Compassion Training and Resilience

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Felicia Walton
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1 CENTILE International Conference to Promote Resilience, Empathy, and Well-Being in Healthcare Professionals Workshop Session October 19, 2015 Compassion Training and Resilience Integrating Cognitive-Based Compassion Training (CBCT) & Other Contemporary Models for Health Care Professionals Steven Rosenzweig, MD Clinical Associate Professor, Director of Professionalism Education, Drexel Univ College of Medicine Timothy Harrison Assistant Director for Cognitively-Based Compassion Training, Emory-Tibet Partnership, Emory University

Steven Rosenzweig, MD Clinical Associate Professor, Director of Professionalism Education, Drexel Univ College of Medicine Steven.

3 Humanism Ethics (virtue) Professional formation

4 Singer 2004

5 When empathic concern tips over into empathic distress

7 Nurse-midwife Maureen Callen. (W. Eugene Smith,1951)

8 Compassion the motivation to relieve suffering, activated by empathy, grounded in the positive emotional experience of caring, kindness, attunement and human connection.

9 Contemplative Traditions Neurobiology Psychology

10 Empathy vs Compassion Klimecki 2014

12 positive emotion empathy

13 Secular Compassion-training Cognitively Based Compassion-training (Pace, Negi et al. 2009, Desbordes, Negi et al. 2012) Compassion Cultivation Training (Jazaleri, McGonical et al. 2013) Compassion Focused Therapy (Gilbert 2010) Mindful Self Compassion program (Neff and Germer 2013) Contemplative Emotion Training (Kemeny, Foltz et al. 2012) (Mindfulness Based Stress Reduction)

2013) Compassion Focused Therapy (Gilbert 2010) Mindful Self Compassion program (Neff and

14 Compassion-training common elements Calm, stable presence (mindfulness) Inquiry Empathy expansion Practice of kindness and caring

15 Cognitively-Based Compassion Training Emory University An Overview

16 Compassion Basic Human Value However the tea is prepared, the primary ingredient is always water. While we can live without tea, we can't live without water. Likewise, we are born free of religion, but we are not born free of the need for compassion. - The Dalai Lama

While we can live without tea, we can't live without water.

17 Can Compassion Be Cultivated? While compassion at the biological level can be unconditional, like the mother s love for her baby, it is also biased and limited in scope. Nevertheless, it is of the utmost importance, because it is the seed from which unbiased compassion can grow. We can take our innate capacity for warm-heartedness and, using our intelligence and conviction, expand it. The Dalai Lama Beyond Religion: Ethics for a Whole World

18 Can Compassion Be Cultivated? As man advances in civilization, the simplest reason will tell each individual that he ought to extend his social instincts and sympathies to all the members of the same nation There is only an artificial barrier to prevent his sympathies becoming more tender and more widely diffused, until they are extended to all sentient beings. Charles Darwin, The Descent of Man

extend his social instincts and sympathies to all the members of the same nation There is only an

19 Benefits of Compassion The human capacity to care for others is not something trivial or something to be taken for granted. Rather, it is something we should cherish. Compassion is a marvel of human nature, a precious inner resource, and the foundation of our well-being and the harmony of our societies. If, therefore, we seek happiness for ourselves, we should practice compassion; and if we seek happiness for others, we should also practice compassion! The Dalai Lama, Beyond Religion

Compassion is a marvel of human nature, a precious inner resource, and the foundation of our well-being and the harmony

20 Emory University School of Medicine CBCT Pilot Study Fall week CBCT course for 2 nd year medical students Presented in mentored groups, randomized to 50% of the students, with booster classes in Spring 2015 Compassion App in development to promote stickiness Investigators: Andrew H. Miller, MD, Prof. of Psychiatry, Jennifer Mascaro, PhD, Anthropology Dean Christian P. Larsen, MD, DPhil Executive Associate Dean J. William Eley, MD, MPH Associate Dean Ira K. Schwartz, MD

development to promote stickiness Investigators: Andrew H. Miller, MD, Prof.

21 Emory School of Medicine - 2nd Year Students, week CBCT course, randomized with wait-list control, n~60 Investigators: A. H. Miller, MD, Prof. of Psychiatry, J. Mascaro, PhD, Anthropology 2015 Poster Presentation Submitted for Publication In Review

22 Benefits: Effects of CBCT on biochemical stress responses IL-6 log plasma IL-6, pg/ml TSST prior to meditation training TSST Time (min) log plasma IL-6, pg/ml TSST after meditation training TSST Time (min) Cortisol plasma cortisol, µg/ml TSST Time (min) plasma cortisol, µg/ml TSST Time (min) Pace et al. Psychoneuroendocrinol 2009;34:87-98; Pace et al. Psychoneuroendocrinol 2010; 35: low practice high practice

23 Differential effects of mindful-attention training vs. compassion training Mindful-Attention Training Compassion Training Amygdala response Depression score Before Before After After Desbordes, Negi, et al., Frontiers in Human Neuroscience, 2012 *

24 Benefits of Compassion Training: Empathic Accuracy IFG Brain Activation and Reading the Mind in the Eyes * p < 0.05 CBCT Group Control Group p < 0.05 * Mascaro et al. SCAN 2013; 8(1):48-55.

25 CBCT Research Projects 2015 Students, Emory University School of Medicine NICU Nurses, Children s Healthcare of Atlanta PTSD Sufferers, San Diego VA Medical Center AIDS Patients, Grady Midtown (Ponce Clinic) Breast Cancer Survivors, U. of Arizona - Tuscon Pre-School Parents, U. of Wisconsin - Madison Elementary Public School Teachers, Decatur

26 Cognitively-Based Compassion Training: specific approach to cultivating compassion Developed as a protocol in 2005 for research at Emory University by Lobsang Tenzin Negi, PhD, former monk, Professor, and Director of the Emory-Tibet Partnership Drawn from the lo jong ( mind training ) traditions of Tibetan Buddhism, and combined with insights from contemporary emotion science and neuroscience. Secularized so that the practices are accessible to individuals of any or no - faith tradition.

27 Progressive Skills/ Mindsets of CBCT I. Attentional Stability and Clarity II. Insight into Nature of Mental Experience III. Self-compassion / Self-care IV. Cultivating Impartiality V. Appreciation & Affection for Others VI. Empathy & Engaged Compassion

The Cosmology and Consciousness Conference themes were as follows:

The Cosmology and Consciousness Conference themes were as follows: December 16-18, 2011, Dr. Bruce Greyson travelled to Dharamsala, India to present at the conference, " Cosmology and Consciousness: A Dialog Between Buddhist Scholars and Scientists on Mind and Matter".