S1E8 Compassion

Have you tried to live with compassion? Dr. Pete and Dr. Rubin talk about compassion as a clinical intervention and as a way of life; of course, they address how compassion fits into behavioral science within the third wave CBT world. Listen in to see how you can practice compassion in your life, and how it can help you!




Pete: Many times people struggle and they have no idea what it means to live with compassion and so this is the idea of distress together with the desire to alleviate. And I think that that's the formal definition but today Dr. Nikki and I are going to talk about compassion.

Nikki: And I’m curious whose definition is that?

Pete: [inaudible 00:39] Webster.

Nikki: The ultimate authority on psychological Science.

Pete: Well I think for me as an academic there just to have an objective sort of personal about it, so yeah, it's listed as the sympathetic consciousness of others distress together with the desire to alleviate it. That’s a beautiful thing.

Nikki: Yeah, it is beautiful.

Pete: let me hear your hate on it.

Nikki: I was actually just curious because I was like, “I like that.” where did you get that definition? Now I know, Merriam Webster cool.

Pete: If were writing this we would have to cite it but we're citing it now in an audio way

Nikki: Yeah. Well I was going to say like I think maybe it's important to sort of acknowledge some of the current folks in the behavioral world that are studying this. This goes both for compassion and self-compassion

Pete: A former supervisor or yours.

Nikki: A former supervisor yeah. So, Dennis Hirsch, you've got Kristin Neff who is UT Austin, Christopher Grimmer, Paul Gilbert, yeah these are all some great folks we can…

Pete: Yeah, these are compassion focus therapy just to add another acronym in the alphabet soup of call psychology. I mean my students, I see their eyes spinning as we're talking about, they're like what another acronym it's like yeah there's lots of them, buckle down.

Nikki: CFT, CBT, yeah.

Pete: I mean, look CFT, it's cool and I think for me compassion is a humanist quality you know so it's not necessarily one that I felt had to like be individualized as its own entity or as his own practice. I mean certainly as you know if you're practicing mindfulness compassion is a core component of the practice of mindfulness, would you agree to that?

Nikki: Absolutely, and I think you know to that point I mean I actually a lot of things that we do in third wave therapies have been done as Pete and I’ve been talking about for thousands of years. And yeah western behavioral science has really just put our lens, you know using the scientific method trying to operationalize things and learn some western evidence, although there's been other kinds of evidence for many, many years here. But let's get into compassion a little bit more because I do think people often confuse compassion and empathy. Actually that's something that I come across quite a bit, do you experienced that?

Pete: Well no, maybe we'll have you just differentiate it. I think one of the things I find the most people don't know how to do it, so if they're lucky. So especially for like executives or high performers so we'll talk about compassion and usually I start with self-compassion. Again depending on who the individual is but I think when you start with the self-compassion you're able to kind of recognize yourself and you and I kind of share a couple exercises that are good with that. And then you can look at, are there ways that you can use this with other people in your life, so I think the how to.

Nikki: That's very interesting because I often find the opposite that I find that… yeah, were different. Because I think a lot of times a lot of times folks are better at being kind to others and they have a harder time being kind of themselves. Like something I come across over and over again when people say ‘I would never talk to somebody else the way I talk to myself.’

Pete: Yeah well we are our worst critic so for me I do think that when I do like thought awareness cognitive distortions and I raise awareness of how people see their thoughts and they're more aware of them. So if we can label it as a distorted thought that we're able to have compassion for when I have a thought that's like ‘oh you're such a loser or you're bad at your job.’ Well I hear you, I think it's a good point.

Nikki: That's true, that’s true. So then I think what you're saying is that there are different ways to practice compassion. So what you're really defining is sort of like the just mindfully noticing that you're having an emotion or a thought or sensation that you don't like or is distressing just acknowledging and getting old space is that act of compassion?

Pete: And then sprinkle in regular massages inaudible 04:46] of manicures.

Nikki: So let me define compassion because I think also something people get confused about with self-compassion where they're like, ‘is it just eating bonbons on the couch, is it just being… which maybe I mean, those could be self-care. So let me define compassionate and we’ll define this other thing.

Pete: So self-care is compassion or compassion is self-care, which one…

Nikki: Well, compassion is self-care. Self-care is not necessarily compassion.

Pete: Yeah, that's right. So that was good for us to struggle with but we got through it together.

Nikki: Yeah, that was, that was… We did. So let me explain a little bit. I'm going to start with empathy, because I think that's actually something that people sort of use the word like, they're empathetic, or they're empathic. And I want to clarify that empathy is something we can learn to be more empathic, like there is mindfulness research, for example, that you can grow neurons, the part of your brain that has to do with perspective taking has to do with empathy, because you're like putting yourself in someone else's shoes. Though, I would say that there are a lot of people that are more hardwired that way. I'm definitely somebody like that. Like, I tend to, like feel people's emotions, more I hear people talk about they absorb people's emotions. So I always define empathy, as basically, with without boundaries, like, it's how you feel as if it's happening to you. Do you agree with that?

Pete: And then we usually it's like in class will say, like walking in someone else's shoes. And then people [inaudible 06:15] in that way, too. So, like you feel like you're walking in their shoes.

Nikki: Yes, exactly. And so compassion is different in that it's dialectical, which means that two opposite things are true at the same time. And the mindfulness part is you're very present and I would say, bearing witness to someone else's pain.

Pete: Yeah.

Nikki: And there's a boundary, you recognize that it's not happening to. And this is really important, because, look, there's a lot of suffering in the world and if we were to absorb all of it as if it was happening to us, you would actually significantly impact our ability to take steps to help alleviate the suffering, like I always say to patients, like, I want you to imagine if I practiced empathy all day, in my job, what do you think what happened? Patient was like, “oh, yeah, you'd be like a puddle on the floor.” I'm like, absolutely. I'm not saying I never access empathy I do. So I've tear it up in sessions sometimes, we're human and I'm actively practicing compassion. I'm presently bearing witness to the pain and suffering of my patients and I'm recognizing like, this is not my story, this is not happening to me.

Pete: So in western Psychological Science, we would also termed this compassion fatigue. So if I practice compassion, without boundaries, that leads to what we were historically called burnout, and the body of literature now looking at compassion fatigue.

Nikki: Which I always say is a misnomer. I think it should be called empathy fatigue, right? Because the science said that we're actually practicing compassion is, this more boundaries approach you don't get burnout?

Pete: Yeah, yeah. Good point, well, maybe we should rewrite that.

Nikki: Well, maybe we should.

Pete: Or perhaps they're just non empaths, or people without our training that end up showing compassion and don't know how, so I hear what you're saying. Like it's not the actual definition because it's with boundaries. But I think a lot of people in any helping field or just being constantly in chronically around experiences of pain and prejudice, and you know, all these other experiences that people have, it's hard to remind yourself to put those boundaries in. And I think will say, I'm really good at this, only because it's survival, frankly. Because I cannot be a puddle on the floor and my values say that life is about living not about working or serving. And I see myself as a servant, I see myself in that regard but for me, it's key. And there was a time and I'm sure I've said this to you, and honestly, one of the biggest things I miss from quarantine and the pandemic, or my Korean spas, I'm putting it out there. Oh my God! Maybe one of them will be a sponsor one day. Yeah,

Nikki: Maybe they will. So then I think like, it's important to clarify like this distinction between compassion and self-care. So like, what Pete’s talking about is really important is self-care. And self-care, doing soothing activities, things that you treat yourself, let's say like, those are important though, we want to be really careful, because a lot of times those behaviors can then become avoidance strategies, right? And compassion is, again, if we come back to that definition of like, bearing witness to pain, right. Like, if you're out getting a manicure, you're probably not focused on bearing witness to your pain, you're probably trying to move away from it, which again, there's nothing wrong with that….

Pete: Well, that's just how I see self-care. And I guess you and I are going to make a distinction here and I think for me, it's like when I set the boundary, I then have to then commit to something that creates healing. And for me, that's compassion.

Nikki: [inaudible 09:56] yes.
Pete: And so even in Zen, you know, that's part of this idea of, you know, trying to just be with what is and suffering, because in Zen the first noble truth states that everything is suffering we all are, universally we all suffer. There's not one living being that does not suffer.

Nikki: That's right. That's right. I would then argue if we bring it back to the human species, and we've got these pretty, like fancy brains that are cool in a lot of ways, but…

Pete: We don't understand.

Nikki: Yeah, we don't understand. Right. We understand a little bit like, we just don't understand a lot. They get us into trouble a lot because when we as humans encounter suffering or pain, we're like, we got to fix it, we got to problem solve it, you know. Like, if you watch animal animals are very skilled at practicing compassion, which is this very, like mindful presence, very accepting, bearing witness. Like, ‘oh God,’ it makes me cry when I think about it, like elephants, how matriarchal society, and they have funerals for their dead, they mourn.

Pete: [inaudible 11:07]

Nikki: I know, it's moving right? But they so they know how to practice compassion, for us it's like, something painful shows up and what do we want to do? We might go like, “it's going to be fine don't worry about it.” Or, you know, I'm going to go, you know, push it away, or I'm going to avoid it, or people are going to go drink or overeat or all those things.

Pete: Yeah.

Nikki: That's why I just want to be really clear about distinguishing....

Pete: No, it's important. And I'll even bring in motivational interviewing Miller and Rollnick, where they talk about the righting reflex. And that's something I think we all have, just to your point about, we want to fix. So, back to Merriam Webster's definition, it's the desire together to alleviate the distress. And I think the righting reflex is something that we all experience where we're trying to fix.

Nikki: When you say the righting, is it the righting, R- I- G- H- T- I- N- G?

Pete: Yeah.

Nikki: I was like, I actually don't know that from that's from…

Pete: Oh, that’s a good one. You're going to like it, borrow it. Yeah.

Nikki: Okay, I will.

Pete: The righting reflex is this idea that we want to fix. So if someone comes in with pain, let me find out your behavioral plan to get you to alleviate pain. And so the righting reflex says watch that, because it often in that time, you're pushing someone too fast when they're not ready. Because Motivational interviewing is about like this ambivalence for change.

Nikki: Absolutely.

Pete: And a lot of people who come into practice, you know, they're committed to change, or they have some awareness that there's change, I guess we can get into stages of change.

Nikki: So many dorky behavioral things to discuss. Yes.

Pete: La de Clemente just thinking about changing where am I in that? And I think it's looking at not trying to write that is not good…

Nikki: Yeah. I love that, and I think that's such a helpful framework because, again, when we see somebody, we love something, we want to take it away. I mean, I feel it in my personal life. I mean, frankly, I'm sure you've had this experience, too. I feel that with patience, right? Sometimes I'm like, I want to fix it, right? Like I want to fix it. And that's actually not helpful that we need someone to just be present in this like really caring way that's willing to, frankly, like, walk with us. It's like they can't carry the pain for us but they can walk next to us.

Pete: That’s right. Oh, and back to our definition from Merriam Webster but let me hear your how to. So if you talk about like compassion with boundaries, and you're working with a client who's trying to say like, “hey, doctor, Dr. Rubin, how can I be compassionate this week?” What are some examples?

Nikki: Yeah, actually, with other people, what I ask them to do is pretty much what I what I shared a few minutes ago, which is to say to themselves, like I'm bearing witness to their pain. Like actually say it internally, and then say, and this is not happening to me, like this is not my story. And that's what I myself practice, especially when I feel the pull to fall into the empathy pool where there's not boundaries, like I said, that actually doesn't help like how am I going to support somebody that I love who's suffering if I'm drowning, too? Yeah, like they like they need me...

Pete: That infamous metaphor about the airplane. Dr. Rubin?

Nikki: Oh, yeah. My favorite. Love it. If you've traveled by plane before you know that, when they're going through the safety features in the beginning with the oxygen masks, they say you need to put your oxygen mask on first, before putting it on a child or somebody else who may need help. And the reason is, is that if you focus on the other person first, you're, you're probably going to run out of air, right? You got to quickly put it on yourself, then you're taken care of and then you can support someone in need.

Pete: So one time I was flying and the flight attendant had a really good time. It was like in the unlikely event that I become your cruise director. Which is so funny because they're talking about like the slides that’s coming, It was very funny. And at that time, I didn't have any plane phobia or anxiety so I was like, ha ha, ha and then like, as I've aged, I'm like, holy cow. Like, I can't imagine how that triggered some people because that’s not a compassionate exercise.

Nikki: Right. I was just thinking like, I would probably feel anxious if I heard that.

Pete: Oh, he was so great. I remember like very vividly, like a very educating thing. But to hear that it was just like, okay.

Nikki: Okay. Yeah. So Pete, how would you encourage somebody to begin to practice compassion?

Pete: I guess I do it more behaviorally. Again, I think I learned a lot from you always, I always have and I always will, probably until the day not practicing.

Nikki: Vice versa here.

Pete: I think I help people break it down, I also find that I keep saying the same thing. I work with high performers and executives, which I think is an annoying script. But I think it has framed a little bit of how I see these things today. So, if I'm working with like a high level coach like compassion, he's not going to be like patting an athlete or an assistant coach on the back does a good job. Rather, can he bring coffee to the morning meeting? Or can he acknowledged somebody in a certain kind of way? So I do think about compassion because that's gratitude, too. So like, all these terms are kind of linked together for me.

Nikki: Well, there are many sides of the same coin right there, they're interrelated processes. And actually, I think to distinguish and relate what you and I are saying with one another, you're describing some more concrete, overt behaviors. Right. And I'm actually talking about as, as I'll say, many times as covert behaviors or behavior you're doing in your body. So talking to yourself, right, internally is a covert behavior.

Pete: Maybe it's because athletes want those overt behaviors, I’m just sort of justifying why I've seen it that way in my practice, but I think also the gratitude piece is that thanks. It’s giving thanks outside of the coin there for me in the practice of compassion and frankly, I did enough of the CFT literature to know how they're framing it.

Nikki: Yeah, I mean, we can always save that for another day. [crosstalk 17:20] Oh, yeah, it should, because they actually also talk about evolutionary psychology, which we're…

Pete: We’re big on.

Nikki: Super, as Pete. Yeah, we love that in behavioral science. Though, I will bring in the research around compassion itself, which is really cool. The more people practice compassion, both for themselves and others, it is correlated with psychological wellbeing.

Pete: Yeah.

Nikki: Which makes sense because there's a softening, and it's what's so fascinating to me, and I really want people to hear this is that it's not about not feeling pain. It's that you can be more psychologically well, by practicing presence and kindness and understanding for yourself and others.

Pete: I just felt so much better in that moment when you just said that.

Nikki: oh, that's a little piece of anecdotal data.

Pete: I just felt like a little bit of lifting and like a little lighter breath.

Nikki: Yeah, I mean, isn't that interesting, right? And that's what it is, and that's where people can experiment in their own lives. Again, I would say, it's like not to be cheesy, though, I seem to be cheesy a lot. Like life's an experiment, right? Like, you get to experiment, you get to try things, you know, you can play around and see like, well, what happens. Like if I'm always speaking critically to myself, or I'm always diving into the pool with other people's emotions, like, what's it like to set some boundaries? What's it like to speak to myself or others in a kind manner? What's it like to not try to fix somebody else's hurt and just be present for it? Like it's an experiment, you get to see what your own data shows?

Pete: Yeah, it's an opposite action, maybe even flexibility, you know, this idea of just trying to be open to a new experience. Any last things that you would want listeners to understand about compassion?

Nikki: I mean, I think that self-compassion just as a big part of it, too, right. Like I said, the thing that I see a lot is more that people are very skilled at being compassionate towards others, though, have a hard time being compassionate towards themselves. That there's a type of compassion meditation referred to as loving kindness, which obviously Pete and I both practice, “metta” is the term you can guys can look that up. And in that there's a focus sometimes on first of all, basically sending compassion and care to other beings and then the last one will be to do it to yourself. And often what I find was when I leave that meditation with people, they find that one really hard and so I would just say, look, if it's easier for you to practice self-compassion, start there. And then try it with other people if it slipped, see if you can generalize these behavioral terminology here, that behavior that use with others and turn it towards yourself and see what that's like

Pete: Baby steps and just trying to bring others distress together with the desire to alleviate it. This has been when East meets West, I'm Dr. Peter Economou.

Nikki: And I'm Dr. Nikki Rubin. Be present. Be brave.

Pete: This has been when East meets West all material is based on opinion and educational training of Dr. Pete Economou, and Nikki Rubin.

Nikki: Content is for informational and educational purposes only.