McLean Hospital 115 Mill Street Belmont, MA 02478
Last year I wrote an article for the McLean nursing newsletter about traveling to India and my journey with global health nursing. This year I am writing about another journey, an inner journey. A journey of burnout and creating resilience which has brought me to teach a class in compassion meditation here at McLean Hospital for nurses and other health care providers.
In my career as a psychiatric nurse, I have been “burned out” at various times. This has caused me to change positions, leave jobs, return to school, and study a new form of meditation based on compassion. These experiences led me to ask many questions. How can we retain the core motivation that inspired us to enter this field of caring? How can we restore ourselves? How can we create resiliency within the profession and within ourselves?
Compassion can be defined in many ways—one is: loving, empathetic concern for someone who is suffering and wishing him or her to be free and deeply well. Compassion is a core value of all the healthcare professions (Baur-Wu, Fontaine 2015).
Some of the challenges faced by those working in mental health (and other fields) can be described as compassion fatigue, empathic distress, or burnout. Compassion fatigue has been characterized as the “cost of caring” for those in emotional or physical pain (Figley 1982). Because we care, because we have empathy for the suffering we see on the job every day, we are susceptible. These effects are physical and emotional and can result in work related stress. The impact of compassion fatigue and burnout on both providers and patients has been well documented (Lombardo, Eyre 2011).
There are many strategies suggested for nurses on how to reduce the tendency to burn out and the effects of secondary trauma. Lombardo and Eyre write, “Developing positive self-care strategies and healthy rituals are very important for a caregiver’s recovery from compassion fatigue. Healthy rituals are those activities that one participates in on a regular basis and that replenish personal energy levels and enhance feelings of well being.”
Meditation is one of the ways that we can learn to evoke our natural compassion. Sustainable compassion meditation is a practice, a means to cultivate the innate capacity to find our own inner resource for replenishment, to cultivate resiliency and a sustainable source of compassionate presence to others. We are not seeking to find it outside of ourselves, in a better ‘strategy’, but rather to reveal to oneself our innate capacity for care and compassion.
The basic understanding of sustainable compassion training is that we are all compassionate by nature. However, our habitual patterns of thinking and judging obscure a free flowing power of care. The purpose of sustainable compassion training meditation is to interrupt these mental patterns with the loving energy available to us in moments of care and connection, so that our innate compassion can manifest. The ability to sense what others are going through evokes a spontaneous wish for their freedom from suffering and an urge to alleviate their pain.
This involves training in three aspects of care: receiving care, extending care, and deepening oneself in the field of care. The practice allows us to touch in on the rich and sustainable source of loving care that surrounds us and sustains us all whether we are normally aware of it or not.
After studying various forms of meditation for many years, I was introduced to sustainable compassion meditation. I am continually impressed by the impact that these seemingly simple practices have had on my ability to be present for my patients and myself. The power that these practices seem to unlock in so many, has led me to learn to teach, as I feel they are a key skill for anyone in a caring position.
These practices began as the, “Compassion Beyond Fatigue” workshop, offered by Dr. John Makransky, a professor of Buddhism and comparative theology at Boston College, who adapted these meditations to make them accessible to people of all backgrounds and faiths. They have been taught to people in many diverse professional settings including therapists and clinical psychologists, social workers, social justice activists, health care providers, pastoral counselors, and ministers through the organization The Foundation for Active Compassion.
In 2014, The organization Mind & Life Institute, (founded in a series of dialogues on science with the Dalai Lama), launched its Ethics, Education, and Human Development Initiative, inspired in part by the Dalai Lama’s call to design a curriculum in “secular ethics.” Working with experts in psychology, neuroscience, and education theory, they modified these practices and created a program of contemplative training designed for teachers and children, the “Call to Care Initiative.”
A new program titled “Courage of Care” is the next iteration. Part of the program was specifically created with the intention to present this training to heath care providers, nurses, mental health counselors, therapists, and doctors.