Compassionate health technology – Articles
1
,Week 1
Article 1: What is compassion and how can we
measure it? A review of definitions and measures
Strauss, C., Lever Taylor, B., Gu, J., Kuyken, W., Baer, R., Jones, F., &
Cavanagh, K. (2016).
• This paper has two aims:
1. to suggest a definition of compassion based on a consolidation of conceptualizations
and definitions in the field
2. to systematically review self- and observer-rated measures of compassion.
the paper aims to propose a definition and review measurement methods.
- systematically review:
- and observer-rated measures:
HIGHLIGHTS
• Compassion is recognized as important across many sectors of society.
• There is lack of consensus on definition and few self/observer-rated measures exist.
• Five elements of compassion are proposed after consolidating existing definitions.
• The psychometric properties of measures could be improved, limiting their utility.
• A new measure of compassion with robust psychometric properties is needed.
From reading the article:
• Without an agreed definition and adequate measures, we cannot study compassion,
measure compassion or evaluate whether interventions designed to enhance
compassion are effective
• Five elements of compassion are proposed:
1. recognizing suffering
2. understanding the universality of human suffering; knowing that everyone suffers
3. feeling for the person suffering
4, tolerating uncomfortable feelings
5. motivation to act/acting to alleviate suffering.
• Despite the importance of compassion and increasing interest from researchers,
clinicians, teachers, and other professionals, there is lack of consensus on its definition
and a paucity of psychometrically robust measurement tools.
• Without these, scientific enquiry is greatly impeded — we need consensus on a definition
and valid and reliable measurement tools in order to assess compassion in empirical
research.
• A lack of reliable measurement tools hinders scientific progress.
• Kanov et al. (2004) define compassion in organizations as comprising three key facets:
noticing, feeling, and responding.
1. Noticing involves recognizing a person’s suffering, either cognitively or through an
unconscious emotional or physical reaction.
2. Feeling refers to an emotional response characterized by empathic concern, where
2
, one adopts the other person's perspective.
3. Responding entails the desire to take action to reduce suffering. Similar to Buddhist
perspectives, this view suggests that compassion is not solely emotional and behavioural
but also includes cognitive elements, as it involves reasoning about and imagining
another person's experience.
• Gilbert (2009) describes compassion as an evolved motivational system that helps
regulate negative emotions, originating from the same capacities that enabled primates to
form attachment bonds and cooperate for group survival (compassion evolved from the
same abilities that helped primates (including humans) develop close social relationships
and work together in groups to survive).
• He defines compassion as “a deep awareness of the suffering of another coupled with
the wish to relieve it” and, like Kanov et al. (2004), views it as having cognitive, affective,
and behavioral components.
• Gilbert identifies six key attributes of compassion:
1. Sensitivity: being responsive to other people's emotions and perceiving when they
need help, which appears to correspond to Kanov et al.'s ‘noticing’ facet
2. Sympathy: showing concern for the other person's suffering
3. Empathy: putting yourself in their shoes
Sympathy + Empathy = correspond to Kanov et al.'s ‘feeling’ facet.
4. Motivation/caring: to act is akin to Kanov et al.'s ‘responding’ facet.
5. Distress tolerance: ability to tolerate difficult emotions in oneself when confronted
with someone else's suffering without becoming overwhelmed by them
if we over-identify with a person's suffering we may feel a need to get away from
them or reduce our awareness of their distress, preventing a compassionate
response.
6. Non-judgment: remaining accepting of others, even when their suffering or reactions
evoke frustration, anger, or discomfort.
This aspect of unconditional compassion is also central to Buddhist thought. The Dalai
Lama (2002) emphasizes this by stating that an enemy is an essential teacher, as
practicing tolerance toward them helps build a strong foundation for compassion.
• Gilbert includes two additional components: distress tolerance and non-judgment.
• Sprecher and Fehr (2005) developed a measure of ‘compassionate love’ which
emphasized Compassion can be experienced towards close others and those we do not
know.
• Neff (2003): definition of compassion for others into a model of self-compassion, arguing
that "Self-compassion can be viewed as compassion directed inward towards the self."
→ Instead of only feeling compassion for others, self-compassion means treating yourself
with the same care and understanding.
• Self-compassion consists of three principal components:
1. Kindness → Being kind and understanding toward yourself instead of being overly
self-critical.
2. Mindfulness → Acknowledging painful emotions without becoming overwhelmed by
them (similar to "distress tolerance" in Gilbert’s model).
3. Common Humanity → Recognizing that suffering is a shared human experience,
rather than seeing it as something that isolates you from others.
3
,4
, • Empathy VS Compassion: reference is commonly made to related terms such as
empathy
• Empathy: “the power of mentally identifying oneself with (and so fully comprehending) a
person or object of contemplation”
• Cognitive empathy: intellectually understanding another person's emotions and
perspective
• Affective empathy: refers to being affected by and sharing another's emotions
• Compassion as requiring empathy and therefore appear to see empathy as an essential
element of compassion. Even suggest that compassion has additional components over
and above empathy.
• Empathy vs Compassion
- Pommier: Compassion is only suffering, empathy is more broad (anger, fear, or joy)
- Goetz et al; Compassion is an emotion, empathy is an experience of another’s emotions
- Sprecher and Fehr: compassion is broader because it can be felt for humanity at large
rather than only in relation to specific interpersonal encounters.
- Klimecki Leiberg/Singer: Different brain regions are activated when you train empathy
and compassion.
• Empathy has been defined as the vicarious experience of another’s emotions, where
one understands, is affected by, and shares another’s emotions and perspectives. It does
not involve a motivation to act to alleviate another person’s suffering
• New definition of compassion: a cognitive, affective, and behavioral process consisting
of the following five elements that refer to both self and other-compassion:
1) Recognizing suffering;
2) Understanding the universality of suffering in human experience;
3) Feeling empathy for the person suffering and connecting with the distress (emotional
resonance);
4) Tolerating uncomfortable feelings aroused in response to the suffering person (e.g.
distress, anger, fear) so remaining open to and accepting of the person suffering;
5) Motivation to act/acting to alleviate suffering.
• Measures: The strongest measures identified were Neff's (2003b) Self Compassion
Scale and Hacker's (2008) Relational Compassion Scale, but neither of these measures
capture each of the five elements in our definition. As Neff's measure focuses on self-
compassion rather than compassion more generally or compassion for others, it is in any
case not entirely suitable as a measure that can be used to determine levels of
compassion in populations for whom compassion towards others is of interest
- This review assumes that compassion can indeed be measured with questionnaire
methods
5
1
,Week 1
Article 1: What is compassion and how can we
measure it? A review of definitions and measures
Strauss, C., Lever Taylor, B., Gu, J., Kuyken, W., Baer, R., Jones, F., &
Cavanagh, K. (2016).
• This paper has two aims:
1. to suggest a definition of compassion based on a consolidation of conceptualizations
and definitions in the field
2. to systematically review self- and observer-rated measures of compassion.
the paper aims to propose a definition and review measurement methods.
- systematically review:
- and observer-rated measures:
HIGHLIGHTS
• Compassion is recognized as important across many sectors of society.
• There is lack of consensus on definition and few self/observer-rated measures exist.
• Five elements of compassion are proposed after consolidating existing definitions.
• The psychometric properties of measures could be improved, limiting their utility.
• A new measure of compassion with robust psychometric properties is needed.
From reading the article:
• Without an agreed definition and adequate measures, we cannot study compassion,
measure compassion or evaluate whether interventions designed to enhance
compassion are effective
• Five elements of compassion are proposed:
1. recognizing suffering
2. understanding the universality of human suffering; knowing that everyone suffers
3. feeling for the person suffering
4, tolerating uncomfortable feelings
5. motivation to act/acting to alleviate suffering.
• Despite the importance of compassion and increasing interest from researchers,
clinicians, teachers, and other professionals, there is lack of consensus on its definition
and a paucity of psychometrically robust measurement tools.
• Without these, scientific enquiry is greatly impeded — we need consensus on a definition
and valid and reliable measurement tools in order to assess compassion in empirical
research.
• A lack of reliable measurement tools hinders scientific progress.
• Kanov et al. (2004) define compassion in organizations as comprising three key facets:
noticing, feeling, and responding.
1. Noticing involves recognizing a person’s suffering, either cognitively or through an
unconscious emotional or physical reaction.
2. Feeling refers to an emotional response characterized by empathic concern, where
2
, one adopts the other person's perspective.
3. Responding entails the desire to take action to reduce suffering. Similar to Buddhist
perspectives, this view suggests that compassion is not solely emotional and behavioural
but also includes cognitive elements, as it involves reasoning about and imagining
another person's experience.
• Gilbert (2009) describes compassion as an evolved motivational system that helps
regulate negative emotions, originating from the same capacities that enabled primates to
form attachment bonds and cooperate for group survival (compassion evolved from the
same abilities that helped primates (including humans) develop close social relationships
and work together in groups to survive).
• He defines compassion as “a deep awareness of the suffering of another coupled with
the wish to relieve it” and, like Kanov et al. (2004), views it as having cognitive, affective,
and behavioral components.
• Gilbert identifies six key attributes of compassion:
1. Sensitivity: being responsive to other people's emotions and perceiving when they
need help, which appears to correspond to Kanov et al.'s ‘noticing’ facet
2. Sympathy: showing concern for the other person's suffering
3. Empathy: putting yourself in their shoes
Sympathy + Empathy = correspond to Kanov et al.'s ‘feeling’ facet.
4. Motivation/caring: to act is akin to Kanov et al.'s ‘responding’ facet.
5. Distress tolerance: ability to tolerate difficult emotions in oneself when confronted
with someone else's suffering without becoming overwhelmed by them
if we over-identify with a person's suffering we may feel a need to get away from
them or reduce our awareness of their distress, preventing a compassionate
response.
6. Non-judgment: remaining accepting of others, even when their suffering or reactions
evoke frustration, anger, or discomfort.
This aspect of unconditional compassion is also central to Buddhist thought. The Dalai
Lama (2002) emphasizes this by stating that an enemy is an essential teacher, as
practicing tolerance toward them helps build a strong foundation for compassion.
• Gilbert includes two additional components: distress tolerance and non-judgment.
• Sprecher and Fehr (2005) developed a measure of ‘compassionate love’ which
emphasized Compassion can be experienced towards close others and those we do not
know.
• Neff (2003): definition of compassion for others into a model of self-compassion, arguing
that "Self-compassion can be viewed as compassion directed inward towards the self."
→ Instead of only feeling compassion for others, self-compassion means treating yourself
with the same care and understanding.
• Self-compassion consists of three principal components:
1. Kindness → Being kind and understanding toward yourself instead of being overly
self-critical.
2. Mindfulness → Acknowledging painful emotions without becoming overwhelmed by
them (similar to "distress tolerance" in Gilbert’s model).
3. Common Humanity → Recognizing that suffering is a shared human experience,
rather than seeing it as something that isolates you from others.
3
,4
, • Empathy VS Compassion: reference is commonly made to related terms such as
empathy
• Empathy: “the power of mentally identifying oneself with (and so fully comprehending) a
person or object of contemplation”
• Cognitive empathy: intellectually understanding another person's emotions and
perspective
• Affective empathy: refers to being affected by and sharing another's emotions
• Compassion as requiring empathy and therefore appear to see empathy as an essential
element of compassion. Even suggest that compassion has additional components over
and above empathy.
• Empathy vs Compassion
- Pommier: Compassion is only suffering, empathy is more broad (anger, fear, or joy)
- Goetz et al; Compassion is an emotion, empathy is an experience of another’s emotions
- Sprecher and Fehr: compassion is broader because it can be felt for humanity at large
rather than only in relation to specific interpersonal encounters.
- Klimecki Leiberg/Singer: Different brain regions are activated when you train empathy
and compassion.
• Empathy has been defined as the vicarious experience of another’s emotions, where
one understands, is affected by, and shares another’s emotions and perspectives. It does
not involve a motivation to act to alleviate another person’s suffering
• New definition of compassion: a cognitive, affective, and behavioral process consisting
of the following five elements that refer to both self and other-compassion:
1) Recognizing suffering;
2) Understanding the universality of suffering in human experience;
3) Feeling empathy for the person suffering and connecting with the distress (emotional
resonance);
4) Tolerating uncomfortable feelings aroused in response to the suffering person (e.g.
distress, anger, fear) so remaining open to and accepting of the person suffering;
5) Motivation to act/acting to alleviate suffering.
• Measures: The strongest measures identified were Neff's (2003b) Self Compassion
Scale and Hacker's (2008) Relational Compassion Scale, but neither of these measures
capture each of the five elements in our definition. As Neff's measure focuses on self-
compassion rather than compassion more generally or compassion for others, it is in any
case not entirely suitable as a measure that can be used to determine levels of
compassion in populations for whom compassion towards others is of interest
- This review assumes that compassion can indeed be measured with questionnaire
methods
5
