Compassion fatigue

I have been teaching meditation and mindfulness for over 15 years.  I have taught to police officers, nurses, medics and regular working folk.  I now teach at a psychiatric treatment center that focuses on military, first responders, drug recovery and acute psychiatric care of children and adults.  One of the main guided meditations I do is the Metta Bhavana or Loving Kindness meditation. 

Compassion is a difficult term to really put into words that translate into our daily routines.  For some of us in the healthcare field it is a daily and moment by moment practice we all are in the middle of, even when patients and clients are being difficult.  We have to remember that they are being that way BECAUSE of their suffering and not just to be mean to us.  

There is a term in animal care called 'fear aggression' it is when an animal is cornered or feels threatened that it can attack us.  This is why we see professional animal handlers often down at the level of the animal or even below them.  This makes them a little more receptive and comfortable.  It is that way with people too. Too often healthcare workers find themselves at the brunt end of insults, harassments and even physical violence from people they are caring for. 

As healthcare workers we often have to remind ourselves and others to 'be compassionate'.  

Practicing compassion and loving kindness are often seen as core practices in Buddhism.  At least in the form(s) of Buddhism I have studied; Theravada, Mahayana, Chan, and Vajrayana.   There is great variation in how practice is done in all forms of Buddhism with some even evolving today both in the East and the West.  However I feel that this practice is a good foundation no matter how you are practicing Buddhism.

In our general practices we may not visit loving kindness or compassion too often.  It is commonly a 'feel good' meditation that is not as mainstream as Samatha, Vipassana, Breath observation, mindful abiding, etc.   We may contemplate certain aspects of the teachings, read then meditate etc.  Many times I have had people report and I often see in online conversations that people want to meditate to relieve stress, they meditate when stressful events occur, or they feel some upset over some event, presentation, conversation or thought.  

I see many also complain about the injustices in the world and the need for action.  This is a passionate conversation but not really compassionate.  When studying the Metta Bhavana and Sutra, we include ourselves, our most loved beings, our friends, family, neutral people and even those we disagree with.  Not to convince them, nor to somehow morally 'one up' them or try to change them via thought, we offer them this loving kindness without expectation of anything.  Without the 'need' to do it, or even the want for them to be any other way than free from suffering, worry, affliction and to be happy.  Here is the readings I have done for many years on loving kindness.

The teaching on Loving Kindness (Metta Sutta)

Thus I have heard..

One skilled in good, wishing to attain peace should act thus:

One should be able, straight, upright, obedient, gentle, and humble.

One should be content, easy to support, with few duties, living lightly, controlled in senses, discreet, not impudent, balanced about family.

One should not do any slight wrong for which the wise might censure one.

May all beings be happy and secure!  May all beings have happy minds!

Whatever living beings there may be without exception, weak or strong, tall, large, middling, short, subtle, or gross, visible, or invisible, near or far, born or coming to birth, May all beings have happy minds!

Let no one deceive another nor despise anyone anywhere.

Neither in anger nor enmity should anyone wish to harm another.

As a mother would risk her own life to protect her only child, even so towards all living beings one should cultivate a boundless heart.

One should cultivate, for all the world...

a heart of loving kindness above, below, and all around, unobstructed, without hate or enmity.

Monk/Minister: “Sadhu”  Congregation: “Sadhu, Sadhu, Sadhu”

Begin sitting meditation…

Meditation on loving kindness (Metta Bhavana)

Having seen that all beings have a desire for happiness,

One should mindfully develop loving kindness towards all beings.

May I be happy and free from suffering,

and always like myself may my friends, neutral persons, and the hostile be happy too.

May all beings in this village, in this state, in other countries, in our galaxy be ever happy.

May all persons, individuals, beings, creatures in all the galaxies be ever happy.

So too may all women, men, noble ones, non-noble ones, gods,

humans, and beings in the lower worlds be happy.

May all beings throughout the universe be happy.

May I be free from hatred, may I be free from affliction, may I be free from worry, may I live happily.

As I am so also may my parents, teachers, preceptors, friendly,

indifferent and hostile beings be free from hatred.

May they be free from affliction, may they be free from worry, may they live happily,

may they be released from suffering,

may they not be deprived from fortune duly acquired, All have karma as their own.

 

Thinking of Family…

Thinking of Friends…

Thinking of those that have passed, friends, family, known and unknown, before and before…

Thinking of a person I know but is not a close friend

Thinking of a person I have seen but not met…

Thinking of a person I know of that I have never seen

Thinking of a person I am neutral about

Thinking of a person I have had difficulty with or do not like

Thinking of a person that has had difficulties or does not like me.

Thinking of a person that I hate or I think hates me.

Expand it to all animals, in the air, in the waters, on the ground, and under the ground.

Expand that to all of these… …and all living or non living beings… Beings coming to birth, and leaving this life,

There are a few places this practice can fall apart. The first is giving compassion to ourselves, to wish any well upon ourselves seems like a problem as we often feel we do not deserve this compassion. After all, isn't all life suffering? Therefore I must suffer? (there are reasons this is totally incorrect, which I go over in another post).

We often suffer from imposter syndrome or some other similar issue that keeps doubt in our minds. As we begin this practice, I often leave this out in the first repetition of this meditation. But only at first. It really needs to be done, and practiced over and over so that some hint of self love and caring can develop over time. This is why this Metta practice is important to do often.

The second place we can find challenges is where we are asked to think of neutral persons. The process of thinking of a 'favorite' person, as I put it in my guided meditations is a person that would be happy to see you and you would be happy to see them. A neutral person is anyone that you simply pass by in life. The attendant at the gas station, the bank teller, the checker at the store, or even the produce stocker. Those people you may not even acknowledge. This is where slowly we can bring them back into our consciousness of our community, our fellow citizens and humans. We can hopefully stop and see them as people that suffer and deserve happiness too. With this also comes the development of empathy. When we see others suffer we realize we too are sharing this experience, not just on a screen or on our phones but in real life. This is a very important concept to develop. We need lots of practice in this as we are bombarded by visual and audible violence in television, movies, video games, music and songs. We learn through repetition that people are distant from up socially and emotionally that they are expendable. It is the purpose and hope of the practice of Metta to develop some sense of outreach from our own little bubbles and see others as ourselves too.

The third and most difficult people to bring into this concept of Metta are those we have had difficulties with, that hate us, or that we hate. When I was teaching about this concept of empathy and compassion I happened across a small statue of Donald Trump in a meditation position. I thought it was a goofy little item that offered a good practice in conversation as well as practice so I bought one. I posted on some social media that I had gotten it and that a good practice for a new Buddhist would be to see the Buddha nature even in him, and to wish him well even if we disagreed with him and to have sympathetic joy for him if he won the election and wish compassion and wisdom on his opponent in the same way. For that comment I was banned from two groups and trolled for days. It was more amusing to me because I understand the practice well and was able to even offer calm and compassion to those I had triggered. It was a wonderful lesson in how not to take things personally. In fact even The Buddha had similar teachings. On the website Buddhasutra.com you can find the Akkosa Sutra, here is a copy of that.

Akkosa Sutra, The Insult

I have heard that on one occasion the Blessed One was staying near Rajagaha in the Bamboo Grove, the Squirrels' Sanctuary. Then the Brahmin Akkosaka ("Insulter") Bharadvaja heard that a Brahmin of the Bharadvaja clan had gone forth from the home life into homelessness in the presence of the Blessed One. Angered and displeased, he went to the Blessed One and, on arrival, insulted and cursed him with rude, harsh words.

When this was said, the Blessed One said to him: "What do you think, Brahmin: Do friends and colleagues, relatives and kinsmen come to you as guests?"

"Yes, Master Gautama, sometimes friends and colleagues, relatives and kinsmen come to me as guests."

"And what do you think: Do you serve them with staple and non-staple foods and delicacies?"

"Yes, sometimes I serve them with staple and non-staple foods and delicacies."

"And if they don't accept them, to whom do those foods belong?"

"If they don't accept them, Master Gautama, those foods are all mine."

"In the same way, Brahmin, that with which you have insulted me, who is not insulting; that with which you have taunted me, who is not taunting; that with which you have berated me, who is not berating: that I don't accept from you. It's all yours, Brahmin. It's all yours.

"Whoever returns insult to one who is insulting, returns taunts to one who is taunting, returns a berating to one who is berating, is said to be eating together, sharing company, with that person. But I am neither eating together nor sharing your company, Brahmin. It's all yours. It's all yours."

"The king together with his court know this of Master Gautama -- 'Gautama the contemplative is an arhat' -- and yet still Master Gautama gets angry." [1]

[The Buddha:]

Whence is there anger
for one free from anger,
 tamed,
 living in tune --
one released through right knowing,
calmed
 and Such.

You make things worse
when you flare up
at someone who's angry.
Whoever doesn't flare up
at someone who's angry
wins a battle
 hard to win.

You live for the good of both
    -- your own, the other's --
when, knowing the other's provoked,
you mindfully grow calm.

When you work the cure of both
    -- your own, the other's --
those who think you a fool
know nothing of Dhamma.

When this was said, the Brahmin Akkosaka Bharadvaja said to the Blessed One, "Magnificent, Master Gautama! Magnificent! Just as if he were to place upright what had been overturned, were to reveal what was hidden, were to show the way to one who was lost, or were to hold up a lamp in the dark so that those with eyes could see forms, in the same way Master Gautama has -- through many lines of reasoning -- made the Dhamma clear. I go to the Blessed One for refuge, to the Dhamma, and to the community of monks. Let me obtain the going forth in Master Gautama’s presence, let me obtain admission."

Then the Brahmin Akkosaka Bharadvaja received the going forth and the admission in the Blessed One's presence. And not long after his admission -- dwelling alone, secluded, heedful, ardent, and resolute -- he in no long time reached and remained in the supreme goal of the holy life, for which clansmen rightly go forth from home into homelessness, knowing and realizing it for himself in the here and now. He knew: "Birth is ended, the holy life fulfilled, the task done. There is nothing further for the sake of this world." And so Ven. Bharadvaja became another one of the Arhats.

This was the teaching that I most associated with those trolls and triggered people that were rather upset, I also had to practice and really see them without that suffering and that they too should be happy and find what they want. You see, often in the sutras we can see a concept of staying 'in tune' this has to do with the middle path. For example, a guitar that has strings that are too tight will soon break and those that are too loose will not play. This is a part of our training where we need to see both sides and not take sides too quickly nor out of emotive upset.

Often for first timers practicing the Metta sutta I edit out that part as well, it is difficult, especially for those that have PTSD and previous trauma. Many times this can bring up more anxiety and is not conducive to continuing meditation and contemplative practice.

The cure,

So what do we do? In the beginning of this meditation I often do not include the self or difficult people. I know that this does not follow the specific sutta nor the teachings, but I have to be careful as I am working with people in a psychiatric and rehabilitation hospital and they are fragile. On a second run of this guided meditation I can add in the self as they now know what it feels like to give love and compassion to a 'favorite' being. I feel that compassion is like a muscle and it needs to become flexible and strong with continuous practice over time, with small steps at first. We would not just jump into a marathon without at least stretching and practicing a little right? As we go over this practice again and again, it gets easier and easier. Soon we are even thinking about it in our daily routine, not even near a meditation cushion or class. We do see the checker or the road worker and have a little more compassion, we see the homeless or ill or angry or whatever and can see them as beings worthy of our compassion and that makes us stronger morally and ethically. This is the foundation of empathy in my opinion.

The fatigue, 

We are compassion fatigued, empathetically apathetic. We lose our sight of what it means to be human and a part of humankind... We are overworked and stressed, we have to make ends meet and find ways to maintain our lives in the onslaught of inflation, poor service, price increases, social injustice, all sorts of 'isms' and much much more. It is hard to keep a level head at times, especially when others are also in the same boat or worse off.

IF we can develop a little compassion and empathy we can wisely change the world a meditation at a time.

Restructuring our practice. 

When we are fatigued we not only need rest, but rejuvenation. This is where the practice of silent abiding or calm abiding, equanimity and just plain sleep and play come to the rescue. We can come back to compassion when we are well rested and fresh. This is why in my classes I have a time for just breathing and calming then go into the guided thinking of Metta.