Do you have any loved ones going through a difficult time? Or maybe you work with people who are often in pain or distress.

At some point, we’re all bound to witness pain and suffering.

Some people turn away from it – if they can – to avoid the discomfort. But there are times when we can’t, or don’t want to, because a desire to help the person in pain is strong. That kind of compassion is a positive, human response.

But if you’re often with people in pain or crisis, either through your work or care for a loved one, then you need to be careful not to become overwhelmed.

When I was a public interest lawyer, I worked with people in crisis every day. I felt their fear and hopelessness. I became chronically stressed, overwhelmed and suffered burnout.

I experienced what experts call empathic distress. But you don’t have to, if you understand what’s going on.

The good news is two-fold:
(1) you can train your brain toward a healthier, positive response; and

(2) this training is good for you – for your brain, your executive functioning, emotional regulation, and well-being.

Empathy vs. Compassion

As humans, our brains and nervous systems are wired to connect with each other.

Empathy is important for our connections because it allows us to relate to what others are feeling. It’s what makes our eyes well up when we observe another’s joy or suffering.

Empathy is a good thing, most of the time.

The problem arises when empathy leads to our own suffering, because we continue to experience another’s pain as our own. The result is what many call “compassion fatigue” but is more accurately described as “empathic distress.”

In order to alleviate the overwhelm of empathic distress, people may try to cope by withdrawing, distancing themselves, and depersonalizing those in pain. Unfortunately, such coping strategies not only fail to alleviate the other’s suffering, but could even make it worse.

Empathic distress and burnout are common among helping professionals such as health care workers, social workers, veterinarians, and social and criminal justice professionals.

Compassion is different. With compassion, we recognize the pain of others and feel for them, but we differentiate ourselves from them. The pain belongs to them, and we understand it, but it does not become our pain.

While empathy can result in feelings of helplessness and emotional exhaustion, compassion tends to motivate us to do something to alleviate the other’s suffering.

Empathic distress in the brain

The areas of the brain that are activated (as shown in MRI scans) in response to pain are areas in the limbic or emotional brain, including the insula and anterior cingulate cortex. These areas are also involved in a network that processes stimuli and helps the brain decide what to focus on.

These areas are activated not only for both physical and emotional pain, but also when observing someone else’s pain.

Limbic areas such as the amygdala, integral to our fight-flight response, also become more active when the observer focuses on how the observation of pain is affecting them.

Research also shows that experiencing longterm or chronic pain, directly or empathically, depletes the supply of dopamine in the brain, a chemical that is tied to the brain’s motivation and reward circuits. And the chronic depletion of dopamine which results from continuous empathic distress (e.g., experiencing another’s pain as our own), causes emotional exhaustion and burnout.

Compassion is the solution

Unlike empathy, compassion increases activity in areas involved in the generation of dopamine, oxytocin (a “feel-good” hormone) and enhances positive emotions in difficult situations.

This increase of brain chemicals is related to the motivation and reward circuitry that makes us want to do something to help.

So unlike empathy, compassion makes us want to take action to alleviate suffering. Rather than avoiding or withdrawing, compassion enables us to be present with another in distress.

And sometimes, just being present with the person is enough to help.

In a study at the University of Wisconsin-Madison, Dr. Helen Weng and others found that compassion can be cultivated through a 2-week training program that affected the brain’s neural circuits that support altruism, self-regulation and positive emotions.

In the study, participants trained 30-minutes via guided audio instructions to either cultivate feelings of compassion towards others, or to decrease negative feelings by re-interpreting the emotional meaning of images showing people in distress.

The group who trained in compassion showed more altruistic responses than those who re-interpreted the meaning of images.

MRI images also suggested that the brains of those who trained in compassion showed greater activation in brain regions associated with social cognition (awareness of others), maintaining attention, goal direction and emotional regulation (e.g., the inferior parietal cortex, which is involved in visual spacial processing and understanding others, and the dorsolateral prefrontal cortex, which helps with attention and goal direction).

Both the behavior and the brain activity in the study suggest that compassion training helps activate the executive control network that aids in regulating the emotional response of the limbic area.

In other words, compassion actually allows us to move toward suffering with the goal of helping another, rather than moving away from it to avoid our own discomfort.

Compassion can be trained

Compassion is a sort of antidote to empathic distress. It can not only improve your well-being, but it can improve your brain’s neural patterning.

And it’s good for those you are wanting to help. When you are able to be present with their suffering, and are more motivated to help them – which is what compassion will do –  they will be better off as well.

So if you’re working with or caring for people in pain (emotional or physical), it’s time to start training your brain!

The way to train for compassion, as shown by research, is to regularly practice directing one’s attention to kind thoughts and well-wishes towards others and oneself.

The practice is often called lovingkindness meditation which involves repeating phrases such as: “may you be safe; may you be well; may you be happy and free,” directed at different people. The exact words don’t matter as much as the meaning of them, and you can use phrases and words that resonate for you.

You can find a number of free guided compassion practices online. Choose one that works for you. To get you started, here are several options:

(1) Get a copy of the script or audio file of the 30-minute practice used in Dr. Weng’s study (above) here.

(2) Follow this guided 30-minute compassion/lovingkindness practice from Berkeley’s Greater Good Science Center here

(3) Find a number of shorter guided compassion/lovingkindness practices through the free app Insight Timer. A number of very experienced teachers, including Sharon Salzberg, Jack Kornfield and Tara Brach, offer practices here.

Experiment with different practices, or choose the teacher and practice that resonate for you. Try it for at least 2 weeks, and see what happens.

Your brain and those you care for will be the better for it!

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