Cultivating compassion in healthcare

Working in an overburdened, under-resourced healthcare setting in one of the most unequal societies in the world can be tough on the psyche. Yet, despite this, practising compassion is beneficial for healthcare workers, the patients they serve and the organisations they work in.

This was one of several key messages Dr Heidi Matisonn drove home during an early morning University of Cape Town (UCT) Summer School lecture on Monday, 26 January. Dr Matisonn is a senior lecturer in UCT’s EthicsLab, based in the Neuroscience Institute. Her lecture was titled: “Why empathy is breaking healthcare: The neuroscience of compassion.” It touched on how to develop a more regulated response to people’s suffering, which Matisonn argues, starts with compassion.

The role of compassion

But what is the role of compassion in healthcare?

Simply put, she explained, compassion involves recognising suffering without fully embodying it. Interestingly, it is characterised by warmth rather than distress; concern rather than emotional contagion; and is likely to result in action-orientated care rather than shared pain. And it does not require an intense salience network activation.

Instead, Matisonn said, compassion comes with a stress-buffering function. It activates parasympathetic (a division of the autonomic nervous system that promotes rest and digest functions) pathways, reduces cortisol and threat responses and enhances emotional regulation and resilience.

“What we want is a more regulated response to people’s suffering so that we are not so emotionally affected by it. Compassion functions as a psychosocial buffer, particularly in chronic caregiving roles. Push compassion. It’s cheap,” she said.

Cultivating compassion

But ultimately, practising compassion is a skill. The more you practise it, Matisonn said, the better you’ll become.

But how do we cultivate compassion, she asked the audience.

In the healthcare setting, Matisonn advised healthcare workers not to imagine a patient’s suffering. Phrases like “I can imagine how difficult this must be for you” should be a no-no. She advised healthcare workers to adopt phrases like “I hear how much this frightens you. Let’s talk about what matters to you now and how we can support that.”

She added: “Taking on a patient’s suffering is fine if you only have one patient. But if you work in the Oncology Department at Groote Schuur Hospital, you don’t only have one patient. And so, to take on and imagine the suffering of all your patients is just too much.”

She advised keeping a compassion diary and to write down experiences that involve coming into contact with people (including yourself) and how best to be compassionate during those moments.

Matisonn concluded her talk with a quote by mindfulness teacher and coach Vidyamala Burch.

“Compassion is very clear-eyed. It is not sentimental; it’s very clear-eyed and wise and objective.”