Compassion, the new healthcare intelligence

By Nancy Gahles

The seeds of change in conscious evaluation of educational competency were planted by Daniel Goleman, author and journalist, who proffered to the public in his book, “Emotional Intelligence.”  Emotional intelligence is a term created by Peter Salovey, PhD, and John Mayer, PhD, researchers and psychology experts who defined it as the ability to recognize, understand, and manage our own emotions—and to recognize, understand, and influence the emotions of others.

In leadership positions, having emotional intelligence is key to success. People with a high degree of emotional intelligence know what they are feeling, and they understand what their emotions mean, where they are generated from, and how these emotions can affect others.

In the healthcare field, practitioners bear responsibility for their level of emotional intelligence as well, although this is less clearly defined or given a valued position. Witness the amount of burnout syndromes, depression, and suicides among students, doctors, and nurses.

According to Goleman, there are five key elements to emotional intelligence:

1. Self-awareness
2. Self-regulation
3. Motivation
4. Empathy
5. Social skills

Empathy training in physicians was shown, in a 2012 study in the journal General Internal Medicine, to significantly improve the patient’s experience, suggesting that the quality of care in medicine could be improved by integrating the neuroscience of empathy into medical education. But according to 2011 research, “Empathy decline and its reasons: a systematic review of studies with medical students and residents,”  the clinical practice phase of training and the “distress produced by aspects of the hidden formal and informal curricula were the main reasons for empathy decline.” Or, as my mother would say, “it got lost in the sauce.”

Certainly, there is a high priority placed on ensuring that medical professionals have sound medical knowledge. As demonstrated by the study above, the crowded medical school curriculum takes precedence over empathy and compassion training. There is also an urban legend that a doctor who feels your pain, as in empathizing with you, is most likely to burn out.

In fact, my research in Burnout Syndrome and Compassion Fatigue: A Self-Care Guide for Integrative Practitioners indicate just the opposite. It is the disconnection that “fries” the practitioner, and leads to cynicism, depersonalization, and feelings of lack of efficacy. This lack of emotional intelligence, empathy and compassion goes both ways impacting and demoralizing the practitioner and the patient. Henri Nouwen, the Dutch theologian, writes in his book, “The Wounded Healer”:

“How many leave the hospital healed of their physical illness but hurt in their feelings by the impersonal treatment they received; how many return from their consultations with psychiatrists, psychologists, social workers or counsellors, increasingly irritated by the non-committal attitude and professional distance they encounter?”

In my estimation, the new intelligence in healthcare is compassion intelligence.

Carl Rogers, PhD, psychologist, agrees by his theory that there are three main ingredients to a good doctor-patient relationship, empathy, honesty, and genuineness.

Other psychologists follow this train of thought about the value of compassion intelligence. Rollo May, theologian and psychologist, used the Greek word agape and the Latin word caritas to compassion to underscore that which is essential in a therapeutic relationship— that is, an emotion of regard and affection.

There is a demand for a new intelligence in healthcare. There is a demand from consumers for more compassion, more engagement, and more respect of their time and concerns. There is a similar demand from practitioners for these same values in terms of decreasing the burden of the electronic health record, allowing for more time per patient without decrease in fee for service system, realistic time off for work-life balance leading to self-compassion. Compassion fatigue is a predictive risk for burnout.  

Compassion Intelligence Training can be a valuable tool for shape shifting. Compassion can be assigned a value, a virtue algorithm that increases job satisfaction and existential joy. It is happening now.

Compassionate integrity is fomenting a paradigm shift in secular ethics that is poised to permeate the groundwater of the current systems and create a sea change in the way in which healthcare is experienced by both the giver and receiver. It is manifesting in a simultaneous, interdependent dance, increasing the return on investment in demonstrable deliverables, such as increases in vitality and self-care actualization. A conscious compassionate lifestyle is the new lifestyle.

Self-compassion, as brought forth in the research of Kristen Neff, PhD, begets compassion in action for others. The whole systems dynamic of interdependence is in play. The symphony has begun.

Wayne Jonas in his book, “How Healing Works,” says:

“If there is a single secret to how healing works, it can be found in how we handle our love and fears. Whole systems science has now shown that not only can we learn to manage these emotions, but our health and healing depend on having just the right balance of them in our lives-both to get healthy and to stay healthy. Modern medicine’s failure to take advantage of the social and emotional dimensions that help us manage love and fear leaves much of our healing potential untapped.”

We now know that when health systems have made these social and emotional dimensions central to their operations, those systems universally produce better outcomes and reduce costs.

Where do we go to learn to Compassion Intelligence? The Center for Compassion, Integrity and Secular Ethics at Life University in Marietta, Georgia, offers a brilliantly designed program called Compassionate Integrity Training (CIT). CIT is a multi-part training program that cultivates basic human values as skills for the purpose of increasing individual, social and environmental flourishing. The Center is in the vanguard in the Compassion Intelligence movement. CIT focuses on and builds towards compassionate integrity, the ability to live one’s life in accordance with one’s values with a recognition of common humanity, our basic orientation to kindness, and reciprocity.

These comprise an intelligent skillset with which to give and receive quality healthcare.

I have taken this training and am now onto the next level of becoming a facilitator. I highly recommend this training to practitioners, academic health institutions, and hospitals.

Compassionate healthcare has been a stealth intelligence in healthcare for years.

The Schwartz Center for Compassionate Healthcare is one national non-profit who has been leading the movement to bring compassion to every patient-caregiver interaction since 1995. The Center’s pioneering programs include promoting compassion and empathy and enhancing spiritual care.

GWish, established by the George Washington School of Medicine and Health Sciences in Washington, D.C., was established in 2001 as a leading organization on education and clinical issues related to spirituality and health. I was fortunate to study with Christina Puchalski, MD, founder and director of the George Washington Institute for Spirituality & Health. She is one of the top visionaries in hospice and palliative medicine and a beacon of light for compassion in healthcare.

Since 2001, Greater Good Science Center (GGSC) at the University of California Berkeley has been at fore of, what they call a new scientific movement, to explore the roots of happy and compassionate individuals, strong social bonds, and altruistic behavior, or the science of a meaningful life. I like forward to experiencing this myself at a GGSC Summit in May.

The field of intelligence in healthcare is burgeoning with the virtue and value of compassion, integrity, secular ethics, and love. It is yours for the taking, yours for the integrating into your life and work. This is the meaning of true work/life balance. This is the essence of a meaningful life. The art of living with compassionate intelligence. For your good and the good of all. The “new” intelligence in healthcare is really not new at all.

“The thing that hath been, it is that which shall be; and that which is done is that which shall be done: and there is no new thing under the sun.” – Ecclesiastes 1:9