As a passionate advocate for compassionate, human-centered healthcare, I’ve been campaigning internationally for ten years. For most of that time I was much less effective than I could have been. I made many mistakes. The insights I now share were won slowly and painfully. As a budding compassion champion, I hope you might avoid some of the mistakes I made. – Robin Youngson, CoFounder, Hearts in Healthcare.
1. Confusing our work with a moral crusade
I began my work in anger. Seeing what happened to my own daughter, during three months of hospital care, radicalized me. I railed against the system. I was angry about doctors, nurses and managers who seemed to have forgotten the ‘care’ part of healthcare. I complained about greedy doctors, uncaring managers and corrupt pharmaceutical companies. I felt that we needed a movement to restore the ‘right’ values in healthcare.
But one of the hallmarks of compassion is non-judgment. If we are to be authentic in our desire to increase compassion in the world, we have to let go of judgment. We need to have compassion for our enemies as well as our friends. Being the crusader and criticizing the ‘sinners’ did my cause great harm.
Non-judgment is a tremendous challenge. I fail every day. But as my attitudes have slowly softened, so I have become more successful.
2. Being an evangelist
Many years ago I was invited to present at a national meeting of all the medical directors of the public hospitals in New Zealand. Several of the attendees praised my passion and energy but one cynic dismissed it as “evangelical enthusiasm”. I was outraged by his comment. But sometimes there is truth in the words that hurt.
I am full of passion. I still tend to over-sell my cause. I have a tendency to become righteous. It’s not helpful.
The days when I stop trying to persuade people to change, I become more effective. Sometimes, a willingness to be vulnerable can soften the hearts of people resistant to your message.
3. Trying to teach compassion
A dozen nurse managers filed into the classroom with an air of resentment. None of them made eye contact. One sat with her arms folded, protesting, “I suppose you’re here to teach us how to be compassionate – only what we’ve been doing for the last thirty years!” Not the best start to the workshop.
That’s the problem with being hired as consultants, the assumption that you are the experts, imparting knowledge to the less educated.
Trying to teach compassion is a mistake: you can’t teach compassion any more than you can teach love. Compassion is an intrinsic human capacity, present in every individual.
Compassion has many components, which individually can be enhanced to build the capacity for compassion: we can create experiences for people that increase empathy, sensitivity and non-judgment. But none of these methods are teaching people how to be compassionate.
However, it’s valuable to teach about compassion: clarifying the component parts; learning about the neurophysiology of human connection; and sharing the evidence of how powerfully compassionate care improves patient outcomes.
So with any new audience, we’ve learned it’s helpful to say: “We haven’t come here to teach you how to be compassionate.”
4. Applying business models to our work
We all have to make a living. So we wrote a business plan to justify investing tens of thousands of dollars of our own money in Hearts in Healthcare. We identified sources of revenue: running workshops, doing consulting work, earning speaker fees, and selling books. But doing all those things for a fee has made us more and more uncomfortable.
Compassion lives in a world of inter-being, where all things are intimately connected, not in the material and transactional world of business. Every time we sold our ‘products’, we were turning compassion into a commodity. It seemed like a fundamental disconnection of values.
To be more effective in promoting compassion, we needed to step out of transactional relationships. So now we don’t quote a consulting fee. This is our offer to clients: “We will serve your organisation to the best of our ability. Please pay our expenses but we will not charge for our time. After we have left, you can decide what value we offered to your organisation and make a donation to support our future work.”
We give away all our material. Anyone can use or adapt our slides, our videos and our reference database. We invite organisations to film our events and to use the recording for their own purpose.
In our experience, when we offer our work more as a gift than a service, we encounter extraordinary generosity. Organisations sometimes donate more than the fee we would have charged. And we’re left with a good feeling in our hearts.
This strategy is not easy. We worry about finances but still try to take the leap of faith. Sometimes a client demands a quote because they just don’t ‘get’ our approach. We serve the best we can.
5. Focusing on problems rather than solutions
The whole world of healthcare is focused on problems and risks. The art of diagnosis is to uncover the one pathology that explains all the symptoms. We are held to account for our failings, not our successes. When you visit the doctor she’s unlikely to say, “Lets list all the positive strengths, healing capacities and sources of resilience in your life and see how we can enhance them.” We have a ‘sickness’ system rather than a health system.
So we naturally began our work by focusing on all the part of healthcare that needed to be fixed. We were driven by the moral distress of seeing so many patients and professionals harmed by an uncaring system.
But focusing on problems just digs us deeper into the black hole. The day we learned about Appreciative Inquiry we took a huge leap forward. This process asks us to focus on the times things went exceptionally well – and to learn from them. It’s the foundation of our signature ‘Reawakening Purpose’ workshop, which has been experienced by over a thousand participants. We ask people to tell a story of a day when they had an extraordinary connection to a patient or colleague and then share stories in the circle.
What emerges are inspiring stories of courageous, compassionate caring. We uncover so many hidden strengths, talents, ideas and insights. We learn that everything we need to create a truly compassionate organisation is already in the room. The positive impact on energy and morale is amazing!
So when we remember to stop diagnosing problems and instead look for what already works well – then we start to accelerate our cause.
6. Blaming the system
In every visit we meet amazingly compassionate nurses, midwives, doctors, therapists, technicians, support workers, clerks and managers. And yet ‘the system’ seems so inhuman. Often people complain, “If only the system would let me…”
It’s a habit of Western thought to externalize our problems, we literally ‘work things out’. We see the world ‘out there’ as something material and separate from ourselves. In fact, we hold objectivity as a high value, which separates the observer from the observed. So it’s natural to see the system as something apart from us.
But we are the system. The system is us. We cannot change the system unless we change ourselves. When we shift our attitude, suddenly the world becomes a different place.
By popular demand, I’ve begun to offer a session called “How to love your job”. We can’t change our boss, or the budget, or the rules governing our work but we can learn from the new science of positivity and flourishing. Here are the ways we can change ourselves to create a better world around us.
When we become intentional about small acts of kindness, appreciation and gratitude we build our happiness. Every time we are compassionate towards our selves and our colleagues, our workplace becomes more kind, caring and supportive. The system changes but the change always starts with us.
I had to learn that to change the world, I had first to change myself.
7. Compromising my authenticity
I am deeply blessed to have a loving wife of thirty-five years, my darling Meredith. She must take credit for many of the lessons I have learned. Her compassion, understanding, wisdom and instincts are qualities I greatly admire.
Every time I speak, Meredith sits quietly in the back row sensing how the audience is responding. She make a careful note of the questions asked. After each session we talk about how I can make my presentation more effective and relevant.
The biggest challenge she offers me is to be deeply authentic: “You can’t be compassionate in one part of the your life and not in another.
As a doctor I learned clinical detachment. I tend to compartmentalize different parts of my life. On the same day, I can be deeply compassionate to my patients and insensitive and hurtful to my own family.
I think many of us, called to work in the healing professions, or motivated to lead a movement for compassion, have known deep suffering. We have our wounds and therefore parts of our psyche are protector roles – those tougher aspects of ourselves that come to the fore when we feel threatened or inadequate.
To be truly effective as a leader in compassion, we have to soften our harder parts. It’s an endless challenge. The inner work is reflected in our outward success. Audiences are very sensitive to inauthenticity. If we can have the courage to be vulnerable, to share our mistakes, while showing how much we care – then we will touch people’s hearts. We have to be the change we want to see.
Here are the things that helped me on this journey
To overcome each of the seven mistakes I made, I had to change my attitudes and beliefs. So often, these things are obvious to others but invisible to self. I read widely, reflect deeply, and listen to the views of others. Having a coach is invaluable, someone who can give you honest feedback while building your confidence and skills.
Self-care is critical – physical, mental, emotional and spiritual. I am blessed to have Meredith nourish my needs and call attention to my self-neglect, which tends to occur when I am over-busy and stressed. When I reaffirm my priorities I set time aside for meditation, exercise and connecting to nature. I like doing physical work.
Finally, I learned to be vulnerable. Engaging in work on compassion brings you into contact with many wonderful people. If you can be courageous enough to share your fears and failures you will be warmed by the generosity and wisdom of their support.