If you’ve been to a health care provider lately, your treatment plan probably looked something like this: Take one pill twice a day with meals, drink plenty of fluids, and get lots of bedrest. But don’t you wish that prescription also included compassion, deep listening, and connection from your provider?
According to a new book, The Compassionate Connection: The Healing Power of Empathy and Mindful Listening by David Rakel, this is the unwritten yet essential prescription for healing. As a physician and professor at the University of New Mexico, and founder of the integrative medicine program at the University of Wisconsin, Rakel draws on research and his expertise in the exam room to argue that how doctors interact with their patients can sometimes matter more to healing than what they do.
His book explores why compassionate connections are key to successful caregiving and how they can be established—whether between health care providers and their patients or within any caregiving relationship.
The healing power of human connection
According to Rakel, certain traits are shared by healers across history, including hope, trust, wisdom, caring, gratitude, and mutual respect. These common denominators of the caregiving connection have helped people heal for centuries, he argues, and science bears out their importance. For example, research has shown that more empathic physicians help their patients open up about more vulnerable thoughts and adhere better to treatment plans, providing opportunities for better care.
Connection can affect our immune system as well, writes Rakel, stimulating self-healing mechanisms. In one study, patients whose physicians showed compassion and made a personal connection recovered from the common cold more quickly and had higher levels of immune cells than those whose physicians acted more formally and impersonally.
This might happen partly because expressing emotions verbally or nonverbally, rather than bottling them up, improves your immune function. So, it’s important that caregivers can provide a comfortable space for these vulnerable exchanges—both inside and outside of their offices. For example, research has found that cancer patients who participate in peer support groups tend to live longer—likely because the comfort of a sympathetic social group reduces their stress levels, which in turn affects their immune system.
Rakel describes how compassion benefits not only recipients, but also caregivers, by improving their physical and emotional health and strengthening their immune system. Positive feelings from compassion can also help caregivers overcome burnout. Likewise, volunteering has been shown to help buffer the effects of stress on one’s health—at least for those who generally hold positive views of other people.
How do compassionate connections work? We are biologically wired for connection, which is necessary for our survival. Mirror neurons located in our brain, which fire when we perform a task or feel a particular emotion, also fire when we see others perform the same task or express the same emotion, perhaps facilitating empathy. That’s why a caregiver expressing confidence that a patient will get better encourages that patient to synch up with those feelings and believe she can heal, too.
Additionally, our bodies produce oxytocin—a molecule known as the “love hormone”—that promotes bonding and closeness among one another, starting with mothers and their newborn infants. When two people hug, the release of oxytocin can lower blood pressure and reduce stress hormone levels—important for healing, too.
As Rakel convincingly argues, this all points to the importance of using our human propensity to connect for healing.
How to connect as a caregiver
What can physicians and other caregivers do specifically to activate the power of compassionate connection? Rakel suggests these strategies.
Be present while employing mindful, “other-focused” listening. When listening to others, we may find ourselves preparing a response before they even finish—instead of being completely present and listening to their full story without an agenda. Or our minds may wander to other thoughts vying for our attention. What can help is quieting the mind, a skill that we can hone through reflective, contemplative mindfulness practices. This creates a space for others to feel comfortable opening up completely.
Recognize your biases and try to overcome them. Biases are the result of the experiences and perceptions that form our belief system and are not necessarily based on facts. Because biases can lead to assumptions about others, they may prevent us from forming true connections. For example, it may be tempting to cast off a rude and entitled nine year old as a “spoiled only child,” but there may be more to the story.
We can overcome biases with the help of mindfulness, including the practice of “beginner’s mind,” in which we approach a situation with a naïve attitude and without prior assumptions. Acknowledging that other people’s unique perspectives are shaped by their history of experiences can deter us from hastily projecting our own biases onto them. When we put aside our biases, we can begin to build trust with others.
Make sure your body language matches your (compassionate) words and tone. Another way to show compassion is by keeping the conversation at someone’s eye level and appropriately employing friendly touch on the outer edges of their body. Additionally, mirroring another’s body positioning and posture can convey respect and establish trust.
Recognize and address caregiver burnout, which could hinder making connections. Burnout can result from the overexertion of empathy with another’s distress or from lack of self-care. In physicians, burnout can manifest as withdrawing from others and depersonalizing the patient into a “condition” or “case,” as they emotionally distance themselves from their patients as a protective measure. Fighting burnout requires a balance of self-care and care for others. As mentioned earlier, the positive feelings from compassion can help caregivers overcome burnout. Taking time to recharge and prioritize our own health will also help buffer against burnout.
When I was growing up, I did not dread going to my doctor’s no matter how sick I felt. I have lasting impressions of feeling validated and listened to, and I could never tell that my doctors had countless other concerns zipping through their minds. As a health care provider himself, Rakel recognizes that amidst the stresses of caregiving, it is sometimes easy to overlook the advantages of these compassionate interactions. But when caregivers focus on the person beyond the illness and genuinely connect with their patients, they may be engaging a more sustainable form of healing that benefits them both.