Index
alexithymia, 56
American Medical Association, code of practice, 37
American Occupational Therapy Association (AOTA), code of practice, 42
American Psychiatric Association (APA), code of practice,
amygdala, and visual preference for suffering due to compassion training, 53
‘amygdala hug’ exercise, 92
attention, research into, 56
attentiveness and engagement, demonstrating compassion through,
Australian Medical Association, code of practice, 37
autopilot
breaking out of, 84
breaking out of, Three-Step Breathing Space exercise, 85
evolutionary perspective, 84
awareness
benefits and drawbacks of ‘autopilot’, 84
cultivating mindfulness and,
developing good foundations for, 84
importance of in generating compassionate practice,
meaning of, 84
role of mindfulness and in supporting compassion/self-compassion, 89
role of mindfulness in cultivating, 84
of the habitual, 84
Baqeas, M. H., 62
‘barriers’ vs ‘challenges’, importance of the distinction, 63
beneficence, AOTA principle, 42
Böckler, A., 57
body awareness, research into the impact of mental training on, 56
Body Scan exercise,
Bosshard, M., 79
Box Breathing exercise, 92
brain
empathy and the brain, 28,
involvement in compassion and compassion training, 6
pathways activated by compassion, 28
re-shaping the way our brains work with meditation, 64
studies examining relationship between brain structure and compassion, 53see also functional magnetic resonance imaging (fMRI); neuroscience of compassion.
brain lesion studies, 54
breath-focused meditation, technique, 66
breathing exercises
Box Breathing exercise, 92
Rectangle Breathing exercise, 92
Three-Step Breathing Space, 85
British Association of Social Workers (BASW), code of practice, 41
building compassion into medical training,
Bunjak, A., 12
burnout, 6, 15, 60
comparison with compassion fatigue, 62
lessened by compassionate care, 33
literature on, 100
research on links between emotionally demanding work and, 41
Byrne, M., 31
care priority, support for compassion as, 25
caring, professionalisation of, 17
caring behaviour, comparison with rescuing behaviour, 29
‘challenges’ vs ‘barriers’, importance of the distinction, 63
Code of Ethics for Social Work (BASW), 41
Code of Professional Conduct and Ethics for Registered Nurses and Registered Midwives (Nursing and Midwifery Board of Ireland), 41
The Code: Professional Standards of Practice and Behaviour for Nurses, Midwives and Nursing Associates (Nursing and Midwifery Council), 40
codes of practice
American Occupational Therapy Association, 42
British Association of Social Workers, 41
challenges of defining compassion for, 17
compassion in, 44
evolution of, 36
international importance accorded to compassion in, 5
Nursing and Midwifery Board of Ireland, 41
Nursing and Midwifery Council (UK), 40
codes of practice for medical doctors
American Medical Association, 37
Australian Medical Association, 37
General Medical Council (UK),
Irish Medical Council, 37
New Zealand Medical Association, 37
codes of practice for psychiatrists,
American Psychiatric Association,
College of Psychiatrists of Ireland, 39
Royal College of Psychiatrists (UK), 36,
cognitive behaviour therapy (CBT), 76
collaboration, resilience and, , 110
College of Psychiatrists of Ireland, code of practice, 39
common humanity, exercises to deepen the sense of,
communication, fostering open communication, 110
communication skills
attending to non-verbal cues, 31
benefits of role play, 30
comparison with compassion,
empathic communication, 31
lack of outcomes evaluation in courses focusing on, 31
open-ended questions, 30
relationship with compassion and empathy, 23
training recommendations, 31
value of for compassionate leadership, 31
compassion
absence of in healthcare systems, 114
brain pathways activated by, 28
building compassion into medical training,
components of, 14
conceptual background, , , 17
elusiveness of the concept, 16
fluid nature of, 17
impeded by systemic factors, 106
related terms,
compassion fatigue, 6
Baqeas and colleagues’ study, 62
comparison with burnout, 62
Covid-19 pandemic and,
‘empathic distress fatigue’ as suggested replacement, 62
evolutionary perspective, 62
interventions to minimise occurrence of, 24
literature on, 100
meaning of, 62
Compassion in Care: Ten Things You Can Do to Make a Difference (RCPsych), 38
compassion in healthcare, ,
background to, 4
Baguley and colleagues’ study,
research recommendations, 47
benefits, 81
combining evidence with practical strategies, 115
cultural perspectives,
evidence base, 45
importance of,
Jiménez-Picón and colleagues’ systematic review,
meaning of,
practical perspective, 46
research interest,
Sinclair and colleagues’ model,
Singh and colleagues’ study,
value of, 106
Compassion in Practice (Commissioning Board Chief Nursing Officer and Department of Health Chief Nursing Adviser), 40
compassionate care
barriers to and facilitators of, 6,
challenges of teaching clinicians how to practice, 33
challenges posed by healthcare systems,
compassion as core value, 44
features of, 5
first steps in teaching and modelling, 33
key components, 20
Maddox and Barreto’s study,
staff perceptions, 63
themes, 63
Welsh initiative, 31
The Compassionate Mind (Gilbert), 77
compassion focused therapy (CFT), 7
background to,
benefits for clients, 77
evidence base, 80
importance of positive emotions, 78
influences,
key attributes for cultivation of compassion,
managing habitual patterns with, 76
role of body awareness, 77
techniques involved, 80
‘third wave’ status, 76
contextualization, resilience and,
Core Values for Psychiatrists (RCPsych), 39
cortisol stress reactivity, research into the impact of mental training on, 56
Covid-19 pandemic
commencement of the outbreak, 99
impact on healthcare providers, 23
pandemic-driven research, , 99
prevalence of psychological distress caused by, 99
Cultivating Awareness and Mindfulness, 83
cultivation of compassion, requirement for engagement with suffering, 30
cultural perspectives of compassion in ethnically diverse populations, , 49
‘The current state of empathy, compassion and person-centred communication training in healthcare: an umbrella review’ (Patient Educ Couns), 31
Dalai Lama, 12
Declaration of Geneva (WMA), 39
depression
and difficulties experiencing positive emotions, 78
effects of CFT on, 80
low self-compassion associated with, 90
reduced by self-compassion,
ruminations associated with relapse, 73
sensitivity to suffering associated with, 13
shame and, 78
Desbordes, G., 55
development of compassion
for everyone,
Imaginative Identification exercise, 94
for other people in our lives, 93
Well-Wishing, Compassion, and Loving Kindness exercise,
diet, importance of maintaining a balanced diet, 101
distress, recognition of at the root of compassion, 33
distress tolerance, role of in cultivation of compassion, 78
doctor-patient relationships, importance of empathy and compassion in, 33
efficiency and throughput emphasis, impact on health systems, 19
Egan, S. J.,
empathic communication, Byrne and colleagues’ findings, 31
empathy
basis of psychological models, 54
role of in cultivation of compassion, 77
and the brain, 28,
topics introduced in the ‘teaching’ of, 30
empathy training, effects on the brain, 54
engagement
demonstrating compassion through attentiveness and,
importance of in generating compassionate practice,
ethical guidance
American Medical Association, 22
Canadian Medical Association,
challenges of defining compassion for, 17
compassion in,
General Medical Council, 22
international importance of compassion in, 5
Irish Medical Council, 22
patients’ views, 23
for psychiatrists,
RCPsych’s core values framework, 22
ethnically diverse populations, cultural perspectives of compassion in, , 49
evidence-based medicine/care
combining evidence with practical strategies, 115
compassion in a world of,
dominance in medical education, 21
as potential driver of loss of empathy in clinical care, 22
evolutionary perspective of compassion,
empirical foundations, 15
likely roots of compassion, 29
major life tasks providing a basis for action, 14
self-compassion,
evolutionary perspectives
‘autopilot’, 84
compassion fatigue, 62
of how we view other people, 93
rescuing behaviour as root of compassion, 29
risk avoidance, 84
exercise, benefits of regular exercise for physical and mental health, 100
Fan, Y., 54
food, importance of maintaining a balanced diet, 101
Friendship Bench therapy model, Zimbabwe, 24
Garnett, A., 23
General Medical Council (UK), code of practice,
Global Compassion Coalition, 62
good medicine, key components, 20
Good Psychiatric Practice: Code of Ethics (RCPsych), 38
grief, 13
guided imaginative practice, and resilience,
health systems
absence of compassion in, 114
building compassionate cultures in healthcare organisations,
building compassionate health systems,
compassion as central value, 44
compassionate leadership,
and collectivity,
fostering open communication, 110
fragmented structure, 25
impact of valuing throughput and efficiency on, 19
leading by example, 109
need for change, 114
overstretching of services as reason for erosion of compassion, 19
recognition and reward for compassion, 110
resilience in,
role in limiting compassion and empathy, 44
and self-compassion,
staff support, 109
healthcare, emotional toll of working in, 19
healthcare workers
expectations of detachment, 20
impact of current landscape of healthcare systems on,
importance of paying attention to their physical and mental health, 8
management of emotions, 33
postgraduate medical training experience, 2
sacrifices of, 2
heart-rate variability (HRV)
increase associated with cultivation of compassion,
research into regulation of, 56
Hippocratic Oath, modification, 35
Hughes Spence, S., 99
Lasagna, Louis, 35
leadership
compassionate leadership in healthcare organisations, ,
by example, 109
four pillars of compassionate leadership, 31
role of listening,
Leading Change, Adding Value: A Framework for Nursing, Midwifery and Care Staff (NHS England), 41
listening
role of in leadership,
Liu, Y., 61
Lockwood, P. L., 56
Lyng, H. B., 108
major depressive disorder (MDD), benefits of strengthening self-compassion for, 73
Malenfant, S., 15
medical professionalism and compassion
overview,
codes of practice for medical doctors,
ethical guidance and codes of practice for psychiatrists,
medical training
building compassion into,
the concept of equanimity in clinical practice, 21
postgraduate experience of healthcare professionals, 2
teaching compassion,
value of patient and provider-informed models of compassion, 47
meditation
breath-focused, 66
Desbordes and colleagues’ findings, 55
fMRI research, 65
research into meditation, 56
re-shaping the way our brains work with meditation, 64
and resilience,
mental health
benefits of connections with other people for, 101
building and sustaining compassion in mental healthcare, 5
improvement strategies, 103
relationship with physical health, 8
mental training
Böckler and colleagues’ findings, 57
research into benefits for attention, compassion, and theory of mind,
research into the nature and effects of, 56
structural effects, 57
Trautwein and colleagues’ examination,
Valk and colleagues’ findings, 57
Mid Staffordshire NHS Foundation Trust, Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, 38
Millard, L. A., 80
mindfulness, 8
benefits of for patients and the healthcare system, 50
benefits of regular practice, 12
the Buddhist idea of, 12
cultivating awareness and,
defined, 12
foundations of, 84
Jiménez-Picón and colleagues’ systematic review,
mindfulness of feelings/feeling-tone,
open-ended questions in teachings, 30
and resilience,
role of awareness and mindfulness in supporting compassion/self-compassion, 89
role of mindfulness in cultivating awareness, 84
of states of mind/emotions, 88
of thoughts, 88
topics involved in teaching mindfulness, 30
moral injury, 6
as common human experience, 71
cumulative,
examples of,
and self-compassion,
types of, 70
moral judgement, compassion as source of, 11
National Health Service (NHS)
guiding principles,
Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, 38
negative emotions mistaken for compassion, 32
neuroplasticity, re-shaping the way our brains work with meditation, 64
neuroscience of compassion, 11
associated neural locations, 53
challenges for the field, 53
empathy and the brain,
fMRI studies,
Intersectional Neuroscience framework, 65
meditation research, 65
neural correlates of compassion, 53
neural locations associated with empathy, 54
neurophysiological and behavioural markers study,
reasons for divergence of neuroanatomical findings, 54
research findings,
practical implications,
research on, 6
research recommendations,
ReSource Project, 56
visual attention to suffering after compassion training study, 53see also brain; functional magnetic resonance imaging (fMRI).
New Zealand Medical Association, code of practice, 37
NHS Wales, four pillars of compassionate leadership, 31
non-judgment, role of in cultivation of compassion, 78
non-verbal cues, 31
Novak, L., 56
Nursing and Midwifery Board of Ireland, code of practice, 41
Nursing and Midwifery Council (UK), code of practice, 40
Occupational Therapy Code of Ethics (AOTA), 42
open-ended questions, in mindfulness teachings, 30
outcomes, impact of prioritisation on patient-doctor relations, 19
oxytocin, 15
pain, relationship with empathy, 28
Paterson, R., 38
patient and provider-informed models of compassion,
patient perspectives
experiences of compassionate care, 20,
preferences for personalised and humane clinical care, 20
Sinclair and colleagues’ model,
value of the patient-doctor relationship, 20
patient safety, prioritisation of, 37
patient-reported outcomes, positive impact of compassion on, 15
patients and carers, support for compassion as care priority, 25
physiology, role of in connections between compassion and evolution, 15
positive coping, and the effect of resilience on anxiety among healthcare workers, 61
Principles of Medical Ethics (AMA), 37
Principles of Medical Ethics with Annotations Especially Applicable to Psychiatry (APA), 39
problem solving therapy (PST), Friendship Bench programme, 24
Professional Ethics for Psychiatrists (College of Psychiatrists of Ireland), 39
professional standards for clinicians
pro-social behaviours
compassion described as, 11
neural basis, 11,
research into the impact of mental training on,
research into the impact of mindfulness and meditation on, 65
provider perspective, mirroring of aids and barriers to compassionate care, 63
psychological perspectives, dimensions of the construct of compassion, 11
Rectangle Breathing exercise, 92
relational communication, 31
religious and spiritual figures, compassion associated with, 11
Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry (Francis), 38
research
Baguley and colleagues, 47
brain plasticity, 56
Byrne and colleagues, 31
components of compassion, 5
Covid-19 pandemic driven research, , 99
cultural perspectives,
recommendations for further research, 48
Desbordes and colleagues, 55
doctor-patient relationships, 33
Egan and colleagues,
empathic communication, 31
fMRI studies of meditation, 65
Hughes Spence and colleagues, 99
impact of mindfulness and meditation on pro-social behaviours, 65
Jiménez-Picón and colleagues,
Maddox and Barreto,
meditation training, 55
mindfulness and emotional intelligence, the relationship between,
neuroscience and compassion, 6
patient experiences of compassionate care, 20,
patient-centred model of compassionate care,
resilience, 99
Schairer and colleagues, 33
self-compassion,
Sinclair and colleagues,
Singh and colleagues,
staff perceptions of compassionate care, 63
Svendsen and colleagues, 73
theory of mind, 56
Trautwein and colleagues,
Valk and colleagues, 57
resilience
and barriers to compassionate care,
brain training’s strengthening potential, 63
building physical and mental resilience as a solid basis for compassion,
challenges of working in healthcare for, 60
and compassion, 6
dangers of over-emphasis on personal resilience,
developing, 8
equanimity and,
guided imaginative practice,
in health systems,
in healthcare settings,
Hughes Spence and colleagues’ study, 99
importance of self-care for,
Liu and colleagues’ study, 61
misuse and overuse of the term, 98
role of meditation and mindfulness,
self-compassion and, 73
value of for navigating systemic challenges, 66
ReSource Project, 56
risk, evolutionary perspective of avoidance, 84
role play, benefits of, 30
‘safeness’, ‘safety’ vs, 104
Schairer, C. E., 33
self-awareness, role of in equanimity, 22
self-compassion
‘amygdala hug’ exercise, 92
Box Breathing exercise, 92
building, 8
comparison with self-pity, 32
the concept of, ,
developing,
effectiveness of self-compassion related therapies,
Egan and colleagues’ review of,
evolutionary perspective,
health systems and,
importance of for compassionate leadership, 112
and impossible choices, 69
key elements, 90
as key organisational value, 9
meaning of, 68
mindful self-compassion,
misunderstanding of, 68
moral injury in relation to,
myths and misunderstandings about, 72
positive associations, 71
and prevention and treatment of anxiety and depression,
Rectangle Breathing exercise, 92
and resilience, 73
role of in wellbeing, 90
self-pity vs self-compassion, 72
Svendsen and colleagues’ study, , 73
Three-Stage Self-Compassion exercise, 91
understanding self-compassion,
Wilson and colleagues’ systematic review,
shame
and compassion in clinical settings,
and depression, 78
experienced by people working and training in health services, 79
sleep, importance for wellbeing, 101
‘sonder’, the concept of, 93
Spiro, H., 22
Stevens, L., 28
suffering
amygdala responses after compassion training, 53
arising from the cost of helping, 30
as common human experience, 73
common reactions to suffering of another person, 64
compassion as emotional response to, 13
constraints on responding to, 15
engaging with, 33
impact of increased sensitivity to, 13
as problem compassion evolved to meet, 14
requirements for engaging with, 13
Svendsen, J. L., 73
Sweileh, W. M., 62
teaching, New Zealand Medical Association’s ethical guidance on, 38
teaching compassion,
technology
and the depersonalisation of patient-doctor interactions, 19
theory of mind, research into, 56
threat, effects of practising compassion on neural networks associated with, 53
Three-Step Breathing Space exercise, 85
throughput and efficiency emphasis, impact on health systems, 19
touch, cultural perspective, 48
‘Toward a compassionate intersectional neuroscience: increasing diversity and equity in contemplative neuroscience’ (Weng et al.),
trauma, self compassion and recovery from,
Trautwein, F-M., 56
United Kingdom (UK), guiding principles of the NHS,
values terminology
communication skills,
empathy,
kindness,
sympathy,
vasopressin, 15
Vision, Mission, Values and Goals (APA), 39
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