Compassion

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Chapter 1

Compassion

Definitions and controversies

Paul Gilbert

Compassion is clearly linked to the evolution of caring behaviour (Gilbert,

1989/2016, 2009, 2015a, 2015b; Keltner, Kogan, Piff & Saturn, 2014;

Mayseless, 2016), altruism (Preston, 2013; Goetz, Keltner & Simon-Thomas,

2010; Ricard, 2015) and prosocial behaviour in general (Bierhoff, 2005;

Brown & Brown, 2015; Penner, Dovidio, Piliavin & Schroeder, 2005). The

last 20 years have seen increasing research into the nature and benefits of all

these. For compassion, these include a range of effects on psychological pro-

cesses (Jazaieri et al., 2013; Keltner et al., 2014; Singer & Bolz, 2012), social

relationships (Cozolino, 2006; Crocker & Canevello, 2012; Penner et al.,

2005) and physiological processes (Klimecki, Leiberg, Ricard & Singer, 2014;

Kogan et al., 2014; Simon-Thomas et al., 2011; Weng et al., 2013) that extend

to genetic expression (Slavich & Cole, 2013; Slavic & Conway, Chapter 9,

this volume). Hoge et al. (2013) found that women with experience of

loving-kindness meditation had longer relative telomere length than controls

(see also Fredrickson et al., 2013). Compassionate motives benefit social rela-

tionships and well-being, whereas ego self-focused motives do not (Crocker &

Canevello, 2012). Compassion has become the focus for psychotherapeutic

interventions with increasing evidence for its effectiveness (Gilbert, 2000, 2010,

2015c; Hofmann, Grossman & Hinton, 2011; Kirby & Gilbert, Chapter 15,

this volume; Leaviss & Uttley, 2015; Neff & Germer, 2013). In addition, all the

chapters of this book address these themes too. However, despite this progress

there remains controversy and discussion around the actual nature of compassion,

its definition and constituents. This chapter explores some of these controversies.

Issues of definition: what’s in a word?

We can only understand phenomena by agreeing a set of properties by which

phenomena will be known. So, for example, we can distinguish between a chair,

an elephant, a tiger and a cat by agreeing a set of qualities and properties that

belong to each and those that are specific. Hence, they share qualities as four-

legged things, but not of being living organisms. We can then distinguish between

an elephant, a tiger and a cat and then finally between a tiger and a cat, and even

different breeds of cat. Each subdivision has more and more overlapping features,

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but also more fine-grained distinctions. This is important in areas like compassion

too which are easily fused with concepts such as altruism, benevolence, hearted-

ness, prosociality, kindness and love. Sometimes it’s the fine-grained distinctions

that are important. Second, as the late Prof Kendell (1975) used to drum into us

clinical trainees in Edinburgh in the 1970s, there is no such ‘thing’ as depres-

sion, anxiety or paranoia as rarefied states. Rather there are a set of phenomena

(signs and symptoms) that we agree may cluster/fit together and we will give

labels to, so that we can agree what we are discussing when we use the label.

So too, the definition of compassion will depend upon the shared properties we

give to this concept and its differentiation from similar concepts. Third, definition

problems can plague psychological research because of the insufficient atten-

tion it gives to functions. For example, shame and guilt, envy and jealousy, are

frequently used interchangeably when they are in fact very different, with very

different evolutionary histories, competencies, functions and focus (Gilbert, 1989,

1998, 2005, 2009). So, as will be discussed, although there are many general ideas

around what compassion is, currently there is no clear agreement about what the

specific attributes of compassion are. Let’s take a look at the range.

Defining compassion

One origin of the word compassion is from the Latin compati, meaning ‘to

suffer with’. However, words change their meanings with use over time and across

cultures and this is certainly the case for the word compassion. For example, to

‘suffer with’ need not imply a compassionate motivation to do anything about it.

Today ‘to suffer with or on behalf of’ might be more closely related to what we

now call sympathy (Eisenberg, VanSchyndel & Hofer, 2015) or empathy (Batson,

2009). Aristotle argued that we only had compassion if we thought the suffering

of another was nontrivial; to use one of his examples, ‘we would not have com-

passion for the upset of an emperor who’d lost a shipment of Larks tongues he’d

ordered for his party!’ (Nassbaum, 2003). Aristotle also thought that a sense of

deserve influenced compassion, and third that we would have to have some sense

of that suffering; that we could imagine ourselves in their situation (Nassbaum,

2003). So the seriousness of suffering, sense of deserve and empathy texture com-

passion for Aristotle. Buddhist scholars would not see these qualities as central.

In regard to dictionary definitions there are quite a variety. The Oxford

Dictionary (2016) suggests that compassion is ‘Sympathetic pity and concern for

the sufferings or misfortunes of others’. Teaching in France, Germany and Italy,

colleagues inform me that ‘compassion’ is a difficult word to translate and can

indeed be linked to pity. This is obviously a problem because pity is a very differ-

ent process altogether and involves a sense of looking down on others (Nassbaum,

2003). This is a good example where misunderstanding about the use of a word

can lead to heated debates and serious confusions. Schopenhauer (1788–1860),

who was deeply influenced by Buddhist thought, and one of the first Western

thinkers to introduce compassion into philosophy, argued that compassion was

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Compassion: definitions and controversies 5

one of the highest and most important qualities of humanity. Neither self-interest,

nor duty, social conformity nor fear of punishment could, in his view, be a source

of genuine morality (Cartwright, 1988). However, Nietzsche wrote a number of

significant critiques of Schopenhauer arguing that compassion is a poor source

for moral development. The problem is, as Cartwright (1988) observed, these two

philosophers were talking at cross purposes because of poor word definition:

[B]ecause Schopenhauer and Nietzsche refer to two different emotions by

the German noun ‘Mitleid’; that it is best to understand Schopenhauer’s

conception of ‘Mitleid’ as ‘compassion’ and Nietzsche’s as ‘pity’. I shall

argue that compassion is significantly (and morally) different from pity in

ways that make Schopenhauer’s Mitleids-Moral immune to this element of

Nietzsche’s critique.

(p. 1)

This confusion of concepts remains, especially in translations, and may help

explain why, at times, compassion is regarded as unhelpful (Who wants to be

pitied?), or even as a weakness. In contrast, the Cambridge University Dictionary

(2016) suggests compassion is ‘a strong feeling of sympathy and sadness for the

suffering or bad luck of others and a wish to help them’. Here, ‘pity’ is absent

and is replaced with ‘sympathy’ and ‘feelings of sadness’, and the ‘wish to be

helpful’ is also added. The concept of sympathy or ‘natural sympathy’, as David

Hume called it, as underpinning human benevolence, is prevalent in many early

philosophical texts. This definition also has the idea of a specific ‘feeling’ in

compassion that stimulates motivated helping behaviour. In Goetz et al.’s (2010)

major review of some of the evolutionary and historical origins of compassion

they also place feeling centre stage:

We define compassion as the feeling that arises in witnessing another’s

suffering and that motivates a subsequent desire to help. This definition con-

ceptualizes compassion as an affective state defined by a specific subjective

feeling, and it differs from treatments of compassion as an attitude . . . This

definition also clearly differentiates compassion from empathy, which refers

to the vicarious experience of another’s emotions.

(p. 351; italics added)

They also distinguish compassion from distress, sadness and love. As helpful and

as detailed as this review is, there is a difference in defining compassion as a feel�

ing state rather than a motivational state, and it is important not to confuse motives

with emotions (Deckers, 2014; Gilbert, 2015a, Weiner, 1992). Indeed, Ekman

(2016) surveyed researchers who study emotion. While 91% saw anger and 90%

saw anxiety as basic emotions, compassion was rated one of the lowest with only

20% agreeing that compassion is an emotion. Without an evolved caring motiva-

tion system there would be no emotions arising to signals of suffering/distress.

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It is the motivation system that necessitates emotions in contexts, and those emotions

may well then stimulate motivated actions (Gilbert, Chapter 3, this volume).

It is also unclear what the feeling state of compassion is. For example, what

is the emotion when rushing into a burning house to save a child, consoling a

recently bereaved or dying friend or fighting for human justice? It is likely that in

the first case the feeling states/emotions are of urgency and anxiety, in the second

sadness and sorrow, and in the third case a degree of anger at injustice. It’s not

the emotions that unite them, but the motivation to pay attention (on suffering and

needs) and the motivation and intention to do something about it. That intention

can be present even when people are not thinking about it or are not activated.

Note too that compassion can represent blends of emotions. For example, a doctor

is struck by the suffering of the Ebola virus and dedicates his/her life, working

long hours, to finding a cure. Emotions here may be a blend of anger that such

viruses exist in the world, sadness for the suffering caused and the way people die

from it, and anxiety that if it gets out into the world it could even reach his/her

own family. In addition, whereas emotions wax and wane, a motivation can guide

behaviour for the whole of one’s life.

The facial expressions of compassion can also differ according to context.

The facial expressions we may have when consoling somebody in physical pain

may be different to being with their grief or anger. The facial expression of a

therapist meeting a patient for the first time and wishing to present themselves as

compassionate, trustworthy and a safe listener will be different from compassion-

ate expressions as different aspects of the story unfold. Whereas compassionate,

kind and trustworthy faces are usually perceived as friendly, affiliative, happy

and positive, such facial expressions may be less positively experienced when

the viewer is in pain (Gerdes, Wieser, Alpers, Strack & Pauli, 2012; Godinho,

Frot, Perchet, Magnin & Garcia-Larrea, 2008). When asked to pose compassion

faces people automatically create soft expressions with gentle smiles of softness,

friendliness and signals on being ‘safe’, kindness and gentleness (McEwan et al.,

2014). Furthermore, it is now recognised that although compassion is seen as a

positive act, it actually engages aversive emotions which arise when we are in

touch with suffering (Condon & Barrett, 2013). So context is crucial.

The Free Dictionary definition (2016) suggests compassion is a ‘Deep aware-

ness of the suffering of another accompanied by the wish to relieve it’. In this

definition there is no pity, sympathy or ‘specific feeling’ aspect like sadness or

sorrow, but a focus on ‘deep awareness’ with (again) a motivation (the wish) to

do something about it. This definition gets closer to the traditional philosophical

and contemplative traditions of compassion, as we will see.

The contemplative traditions and the multifaceted approach: Many approaches

to compassion see it as multifaceted, although they do not always agree on what

those facets are. Buddhist scholar Geshe Thupten Jinpa (translator to the Dalai

Lama) and colleagues, who developed the Stanford compassion cultivation train-

ing, define compassion as:

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Compassion: definitions and controversies 7

[A] multidimensional process comprised of four key components: (1) an

awareness of suffering (cognitive/empathic awareness), (2) sympathetic con-

cern related to being emotionally moved by suffering (affective component),

(3) a wish to see the relief of that suffering (intention), and (4) a responsive-

ness or readiness to help relieve that suffering (motivational).

(Jazaieri et al., 2013)

Mindfulness and compassion thinkers Christina Feldman and Willem Kuyken

(2011) also highlight the multifaceted textures of compassion. They suggest that:

Compassion is the acknowledgment that not all pain can be ‘fixed’ or ‘solved’

but all suffering is made more approachable in a landscape of compassion.

Compassion is a multi-textured response to pain, sorrow and anguish. It

includes kindness, empathy, generosity and acceptance. The strands of cour-

age, tolerance, equanimity are equally woven into the cloth of compassion.

Above all, compassion is the capacity to open to the reality of suffering and

to aspire to its healing.

(p. 143)

They go on to add:

Compassion is an orientation of mind that recognises pain and the universality

of pain in human experience and the capacity to meet that pain with kindness,

empathy, equanimity and patience. While self-compassion orients to our own

experience, compassion extends this orientation to others’ experience.

(p. 145)

Kuyken and his colleagues offer a more specific listing from their major, more

recent literature review (Strauss et al., 2016).

[W]e propose a new definition of compassion as a cognitive, affective, and

behavioural process consisting of the following five elements that refer to both

self – and other – compassion: (1) Recognizing suffering; (2) Understanding

the universality of suffering in human experience; (3) Feeling empathy for

the person suffering and connecting with the distress (emotional resonance);

(4) Tolerating uncomfortable feelings aroused in response to the suffering

person (e.g. distress, anger, fear) so remaining open to and accepting of the

person suffering; and (5) Motivation to act/acting to alleviate suffering.

(p. 19)

Dutton, Workman and Hardin (2014), who have done considerable work on com-

passion in organisations, relate compassion to four core aspects that also touch on

cognitive, affective and behavioural processes: (1) noticing/attending to another’s

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suffering, (2) sensemaking or meaning making related to suffering; (3) feelings

that resemble empathic concern, and (4) actions aimed at easing the suffering.

Emotions researcher Paul Ekman (2014), who worked with the Dalai Lama,

suggests four dimensions of compassion: (1) empathic compassion (being in

touch with the feelings of suffering of others); (2) action compassion (taking

action to alleviate suffering); (3) concerned compassion (based on a motivation

for helping); and (4) aspirational compassion (linked to a more cognitive desire

to develop compassion).

Into the mix of what compassion is, Neff (2003) focused on self-compassion and

defines it as follows:

Self-compassion . . . involves being touched by and open to one’s own

suffering, not avoiding or disconnecting from it, generating the desire to alle-

viate one’s suffering and to heal oneself with kindness. Self-compassion also

involves offering nonjudgmental understanding to one’s pain, inadequacies

and failures, so that one’s experience is seen as part of the larger human

experience.

(p. 87)

She also went on to suggest there are three bipolar dimensions that underpin self-

compassion: self-kindness (in contrast to self-judgment and self-criticism); shared

common humanity (in contrast to feeling isolated and alone and the only one);

and mindfulness (in contrast to self-absorption and rumination). These constructs

and resulting measures have not been without controversy (L�pez et al., 2015;

Muris & Petrocchi, 2016) as Neff herself recognises (Neff, Whittakar & Karl, in

press). They are different to, say, a competencies focus (see Gilbert, Chapter 3,

this volume). As Neff (2003, 2011) makes clear, what sits behind her approach

is to consider a ‘self-compassionate frame of mind’ as a way to help people cope

with difficult life circumstances and especially with self-criticism (see Germer &

Barnhofer, Chapter 4, this volume).

Different again is Armstrong’s (2011) focus on the roots of compassion in the

golden rule of Confucius: ‘Do unto others as you would be done to’, or more neg-

atively ‘don’t do things to other people you would not like them to do to yourself’.

This has inspired the Charter for Compassion – designed to spread compassion

values and behaviour through communitie – which is now a major world move-

ment (see http://www.charterforcompassion.org).

Motivation approaches

Listing potential characteristics of compassion, a kind of diagnostic approach can

be supported with a functional approach that focuses on motivation. Motivation

is then not ‘one of’ the characteristics. ‘It underpins signs or symptoms’ of com-

passion; it is the main show that generates the core characteristics. Motivation

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Compassion: definitions and controversies 9

underpins not just action but also being prepared to pay attention to suffering.

Buddhist scholar Mathieu Ricard (2015) suggests that compassion is a form of

altruism, made up of a range of sub-attributes, abilities and skills including sym-

pathy, empathy and commitment. But at its heart, compassion is a deeply felt wish

for others to be free of suffering, the causes of suffering, and to flourish and to

find happiness (personal communication, 2012). This focus highlights motivation

as ‘the wish’ (motive) for the alleviation of suffering.

Interestingly, compassion (motivation) hasn’t been that clearly distinguished

from altruism. For example, Preston (2013) suggests altruism as an almost identical

process:

Altruistic responding is defined as any form of helping that applies when the

giver is motivated to assist a specific target after perceiving their distress or

need . . . Altruistic responding further narrows these classifications to only

include cases where the motivation to respond is fomented by direct or indirect

perception of the other’s distress or need . . . This excludes cases that emerged

later in time or include diverse processes, such as cooperation or helping influ-

enced by strategic goals, social norms, display rules, or mate signaling.

(p. 1307; italics added)

Here, there has to be a cost of helping to the self that might not be the case for

compassion. This also is a different take on altruism than say Ricard (2015). The

Dalai Lama (2001) also links compassion to motivation (a wish):

What is compassion? Compassion is the wish that others be free of suffering. It

is by means of compassion that we aspire to attain enlightenment. It is compas-

sion that inspires us to engage in the virtuous practices that lead to Buddhahood.

We must therefore devote ourselves to developing compassion.

(p. 91; italics added)

He also distinguishes between these wishes:

Just as compassion is the wish that all sentient beings be free of suffering,

loving-kindness is the wish that all may enjoy happiness.

(p. 96)

So compassion also acts as an ‘inspiration’. There is a clear distinction between

loving-kindness (happiness focused) and compassion cultivation, as is captured

in the concept of Bodhichitta (Gilbert & Choden, 2013; Tsering, 2005). Here

again definitions are tricky because actually ‘metta’ means friendliness or open-

heartedness, not ‘love’ as understood in Western psychology. These kinds of

mistranslations and merging of concepts have caused difficulties for compassion,

which can sometimes be confused with love (Gilbert & Choden, 2013; Goetz

et al., 2010). In the West, love implies liking trust and affection, but in reality

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deep-courageous compassion is for those we may not know, may not like, trust

or feel affection for. Indeed, the Dalai Lama (1995) suggests that if we just have

compassion for people we love this is not real compassion! ‘Your love and com-

passion towards your friends is in many cases actually attachment. This feeling

is not based on the realization that all beings have an equal right to be happy and

overcome suffering’ (p. 63). When it comes to compassion for those whom we

do not like, or who may threaten or harm us, then understanding courageous and

assertive compassion, and its distinction from submissiveness and compliance, is

crucial (Catarino, Gilbert, McEwan & Bai�o, 2014).

An insight that drives compassion in the Tibetan Buddhist traditions is insight

into the fact that suffering naturally arises from the life process itself, including

the impermanence of all things and our graspings and aversions (Dalai Lama,

1995; Tsering, 2005). Mindful compassion helps us to have insight into the illu-

sory nature of the self, and our cravings and attachments that give rise to dukkha

(suffering). The Dalai Lama (2001) suggests that if, via compassion, we culti-

vate ‘our insight into the miserable nature of life we overcome that attachment’

(p. 85). Schopenhauer also thought that life is pretty horrendous (miserable) which

should inspire us to compassion. Many of the Gothic horror classics, including for

example Mary Shelley’s Frankenstein, were reflections on the horrors of life;

being born without our consent, into bodies designed to age, decay and disease,

in a world where our minds are set up for tribal and self-interest conflicts; yearn-

ing for love and acceptance, which, even if one gets them, are impermanent, with

often painful death waiting in the wings for us and those we love. Death is the only

escape. No wonder the Dalai Lama calls it ‘a miserable life’.

Insight into this reality can lead either to dissonance, hopelessness, despair

and anger, commonly dissociation (just keep these things out of mind and make

the next dollar, plan the next holiday, buy better wine) or compassion, which

is the bodhisattva insight and dedication. On leaving his Golden Palace, it was

these insights (into decay, disease and death) which set Siddhartha on the path to

enlightenment. So here, compassion arises for a deeper focus into the nature of

our reality, and further, that all beings are struggling with this reality, not wanting

to suffer (in a life inherently full of suffering) but be happy (Dalai Lama, 1995). In

many ways some Buddhist concepts are major attacks on our natural tendencies to

dissociate from the harsh realities of the suffering all around us in the very nature

of biological life. In contrast, Western philosophers focus more on the search for

meaning and morality, and medical solutions, rather than happiness and the illu-

sions of the self (Sensky, 2010).

Compassion also implies the prevention of suffering (where we can), which

means addressing needs. So, for example, if we don’t feed our babies, or look after

them they will die and hence suffer. So compassion must involve evaluating and pro-

viding for needs that prevent suffering; indeed we have a range of newly evolved,

socially intelligent competencies that turn a caring motivation into a compassionate

social mentality (see Gilbert, Chapter 3, this volume). To address needs requires

empathic insight into, and taking an interest in, the needs of others. Now, of course,

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Compassion: definitions and controversies 11

animals can address the needs of their offspring without having deep empathic

insight, but empathic insight along with other socially intelligence competencies

clearly aid our capacity to understand the needs of others and how to address them.

For a bodhisattva ‘a key need’ is to provide conditions for enlightenment.

The point then is that compassion has many textures and definitions which emerge

as partly guided by the functions to which they will be put. We can think of it as a par-

ticular feeling that arises, a motivation to be helpful, a listing of various attributes (of

various types), and linked to personality traits. My own approach has been to focus

on understanding these kinds of dispositions in a functional, evolutionary model

and in particular the way evolved strategies (survival and reproduction) give rise to

motives (see Gilbert, Chapter 3, this volume). In addition I have had an opportunity

to work and meditate with colleagues at Samye Ling Monastery, including Lama

Yeshee and the Buddhist Monk Choden with whom I wrote Mindful Compassion in

2013. Working within motivational theory (Gilbert 1989/2016) and the Mahayana

tradition we have settled on a definition of compassion as ‘a sensitivity to suffering in

self and others with a commitment to try to alleviate and prevent it’.

We added ‘self’ as well as ‘others’, and importantly the concept of ‘pre-

vention’ which is implicit in most models. This actually has two types of

psychology to it. The first is the motivation to attend and engage with suffering

as opposed to avoiding it in various ways. How and why we turn towards or

away from suffering is central to many psychological therapies and even politi-

cal movements. Thus the aspect of motivation to engage is itself a complex

area. Second, we may be motivated to engage but not have much idea of what

to do. So compassion also requires us to think about how we are motivated

to learn how to take action. This can involve courage and also dedication to

understand the causes, prevention and alleviation of suffering so that we take

wise (rather than impulsive or ignorant uninformed) actions. This is why the

model outlined in Chapter 3 tries to identify specific competencies linked to

specific motivation aspects of caring motivation.

In Mahayana tradition this motive underpins Bodhichitta and is supported by

various paramitas – such as generosity, morality, wisdom, patience, energy and

meditation. In the approach outlined in Chapter 3, the motivational approach to

compassion gives a narrative of how it textures our minds. Compassion is rooted

in a motivational care-focused system textured by recently evolved socially

intelligent competencies and it is these competencies that elevate caring into com-

passion (see Gilbert, Chapter 3, this volume).

Conclusion

So where does this leave us? First we see the extraordinary, few thousand year

history that sits behind the concepts of compassion, yet also the way we are reli-

ant on language and cultural contexts to convey meaning. Consequently, different

languages and cultures do not always have exactly the same meaning for the

words they use, and heated debates can arise because people are actually talking

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12 Paul Gilbert

at cross purposes. Hence, striving for precision and clarity are important, but we

also recognise different definitions for different functions. To date, however, this

precision remains elusive for compassion. There are different definitions, differ-

ent listings of its qualities, with different implications for its study and training.

As mentioned in the Preface we can see this as representing a vibrant, fascinat-

ing area of discussion and scientific enquiry with an agreement that all of us

are a little bit like blind folk touching the elephant. It would therefore be unwise

to prematurely settle on certain definitions without a better understanding of the

processes that underpin compassion, the functions it serves, and allowing better

and more comprehensive definitions to evolve. For example, the way a clinician

may think about compassion might be different to how a lawyer thinks about

compassion. This is not unusual. The way a medical, biologically orientated

psychiatrist, wanting specific drugs for specific symptoms, thinks about depres-

sion and defines it is very different to how a psychodynamic therapist thinks

about depression and defines it. Trying to categorise mental states in simple terms

and lists is notoriously difficult. Anyone familiar with the controversies around

psychiatric diagnosis of what ‘is’ depression, anxiety and paranoia will be very aware

of these issues. What this chapter has tried to do is bring these issues to the fore.

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