Practising Compassionate Care In-The-Moment

By - Audrey BurkeMcCarthy, Celia Sikorski, Christine Scordato, Erin Whitehead, Henry Kahn, Jaspal Bajwa, John Lazar, Keyaunoosh Kassauei, Nancy Glynn, Pamela Helwig, Tanya Kleindienst - Fellows at the IOC - Institute of Coaching

In Brief:

Our previous blogs on ‘Presencing’ outlined the importance of ‘Relational Intelligence (RI)’ and ‘Cultural Intelligence (CI)’ to help achieve a deep connection. Having examined the vital importance of Relationship with ‘Self’ and with ‘the Other;’ this sequel delves deeper into the ‘Aha’ moment. In other words, how both coach and coachee benefit from being a “witness” and a “contributor” to the practice of co-creating in-the-moment with compassionate care.   

Introduction 

In addition to Relational Intelligence & Cultural Intelligence — achieving depth in coaching conversations relies heavily on practicing the ‘compassionate pause.’ Cultivating an air of un-anxious presence is a nuanced art form. Just as in music, the silence between two notes can add poignancy and impact; so also, the judgement-free space between two thoughts can be a portal for a deep insight to emerge.

Compassionate Care vs. Empathetic Care

Creating and holding a relationally, emotionally, and culturally intelligent space for our coachees to grow requires a certain kind of energy. While being there for the coachee — it is important to avoid the trap of either trying too hard or swinging to the other extreme of ‘under-doing.’ The cartoon below illustrates very well how coaches can differentiate and manage the dynamic of compassionate care, as differently from empathetic care:

"Empathetic Care” - Illustration by Lohitha Kethu 

Compassion, as different from empathy, is like throwing someone a life vest. It is a state of meta-awareness that helps us to see ourselves and our client at the same time — witnessing and supporting simultaneously.

"Compassionate Care” - Illustration by Lohitha Kethu 

Compassionate care can empower your coachee to arrive at a deeply insightful ‘Aha’ moment. In a flash — everything seems to come together. There is a creative tension between stillness and potentiality. The pause between two thoughts, invariably helps create a space for what is waiting to emerge. 

Case Study 

I was recently reflecting on a coaching conversation to take to supervision. I had an initial meeting with a client - a medical doctor who had just taken on a front-line management position at his hospital. At the start of our Zoom call I learned that he was dialing in from another country where his mother suddenly had become seriously ill and was in intensive care. I asked myself, “Was I with him enough in his distress?”

This was a new client whom I had never met or spoken to before. I felt that I was very present with him and yet was conscious that the way I chose to respond could tip him into a state of distress and sorrow that might disable him for the conversation he wanted to have. 
In this case example the coach paused, judgment-free, as a witness to the client’s distress and thereby created the possibility for a ‘sacred space’ – unfettered by baggage and blind spots, thus, opening the door to courageously explore the potential for new possibilities.

Being present with and being witness to what the coachee is experiencing helps to enable the coachee to adopt a new perspective. By balancing the two, you can avoid being overwhelmed with empathy-fatigue for clients in distress. Alison explains “ … what we're talking about is the critical importance of engaging our witness - not only being present - but being able to be sustained in the Self (one Consciousness) that witnesses the all … the joys, the sorrows, the happiness, the pain … (you) can be with all of it — equally.” Anthony De Mello also talks about this phenomenon in Awareness.

As mentioned in our first blog —  the study and practice of Presencing has been gaining traction over the last two decades. In the 2004 book Presence: Exploring profound change in people, organizations, and society, the co-authors (Senge et al., 2004) underline the fact that the capacity for Presencing can be developed. They state that the “... study of meditation and other forms of individual cultivation over an extended period of time are essential to build the capacity to be an ‘instrument’ of service.” (Senge et al., 2004, p. 225-226)

The importance for leaders and coaches to have a sustaining contemplative practice such as mindfulness or meditation should not be underestimated. Some coaches have attended retreats and experienced being with oneself in silence over an extended period of time. Such silence intensifies a connection with all the joy and messiness that it is to be human and cultivates non-judgment and compassion. To provide your client with a ‘well-held’ environment — a place where they are profoundly seen and heard, with acceptance and care – practicing self-compassion is the first step. Toward this it is vitally important to take small but regular steps for self-care as a daily habit.

Importance of Supervision to Cultivate Presencing

When witnessing coachees in moments of distress and bringing this special, nonjudgmental presence, it is useful to be aware of parallel processes and transference. As described by Judy Ryde (2009) in her chapter on supervising psychotherapists who work with asylum-seekers and refugees in the UK: “An ability to listen without either over-identifying or dissociating can be crucial … I make a distinction between unattached listening, where we are not overidentifying with our narcissistic sense of self and detached listening, which involves a state that is cut off from our emotions and bodily responses.”

Supervision is vital to reflecting on and working with emotionally charged, and at times distressing, situations in coaching, understanding one’s own processes and expanding one’s ability to listen and bring this special quality of Presencing.

Transforming Empathetic Care to Compassionate Care

Emotions are contagious; they are transmitted through the mirror neurons that we have in our brain. If a child is sick and hospitalized, the presence of a caring mother who holds his hands and sits by his bed with an attitude of altruistic love, using kind gentle words, creates a positive space for the child. Quite distinct from an overly empathic distressed mom whose overwhelm is on display. How we grieve over a loss is another example of the difference between the two approaches. One manner is to grieve over hurt and loss with extreme sadness or despair, while the other focuses on celebration of the life of a loved one and the meaning it brought. The tears are the same, and they are both valuable and valid, but one relays sorrow and the other possibility.

With the help of techniques like fMRI-rt tracking, real-time changes of brain-activity are possible. These studies indicate compassion and empathy activate different cerebral networks. When observing someone suffering with empathy, the anterior insula and cingulate cortex gets activated (due to a correlation with a negative experience of pain). On the other hand, a compassionate or altruistic love activates a different cerebral area that is related to positive emotions.

From studies in healthcare and social workers, one can see that burnout can result from empathic fatigue, and also over time, from compassion-fatigue. This is why it is so important to remain strongly grounded in love and compassion – buttressed by daily habits of self-care, reinforcing strength of mind, resiliency and courage. The trick lies in the ability to toggle seamlessly between being ‘switched-on’ during work hours and regularly ‘switching-off’ to replenish your compassion-reserves.

Conclusion 

Presencing in a coaching relationship is not an exceptional act, it is integral to coaching.  How we approach our client and mirror them sets the tone for each coaching conversation.  As coaches, it allows us to remain in a state of meta-awareness of seeing where we stand with our client or what we ourselves are feeling at all times. This is why the role of an observer (or ‘coaching supervision’) becomes key to strengthen our ability to practice presencing with compassionate care. 

As we conclude this 3-part blog on ‘Presencing,’ it would be pertinent to draw out one common thread that runs across all three relationships: with self, with others, and with the emergent moment. This is the ability, at all times, to be aware of how we as leaders and coaches ‘show-up’ in-the-moment: neither ‘over’ nor ‘under.’ As the wise sage Lao Tzu said “Govern a great nation as you would cook a small fish. Do not overdo it.”

References

Burke McCarthy, A., Sikorski, C., Scordato, C., Whithead, E., Kahn, H., Bajwa, J., Nayer, K. K., Glynn, N., & Helwig, P. (2021, April 1). Presencing: Leveraging Cultural Intelligence for a deeper connect. Institute of Coaching. Retrieved January 15, 2023, from https://instituteofcoaching.org/blogs/presencing-leveraging-cultural-intelligence-deeper-connect 

Cocker, F., & Joss, N. (2016). Compassion Fatigue among healthcare, emergency and Community Service Workers: A systematic review. International Journal of Environmental Research and Public Health, 13(6), 618. https://doi.org/10.3390/ijerph13060618

Compassion Fatigue Awareness Project - Home. Compassion Fatigue Awareness Project. (n.d.). Retrieved January 15, 2023, from https://compassionfatigue.org/index.html

IOC Fellows. (2020, October 1). 5 ways we can exercise self-care (for ourselves, and for our clients). Institute of Coaching. Retrieved January 15, 2023, from https://instituteofcoaching.org/blogs/5-ways-we-can-exercise-self-care-ourselves-and-our-clients

Lametti, D. (2009, June 9). Mirroring behavior. Scientific American. Retrieved January 15, 2023, from https://www.scientificamerican.com/article/mirroring-behavior/

Mello, A. D. (1990). Awareness. Random House USA.

Miller, M. (2022, July 26). 2016 conference talk: Creating a developmental culture. Institute of Coaching. Retrieved January 15, 2023, from https://www.instituteofcoaching.org/resources/2016-conference-talk-creating-developmental-culture

Nayer, Z. (2017, May 30). What a dead body taught me about empathy. HuffPost. Retrieved January 15, 2023, from https://www.huffpost.com/entry/what-a-dead-body-taught-me-about-empathy_b_592b00e1e4b0a7b7b469cb86?fbclid=IwAR1bAu-M75DvuTBxrdh2f8k1V7VzYkqWJbejmcUS0GjXvWaKaFF6ga409sY

Ricard, M. (2015). The differences and the relationship between empathy and compassion – Matthieu Ricard. Tibetan Buddhism in the West. Retrieved January 15, 2023, from https://info-buddhism.com/Empathy-Compassion-Neuroscience-Ricard-Altruism.html

Ryde, J. (2009). Being white in the helping professions. Jessica Kingsley.

Senge, P. M., Scharmer, C.O., Jaworski, J., & Flowers, B. S. (2005). Presence: Exploring profound change in people, organizations, and Society. Doubleday.

Shohet, R. (2011). Supervision as transformation: A passion for learning. Jessica Kingsley Publishers.

Smith, P. (2017). How to Manage Compassion Fatigue in Caregiving. YouTube. TEDx Talks. Retrieved January 15, 2023, from https://www.youtube.com/watch?v=7keppA8XRas.

Suzuki, D. T. (1979). Zen Buddhism and its influence on Japanese culture. Southern Materials Center.