Magazine Issue: July/August 2011

Health

The compassion instinct

By Editorial Team

Research shows that a compassionate attitude towards others improves mental and physical health.

Larry Gallagher | July/August 2011 issue

The Dalai Lama has been telling us for years that it would make us happy, but he never said it would make us healthy, too.

“If you want others to be happy,” reads the first part of his famous formula, “practice compassion.” Then comes the second part of the prescription: “If you want to be happy, practice compassion.”

Maybe the Dalai Lama knew all along or maybe he’s just finding out like the rest of us, but science is starting to catch up with a couple millennia of Buddhist thought. In recent years, the investigation of compassion has moved beyond theology and philosophy to embrace a wide range of scientific fields, including neurology, endocrinology and immunology. And while the benefits of being the recipient of compassion are obvious, new research shows that the practice of compassion has beneficial effects not only on mental health but on physical health, too.

Which is good news for everyone on the planet, as you can never have too much compassion. Job layoffs and home foreclosures, the cultural erasure of Tibet and the abscess that is Gaza, the sorrows of disease, natural disasters and death that are always with us: To create a short list makes one guilty of omission. Despite all the progress and advances we have made, there is still plenty about which to feel compassion.

So it can only be good news that in the last decade, the study of compassion and its associated emotions has caught the interest of science, with programs on affective neuroscience, as it is known, blossoming at places like Emory University, Harvard University and University of California, Los Angeles, to name but a few. In 2008, the Dalai Lama donated $150,000 to help kick start the Center for Compassion and Altruism Research and Education (CCARE) at Stanford University in California. In 2010, he gave a chunk to the Center for Investigating Healthy Minds, an offshoot of the Lab for Affective Neuroscience at the University of Wisconsin.

Here’s even better news: We can train ourselves to be compassionate. In Europe, leading compassion researcher Tania Singer, director of the Department of Social Neuroscience, a wing of the Max Planck Institute in Leipzig, Germany, is exploring the use of brain imaging and biofeedback to teach subjects to activate parts of the brain associated with compassion. “One of our major goals is to see how we can actually train [people in] compassion in Western society,” she says, “not using one-to-one practices from Asia, but to see how we can integrate such training into our very busy and stressful everyday lives.”

Compassion starts with taking time out of our busy and stressful lives to empathize, which is the ability to register and mirror the feelings of our fellow creatures. But compassion takes this empathic response and adds the strong desire to alleviate that suffering.

From a social evolutionary point of view, compassion has long been considered something of an aberration, even a weakness. For Dacher Keltner, director of the Greater Good Science Center at the University of California, Berkeley, and author of Born to Be Good, this is a major oversight. “We missed one of the most central elements in our physical evolution that has implications for gene replication,” says Keltner.

When you say the word “Darwinism,” Keltner explains, people immediately see an image of “red in tooth and claw” and “survival of the fittest.” But in The Descent of Man, Darwin writes, “Sympathy is our strongest instinct.” With human offspring among the most vulnerable in the mammalian world, Keltner argues, evolving the caregiving part of our psyches was critical for the survival of our genes. And in small groups of hunter-gatherers, from whom we evolved, social skills—particularly compassion—can prove to be matters of life and death. For Keltner, these aspects of our collective heritage should be emphasized in schools and other public institutions.

Scanning technology gives us a rough idea of which parts of the brain are implicated in compassion, although researchers point out that the brain uses the same regions for multiple functions. Experiments have implicated the anterior cingulate cortex (ACC)—an area associated with empathy and reward-based decision-making—in the compassionate response. When the ACC is compromised, patients manifest symptoms like increased aggressiveness, emotional blunting and impaired mother-infant interactions, all of which occupy the opposite end of the emotional spectrum from compassion. The other chunk of the limbic brain that is most frequently linked to compassion is the insular cortex, or insula, a region that helps both in emotional processing and in balancing the body’s functions.

Further down the brainstem, and back down the evolutionary time scale, researchers at Stanford have found interesting activity in the periaqueductal gray (PAG), a region responsible for muting the pain of severe injury that presumably evolved to help us escape whatever caused the injury. When shown disturbing images of suffering, the PAGs of test subjects light up. Emiliana Simon-Thomas, associate director of Stanford’s CCARE, theorizes that this is part of the neural machinery of compassion: an empathic response that prepares the way for a compassionate response, enabling us to move beyond the pain of others to do something about it.

To get from compassion to health, though, we must first take a detour through stress. Our stress responses evolved for do-or-die situations, for that proverbial encounter with the saber-toothed tiger. Today, though, real tigers have been replaced by paper tigers that never go away, so our fight-or-flight mechanisms stay activated for too long. This 24/7 alarm takes a major toll on circulation, digestion, immune and brain function and aging, for starters. Learning the effects of stress on the body is frightening enough to give you an anxiety attack—if you weren’t having one already.

Yet, oddly enough, developing the ability to feel the pain of others via compassion can lower stress levels. How could this be?

One possible answer comes from a University of Maine experiment in which a group of women was assigned the task of delivering an address to a roomful of professionals, a notoriously stressful experience. Some of the women were given emotionally positive coaching before the speech; others were guided in a way that was emotionally neutral. Subjects were tested before and after for three different measures: blood pressure, the presence of the stress hormone cortisol in their saliva and high-frequency heart rate variability, a measure of the body’s ability to down-regulate the heart’s runaway tendencies.

The women’s stress responses had little or nothing to do with the kind of coaching they received. But the researchers found that those who self-identified as being on the high side of the compassion scale showed a measurable drop in their stress responses when they were offered emotionally positive coaching. The compassionate ones were able to utilize the support of others to mitigate the damaging effects of stress. Lead author Brandon Cosley theorizes that this ability might come down to practice. “It could be that people who are more concerned with others put themselves in situations like this, where there are these supportive interactions, and this emotional fluency helps them turn down their own responses when they are on the receiving end.”

Another path from compassion to health passes through social neuroscience, an emerging field in which researchers seek to understand how social interactions affect the wiring and firing of our nervous systems. A number of studies have shown that people with strong, positive social connections have lower inflammatory responses—a stress reaction linked to cancer, depression and arthritis—than people who are socially isolated or in conflict.

It turns out that some forms of compassion meditation—in which the practitioner consciously, intentionally dwells in caring regard for widening circles of fellow creatures—involves many of the same brain regions and brings with it many of the benefits of positive social interaction.

In a 2009 study by researchers at Emory University, 61 students were randomly assigned to either a six-week series of classes on compassionate meditation or a health discussion group. The study showed that attending one class or the other had no effect. But among the meditators, there was a sharp difference between those who logged the greatest number of hours in daily ­practice and those who spent the fewest on the mat. When they were subjected to a stress test, all of the heavy meditators showed a clear reduction in interleukin-6, a marker for inflammatory response regulated by the immune system, after the six-week training program.

That human beings have an innate instinct for compassion is not something anybody needed science to prove, of course. But research is beginning to answer one vexing question: Is compassion a fixed personality trait, locked in by nature and nurture, or can higher states of compassion be cultivated? Scientific studies suggest that we can learn to be compassionate and that compassion can even physically change the wiring of our nervous systems.

In a 2008 study carried out at the University of Wisconsin’s Lab for Affective Neuroscience, the empathic responses of Tibetan Buddhist monks with more than 10,000 hours on the cushion were contrasted with those of subjects who were newly initiated into compassion meditation. The test subjects were put into a brain scanner and subjected to sounds of human joy and distress as well as neutral sounds. The researchers found significantly more synapses firing in the monks’ insulas and ACCs during the distressing sounds compared to the novices. This suggests that, like playing the saxophone or throwing a curveball, compassion can be developed as a skill. The lead author of the study, Antoine Lutz, believes this skill may also be helpful for people prone to depression. “Thinking about other people’s suffering and not just your own helps put everything in perspective,” he says.

The vagus nerve, a cranial nerve that runs between the brain, the heart and gut, is another route through which compassion influences health. The vagus helps the brain regulate heart rate and respiration, among other things, and high vagal function is associated with all sorts of good things, such as efficient regulation of glucose and inflammation as well as lower incidence of heart disease and diabetes. Those with high vagal function are statistically better at regulating their emotions, attention and behavior, too.

It has long been believed that in adults, vagal function is about as stable as height; that is, once adolescence is over, you are pretty much stuck with what you’ve got. But recent research by Barbara Fredrickson, a professor of psychology at the University of North Carolina at Chapel Hill and the author of Positivity, has shown that over a six-week course of “loving kindness” meditation, a Buddhist technique in which the practitioner extends positive feelings toward friends, associates and even enemies, subjects can raise their vagal function, reaping all the positive effects that come along with it. “Just as you can increase your muscle tone with physical training, so can you increase your vagal tone with emotional training,” Fredrickson says.

Of course, like anything else, too much compassion can be bad for your health. A 2004 study with caregivers of autistic children showed that the stress and pressure of this kind of relentless support left women impaired on a cellular level, setting them up for the whole host of stress-exacerbated health conditions. The challenge, then, is to open our hearts in ways that don’t end up harming those hearts. Especially today, when there is so much bad news and so many media outlets focusing on it, it’s easy to become paralyzed by the world’s suffering. “Don’t be overwhelmed,” says Stephen Post, author of Why Good Things Happen to Good People. “Know how to draw boundaries. And be careful to acknowledge limits.”

Compassion can’t cure cancer or banish suffering. But the steady re-orientation of the mind toward compassion can be the beginning of a virtuous cycle, with decreased stress boosting the immune system and the boosted immune system improving attitude, which can further enhance health. And we can all take comfort in knowing that we are part of a larger movement, says Charles Raison, clinical director of the Emory University Mind-Body Program: “We ignored the emotions for 50 years, and like everything that gets ignored or undervalued, like real estate, there’s a goldmine there”—a goldmine whose wealth we all can share.

Larry Gallagher, who wrote about healthy soil in the March 2010 issue, is working on his saxophone playing as well as his compassion quotient.

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