Opinion

Cynical about compassion.

Lilley

Roy Lilley, in his  25th March newsletter at nhsManagers.net wrote, “I’ve been thinking about it.  Ruminating, cogitating and turning it over in my mind.  I’m not sure I should be saying this but I have a bit of a problem with ‘compassion’.  It’s too slick, too easy, too glib.” – Robin Youngson responds:

Lilley starts badly. Few would agree with the definition of compassion he offers:

Definition; Sympathetic, pity and concern for the sufferings or misfortunes of others.

Compassion is not pity. True compassion has non-judgment at its heart but pity is a form of moral superiority. The person being pitied is belittled – poor you!

Even Lilley has misgivings with the definition he offers.

That’s not good enough for me.  Compassion should have a depth to it… Strictly speaking it means ‘suffer with’, from the Latin ‘Cum Passus‘.

He goes on,

Compassion doesn’t do it for me.  How can a young nurse with little experience of life ‘Cum Passus‘, suffer-with, a terrified, dementing  90year old.  How can a childless person ‘Cum Passus‘ a family bereft at the death of their child.  Few of us can ‘Cum Passus‘ with an amputee or understand the life of a refugee or a rough sleeper.

I can only think that Lilley has never found himself, or a loved one, in a situation of deep suffering and vulnerability as the result of serious illness or injury. Then he would know that the young and open-hearted nurse might be the one to offer the most exquisite compassion and loving kindness. Life experience helps us to empathise with a person’s situation but it’s not needed to recognise suffering and to feel motivated to do something about it. It’s the caring that counts.

How often do you hear; ‘I know how you feel’.  You can’t know how ‘I’ feel.  You might know how you felt when something pivotal happened in your life but that’s all.  You might be able to say; ‘I can’t imagine how you must be feeling; all I can say is when my Mum died, I felt terrible and I expect you do too‘.  That’s empathy.  It is not compassion but it is sensible and meaningful.

Empathy has several components: an ability to sense what someone is feeling and to name that feeling; the ability to listen carefully, comprehend a situation, and paraphrase your understanding; and the capacity to convey all these with touch, tone, facial expression and body language. The person who says, “I know how you feel” may be lacking in empathy. The person who takes the patient’s story and makes it their own – ‘autobiographical empathy’ – is not expressing empathy either. Empathy is a good start but it’s not enough. Torturers use empathy to increase the suffering of their victims. Empathy is not a moral virtue, it’s a skill. Compassion, on the other hand, is a motive: the humane quality of understanding suffering and wanting to do something about it.

We can wish for the safety and happiness for other people but that’s not compassionate.  We can do everything we can to avoid pain, fear and sorrow but that’s not compassion.  It’s professional.

What ghastly vision of “professional” includes the treatment of pain, fear and sorrow without recognising the suffering of the patient and being motivated to lessen it – other than to act like a robot? When the patient is in pain, fear and vulnerability, the coldness of a detached professional is like a knife to the heart. Yes, we want our health professionals to be knowledgeable and technically competent but we also crave kindness,  compassion and love. When medicine runs out of treatment, there’s nothing else left. Love can save a life.

We simply cannot share the dark inner recesses of other people’s lives.  To pretend we can, in the name of ‘compassion’ means the word has been hijacked and professionalised, sloganized, polished and devalued.  We cannot share someone else’s sorrow or fear but we can share our own, with them.

I wish that Lilley could sit with us in a ‘Reawakening Purpose‘ workshop and hear the extraordinary stories told by so many health professional – young and old. Time after time we hear stories that bring tears to our eyes. They tell of the extraordinary capacity of caring health professionals to leap into the chasm and be with their patients in the darkest places. It’s a capacity to be vulnerable, to step beyond any sense of knowing what to do, and to witness pain, despair and suffering without having to ‘fix’ it. From these precious moments of deep connection arise a mysterious force of healing. This is the nature of compassion. There is no pretense.

Compassion is a fad-word; it trips easily off the tongue.  It’s neat and smooth and not right. 

Yes, when politicians and health leaders glibly talk about compassion, it can become a fad-word. But let’s not devalue the deepest expression of caring in our healthcare system – compassion is what called most health professionals to join their profession.

8 Responses to “Cynical about compassion.”

  1. Gauri says:

    So beautifully written, Robin. The truth of compassion just oozes out through your words. I believe compassion is something that is innate within all of us- sometimes we just need to knock down the walls we have put around our hearts to protect ourselves from others suffering in order to feel that innate compassion. I am not saying we have to suffer to have compassion but I do not believe we have to experience the exact trauma another has experienced in order to have compassion. I do however feel that because of the interconnectedness of all beings, we do share suffering, as well as love, beauty and grace. Arch Bishop Desmond Tutu said, “what hurts one, whether or not we are aware of it immediately, hurts the other.”
    I believe a heart truly ignited by compassion and love is like a fire that is able to understand and consume suffering and burn brighter as a result.

    I love your statement,

    “When medicine runs out of treatment, there’s nothing else left.
    Love can save a life.”

    Can I quote you? 🙂

    Keep up the awesome work!

    Gauri

  2. I feel sorry for Roy Lilley. He does not seem to know the difference between sympathy and empathy. Patients do not want people to feel sorry for them – pity is indeed a form of ‘moral superiority’. Being pitied makes one feel inferior, and gives the person doing the pitying a false sense of superiority – which can lead to lack of care and callousness.

    It’s easy to feel powerful when in charge of vulnerable people. That’s how bullies are made.

    This is something that needs to acknowledged by everyone in the caring profession.

    The difference between empathy and sympathy should be drummed home in basic training and reinforced regularly in professional development – and that same understanding is needed by managers and others who influence healthcare.

  3. Kathy Torpie says:

    Robin, so glad to see misconceptions about the nature of compassion demonstrated and debunked. An important discussion. Too often compassion, pity ,and empathy are confused and debunked.

  4. Karen says:

    Roy Lilley hit the nail on the head with his article about compassion. The above piece quotes selectively from Roy’s very measured analysis.

    Our family have been treated appallingly by the Chief executive of a Trust who constantly espouses “compassion” yet shows not the slightest concern about the pain and upset he is causing. It is this type of glib use of one of the 6 C’s that undermines it’s value.

  5. Lilley’s argument about a childless person not being able to feel compassion for others who have lost children, etc, leads to the absurd conclusion that no one can have compassion for anyone else because no two people are alike. Is a priest necessarily unable to feel compassion for married people and people with children? Is a hospice chaplain whose parents are alive unable to give compassionate counsel to all those children who are about to lose a parent on hospice or who have lost that parent? You get the idea.
    –hospice chaplain Karen, of offbeatcompassion.com

  6. Peta Joyce says:

    I think it’s good to question the glib use of compassion and to bring our awareness to the deeper sense of that word. It can also stretch my ability to practice compassion around those who are cynical or have different views to my own!

    I once heard a story about Quakers who were prison visitors; they considered themselves unready to work with a prisoner until they could find in themselves the place that would have led them to commit that particular crime – now that’s compassion!

  7. Nikki says:

    Robin I think this man is very arrogant . The opposite of compassionate surely.
    Who is he to presume he knows the life experience of the young nurse. Perhaps her family looked after a relative with dementia at home for years,maybe she lived next to a care facility and spent her spare time reading to or just listening to the same story being told by a women with dementia.
    Perhaps that childless woman was childless because she had lost 3 babies at 20 weeks like a friend of mine. I’m sorry but such arrogance from a person who judges people so easily .
    Two memories that spring to mind one of them a colleague of mine from years ago who outwardly was a very cool dude interested in his appearance ,clothes and his car but to see him interacting and caring for his younger sister who had Down’s syndrome you almost forgave him his vanity.
    The other was a visit to an old folks home by Bens year 7 school band and how kind,considerate and genuinely nice one of the girls was to a 90 year old man with dementia attentively listening to his stories and his harmonica playing. She was fine till she got on the bus to leave when she became extremely distressed and between gulping sobs said he reminded her of her beloved grandpa
    You never know what someone’s life experience has been and it is unwise to presume

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