The language of compassion and love has traditionally been the language of poetry and literature. Recent advances in science have helped bring a scientific approach to considering compassion and love, with advances coming in the areas of neuroscience, psychology, sociology, and organizational behavior. Although epidemiology is commonly defined as the study of the incidence and distribution of diseases, it has much to offer in terms of compassion and love. Understanding how phenomena are clustered in time, place and by person applies just as much to positive factors such as compassion and love as it does to disease. If we understand how love and compassion are spread, we should be able to create environments that will accelerate their distribution. Global health understands how to create solutions at scale, and compassion and love are certainly two solutions worth scaling.
These considerations were the focus of The Epidemiology of Compassion and Love Conference, a gathering of 70 invited interdisciplinary scholars, scientists, practitioners and leaders, held January 8-10, 2020 in Atlanta. This gathering has been the dream – years in the making – of one person, David Addiss, MD, MPH, director of the Focus Area for Compassion and Ethics (FACE) at the Task Force for Global Health. While the success of the event was the result of the shared wisdom of the participants and the sponsoring partnership of The Fetzer Institute and FACE, it was clearly the vision and devoted hard work of Dr. Addiss that brought this amazing event to life.
At the Center for Compassionate Leadership, our dream is that the 2020s will become the decade of compassion. On many levels this meeting was an ideal place to begin such a journey. The cross-disciplinary dialogue that began here occurred among a group of leaders who have the capacity to change the face of compassion and love around the globe.
An important starting point for the gathering was a discussion around the conceptual foundation of compassion. Richard Davidson, PhD, Founder and Director of the Center for Healthy Minds at The University of Wisconsin, made a clear case for the human pathway to compassion cultivation. Our innate basic goodness has been established scientifically, and can be seen in children as young as 4-6 months old. The scientific study of neuroplasticity has shown us that we can develop the connections in our brain, including for the purpose of greater compassion. Studies in epigenetics show that we even have the capacity to impact how our genes are expressed, demonstrating even greater levels of impactful adaptability. Finally, while we think of our brain as directing how our body functions, emerging evidence is clearly showing that communication is a two-way street. Compassion is an embodied practice, and we can use our body in ways to impact the brain.
David Shlim, MD, observed, in a discussion of the origins of compassion, that because of the very natural occurrence of the capacity for compassion in all of us, a capacity which has been with us from the earliest age, that compassion training is more about removing obstacles than it is about teaching something new. Heather Howard, MPH, Senior Global Health Advisor, Alight, drew the important conclusion surrounding the origins of compassion: If compassion is innate, then it is already scaled!
Compassion is already significant in the global healthcare arena. Shams Syed, MD, MPH, Quality Care Lead at the World Health Organization, spoke of the importance of improving the quality of health care around the world, noting 8.4 million unnecessary deaths each year due to low quality care. One of the three World Health Organization learning pods to improve quality universal health care is devoted to compassion. We heard from Daniel Burssa, MD, of the Ethiopian Federal Ministry of Health, where compassion is a central pillar of their National Health Sector Transformation Plan. Liz Grant, FRSE, FRCPE, MFPH, Professor of Global Health at University of Edinburgh, suggested that compassion is the glue in the global health arena.
A number of the panels focused on the three levels to measure compassion and love; the individual, the organization, and the community. There was consensus in the room that compassion begins at the individual level. Effective individual compassion training was well represented with a number of experts from nearby Emory University, home of Cognitive Based Compassion Training; and the Compassion Institute, home of Compassion Cultivation Training. Both groups presented significant evidence of the benefit of compassion training on individual outcomes. The importance of each of these three different levels and how they relate to each other is also an important aspect of the Center for Compassionate Leadership’s model, which was presented at the conference.
Matthew Lee, PhD, Director of Empirical Research at the Human Flourishing Program at Harvard University, laid out the path for deepening compassion. At the first level is reactive deficit reduction where the task is to ease current suffering. At the next level exists proactive deficit prevention which is systematic work to reduce the causes of suffering. Finally, at the deepest level is proactive promotion of full flourishing, which is the creation of a community where everyone thrives.
Developing compassion within organizations is more challenging than for individuals. Compassion is often considered to be an emotion. How do you even define what an organizational emotion is? In her talk, Jane Chun, PhD, Program Director of the Compassion Institute, articulated a clear method of using system change theory’s iceberg model to bring about lasting, system-wide change. The events that we can observe are only a small part of the full story of what is occurring in organizations. Those events are parts of pattern and trends, which occur within systems structures, which are in turn defined by our own mental models of things. Therefore, if we want to have a lasting impact on the way events are patterned, we must change things at the root systems structure level. Epidemiology can play a valuable role in this change by applying its analytical framework to understanding the patterns and trends of events.
In one of his talks, Richard Davidson, discussed the importance of both declarative learning and procedural learning for developing compassion. Through the thoughtful design of this event we engaged in both forms of learning. In addition to twice daily, brief, engaged practices, the participants also broke into three groups to begin the very challenging process of creating case definitions and metrics for compassion and love in individuals, organizations, and larger communities. While the time available was not enough to reach conclusive resolution for case definition and metrics (devoting the entire three days would not have been enough), some very valuable preliminary steps were laid for future work around in these different dimensions.
Thupten Jinpa, PhD, Founder and President, Compassion Institute and the Dalai Lama’s principal translator for over thirty years, shared his wisdom as senior statesman, from the opening session to leading us in our final practice on the last day. In closing remarks, he challenged the group to find ways to scale compassion and love on a global scale without losing the preciousness of them as intentions. “If we want to scale, we must operationalize, but we must not lose our soul in the process. Reductionism as a method cannot become reductionism as metaphysics.”
Three days in community with a group of diverse, exceptional leaders interested in advancing compassion and love in global health gives us hope that the Decade of Compassion is truly underway. Anticipated next steps include ongoing dialogue to tackle the issues around definition and measurement of compassion and love. We look forward to participating in this work and reporting back on what we uncover.
The depth and volume of exceptional content during the meetings and the number of thoughtful participants means that we have left out important points and critical observations by many other participants. Read Part 2 of our report here.
Image credit: NASA.