This much we know: Taking deep breaths relieves stress in your body; compassion relieves stress in your relationships. Both are psychophysiological phenomena. But what we’re learning beyond that may have far more global consequences. Current research led by James Doty, MD, suggests that the intersection of stress, mindfulness, and compassion has major implications not only for individual and relationship health but for the broader health of our communities.
A Q&A with James Doty, MD
How does mindfulness set the stage for compassion?
It has to do with threat perception and your innate stress response.
Your baseline is your rest-and-digest mode, governed by the parasympathetic nervous system. When you’re in that mode, you’re relaxed, you’re calm, and your digestive system is working. And the area of your brain associated with executive control, discernment, and thoughtful decision-making works at its best. This mode facilitates a slow response and integrates experience and memory into your actions.
On the other hand, when an individual feels insecure or threatened, the sympathetic nervous system engages, and as a result, you shift into a threat response mode best known as fight-or-flight. This will result in an increase in heart rate, the shift of blood from the digestive system to skeletal muscles to allow you to run away, and dilation of the pupils. This is a fast mode. It is immediately reactive. Your decisions don’t rely on past experiences or memories. You are just in survival mode. And therefore, when you feel threatened, you make judgments very quickly. In a survival situation, this is perfectly fine, and it works well. Yet oftentimes, especially in modern society, those snap judgments and decisions don’t always work in our favor.
“One of the problems in modern society is that people don’t feel psychological safety. It’s an issue of chronic disconnection from the people around us.”
Here’s where mindfulness and breath come in: In the process of taking long, intentional, relaxing breaths, you shift your nervous system engagement from sympathetic (fight-or-flight) to parasympathetic (rest-and-digest). And suddenly your brain’s executive control functions work better. You’re more thoughtful. You’re more discerning. And with just fifteen minutes or so of this type of practice, your physiological function starts to work better: Your stress hormone levels decrease, your muscles unclench, your heart rate lowers, and your blood pressure goes down.
We know that people feel most comfortable when they’re in a group of people they identify with through shared values, political views, social class, or some other unifying factor. And when you have a psychological feeling of comfort and safety, your physiology works better. The same is true in reverse. When you intentionally activate a physiological state of comfort and safety—usually through some sort of mindfulness practice, as simple as taking deep breaths—you feel better. And you relate better to those around you, even if they’re not part of any identifiable in-group. In other words, it’s easier to be compassionate.
2. Why is practicing compassion a powerful tool in building relationships and communities?
When you look at the world through a lens of compassion, you experience not only physiological changes but also social ones. We have the ability to intuit the emotional states of others. So when somebody looks at you and sees that you’re relaxed, that you’re open, that you’re caring, they feel a sense of psychological safety. Because they don’t register you as a threat, their fight-or-flight stress response doesn’t flare up. And that changes how they interact with you.
I know this from the science, but I experienced it for the first time when I was twelve years old: I was scared, angry, despairing, and chronically engaged in a stress-response mode. One day I walked into a magic shop, and there was this woman there named Ruth. She had a radiant smile, and without knowing anything about me, she embraced me in her kindness. And immediately, for the first time in my life, I felt a sense of psychological safety.
“That’s what we need to cultivate in our communities: openness.”
When a person is given the gift of psychological safety, their body shifts over from sympathetic nervous system engagement—again, that’s fight-or-flight—to the parasympathetic nervous system. That comes with a sense of calm, ease, and comfort. In that state, they open up, they can listen, and they can connect. And one of the problems in modern society is that people don’t feel that psychological safety. Often we’re in environments where we’re fearful of being judged. And as a result, we have difficulty being authentic and sharing the things that are bothering us or that we’re frightened of. It’s an issue of chronic disconnection from the people around us.
Conversely, if you look at parts of the world called Blue Zones, where people routinely live to be over a hundred years old, there are critically important social aspects of their longevity. In those environments, typically, people are born there and they die there, staying in the same community nearly their whole lives. And what happens in a community like that is those people—your neighbors, your friends, your relatives—know everything about you from the time you are very young. Your good parts. Your bad parts. Everything. And guess what? They still love you. They’re not judging you, they accept you, they’re there for you, and they help you. And in that environment, where you are loved and cared for and heard, you have a sense of psychological safety. And people in those groups routinely live longer, healthier lives.
That’s what we need to cultivate our communities: openness. The ability to show our vulnerabilities and weaknesses. When that happens, when people open up to one another, you can truly connect.
3. Why do we need self-compassion?
One common aspect of Western culture is that we are hypercritical of ourselves. And as a result, we have a hard time loving ourselves. Many people have an ongoing dialogue in their head in which they’re constantly beating themselves up. And they believe that voice in their head speaks the truth. But in many cases, what they don’t know is that adverse events in our lives put us at risk for that negative self-talk, and then those threatening voices in our head affect us more strongly than positive or neutral ones. It’s at the root of a lot of our chronic stress.
This is the basis of imposter syndrome: As a result of a negative comment or experience, someone may say to themselves, “I’m not good enough. I’m not smart enough. I really shouldn’t be in this job.” It’s this idea of: They’re going to find me out as a fraud. When that voice passes through your mind dominantly and often, you start to believe it. And when you start to believe you’re not good enough, it’s so hard be compassionate with yourself.
Negative self-talk can be difficult to reverse without carefully and intentionally choosing to do so. When those thoughts go through your head, you don’t have to accept them. You can choose reality over false, passing thoughts and change that negative self-talk to positive self-affirmation. That’s self-compassion.
4. How does self-compassion facilitate compassion for others?
We know that through studies we’ve done and others that when a person practices self-compassion with intention, it not only changes their physiological stress response but also creates an environment for others to be their best selves, to be more compassionate, to be more kind.
This is the reality: If you’re beating yourself up all the time, it’s hard to keep a positive worldview. Instead, you tend to be hypercritical of others. And then people read that in your body language, and they feel judged. They put themselves on guard. It’s the same threat-response cycle I mentioned before.
On the other hand, we know that when you’re self-compassionate, when you’re kind to yourself, when you accept who you are, it has a profound positive effect on your physiology and, with your guard lowered, allows you to look at the world and at other people with a more open, positive outlook. You can embrace people without making judgments. And when you do that, you create that sense of psychological safety for others. And because they feel safe and accepted, they can authentically interact with you.
5. Do we have a “set point” for compassion?
We know that, as with happiness, there is a genetic component to compassion. Actually, there’s a research group that has studied voles (yes, the rodents!) and has found there are subset groups of voles that have fewer receptor sites for oxytocin or that lack them completely. The voles—male as well as female—that have the full number of oxytocin receptors form monogamous relationships and care for their offspring. The ones who lack oxytocin receptors or who have fewer receptor sites are more often philanderers that don’t hang around to care for their offspring.
“We know that, as with happiness, there is a genetic component to compassion.”
This phenomenon is also occurs in humans. Individuals who have fewer oxytocin receptors or who have a different variant of the receptor are less likely to have permanent relationships. We first began to understand this by studying sociopaths, many of whom have a structural abnormality that diminishes or destroys their capacity to connect with the emotional states of others. Or if they can connect and understand another’s suffering, it has none of the normal physiological or psychological effects.
So people have different inborn capacities for compassion and kindness. That being said, most of us have not maximized our abilities in this area. From that starting point, we know that something we call compassion cultivation training can significantly increase our capacity for self-compassion and compassion toward others. This is a program we’ve developed at Stanford to teach compassion to a variety of groups—including health care providers, businesspeople, and people in the prison system.
6. What would it look like to live in a more compassionate world?
Well, I would like to believe that it would be a much kinder and fairer world. One in which instead of being so inwardly focused, we would seek to understand others. As the world has globalized and we’ve gained more access to other cultures than ever before in history, we have to recognize that we are more alike than we are different.
A major problem with our present political environment is a lack of compassion. When we don’t seek understanding of those who are different from us and instead demonize and dehumanize them and create false narratives about their nature, we give ourselves permission to be selfish and cruel. This can have awful consequences. It’s a classic way tyrants wrest control of entire societies: If you create a narrative about scarcity, for example, where you have to protect your group from outside threats, that story may pull together a tribe. And within that tribe, you can sit there and say, “Well, they’re out to destroy us. There’s not enough for everybody. And we need to do what’s necessary for us to survive.”
“As the world has globalized and we’ve gained more access to other cultures than ever before in history, we have to recognize that we are more alike than we are different.”
But if you identify your biases against others, understand where they’re coming from, and have the self-awareness to correct your false assumptions, then you can overcome them. This is a compassionate lens. From that point, you can acknowledge that all people deserve to be happy. All people deserve to be fed. All people deserve to be safe. All people deserve to have shelter.
You have to see the other as yourself. Despite any differences, you are ultimately the same. When you see others, immediately, as ones of your own, kindness and generosity and care are automatic. And that is self-actualization. That is true compassion.
James R. Doty, MD, is a clinical professor of neurosurgery at Stanford University and the founder and director of Stanford’s Center for Compassion and Altruism Research and Education. He is also an inventor, an entrepreneur, and a philanthropist. His book Into the Magic Shop is part memoir and part instructional guide to mindfulness, visualization, and meditation.