“Empathy is seeing with the eyes of another, listening with the ears of another and feeling with the heart of another,” wrote the Austrian psychotherapist Alfred Adler. Another sage of our time, the Dalai Lama, defines compassion in similar terms, as “sensitivity to the suffering of self and others, with a deep wish and moral commitment to relieve the suffering.” Compassion, then, might be defined as empathy translated into action—which encapsulates the heartfelt calling that draws mental healthcare providers to their chosen field. At Newport Healthcare, our staff are deeply emotionally invested in the work of helping young people find sustainable healing, and empathy, compassion, and unconditional love are central to our philosophy of care.
Empathy involves a direct identification with patients’ distress—feeling and experiencing it almost as if it were your own. Therefore, empathy—one of Newport Healthcare’s foundational values—allows us to deeply understand one another’s pain and also their joy, which can be enormously supportive of the therapist-client relationship.
“Empathy plays a critical interpersonal and societal role, enabling sharing of experiences, needs, and desires between individuals and providing an emotional bridge that promotes pro-social behavior,” writes Helen Riess, MD, in “The Science of Empathy.” “The personal distress experienced by observing others’ pain often motivates us to respond with compassion. The survival of our species depends on mutual aid, and providing it reduces our own distress.”
While empathy gives us a deep emotional connection with another, compassion helps us adopt a caring perspective without being absorbed or overwhelmed by the others’ pain. Compassion—and the equally essential quality of self-compassion—offer scientifically validated benefits that support the health and resilience of providers as well as their clients. In a time when 70 percent of teens and 75 percent of young adults are struggling with mental health issues as a result of the pandemic, it is more vital than ever for providers to build empathy and compassion for their clients and themselves.
Empathy and Compassion Are Key in Efficacy of Care
Research shows that the quality of the provider-client relationship is critical to successful delivery of care. Known as the therapeutic alliance, this relationship is proven to have the most significant impact on treatment outcomes for individuals with mental health conditions, regardless of the modalities or interventions employed. And both compassion and empathy are key to this therapeutic alliance.
The therapists’ ability to show compassion toward clients’ suffering and to their own suffering and to help clients relate to their own suffering with compassion creates a constructive, healing therapeutic process.
—Miriam Brill and Nurit Nahmani, “The Presence of Compassion in Therapy”
The quality of mental healthcare reported by clients is directly connected to the connection they feel with their providers—a connection that is nurtured by elements such as respect, quality of listening, and a nonjudgmental attitude, all of which are supported and enhanced by empathy and compassion. A poor therapeutic alliance not only negatively impacts the outcomes of the care provided within that relationship, it can also discourage clients from looking elsewhere for help. In a study of LGBTQ+ clients receiving mental healthcare, participants not only were less satisfied with their care when they felt pitied or judged by providers, they were also less likely to seek care in future.
How, then, can clinicians, counselors, and other behavioral and mental healthcare providers build empathy and compassion for those they serve? The most effective way, experts say, is by building compassion for oneself. We’ll take a closer look at self-compassion later in this article. First, let’s examine what distinguishes compassion from empathy, and why that distinction is important.
Compassion and Empathy Fatigue
There are subtle yet meaningful differences between compassion and empathy that are especially relevant in mental healthcare, particularly in regard to what’s known as “compassion fatigue.” This phrase is commonly used to describe the emotional exhaustion and “numbing out” that caregivers experience as a result of persistent contact with and attempts to alleviate others’ pain and distress. However, researchers suggest that “empathy fatigue” may actually be a more accurate description of this type of burnout. Empathy can be draining and fatiguing unless we balance it with self-care and self-awareness.
Know the Facts
Neuroimaging studies show that empathizing with others’ psychological or physical pain activates the same parts of the brain involved in processing one’s own pain, while compassion toward another person who is in pain activates parts of the brain associated with reward, connection, and stress resilience.
Neuroimaging studies show that empathizing with others’ psychological or physical pain activates the same parts of the brain involved in processing one’s own pain, while compassion toward another person who is in pain activates parts of the brain associated with reward, connection, and stress resilience. Both qualities are powerful drivers for effective and loving caregiving—and finding a balance between them can actually protect us against burnout.
How Balancing Empathy with Self-Compassion Keeps Burnout at Bay
Not only are healthcare providers more likely than the general population to turn to unhealthy coping strategies, such as alcohol or substance abuse, their chronic stress puts them at greater risk of health issues such as heart disease, fatigue, digestive and respiratory issues, insomnia, and mental health conditions.
Multiple studies have found that self-compassion can ameliorate these negative risk factors and reduce the risk of empathy fatigue by lowering stress, depression, and anxiety and enhancing optimism, happiness, and resilience (the ability to bounce back from difficulty more quickly). In two studies led by self-compassion expert Kristin Neff, healthcare professionals who attended a series of six sessions and practiced a set of self-compassion exercises over four weeks showed significant increases in self-compassion and well-being measures and significant reductions in symptoms of secondary traumatic stress and burnout. These results were maintained at a three-month follow-up.
Furthermore, self-compassion may be ultimately more helpful than self-care for providers, Neff notes. While exercising, getting a massage, doing yoga, or spending time in nature are all beneficial for “refilling the well,” none of these activities can happen while a provider is working with a client—they all take place outside of work. By contrast, “self-compassion is actually practiced in the moment pain arises,” Neff writes. “Healthcare providers can give themselves compassion for the feelings of stress, fatigue, and empathetic distress they experience while professionally caring for others, providing protection against its deleterious effects. Thus, self-compassion has the potential to offer them more than self-care alone.”
5 Ways to Build Compassion and Empathy
Fortunately, there are practical and simple ways to build empathy and compassion, while bolstering your own resilience and self-care. Here are five tools to integrate into your everyday life.
1. Validation for Self and Others
Words of validation go a long way toward making others feel heard. You can also offer yourself validation and understanding, as a form of soothing self-talk, perhaps when you’re feeling stressed or overwhelmed with the person you’re caring for. The words for self and others could be nearly identical; Neff suggests language such as, “I know this is hard right now, and it’s only natural you’re feeling so stressed. I’m here for you.”
2. A Loving Phrase
The practice known as Loving-Kindness Meditation (LKM) is proven to build compassion and empathy for self and others. Begin with the phrase May I be happy, May I be well, May I be safe, May I be peaceful and at ease. Next, direct this outward toward others: May you be happy, May you be well, May you be safe, May you be peaceful and at ease. You might direct these phrases inwardly toward a client, a family member, or a colleague. These words can be particularly helpful when you are struggling with a difficult situation or interaction. You can use similar phrases to activate self-compassion, such as May I learn to accept myself as I am, May I be strong, or May I give myself the compassion I need.
3. Supportive Touch
Comforting touch releases the hormone oxytocin, which enhances feelings of well-being. When appropriate, a caring touch—such as a gentle pressure on someone’s shoulder or hand—can communicate that you empathize with their experience and you’re there for them. You can offer loving touch to yourself as well: When you are feeling stressed, take a few deep breaths and place a hand or both hands on your heart. Take in the warmth and pressure, and notice the rising and falling of your chest as you breathe.
4. Transform the Critic
When we learn to let go of self-judgment, our tendency to judge others for their actions or beliefs also falls away. In the moments when your inner critic rises up, address this part of yourself lovingly and clearly, asking it to step aside. Neff suggests words such as, “I know you’re worried about me and feel unsafe, but you are causing me unnecessary pain. Could you let my inner compassionate self say a few words now?” This practice not only activates self-compassion, but also opens our minds and hearts to what others are feeling, and allows us to see their viewpoint more clearly.
5. Journaling
For a week or more, write down anything that you felt bad about, judged yourself for, or caused you pain. For each event, write about how you felt, without judging it. Next, examine some of the underlying causes that might have contributed. Perhaps you were impatient with a client as a result of being behind schedule on other tasks, or because of a difficult conversation with a family member earlier that day. Acknowledge that you, like all of us, are human and thus imperfect. Finally, write yourself a kind and understanding message of forgiveness and encouragement.
By taking just a few moments each day to strengthen your empathy and self-compassion, you can create a life and career that’s more joyful and fulfilling, while strengthening your ability to be present for your loved ones, colleagues, and clients.