The Shadows of Compassion

“Who taught you all this Doctor?” The reply came promptly: “Suffering.” —Albert Camus

Human beings suffer. Often they have no control over the forces of nature or evil or neglect that they experience. Sometimes they are the perpetrators of evil or neglect themselves. But, wherever there is suffering, there are those who tend to it, and who live their own lives responding with care, kindness—or simply necessity. Those of us who do such work and are honest with ourselves might admit that we are not saints, nor our purposes completely selfless. We are often as profoundly transformed in the act of care as the ones who receive it. Even if we experience emotional exhaustion in response to those we serve, many of us report feeling inspired by what we have witnessed and done. We are wiser, grateful, connected to life and hopefully our spirit, which might account for the endless hours of work with people who may or may not be able to be saved or restored, or why we tolerate such difficult conditions, often with little support.

Edward Tronick speaks of the impact of powerful experiential exchanges between individuals, and how they create an expanding state of consciousness. These can be organized in a positive or a negative way. When there is profound affirmative connection, there is a “fulfillment” in the engagement. Both parties expand to incorporate elements of consciousness of the other in a new and coherent form. One becomes paradoxically larger than oneself. The experience is imprinted and restructured, incorporating the expansiveness into other relationships.

There are many stories about those who deal with the most unimaginable danger, trauma, or distress in work or ministry, as inspired and enlivened by their experiences, choosing to serve, rather than return to the safety of their ‘other’ lives.

That is why it might be so hard for we as caregivers to remember to stop or rest, or why we have such resistance to taking better care of ourselves. Maybe it is not possible because there is simply too much to do, or perhaps no other way to be in the world. “Why do you do this?” We might shrug our shoulders and say, “Well, it’s just who I am.” It is as much a part of our identity as our innate talent, our gender, our family, or our history. The work may feed or deplete us, but it continues, despite how tired we are.

Occasionally, one might be able point to a darker motive than altruism here. It is difficult to name this as a shadow in oneself, which it might have nothing at all to do with the other. Caregiving itself is a noun as much as it is a verb, as much a relationship with the work as the people with whom we serve. It is pivotal to our sense of the self. It might even define our sense of otherness, and often, our inner life. The experiences that occur in the field could be far more intimate and dangerously seductive than other relationships. The work itself becomes the “beloved.”

Chris Hedges speaks about a similar experience as a war journalist (2002). He had come to know first hand that war is a culture of its own which wastes not just the body, but the heart and mind of those who engage with it. Yet, war is also seductive in its quality of purposefulness and comradery. It creates a sense that one can rise above smallness and divisiveness. And initially, the selflessness of it mirrors that of love, which is the chief emotion that war destroys.

But, unlike love, war gives nothing in return but an ever-deepening dependence, like all narcotics, on the road to self-destruction. War does not affirm but places upon us greater and greater demands. It takes a higher and higher dose to achieve any thrill. Finally, one ingests the war only to remain numb. The world we once understood and longed to return to stands before us as alien, strange, and beyond our grasp.”

Life in war is theatre. At a given point, it enobilizes the acts of violence, valor, or resistance, even as it inflicts destruction. It feeds the myth that gives purpose to the players as well as their spectators. It also feeds upon itself, for war and the drama surrounding it can make those engaged feel more alive in the process. In this, there is a sense of righteousness and pride; there is often tremendous courage. But there may be secrets held or shared by the recipients of such trauma, or from being perpetrators of dark acts of unimaginable cruelty.

After covering the wars in Central America. Angola, and the Balkans, Chris Hedges, the journalist, left the battlefield. He found himself both horrified by and addicted to the business of war. Though he had become hollowed out with witnessing its ravages, he experienced his life away from the battlefront as vapid and void of purpose. He had become alienated from anything outside of it. When he realized this sordid fact, he had to pull out before his work destroyed him.

For those of us who tend to the care of others, there is a compelling resemblance to being on the battlefield. We witness unimaginable acts of violence and pain. We feel the affects of others’ triumphs and traumas, their lives and their losses, the good and the evil of nature and human beings. We are often in treacherous physical or psychological circumstances ourselves. Responding to the human condition like this creates a sense of meaning and vibrancy to life that is unmistakable—and perhaps, dangerous.

Recently, there has been a flood of professional literature about caregivers and compassion fatigue. There are definitions, recipes for self care and watch points for how to detect the signs of burnout. The act of compassion, the most important component of humanness, has little written about its shadows, the parts of caregiving that have more to do with the giver than the receiver of care.

Compassion is a deep awareness of the suffering of another coupled with the wish to relieve it. It is not the same thing as pity, or even sympathy. In fact there is a distinct difference between sympathy and compassionate empathy, although they are often confused for one another. Sympathy is when the witness experiences the feelings of the other as if he or she were the sufferer. It can actually deplete real care and responding to the one in pain because the caregiver is too identified with it. Empathy, on the other hand, is the consideration of the other’s feelings and experience, and readiness to respond to their needs…without making the burden one’s own. When the gap between experience and thought is bridged, we can be a witness and truly respond without condescension or the interference of our own history of pain. But the work itself can be contaminated by an undigested sense of mission, love or kindness. The shadows: pity, histrionics, over involvement, loss of perspective, loss of one’s own health, over identification, anger, coldness or cynicism, might be the result of the caregiver’s own history or sense of self which has little to do with others.

Compassion fatigue, the emotional residue of exposure from working with the suffering of others, is when the caregiver experiences an extreme state of tension and preoccupation about the distress of those they serve. This experience differs from burnout, which brings feelings of being emotionally overextended and exhausted with one’s work. It is when one loses the ability to feel for others, or to continue to feel competent to do the work. Compassion fatigue on the other hand creates toxicity by the amount of exposure the caregiver has to the trauma and pain of others. We can lose perspective about ourselves or about the people who count on us. We may continue to work even when it is toxic, unconsciously reenacting some part of our past, unable to stop to replenish our exhausted reserves.

In Chinese medicine, this process of being overwhelmed or overloaded is called empty fire. Yin is the water element that nourishes, and yang is the “fire” of activity and energy. Yin nourishes, and yang consumes. When nourishment is deficient, the “fire” is not held in check and rages out of control. Because there is a lack of inner resources, activity overcompensates, but there is no real energy. On a psychological or spiritual level, such an imbalance creates feelings of emptiness and desperation. Such fatigue is often difficult to diagnose and even harder to resolve because caregivers simply cannot stop long enough to assess the impact of what they are doing on themselves. Besides, in empty fire, when the “fire” is raging out of control, the activity even intensifies. Individuals might be too depleted to stop and paradoxically, move faster. They are going so fast, they lose the imagination to consider any other way to give care, take respite, or to be in the world.

One of the prickliest shadows of caring for others is difficult to name without almost invalidating the essence of compassion itself. It sometimes shows up in patronizing attitudes of condescension, or excessive identification with the people we counsel. These are not particularly conscious situations for the caregiver, which is why they are so insidious. They manifest as ostentatious humility, in piety, or the quality of dramatic selflessness. We might believe that we are essential and that the work cannot go on without our participation. In fact, we may be so identified with the work that we do not know how to be without it. Just like the compelling quality of war, the drama of other people’s pain may be addictive. In fact, the work might have the capacity to feed the caregiver, but possibly at the recipient’s expense. It is an unconscious process that is not only hard to name, but difficult to recognize in oneself, an attachment to oneself in the identity of caregiver, to the degree that to recognize any other motive other than selfless service is met with shame, or even intense rage. Psychologists have cleverly named this closet narcissism, when individuals see or create themselves to be indispensable in their caregiving, and need to be recognized not for their contributions alone, but for their goodness. They may experience themselves as indispensable, and have a fierce attachment to their identity as minister, therapist, or self-sacrificer. They might unconsciously put themselves and their patients, parishioners, or loved ones in a double bind of power and guilt, all the while claiming to be less than: the worst, the least, the last. Their need to control the politics of giving creates an inability to see where they fail to care. And, a fear of criticism or of being deficient creates an inability to be reflective. In fact they may mistake self-care and self-vigilance for self-indulgence because it will require that they rest, or eat, or take time away from the work they are dependent upon.

A closet narcissist is rigidly invested in how he or she does their work, and quite angry if the receivers are ungrateful, or neglectful of how much they have endured to help. They might become dependent upon others’ loyalty or dependence on them, which will only sabotage everyone’s health and growth. Sometimes in the act of caregiving however, they allow themselves to be abused and misused, enabling patients or parishioners to cross boundaries or take advantage of the system. This is not humility or self sacrifice, nor is it a particularly spiritual activity. It is a sick and codependent relationship that neither feeds the one in need, nor extends any true quality of compassion, because it does not give the patient or parishioner the dignity of empowerment and equanimity.

Those of us who are caregivers, if we are truthful, will admit to some capacity for closet narcissism in ourselves. Recognizing this particular shadow can be the difference between spiritual awareness—and arrogance, masked as benevolence. It requires a mature and honest assessment of oneself, by noting one’s true charism, particular strengths and gifts, as well as what can shadow them. It necessitates time for self-reflection, forgiveness for oneself as imperfect, and a healthy respect for our limitations. It might also be damn uncomfortable to discover how afraid we are to be alone, to be truly intimate or vulnerable with others, or ourselves or to confront our tendencies for grandiosity.

Addiction is another manifestation of compassion’s exhausted shadow. Addiction is a compulsive response to pain. We can be addicted to stimulants, exercise, food, sex, the Internet, television, alcohol, drugs, work, bad professional or intimate relationships, or even religion—not in its most spiritual sense, but in the particular compulsions to form and regulations. We can also be addicted to other people’s pain, and to the simulacra of their lives, when their life dramas are more interesting or compelling than our own. Addictions like this make it difficult to stop even when we should. And they come at a tremendous psychic and spiritual cost.

Sometimes addictions are the outcome of spiritual burnout, when it has become difficult for the caregiver to grapple with the problems of evil and the problem of God, the seeming futility of suffering, and the depths of grief and despair, others or ours. We want others to be free from suffering, and wish to relieve it. We desire to numb ourselves from the pain of what we witness, of our insufficiencies to eradicate their suffering, or of what it triggers in our own memories and lives. We want to be free, and to find the spark that prompted us to do the work we love in the first place

The truth is that we cannot cover over the suffering of the world, nor can we control it simply by our labors. This is the challenge of true spiritual courage: to humbly work as hard as we can for those we serve, to let go of the ego’s investment in the outcome, and to remember that the meaning and point of what we do, has little to do with us.

In Tibetian Buddhism, there is a method for connecting with the pain of the world and awakening compassion, called tonglen. In the practice of tonglen, we breathe the suffering in, owning instead of avoiding it. Then we breathe out our fear and resistance, sending calm, and whatever brings sustenance to the source of suffering. At first such a practice may feel contrived, and in fact, opposite to how we try to hold ourselves together. It may bring forth tightness, anger, or revulsion, and a resistence to what we wish to avoid. But a practice like this can dissolve our armor of self protection and fear as we join in compassion with those who share our suffering.

The ego clings to its own notions of how things should be. Our task, as caregivers, compassionate professionals, and as human beings in relationship with others, is to be mindful and aware of whatever it is that keeps us stuck in paradigms of shame or shame making, and of the shadows that keep us from being fully alive in our work and relationships. It may mean that we seriously assess the impact and cost of the work of compassion, re-nourishing ourselves and our inner lives altogether differently, or at least with both kindness and rigorous truthfulness. It requires a sense of self deprecating but kindly humor about ourselves and our importance. At some point, we need to be able to untangle ourselves from our cellphones, computers and pagers, the lists, and meetings, and appointments. At first, it will seem impossible because our work is important and so many people need our care. But unless we stop once in awhile, star into space, sing and dance, play—and pray, we will have but the empty fire of our own activity, which will serve nobody.

We cannot do this alone, nor should we, for one of the most important elements of compassionate care is the recognition and need for a respectful community that makes us equal in the struggle as givers and receivers, and as human beings. We must strive to create somewhere to be safe enough to do this, and to accept the compassion of others and ourselves.

Tonglen:

I have a talent for sadness.
But you are gifted in other things—
like smiling and sneezing
and stillness
There is noise in my head
I’m losing the memory of the music…
Listen to the snow.
What of the orphans and the pederasts
the women going into combat
the widows in burka?
I’m losing my strength, shoveling the ice…
Did you notice the black branches stacked against the sky?
Think of Terry the homeless guy who froze to death in front of the library
I'm losing my will to feel, to fight, to understand…
This is the long view
Past the black branch
Past the sky
I’m losing my sight
Close your eyes
And look
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