Summary of the articles: Compassionate Technology
Compassion and Ethics
Strauss et al. (2016): What is compassion and how can we measure it? A
review of definitions and measures
Abstract
There is a lack of consensus on definition and a paucity of psychometrically
robust measures of the construct compassion. This paper proposes a definition of
compassion.
- A systematic review of self- and observer-rated measures.
- Following consolidation of existing definitions, we propose that compassion
consists of five elements:
o Recognizing suffering
o Understanding the universality of human suffering
o Feeling for the person suffering
o Tolerating uncomfortable feelings
o Motivation to act/acting to alleviate suffering.
Introduction
International professional bodies in healthcare showing the importance of
compassion:
- The American Medical Association's (AMA) Principles of Medical Ethics
states that “A physician shall be dedicated to providing competent medical
services with compassion and respect for human dignity”.
- In the UK, compassion is one of the six core values in the NHS constitution.
- The international ‘Compassion in Education’ foundation offers a range of
services to educational professionals in order to promote compassion in
the education system
Darwin: “communities which included the greatest number of the most
sympathetic members would flourish best, and rear the greatest number of
offspring”
Compassion is reproductively advantageous, being part of the care-giving system
that has evolved to nurture and protect the young
- Evolved from an adaptive focus on protecting oneself and one's offspring
to a broader focus on protecting others including and beyond one's
immediate kinship group.
- Also evolved in primates; desirable criterion in mate selection and
facilitates cooperative relationships with non-kin.
In healthcare compassion has benefits, as it improves mental health:
1. Improving clinical outcomes
2. Increasing patient satisfaction
3. Enhancing quality of information gathered from patients
Compassion buffers reactivity to stress and is central to the process of recovery
from psychopathology.
,Found relationships between parenting styles and children's levels of sympathy
and caring.
- And between attachment security in childhood and capacity for
compassion in adulthood
Aims of the paper:
1. Definition of compassion based on a consolidation of conceptualizations
and definitions in the field.
2. Systematically review self- and observer-rated measures of compassion.
In the literature, there appears to be a broad consensus that compassion involves
feeling for a person who is suffering and being motivated to act to help them.
- Compati (Latin): to suffer with
- Lazarus: “Being moved by another's suffering and wanting to help”.
- Goetz: “the feeling that arises in witnessing another's suffering and that
motivates a subsequent desire to help”.
- Buddhist philosophy: “openness to the suffering of others with a
commitment to relieve it” > not only emotional, but also a response of
reason and wisdom.
o Thus, also wanting to help the people who are suffering.
Compassion three facets (Kanov et al., 2004):
1. Noticing
2. Feeling (empathic concern)
3. Responding
Gilbert (2010) conceptualizes compassion in evolutionary terms: “A deep
awareness of the suffering of another coupled with the wish to relieve it”
- Same capacities that primates evolved to form attachment bonds and
engage in affiliative and cooperative behaviours for group survival.
Gilbert (2010) six attributes of compassion:
1. Sensitivity
a. Responsive to emotions
i. Noticing of Kanov
2. Sympathy (concern)
3. Empathy (other’s shoes)
a. Sympathy and empathy > feeling of Kanov
4. Motivation/caring
a. Responding of Kanov
5. Distress tolerance
a. Ability to tolerate difficult emotions in oneself when confronted with
someone else's suffering without becoming overwhelmed.
i. If we feel such extreme personal distress in the face of
another's suffering that we become too focused on our own
discomfort, this may hinder our ability to help
6. Non-judgement
a. Remain accepting of and tolerant.
,>>> Wispe (1991) also includes the ability to adopt a non-judgmental stance
towards others and to tolerate one's own distress when faced with other people's
suffering.
The idea that compassion can be experienced towards close others and those we
do not know (starving in Africa) is also emphasized by Sprecher and Fehr:
compassionate love.
Self-compassion can be viewed as compassion directed inward towards the self
(Neff 2003):
1. Kindness
2. Mindfulness
a. Involves holding painful feelings in mindful awareness rather than
over-identifying with them.
3. Common humanity
a. One's suffering as part of the human condition rather than as
isolating.
Self-compassion and compassion overarching?
- Buddhist: false distinction between the self and others, and moreover that
self-compassion is a prerequisite for showing ‘true’ compassion towards
others.
- Recent research: association is weak, or non-existent in some populations.
- Neff and Pommier (2013): no correlation.
- Pommier (2010): no association.
This emphasis on seeing a ‘common humanity’ with the person who is suffering is
also evident in Buddhist definitions of compassion.
- Dalai Lama (2005) arguing that: Genuine compassion must have both
wisdom and loving kindness.
o That is to say, one must understand the nature of the suffering from
which we wish to free others (this is wisdom).
o And one must experience deep intimacy and empathy with other
sentient beings (this is loving kindness).
Feldman and Kuyken (2011) “an orientation of mind that recognizes pain and the
universality of pain in human experience and the capacity to meet that pain with
kindness, empathy, quanimity and patience”.
, Compassion: awareness of someone's suffering, being moved by it (emotionally
and, according to some definitions, cognitively), and acting or feeling motivated
to help.
- Also involves being able to tolerate uncomfortable feelings that arise in
oneself as a result of seeing suffering (distaste, frustration, anger etc.)
Related constructs of compassion:
1. Empathy
a. Cognitive empathy can be defined as intellectually understanding
another person's emotions and perspective, whereas affective
empathy refers to being affected by and sharing another's emotions.
b. The Dalai Lama (2005) all explicitly define compassion as requiring
empathy.
i. So, compassion has additional components over empathy
(helping)
c. Compassion is felt specifically in response to suffering, empathy
may apply to a broader range of situations, for example one could
feel empathy with someone else's anger, fear or joy.
2. Pity
a. Despite also having similarities to compassion, does not require an
inclination to help.
i. Unworthy or condescension of help.
b. Altruism has a greater focus than compassion on behavioural acts
that may be at a great personal cost to the person, but do not
necessarily involve the same elements as compassion.
3. Kindness
a. Compassion includes elements beyond kindness (e.g. recognizing
and being touched by suffering), as kindness is not only linked to
suffering.
Strauss’s definition of compassion: a cognitive, affective, and behavioural process
consisting of the following five elements that refer to both self and other-
compassion:
1. Recognizing suffering;
Compassion and Ethics
Strauss et al. (2016): What is compassion and how can we measure it? A
review of definitions and measures
Abstract
There is a lack of consensus on definition and a paucity of psychometrically
robust measures of the construct compassion. This paper proposes a definition of
compassion.
- A systematic review of self- and observer-rated measures.
- Following consolidation of existing definitions, we propose that compassion
consists of five elements:
o Recognizing suffering
o Understanding the universality of human suffering
o Feeling for the person suffering
o Tolerating uncomfortable feelings
o Motivation to act/acting to alleviate suffering.
Introduction
International professional bodies in healthcare showing the importance of
compassion:
- The American Medical Association's (AMA) Principles of Medical Ethics
states that “A physician shall be dedicated to providing competent medical
services with compassion and respect for human dignity”.
- In the UK, compassion is one of the six core values in the NHS constitution.
- The international ‘Compassion in Education’ foundation offers a range of
services to educational professionals in order to promote compassion in
the education system
Darwin: “communities which included the greatest number of the most
sympathetic members would flourish best, and rear the greatest number of
offspring”
Compassion is reproductively advantageous, being part of the care-giving system
that has evolved to nurture and protect the young
- Evolved from an adaptive focus on protecting oneself and one's offspring
to a broader focus on protecting others including and beyond one's
immediate kinship group.
- Also evolved in primates; desirable criterion in mate selection and
facilitates cooperative relationships with non-kin.
In healthcare compassion has benefits, as it improves mental health:
1. Improving clinical outcomes
2. Increasing patient satisfaction
3. Enhancing quality of information gathered from patients
Compassion buffers reactivity to stress and is central to the process of recovery
from psychopathology.
,Found relationships between parenting styles and children's levels of sympathy
and caring.
- And between attachment security in childhood and capacity for
compassion in adulthood
Aims of the paper:
1. Definition of compassion based on a consolidation of conceptualizations
and definitions in the field.
2. Systematically review self- and observer-rated measures of compassion.
In the literature, there appears to be a broad consensus that compassion involves
feeling for a person who is suffering and being motivated to act to help them.
- Compati (Latin): to suffer with
- Lazarus: “Being moved by another's suffering and wanting to help”.
- Goetz: “the feeling that arises in witnessing another's suffering and that
motivates a subsequent desire to help”.
- Buddhist philosophy: “openness to the suffering of others with a
commitment to relieve it” > not only emotional, but also a response of
reason and wisdom.
o Thus, also wanting to help the people who are suffering.
Compassion three facets (Kanov et al., 2004):
1. Noticing
2. Feeling (empathic concern)
3. Responding
Gilbert (2010) conceptualizes compassion in evolutionary terms: “A deep
awareness of the suffering of another coupled with the wish to relieve it”
- Same capacities that primates evolved to form attachment bonds and
engage in affiliative and cooperative behaviours for group survival.
Gilbert (2010) six attributes of compassion:
1. Sensitivity
a. Responsive to emotions
i. Noticing of Kanov
2. Sympathy (concern)
3. Empathy (other’s shoes)
a. Sympathy and empathy > feeling of Kanov
4. Motivation/caring
a. Responding of Kanov
5. Distress tolerance
a. Ability to tolerate difficult emotions in oneself when confronted with
someone else's suffering without becoming overwhelmed.
i. If we feel such extreme personal distress in the face of
another's suffering that we become too focused on our own
discomfort, this may hinder our ability to help
6. Non-judgement
a. Remain accepting of and tolerant.
,>>> Wispe (1991) also includes the ability to adopt a non-judgmental stance
towards others and to tolerate one's own distress when faced with other people's
suffering.
The idea that compassion can be experienced towards close others and those we
do not know (starving in Africa) is also emphasized by Sprecher and Fehr:
compassionate love.
Self-compassion can be viewed as compassion directed inward towards the self
(Neff 2003):
1. Kindness
2. Mindfulness
a. Involves holding painful feelings in mindful awareness rather than
over-identifying with them.
3. Common humanity
a. One's suffering as part of the human condition rather than as
isolating.
Self-compassion and compassion overarching?
- Buddhist: false distinction between the self and others, and moreover that
self-compassion is a prerequisite for showing ‘true’ compassion towards
others.
- Recent research: association is weak, or non-existent in some populations.
- Neff and Pommier (2013): no correlation.
- Pommier (2010): no association.
This emphasis on seeing a ‘common humanity’ with the person who is suffering is
also evident in Buddhist definitions of compassion.
- Dalai Lama (2005) arguing that: Genuine compassion must have both
wisdom and loving kindness.
o That is to say, one must understand the nature of the suffering from
which we wish to free others (this is wisdom).
o And one must experience deep intimacy and empathy with other
sentient beings (this is loving kindness).
Feldman and Kuyken (2011) “an orientation of mind that recognizes pain and the
universality of pain in human experience and the capacity to meet that pain with
kindness, empathy, quanimity and patience”.
, Compassion: awareness of someone's suffering, being moved by it (emotionally
and, according to some definitions, cognitively), and acting or feeling motivated
to help.
- Also involves being able to tolerate uncomfortable feelings that arise in
oneself as a result of seeing suffering (distaste, frustration, anger etc.)
Related constructs of compassion:
1. Empathy
a. Cognitive empathy can be defined as intellectually understanding
another person's emotions and perspective, whereas affective
empathy refers to being affected by and sharing another's emotions.
b. The Dalai Lama (2005) all explicitly define compassion as requiring
empathy.
i. So, compassion has additional components over empathy
(helping)
c. Compassion is felt specifically in response to suffering, empathy
may apply to a broader range of situations, for example one could
feel empathy with someone else's anger, fear or joy.
2. Pity
a. Despite also having similarities to compassion, does not require an
inclination to help.
i. Unworthy or condescension of help.
b. Altruism has a greater focus than compassion on behavioural acts
that may be at a great personal cost to the person, but do not
necessarily involve the same elements as compassion.
3. Kindness
a. Compassion includes elements beyond kindness (e.g. recognizing
and being touched by suffering), as kindness is not only linked to
suffering.
Strauss’s definition of compassion: a cognitive, affective, and behavioural process
consisting of the following five elements that refer to both self and other-
compassion:
1. Recognizing suffering;
