Compassion and empathy are commonly discussed attributes. It is important to understand the neurophysiological implications of each.
Dr. Darin Davidson partners with Learner+, a CME/CE reflective learning platform for healthcare providers. For the opportunity to reflect on this article and earn CME/CE credits, Launch here. Check out all past articles which are also eligible for reflections and CME/CE credits.
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Across all domains of life, we frequently encounter discussions related to the traits of compassion and empathy. While they are related, they are nonetheless distinct attributes. The specific neurophysiological implications of each are important to understand, particularly in high demand domains in the service of others. As such these concepts are important within the framework of the Practices of the Healthcare Athlete.
Prior to further discussing these concepts, it is important to first define them. Typically empathy is described as the experience of fully understanding and even taking on the thoughts and feelings of those around us. As such when others experience significant feelings and emotions, exhibiting the attribute of empathy would suggest that we not only recognize that which they may be feeling, but also experience those feelings ourselves. Compassion, on the other hand, refers to the trait in which we can acknowledge and understand the experience and feelings of another and be present with them to offer support and assistance without necessarily taking on the actual feelings and emotions.
A framework for considering the neurophysiological basis of both empathy and compassion has been described by Michael Allison. To summarize, when we experience an empathetic response to another person, it is often accompanied by shifts in our own biological state. For example, if we are delivering bad news to a patient within a healthcare setting, the understandable anxiety, worry, and fear which they may experience is not only acknowledged on our part, but we also, if we are empathetic, take on an element of those feelings as well. In contrast, compassion can be understood, from a neurophysiological perspective, to describe the ability to either maintain or regain an anchored and grounded state in the presence of another, who may have shifted towards activated, anxious, overwhelmed, or shutdown states. In order to provide presence, support, and assistance to the other individual from a compassionate perspective, it is necessary that we either maintain or regain an element of anchored and grounded state.
Misunderstanding of the neurophysiological distinction between empathy and compassion has significant implications within high demand domains, especially in the service of others. To begin with an example from healthcare, we can readily appreciate how if a healthcare provider is delivering a life-threatening diagnosis to a patient and does so in an empathetic fashion the healthcare professional will take on the feelings and aspects of the biological state that the patient experiences. In this setting, it is understandable that upon hearing this news, a patient will shift into activated, anxious, overwhelmed, or shutdown states. An empathetic provider will similarly experience a degree of these shifts in biological state as well. On account of the principle of social interactions, when we shift our biological state, we will inherently emit cues consistent with that state. As such if we fully experience that which our patient is experiencing in the above example, we will experience a shift in biological state towards activated, anxious, overwhelmed, or shutdown states and emit further cues of those states. On account of neuroception, the patient will likely experience further shifts into those states as well. As discussed in past articles, in order to heal, recover, and restore it is essential that we maintain an element of anchored and grounded states. As such, the unintentional cues which we may emit to the patient may actually be counterproductive in assisting them in the situation.
When the above example is considered from the perspective of compassion, we can readily acknowledge a different scenario. Upon giving the same news to their patient, if the healthcare professional is able to be compassionate, then they will maintain their ability to be present with their patient, to understand and acknowledge the feelings and responses of their patient, but also provide cues from an anchored and grounded state. This will assist the patient to experience less of a shift towards activated, anxious, overwhelmed, and shutdown states and provide cues of anchored and grounded states. This is advantageous to the patient in their need for recovery, restoration, and healing.
In addition, there is significant importance for healthcare professionals to be compassionate rather than empathetic for their own biological states. Given the nature of the healthcare profession, it is often the case that professionals within this domain are providing information and news to their patients which may lead to biological state shifts towards activated, anxious, overwhelmed, and shutdown states. If each time this scenario occurs, the healthcare professional experiences similar shifts in their biological state then it becomes more likely that they will become stuck in the states. This has significant implications, as has been discussed in past articles, on their health, wellbeing, and ability to pursue sustainable high performance.
It is also informative to consider the issue of empathy and compassion from the perspective of members of a team working within a high demand situation. If a member of the team shifts into activated, attacking, anxious, overwhelmed, or shutdown states they will emit cues of those states to the other team members. If the other team members have an empathetic response, then they too will shift into these states. The impact on their ability to perform to their highest level will be negatively impacted as they will have shifted away from anchored and grounded states, in particular the mobilized state, which are optimal for high-performance. Furthermore, the shifts towards attacking, activated, anxious, overwhelmed, and shutdown states will cause further cues of these states to be emitted to the other teammates. It is easy to appreciate how this can rapidly lead to a biological state shift amongst many, if not all, members of the team. On the other hand, if the initial teammate who notices another has shifted into activated, attacking, anxious, overwhelmed, shutdown states provides a compassionate response to their teammate then it is more likely that the cues of anchored and grounded state will be able to help the other teammates maintain a more optimal biological state for performance.
As can be appreciated from the above discussion, compassion is likely a more advantageous attribute within high demand domains than is empathy. In order to enhance our degree of compassion, it is important that we implement strategies and tactics to leverage our biology towards maintaining, and when necessary shifting back to, anchored and grounded states. The framework provided by the Practices of the Healthcare Athlete, provides the necessary paradigm.
To learn more, including about polyvagal informed coaching for healthcare professionals and others in high demand domains, please visit www.darindavidson.com.
Dr. Darin Davidson partners with Learner+, a CME/CE reflective learning platform for healthcare providers. For the opportunity to reflect on this article and earn CME/CE credits, Launch here. Check out all past articles which are also eligible for reflections and CME/CE credits.
For downloadable, actionable strategies and tactics to leverage biology in the pursuit of health, wellbeing, and sustainable high performance, visit the resource store, Launch here. Chapters are arranged by topic so those of interest can be selected and each are also eligible for reflections and CME/CE credits through Learner+.
REFERENCE
Allison M, Porges SW. Empathy to Compassion: A Two-Step Physiological Process. Chapter 14, p. 207-212 in Polyvagal Perspectives: Interventions, Practices, and Strategies. Ed Porges SW. New York: W.W. Norton & Company, 2024.