What we have noticed
We are hearing from many of our medical colleagues about their distress in this time of COVID-19. Many are troubled by the fact that most of the people admitted to hospitals and intensive care units are not vaccinated. Also upsetting are protests, directed at health care workers, against the vaccine and public health restrictions. Faced with yet another variant and uncertainty, we hear that our colleagues are exhausted, frustrated, and angry.
Both authors, being interested in supporting physicians to thrive in their work, have been studying compassion and its role in practitioner well-being for the last few years. As looking at this issue (and other challenges of the pandemic) through the lens of compassion has been personally helpful to both of us, we wanted to share our learnings with you.
- Compassion is innate, AND it can be cultivated and strengthened.
- Compassion is a recognition that suffering is present, a feeling of caring and connection towards the person who is suffering, and a desire to alleviate the suffering.
- Compassion is a lived experience, felt in the body and not just intellectually.
- Compassion can be directed towards others, towards self, and can be received from others.
- Health care practitioners often struggle with self-compassion and receiving compassion.
- Compassion does not require you to change your beliefs. Instead, it understands that other people may prioritize different values, for instance, the value that we as individuals have the right to determine what goes into our bodies.
- Bringing compassion to the conversation can create the possibility for more deeply understanding both sides of a polarized debate. It creates the possibility of tolerating differences and making room for everyone. Demonstrating compassion opens doors to communication and connection, and builds relationships.
Early in the pandemic, I (TW) decided to drop my judgement of anyone for the decisions they were making regarding masking and vaccine choices. I chose to believe that most people were doing what they thought was best for them. I didn’t need to agree with those decisions, but I didn’t want to be judgmental either. I just felt like that was energy that I did not have and I wanted to focus on remaining equanimous through a difficult and scary time as an emergency medicine physician.
Acknowledge Your Own Feelings and Experience First
To cultivate compassion for the people who are not vaccinated, acknowledge your own feelings about this issue. Have you felt angry? Hurt? Do you feel like some of your core values are being violated? Spend some time allowing your feelings to arise. Name each of them. “I feel angry.” “I’m exhausted.” Allow each feeling to be there without judgement. Your feelings are valid. Cultivating awareness of our feelings, naming them, and allowing them, takes away some of the power they have over us. We are not eliminating our feelings, but cultivating a relationship with them that is less draining for us.
Show yourself some warmth and love for what you are experiencing. Dr. Kristin Neff, a researcher in self-compassion, describes a self-compassion break exercise that includes these three steps:
- Say to yourself “This is a moment of suffering.”, acknowledge that your feelings are difficult to be with.
- Remind yourself that you are not alone.
- Show yourself some kindness. Treat yourself as you would treat a good friend.
Seek Common Ground
Draw on the concept of common humanity, which understands that as human beings we all have a desire to be happy and free of suffering. We all know people who are not vaccinated AND are kind, considerate human beings. They are partners, children, friends, and loved ones. Observe, and then drop, any tendency you might have to label or make assumptions about people who are not vaccinated. They are just people, like you and I, with varied reasons for choosing not to be vaccinated. Creating a situation of ‘us’ and ‘them’ is the first step to dehumanizing a group of people. Common humanity acknowledges that we all have fears, hopes, and joys. Not being vaccinated is only one aspect of a complex personality and life experience. Separate the person from the action. We can disagree with the action but still respect the person. Pay attention to language. Say ‘a person who is unvaccinated’, not ‘the unvaccinated’. Creating a feeling of common humanity can be as easy as picturing the mother or father who loves this person.
Seek to Understand
In conversations, seek first to understand, rather than be understood. Consider what it might be like to be a person who is unvaccinated right now. There are more social restrictions, possible loss of employment, and many remain socially isolated. Many are living with fear of the vaccine and of the disease. For someone to choose this path over being vaccinated suggests they have strong reasons for doing so. They are standing up for what they believe to be true for them. Have you ever been certain you were right about something, made a personal choice on something because it was right for you? Get curious about why the person in front of you is not vaccinated. What are their fears? What are their barriers? Seek to understand it from their perspective.
I (SM) decided to ask people “What are your thoughts about vaccination?” The responses were as varied as the people I asked. I found listening to their stories gave me another layer of information about who they were and their values, which added to the richness of my medical practice.
Seek to Do No Harm
Once you have listened and understood, you may have an opportunity to answer questions, share information, and offer your opinion. If it’s clear that your listener is not interested in your opinion, set it aside. Perhaps all you can do is not inflame the situation further. Sometimes the most powerful thing you can do is to allow someone to feel understood.
Seek to Relieve Suffering
Many people who are unvaccinated, are presently suffering from judgements being passed upon them. Seek to relieve that suffering to the degree that you are able. It might be as simple as having that curious conversation. Or just taking a breath before going in the room and remembering that this person too wishes to be happy and free of suffering. In medicine, we tend to measure our impact in cures and fixes. What if our impact is in how we show up and in how we make someone feel? It may be that demonstrating kindness and acceptance creates the possibility for future conversation and future care. We are starting to understand that just by making people feel seen, heard, and respected, we can change health outcomes. Don’t underestimate your impact.
We May Also Need to Relieve Our Own Suffering
Come back to ourselves and check-in. How do we feel now? If anger and frustration are frequently arising for you, this may be a signal of an unmet need. Sleep, nourishment, connection, or more time for yourself might be needed. The pandemic has changed the equation of how much rest we need to replenish and to continue working. Viewing our exhaustion not as a weakness, but as a sign of what we need more of, is the practice of self-compassion. Taking care of ourselves in order to show up as our best selves in the world is essential.
If after reading this, you find yourself unable to take any of these steps, accept that and just sit in compassion for yourself. You are okay, just the way you are. You are just like others in your desire to be happy and free of suffering.
Resources and Further Reading
Compassion Cultivation Resources:
Short Daily Inspirations:
- Wagamese R. Embers: One Ojibway’s Meditations. Toronto, OT: Douglas and McIntyre; 2013. (Find with WorldCat). Accessed December 2nd, 2021.
- Nepo M. The Book of Awakening: Having the Life you Want by Being Present to the Life You Have. Newburyport, MA: Red Wheel; 2020. (Find with WorldCat) Accessed December 2nd, 2021.
- Beattie M. Journey to the Heart. New York, NY: HarperOne; 2014. (Find with WorldCat). Accessed December 2nd, 2021.
- Kimberly Manning MD @gradydoctor on Twitter. (View). Accessed December 2nd, 2021.
- Brach T. Radical Compassion. Barcelona, ES: URANO;2019. (Find with WorldCat). Accessed December 2nd, 2021.
- Neff K. Self-Compassion. London, EN: Hodder & Stoughton; 2013. (Find with WorldCat). Accessed December 2nd, 2021.
- Jinpa, T. A Fearless Heart: How the Courage To Be Compassionate Can Transform Our Lives. New York, NY: Avery Publishing Group; 2016. (Find with WorldCat). Accessed December 2nd, 2021.
- Nagoski E, Nagoski A. Burnout: The Secret to Unlocking the Stress Cycle. London, EN: Vermilion; 2020. (Find with WorldCat). Accessed December 2nd, 2021.
- O’Donohue, J. To Bless the Space Between Us: A Book of Blessings. New York, NY: Doubleday; 2008. (Find with WorldCat) Accessed December 2nd, 2021.
- Oliver M. 1963–2017. Poetry. (Find with WorldCat). Accessed December 2nd, 2021.
- The Louise Penny Mystery series, featuring a compassionate homicide detective modelled after her husband, a Montreal pediatrician: Penny L. 2005–2021. (Find with WorldCat). Accessed December 2nd, 2021.
- Manning K, McMullen A. We are All Support Beams. The Human Doctor. 2021. (View). Accessed December 2nd, 2021.
- I love Insight Timer, a free meditation app. Tara Brach is a favorite instructor, especially her introduction to meditation.
Insight Timer [App]. Version 16.0.2. Sydney, NSW: Insight Network Inc; 2009. (View)
- Self-Compassion.org (View). 2021. Accessed December 2nd, 2021.
- Compassion Institute. (View). 2019 Accessed December 2nd, 2021.
- Compassion Education Alliance. (View). Accessed December 2nd, 2021.