BEYOND SYMPATHY: Learning to Serve with Compassion

Choosing the company of those who are hurting requires courage. Even professionals trained to assist those in pain or grief instinctively want to pull away. In volunteers or friends, our self doubt brings up feelings of inadequacy, to the point of being afraid we’ll say or do things that make people feel worse. Currently healthy and with our loved ones safe, what do we have to offer those who are ill or must face life without their parent, child, or partner?

     There is nothing anyone can say to take away pain and fear. There is no magic incantation that reduces suffering. What you can do is to listen without judging, and offer your time with no expectation it will make a difference. Your willingness to be genuine and kind is all you have to offer. This is the starting point for acting from compassion.

UNDERSTANDING SYMPATHY AND COMPASSION

Although sympathy is a form of caring, it implies pity. We express concern and ask what we can do, yet are grateful their problems are not ours. This perpetuates the fear that we couldn’t bear the same situation, and keeps us wanting to avoid the truth of their experience. While it is natural to feel sympathy when someone is hurting, there is little sense of what to offer as meaningful support.

     Compassion is a hard-won state of being. Much more than a feeling, compassion is a choice to view suffering is a universal experience. This means viewing illness, loss, and even death as human experiences that are bearable with support. This helps us remain calm and keep our hearts open, and we become able to sit with someone in great physical or emotional pain. Compassion bridges the distance between people often created by suffering. This is not comfortable to do, as we must acknowledge their problems might reflect our own future.

PUTTING DOWN THE SHIELD OF SYMPATHY

Separating from someone’s pain protects against feeling overwhelmed and helpless. We are born tenderhearted. The presence of pain or problems engenders the impulse to make things better. This is a child’s view of how to be helpful. Our job is to make suffering into an enemy and rail against it. The adult perspective embraces the truth that the best gift we have is a willingness to share in their experience without the defense of sympathy.

     I learned this early in my career as a social worker volunteering with hospice. Protected by a great deal of study in maintaining professional distance, I offered practical guidance about end of life issues and choices. During my first year I was sent into many homes and hospital rooms, fortified with pamphlets and sympathetic intentions.

     A hospice referral gave me only that the patient was “Caroline,” barely thirty and with only days left due to widespread cancer. Her family requested support from hospice and I was assigned to assess their needs. When I walked into the room, Caroline was in intense pain because her morphine line had become kinked. Her sister and husband were stunned into helplessness. I failed to find helpful words. I leaned against the doorway, feeling panicked and inadequate. My clinical detachment faded and I couldn’t stop the tears. Minutes stretched while the nurse re-opened the IV line and we watched Caroline’s slow release from pain.

     Once I was able to reclaim my breath, I touched the hand of the sleeping woman. No words could give comfort and no advice was warranted. The only gift I could offer was the willingness to stay and be open to whatever the family wanted to say. Looking at the two who were losing her in this difficult way, I said, “This is so sad. Tell me about Caroline and what you have been going through.”

     The sharing of that single moment created a bond of trust between the family and me. This allowed them to openly discuss conflicts and decisions the family struggling with. They were grateful to have an advocate who listened to their feelings without judgment. I was honored by their honesty. It’s been twenty years and whenever I see Caroline’s sister in town, I remember the compassion from our shared vulnerability.
 

THE DIFFERENCE BETWEEN SYMPATHY AND COMPASSION
Read an item on the left list and breathe. Read the companion statement on the right and breathe again. Notice the differences between how you feel after reading each phrase.

Sympathy brings the weight of sorrow into the room. Suffering is viewed as a tragedy beyond bearing. Sometimes it is denied or minimized. “My uncle had this problem and he’s just fine now.” Or, “God never gives people more than they can handle.” Advice about how to think about their situation is given freely. These efforts prevent the giver from entering into a shared state.

     There is a terrible cost to the relationship in keeping separate. We cannot distance our self from others’ pain and still maintain a heart connection. Receivers feel compelled to dilute what they say to avoid adding to the burden their suffering causes others. They are often angry and exhausted after such a visit.

     Compassion on the part of the giver keeps both heart and mind open in the presence of another’s suffering. Compassion accepts every element of the human story and never implies what is happening is unbearable. We also consciously avoid judgment of how emotions are expressed or the choices they are making. This opens us to the perspective of seeing someone going through a very human experience and not faced with an unendurable situation.

INCREASE YOUR EXPRESSION OF COMPASSION

Whether friend, volunteer, or health professional, you can shift from sympathy to compassion by employing simple actions. Compassion springs from the profound sense of being human and acknowledging the truth of another’s experience without pity or fear. Compassion frees us to be courageous and loving, even while sitting with someone who is suffering. When we accept we are not immune from the same fate, we become more skillful and available. Compassion offers a bridge of trust and potential for honesty. use the following tools to help you be grounded in compassion and acceptance.

w        Use breath to increase your compassion and reduce stress. Breathing to release your own tension also brings calm to those around you. Practice conscious breathing by internally counting each exhale as you breathe up to five deliberate breaths, then count your breaths back down to one again. This process quiets internal chatter and increases your ability to be patient and tolerate silence. You enhance the ability to listen beyond intellect and with your whole being.

w        Be empty of expectation. It’s natural to question your usefulness when meeting with people in pain. Prepare for each meeting or telephone call by pausing before you engage with them. As you prepare to dial their number or while standing in front of their door, fill yourself with breath and calm. Empty your thoughts about what you think they need or how they are doing. Detach from the idea to feel important or useful and be open to receiving whatever they have to give.

w        Avoid thinking of clients as helpless. Most of us prefer to do things at our own pace rather than being treated as needy. Imagine you are in a similar circumstance; ask yourself how you would want to be perceived. To increase rapport and trust, ask the patient and family what they would like more of and need less during your visits. It is often easier to give than receive. To accept the time and energy of others, especially volunteers, takes humility and self-esteem. When the giver brings pity, the exchange depletes precious energy.

w        Move and talk calmly, never be in a hurry. Each meeting is an opportunity for a heart connection, even while doing a simple task. Increase your patience by slowing your normal energetic pace. Whatever else in your day has come before or will come after this moment with them has no place in this visit. Adapt to the patients’ voice tone and volume. Pace their rhythm for at least three breaths. This is especially important if you want to touch them, offer a massage, or assist them in moving. Begin by gently touching a non-injured area before starting any process. Ask if there any way you can make this easier or gentler for them. Let them know you want to hear suggestions or requests at any time.

w        Listen without offering solutions: People in need of medical and volunteer assistance are inundated with suggestions from professionals and well-meaning friends. They may feel incapable of discussion or making decisions about what they will do after the death. Just listening lets them feel the freedom to speak from the heart. Practice the counted breathing to help you be patient during long silences or when there are interruptions in your visit. If they ask your opinion, offer one idea at a time, gently and without ego. Don’t try to predict or influence the outcome. If you are asked to assist in making decisions, ask open-ended questions to guide rather than require instant answers. Allow plenty of silence for them to think over their options. Avoid judgment about what they should be doing.

• Don’t take chaos personally or try to fix it: Even when you are in pure compassion, it’s natural to ask if you’re needed or in the way when:
  

*          Patient or family forget you are coming, even if written on the calendar.

*          Staff or volunteers arrive at the same time as your visit.

*          Close friends and family supplant your role for that day, and expect you to understand.

*          Family or friends act inappropriately and you feel powerless to intervene.

     Never question your usefulness or compare what you have to offer. Simply be ready to serve and meet everyone with compassion. Stay as flexible as you can. Leave gracefully, taking the initiative to reconnect later. Be honest if you can’t “come back a little later.” If the situation feels constantly chaotic, ask for guidance or support from a hospice nurse or the coordinator.

w        Allow others to cry or be silent without interruption: Patting someone who is crying is universally perceived as a signal to stop, and the sadness and hurt are making you uncomfortable. Consciously relax. If you say anything, try, “Don’t bite back the tears. It’s good to let them out.” If you feel your eyes well up, let the tears roll. You are showing your compassion and shared experience. This is true for professionals and volunteers as well as friends. Few are comfortable crying in front of others, or expressing strong feelings in front of them. Practice counted breathing, and relax your body. Everyone deserves to have at least one person who allows free expression of fear, tears, and anger without being reminded he or she is supposed to be strong enough to handle what is happening.

w        Expect to feel upset at times. It’s normal to occasionally feel numb or confused. You are connecting with people facing the hardest time of their lives. They might be dying or terrified of losing someone. It’s natural to feel guilty at your fortune, or wonder if you could handle their situation with grace. Compassion means accepting the reality of what is happening in the moment. We all need times of peace and joy. Plan for significant breaks and give yourself places to be self-nurturing. Reflect with kindness on your feelings to sense if you to need to step aside for a time.

w        Compassion with yourself and other caregivers helps avoid burnout: Spending time with people in acute pain and grief asks you to be at your best and highest self. The good days, when you feel you’ve been helpful, make the effort worthwhile. If you make repeated mistakes, or are unable to relieve your mental or physical stress, you are moving into burnout. Burnout can be defined as using up one aspect of your personality. Seek guidance and training whenever you doubt your abilities. Acknowledge others when you observe their good work, kindness, and compassion. Offer to give, and ask for, neck rubs and walking breaks. This makes it safer for others to be vulnerable and admit their needs. We give more when we learn to share in the loving kindness this effort deserves.

COMPASSION THRIVES ON LOVE & TRUST

Professionals are often cautioned they will diminish their technical skills and clinical usefulness by caring too much. Objectivity can bring mental clarity needed for moments in emergency and when making critical decisions There are times when we need to step back, and briefly see a “case” rather than a person. Without tapping into our own self-trust and loving-kindness, spending significant time with those in deep grief or pain can leave us feeling hollow.

     Ultimately, the bond of trust we build with patients and other caregivers strengthens self-confidence and encourages us to improve our skills. We do our best work when we consciously think of and speak to patients as fellow human beings with rich life experiences, and not as tragic victims of circumstance. You’ll build trust by appreciating the ways each patient and family tolerates their unique experiences.

     Reaching out is your gift, reminding others they are loved and important to you even when they need more time and attention than they can give. You offer hope that they can make it through this dark time simply by asking to be with them. Sit with your fears, acknowledge how helpless you feel, then let your compassionate heart show you how to give love.

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