Theory: Can Compassion Reduce or Prevent PTSD

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I have been reading a fascinating and very informative new book called Compassionomics: The Revolutionary Scientific Evidence that Caring Makes a Difference.

As the title suggests, the authors studied the impact of compassion on health outcomes in hospitals and other medical settings. They define compassion as “the emotional response to another’s pain or suffering, involving an authentic desire to help.”

Their research suggests that compassion calms psychological responses to stress. They differentiate compassion from empathy noting that empathy is a feeling component that when evoked, impacts the pain centers in the brain. But compassion is the action of trying to reduce another person’s suffering. A very different part of the brain is then activated which is the reward pathway associated with affiliation and positive emotion.

They speculate the impact of being on the receiving end of compassion when someone experiences trauma. Their question: “Could compassion also be an effective way of preventing posttraumatic stress disorder (PTSD)? While this idea has not yet been proven, it is currently being investigated and promising new research.”

They note that PTSD is characterized by “distressing reexperiencing symptoms, effortful avoidance of trauma reminders, and physiological hyperarousal diagnosed in individuals who have been exposed to traumatic events. It takes an enormous toll on sufferers. It is not only associated with reduced quality of life but also the development of additional serious health conditions over time.” They describe how people who experience life-threatening medical emergencies and critical illness can also develop PTSD.

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They noted research by two physicians. Brothers, Dr. Brian and Dr. Michael Roberts have observed that, “the earlier a psychological intervention is applied—as close as possible to the psychological trauma, or, ideally, during the psychological trauma—the higher likelihood that the intervention can actually prevent the development of PTSD, rather than just treating it after the diagnosis is made.” Their discovery is crucial in our understanding the nature of trauma and the development of PTSD: when a patient is in the recovery phase of their medical trauma, meaning after the trauma has occurred, the psychological symptoms of PTSD are already beginning.

Their recommendation is to train medical personnel to intervene during a psychological trauma, such as occurs in an emergency room setting, instead of waiting for PTSD to set in. This is a way they believe that PTSD can actually be prevented.

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They hypothesize that compassion appears to be the critical component for preventing the onset of PTSD. They first observed this in watching responses to pediatric emergency care from someone acting as a child life specialist. “A child life specialist is a highly trained medical professional who is an expert in working with children who are in terrifying circumstances. They are experts in the psyche of a child and how to make things less traumatic, so they do not develop long-term psychological damage from what they are going through. One of the main methods by which a child life specialist accomplishes this is through tender care and compassion.”

To do this they speak to children using soft tones and gentle touch. They provide reassurance that they will be taken care of. They make emotional connections. They work to alleviate fear, so the experience is less overwhelming for the child. These practices are all ways one can demonstrate compassion.

Research is currently being conducted to see if adults would respond in the same ways children do when compassion is shown during traumatic experiences in the emergency department. It is through this compassion that fear is lessened and therefore stress is lessened. It is through compassion that we ultimately then can prevent the development of PTSD.

In many ways this seems like an obvious way to prevent a traumatic moment from evolving into PTSD, but the authors of this book describe over and over how infrequently intentional and predictable compassion occurs in medical situations and how powerful compassion can be in reducing fear and stress when shown for even a few minutes.

Rapid intervention when a traumatic experience occurs is key to preventing or at least reducing PTSD symptoms. Soothing words of reassurance, calming touch, demonstrations of warmth and appreciation for how frightening an experience is are all ways to demonstrate compassion. It is not magic, it is neuroscience. Compassion changes what is happening in the brain and can switch off alarm responses so that the child or adult is not left with emotional wounds that can lead to PTSD.

Invitation for Reflections:

  1.  Have you ever been in a life-threatening situation in which someone showed compassion towards you? What specifically did they do? How did it impact you in the moment and then later as you recall the situation?
  2. Does this information motivate you to be more mindful about showing compassion to children and adults in moments when they might be experiencing something traumatic?
  3. What are some of the specific ways you can demonstrate compassion so that a person’s stress is reduced and therefore the probability of them experiencing PTSD is also reduced?

Diane Wagenhals, Director, Lakeside Global Institute