"Mighty Mini" Meditation Tactics: Brief Compassion Practice

Source: DALL-E/OpenAI

The last entry of this series I've dubbed the Core 4 "mighty minis"—brief meditation practices that can be simply and clearly taught to patients and students, as well as ourselves—involves some aspirational values to sit with. Compassion practice is the topic of this article.

As with using gratitude as a (positive, aspirational) phenomenon of mind to sit with, meditating on compassion, whether for ourselves or others, can be a potent "vitamin" for our ongoing well-being and outlook, and a mindful poultice in the midst of momentary suffering.

And, as with gratitude work, it can be misapplied, with inadequate or even hurtful consequences. More on that later.

First, a little conceptual setup is in order. From my own study in Buddhism, I'm familiar with compassion as one of the four so-called "immeasurables"—equanimity, compassion, loving-kindness, and joy—which are virtuous qualities we all possess the capacity for, built-in to all of us as a blessing of conscious life.

I've always loved that boundless, transcendent term for them—superpowers that we all have access to, if we wish to attend to them and cultivate them. Some definitions, though Buddhists may quibble over my spin on them:

• Equanimity: The capacity to experience empathic peership with others.
• Compassion: The capacity for empathically recognizing the experience of suffering in oneself and others, naturally generating a wish to alleviate that suffering.
• Loving-kindness: The capacity for unconditional, pure love and benevolence toward ourselves and others.
• Joy: The capacity for contentment as a natural, experiential outcome.

Compassion could be considered a branch office of equanimity, as it attends more specifically to the suffering of self and others. That nit-picking dissolves when we note that suffering is ubiquitous. We all hurt sometimes. We have the capacity to bond with all of it—the pain, the joy, the in-between. So, especially in healthcare settings, a regular tune-in to our native capacity for compassion is worth our effort.

Before I pivot to some tactics in practice, let me address one other term that inevitably gets mixed up in this arena: empathy. The same as compassion? I'd say no.

Empathy is a capacity: an ability to identify with the experience of another individual. It's a receptive capability that most neuroscientists consider as involving some aspects of nature (neurobiological potential) and nurture (through lived experience and learning). In terms of nurture, empathy can be entrained and cultivated—or muffled and devalued.

Empathy is a receptive thing. And our reactions to that blast of received affect are not uniformly a call to a compassionate response. Some folks are overwhelmed by the experience of empathy and must wall it off as a self-protective measure. Others may burn out on the sheer firehose of suffering we can bear witness to every day, courtesy of contemporary technology.

Particularly noxious forms of reaction to the empathic "feels" (i.e. "faux compassion") can be seen in the whole "blame the victim" reaction—in essence, turning an intolerable feeling state in perceiving the suffering of another into a gaslighting "I see nothing to feel bad about" or worse, "You must have brought that on yourself." The misfortune of suffering can be amplified into a kind of deserved personal failure. That's more suffering.

Acts that we identify as compassionate certainly can generate a sense of self-pride—an ego thing, and not in itself terribly wrong. But the ideal of compassion is transcendent—going high for high's sake, as that's how immeasurables roll, and not for the applause.

While empathy is receptive, compassion is not receptive but is an active manifestation of empathy in the form of altruistic behavior and kindness. Some may insist on compassion as a state; for others, an act.

So, how to work with compassion? Like with gratitude practice, we don't chase or play-act at it, but instead open to it, then observe the effect in heart and mind. Starting with some basic breath work to warm up, we then intentionally introduce compassion into the mindscape. We're working here on "shorties," so it's useful to stick to one and focus; breathe into it.

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Some options and tactics:

• We can bring the idea of compassion, or even just the word "compassion" to mind, and put the usual gentle effort into attending to that for a bit; or attend in mind to an individual—ourselves, or someone we know to be aching.
• Consider the rhythmic "breathe in awareness, breathe out compassion (to...)" couple of breaths, taking/sending style.
• We then pull back to witness how the moment is operating in us. What else comes up? Where and how do we feel it?
• While this practice is meant to be a brief one, one additional step can be powerful: After a couple of breaths in attending to "compassion for...," follow it by opening out to "compassion for all beings"—expanding the field of compassionate wish to all in suffering. Sit with that for a few breaths.

We may sample a quick immersion in that aspirational feeling. And, of course, we may not. The power of the practice, even this brief one, is in observing what happens in the sitting with the state—its impact on the body, heart, head, and "meta."

But when this is done with intention and care, it can serve as a powerful tool for nurturing and managing our own empathic capacity, fostering a heartful connection with our patients, students, and ourselves.

One last thing: I recognize that some healthcare professionals may feel allergic to wading into learning and teaching a tactic that straddles a line between medical practice and something more, well, "feely" or even spiritual. I see this as delicious irony, in that compassionate action is a foundation of effective care, our hearts often as valued by our patients as our brains. Directly addressing compassion in our work, by training ourselves and our patients with purpose and intention in nurturing this capacity—well, that's a no-brainer.