When I arrived at medical school, I was excited as I anticipated learning about how to deal with suffering and death. Since I was going to be a doctor, and handling the lives of many people and their families, I assumed that knowing how to handle suffering would be at the core of our training.
But the lesson never came.
I kept asking, until one day a senior doctor looked me in the eye and said: “Nicola, you have to build a wall in order to survive. That’s what we all did.”
That was it. That was the extent of the “suffering training”. Build a wall.
I railed against this. Surely, we could do better than that? But I couldn’t find answers and as I looked around, I didn’t find another way. There were occasionally remarkable doctors who seemed to hang onto their humanity and who inspired me tremendously, but they just seemed to be remarkable people. Most hid behind professionalism and a white coat, and as I didn’t feel like a remarkable person, I duly began to build my wall.
The wall comes up unconsciously when we feel too much, and this question of “feeling too much” became a huge question for me as a doctor. It seemed that I had a choice: continue feeling “too much” when I was with my patients and their families (and risk burning out) or build my wall.
Empathy, we now know from neuroscience, is the way our brains naturally resonate with the suffering of another living being. We suffer with. If you were sitting next to someone who was in tears or in pain, and we scanned your brain, we’d see the same parts of your brain activated, as the person who is suffering.
Empathy is an essential component of compassionate leadership, but unfiltered empathy is exhausting. There are some professionals that need to learn MORE empathy, but in healthcare mostly we need to learn to handle our empathy. I’ve observed that in healthcare, the intense pain of feeling “too much” is what makes clinicians turn away. Our compassion vanishes when we are frustrated that we can’t fix a situation, or when the pain is too intense for us to bear. As professionals we can’t be brought to our knees by the suffering around us, so we put up our wall. And my guess is that this is the same in politics, in law, in teaching. We feel too much, so we build a wall of professionalism in order to cope.
So, it’s understandable that we build a wall, and most people do this. Maybe you recognise this pattern in yourself too?
But over time the wall becomes a problem.
Have you ever been to see a professional and felt like you were getting a “professional veneer”? The sing-song voice, the feeling that they don’t really see you as a human being but as a “case”? Have you ever felt cross that you are asked questions that reveal how little a professional really understands what it’s like to be in your situation?
I have! This doesn’t just apply to medical professionals. I’ve witnessed this with lawyers, teachers, politicians, and social workers too. And I noticed I did it too.
When we build a wall, we lose touch with the people we serve, and they can feel it! Most of the complaints in the NHS are about communication, and in my opinion, this often comes down to patients or relatives not feeling heard and validated. They sense your wall!
When we’re behind our wall it’s also harder to accept help, or for others to reach you. You feel isolated, and alone. You end up doing everything yourself. This is a risk-factor for burnout too.
And, most disturbingly, when you’ve had your wall up for some years, you begin to lose touch with yourself. You don’t notice what you’re feeling, or what you need. You become disconnected from who you really are.
This conundrum puzzled me for years. Was there really no other way?
And then I came across Compassion training. Initially I was learning self-compassion, but it quickly became clear to me that Compassion was the answer to this problem of The Wall.
Compassion is a skill-set, not an emotion and when we’re activating compassion we’re using a different part of the brain from empathy. A little empathy, to connect with and recognise the suffering of others is important, but the skills of compassion bring in a layer of wisdom that helps you the HANDLE yourself and others. Compassion skills help you to stay with discomfort, handle complexity and the non-idealities of life, and to stay present rather than turning away.
There’s been huge amounts of research into compassion and it’s been shown to protect against burnout, as well as helping with trauma, anxiety and depression. This is not a soft skill. It’s a powerful skill-set that helps you to deal with the suffering in the world. Without turning away. Without being dragged under by your heels. And without having to keep putting up your wall.
This is a skill-set that I wish was taught in schools, and was taught to all our politicians and leaders. It’s nobody’s fault that our parents didn’t know about this, but now that we know better, we can do better. Because we need amazing people to stay WITH the suffering of the world and not turn away. We need amazing leaders who can handle themselves and not hide behind a wall.
Nicola Harker is a doctor who worked for 20 years as a GP in the NHS in England, UK. She’s now working as a leadership coach. Find out more here.