compassion springs from the genuine desire to free ourselves from distress and dissatisfaction. As human beings, we all share certain realities – we will all experience some pain, loss and suffering at some point in our lives. It’s inevitable that we will lose things, miss opportunities, make mistakes and end up in situations and with feelings we don’t want. We are all vulnerable. It’s natural that things go wrong in life, and that we will inevitably face adversity and a degree of emotional distress. And though we may have deep aspirations to be free of these problems, both success and struggle are part of the full spectrum of being human.

When our views of our personal setbacks and failures become exaggerated or distorted, this can fuel responses of excessive self-criticism and self-blame, which amplify our distress. However, if we can accept the inevitable vulnerabilities of our human condition, we can more easily respond with kindness and resilience when things go wrong.

This ability to shift our perspective is a powerful emotional regulation strategy understood by contemporary neuroscientists as cognitive reappraisal. Developing this skill for managing our emotional and behavioral responses is key to growing compassion and, over time, this accepting perspective can become the natural way that we understand and view the ups and downs of our lives. The more we can embrace this broader perspective to see that we are more than our limitations and the more we approach ourselves with kindness, the better equipped we will be to extend this same understanding towards others. This is a turning point on the journey toward developing unbiased, inclusive compassion.

Day 3: Expanding our Circle of Concern

Belonging and connection are innate human desires – things we not only want but also rely on for our survival and emotional wellbeing. While our compassion is most often directed toward those closest to us, we are born with the ability to extend care to larger and more diverse groups, expanding our circle of concern and, in doing so, increasing wellbeing for others and for ourselves. Through recognizing the realities we share as human beings, including our shared aspiration to be well and avoid harm, we cultivate the ability to identify with others based on our common humanity.

Though we are all connected through our common humanity, it is also important to appreciate diversity. Being open to challenge our own thinking and expand our understanding is important for fostering possibility, innovation, cooperation and respect, which helps us see that our differences can be valued and celebrated without causing separation and conflict.

Embracing common humanity while appreciating diversity leads to a natural response of understanding, inclusion and kindness toward a widening group of people, and, by shifting our perspective to see all human beings as part of our ingroup, we can transform our bias into inclusion, and promote greater peace within ourselves, our communities and the world.

Reflecting on the things we share as humans does not give us a reason or an excuse to ignore important ways some groups are treated unfairly. Rather, the shift toward seeing others as “one of us” at a human level will naturally strengthen our sense of concern for their struggles. Attuning to the ways that they too want to be well and avoid harm, we will be more interested in their wellbeing, more curious and concerned about what they are up against, and more motivated to do something to help. Though it is true that we all have vulnerabilities, it is also true that we do not share the same vulnerabilities. Some lives are more vulnerable due to different circumstances. By improving our ability to hold both realities in mind – what we share and what makes us different – everyone benefits. Through the recognition of both realities, new alliances can be forged across the lines of power and status to find creative solutions that address our equal right to pursue and find happiness and flourishing.

Day 4: Deepening Gratitude and Tenderness

The bond we share through our common humanity is deepened by seeing how so many others help us every moment of every day. It is natural for us to feel a sense of gratitude and tenderness for those who contribute to our wellbeing and by attuning to our interdependence, we see that everyone is somehow part of the vast web of social beings that we rely on to survive and thrive. Our homes, having safe food to eat, clean water, jobs, roads, electricity, clothing – all of this is possible thanks to the efforts made by other human beings, most of whom we have never met. The awareness that countless other people are valuable to our daily lives has an impact on how we feel and act toward them. As we make this interdependent reality visible, we will find there is no limit to the deepening of our connection to and concern for all beings with whom we share this planet. This understanding builds on our ability to identify with all others, enhances feelings of gratitude and warmth for them, and opens the heart to an ever more inclusive sense of belonging that can extend across the planet.

Day 5: Harnessing the Power of Compassion

Compassion is a response to what others are up against, and tenderness is what strengthens our urge to relieve their suffering when we become aware of it. Becoming aware of others' struggles can sometimes happen spontaneously, but often it requires taking the time to examine what others are up against using discernment and systems thinking. As we examine the complexity of any issue, we uncover different layers that we may be able to impact. We may find that the best way we can help with a bigger issue is to focus on one of the underlying contributors. Sometimes the only thing we can do is hold others with our compassionate wish, but this too can lead to positive effects. When we are with others who are suffering, our warm-hearted presence can itself be a source of comfort and nurturance.

As we sustain our compassionate stance, we remain on alert, ready to act as soon as we see how we can make a difference. Embodying a systems-thinking perspective makes visible our personal role in addressing even the largest problems that humanity faces, and we discover more creative and lasting ways to foster a more diverse and inclusive world.



Meditations

As we emerge from a, likely, hectic semester, we encourage you to take a moment of mindfulness each day this week by doing a meditation. This YouTube channel offers guided meditations, visualizations, hypnosis, yoga and pilates sessions as well as a variety of mindful movement practices to help you live mindfully, move well and feel great. We hope you'll take a few minutes each morning before diving into the Diversity and Inclusion Week sessions to practice mindfulness for just a moment.