Out of Hours Compassion or empathy? A way forward to reduce GP stress and burnout I have often heard from colleagues and ADDREss FOR CORREsPONDENCE felt myself the sense of psychological Manohar Thakur exhaustion when dealing with the Derby Open Access Centre, 207 St Thomas Road, particularly stressful life problems of our Normanton, Derby DE3 9BL, UK. patients. This is part of the ‘burnout’ so E-mail: [email protected] often talked about in general practice. It is common experience that listening to the patient with empathy goes a long way In the light of this new research showing towards helping many of them: being the that compassion is a virtue that can be ‘drug doctor’ of Balint. Empathy, according passed on by training, it may be worth to the Oxford English Dictionary means: thinking of ways to train ourselves in techniques such as meditation, which will ‘... the ability to understand and share the Photo: The Mind and Life Institute. help not only our patients but ourselves feelings of another.’ as well. The Royal College of General Practitioners could play a guiding role in While this is obviously good for the to have been able to make a difference to exploring this dimension of GP training patient, the person at the giving end of this their lives and, rather than stressing me at the undergraduate, postgraduate, empathy can find themselves emotionally out, these formerly difficult patients have and professional levels. The Mind and drained and fatigued. This can be repeated become a source of professional, as well as Life Institute (http://www.mindandlife. time and again, taking its toll in the form of spiritual, satisfaction. org) and the Max Planck Society are two burnout. There is no doubt that compassion cannot organisations that can help spread this Compassion is different from empathy, in be switched on to order, but what I want to wisdom and, perhaps, train us in following that the feeling of sharing the misfortune is highlight is that there is great hope in this a new and mutually-beneficial path.3 accompanied by a strong desire to alleviate direction. Tania Singer and Olga Klimecki2 the suffering. I recently read an article in from the Max Planck Society for Human Manohar Thakur, the November issue of Scientific American1 Cognitive and Brain Sciences in Leipzig, GP, Derby Open Access Centre, Derby. which prompted and encouraged me to Germany (www.mpg.de) have eloquently share my deeply-felt experiences of demonstrated the beneficial effects of DOI: 10.3399/bjgp15X684469 practising kindness and compassion meditation in developing compassion and in my day-to-day practice; especially loving kindness. Working with a group because I work in a demanding inner- of normal volunteers they showed that city practice with ‘problematic’ patients. a surprisingly short period of meditation In my experience over a period of 3 years training aimed at nurturing compassion, in this particular practice, I have observed counterbalanced the potentially detrimental that patients who have been considered effects of training in empathy alone: ‘heartsink’ in the past have come round to negative emotions diminished and positive seeing me preferentially and they feel much emotions increased. more satisfied and empowered to deal with The exciting finding from this piece of their problems. work was that these positive effects were The difference in approach to dealing accompanied by corresponding changes with the complex problems of patients has in several brain networks, including the been to consciously endeavour to have a orbitofrontal cortex, the ventral striatum, humane outlook and kind heart rather than and the anterior cingulate cortex. And it just do my professional duties according took barely a week to be able to show an to guidelines and protocol. This has been increase in prosocial behaviour in a virtual acknowledged by colleagues with whom game designed to measure the capacity to REFERENCEs I work. At the same time I feel privileged help others. 1. Ricard M, Lutz A, Davidson RJ. Mind of the meditator. Scientific American 2014; 311: 38–45. 2. Singer T, Klimecki OM. Empathy and compassion. Curr Biol 2014; 24(18): R875– “There is no doubt that compassion cannot be R878. 3. Shapiro S. Does Mindfulness Make You switched on to order, but what I want to highlight is More Compassionate? Greater Good 2013; that there is great hope in this direction.” Feb 27: http://greatergood.berkeley.edu/ article/item/does_mindfulness_make_you_ compassionate (accessed 10 Mar 2015). British Journal of General Practice, April 2015 193.