At first glance compassion might appear a difficult to measure, rather subjective subject – however, the concept has certainly attracted a great deal of research attention across recent years – principally because of the close philosophical association between compassionate states – and the Buddhist practice of mindfulness.
The intention of this blog post is to explore the manner in which the human brain and nervous system responds to witnessing suffering in others – and to highlight the positive role of compassion in human health. Additionally, the intention is to offer the reader an opportunity to consider how their own feelings of compassion might impact reflexology clients – and finally, to champion the reflexology package as a powerful multi-dimensional therapeutic balm – capable of soothing individual instances of personal suffering through tactile interpersonal touch, and the practitioners engagement in active states of compassion and empathy.
Compassion and The Theory of Human Evolution
Many people tend to associate Charles Darwin with the somewhat dominant phrase – ‘survival of the fittest’. You might be surprised to learn these are not in fact Darwin’s words. The phrase was actually coined by later Darwinists – as they attempted to justify their own particular views on race and social issues of the time. In fact, rather than supporting the notion of survival of the fittest – Darwin conversely theorised those communities comprising of more sympathetic individuals tended to be more successful in raising healthy offspring to a viable age of reproduction.
To help form his opinions, Darwin drew not only upon observations of his own children, but also observations of animals at London zoo – and even his own pet dogs – before concluding all mammals feel some degree of sympathy – and that mammalian expressions of sympathy tend to be played out through social forms of tactile contact (social grooming/interpersonal touch).
“We have seen that the senses and intuitions, the various emotions and faculties, such as love, memory, attention and curiosity, imitation, reason, etc., of which man boasts, may be found in an incipient, or even sometimes in a well-developed condition, in the lower animals.” – Charles Darwin
As our ancestors began to walk upright, and the human brain grew in size, so too the human pelvis narrowed. These enormous evolutionary changes prompted the necessity for human babies to be birthed at an earlier stage in their cognitive development – enabling the large human head to pass safely through the narrow birth canal. The human infant is born entirely vulnerable and dependant on adult care givers and compassionate instincts, whilst conversely, baby chimpanzees are able to feed independently at a much earlier age, and can sit unsupported – without fear of toppling over.
To accommodate for the increased levels of care required by human offspring – more complex care-taking social structures began to emerge – and perhaps unsurprisingly, evolution also enhanced the human nervous system to ensure the presence of appropriate care-taking responses.
Compassion and the Brain
“Consider these empirical findings: When people perform altruistic acts, the same regions of their brain light up as when they receive rewards or experience pleasure; humans are equipped with specialised “mirror neurons” that enable us to empathise with others; we produce the hormone oxytocin, which promotes social bonding, trust, and generosity; and activation of our vagus nerve, a bundle of nerves near the spinal cord, increases compassion and cooperation.” – Dacher Keltner, 2007
With the help of modern neuroscience researchers are beginning to understand in more depth the manner in which the human brain and nervous system responds to the experience of witnessing suffering in others.
Studies have discovered when an individual reacts to their own experience of physical pain activity is noted in a part of the brain called the anterior cingulate. Researchers have also discovered in addition to reacting to our own pain – this part of the brain also shows activity when individuals witness pain in others. Scientists refer to some of the neurons firing in this part of the brain as mirror neurons. Researchers suggest because [mirror] neurons fire when we witness another’s pain or suffering – they may somehow be involved in the experience of empathy – as well as mimicking, goal achieving, and understanding an action.
The amygdala also reacts to suffering in others – the amygdala is described as the brain’s inbuilt threat detector. Researchers believe this part of the brain helps us to identify threats – and therefore also alerts us to the possibility that we too may experience suffering.
Finally, a very old part of the mammalian nervous system called the periaqueductal gray – located deep in the centre of the brain – also shows activity when suffering is witnessed in others. Interestingly, in mammals, this region of the brain is mostly associated with nurturing behaviour.
Compassion and the Vagus Nerve
This vagus nerve (or 10th cranial nerve) has been dubbed one of the great mind-body nexuses in the human body. The vagus nerve is a mixed nerve – with both sensory and motor functions. It is the longest of the cranial nerves – extending from the brain stem, to the muscles of the mouth, neck, thorax, lungs, and abdomen. The vagus nerve is associated with:
- Regulating muscles in the neck responsible for nodding the head, orienting the gaze, voice resonance, and the soft palate
- Coordinating interactions of the cardiovascular system
- Homeostasis of the digestive tract – the stomach, spleen, liver, and lower digestive processes
- Oxytocin release
- Immune system responses
- Inflammation responses
In essence the vagus nerve responds to our conscious awareness of the environment around us. Depending on the brains assessment of the environment, the vagus nerve either responds by supporting homeostasis in the associated systems and organs – or, the nerve reacts to stressor events by elevating associated autonomic responses.
In addition to reacting to our own personal evaluations, researchers have also discovered when study participants are shown photographs or videos of suffering and distress – or are told a sad, or even inspiring story – their vagus nerve responds. Indeed, scientists now believe the stronger the feelings of compassion in the individual – the stronger the vagus nerve response.
It would appear human beings have been evolutionary hard-wired to recognise, and respond to the suffering of our fellow man.
Compassion and Empathy
The term empathy is generally defined as the ability to sense another persons emotions – coupled with the ability to imagine what someone else might be thinking or feeling. Contemporary emotion researchers tend to differentiate between two types of empathy:
- Affective empathy – refers to the sensations and feelings brought about in the self in response to experiencing others’ emotion. This can include physically and/or emotionally experiencing what the other person is feeling.
- Cognitive empathy – refers to the ability to interpret, identify, and intellectually understand others’ experience and emotions. This is sometimes also referred to as perspective taking.
Within a reflexology context it is possible both forms of empathy are present in varying degrees.
Affective empathy – with its associated bodily sensations and a physiological impact – can be defined as experienced in the visceral, and emotional dimensions (perhaps defined alternatively by many reflexology practitioners as an energy rush/transfer).
The presence of cognitive empathy tends to develop as a result of practitioner/client verbal interactions, and client emotional disclosure.
Empathy and the Therapeutic Relationship
“Too often we underestimate the power of a touch, a smile, a kind word, a listening ear, an honest compliment, or the smallest act of caring, all of which have the potential to turn a life around.” – Leo Buscaglia
Carl Rogers (1951), the founder of Person Centred Therapy believed unconditional positive regard, congruence and empathy to be the qualities required to form effective therapeutic relationships. These core therapeutic conditions are often referred to as ways of being. Ideally the practitioner is striving to provide a safe space in which the client experiences unconditional warmth, and acceptance. No demands, or expectations are placed upon the client – they are free to be their real authentic self and are valued as such. The practitioner attempts to demonstrate their empathic understanding of the client’s unique frame of reference – mindful, that for every individual the experience of life (and health) is entirely unique – regardless the commonality of experience.
Empathy essentially begins from a place of awareness. Sometimes our awareness develops through asking clarifying questions – sometimes we use our intuition and read between the lines – and sometimes we might interpret more non-verbal, physical clues. On some occasions we might encounter very emotionally expressive people – those who seem able to tell a fuller story through their facial expressions and eyes.
To empathise is also to acknowledge our awareness. For example, a client might describe how frustrated they feel about an enforced change of position at work – and the practitioner might choose to reflect their own empathic understanding of that expressed frustration.
Practitioner: “I can appreciate how difficult you are finding the changes.”
Whilst telling their story the client might become agitated, angry, or perhaps even weepy, or deflated. To acknowledge the presence of an emotion, or a sense of exhaustion is also to empathise.
Practitioner: “I can see from your posture how agitated/deflated the situation seems to have left you feeling.”
Practitioner: “I can hear in your tone of voice how agitated/deflated the situation seems to have left you feeling.”
Compassion and the Mind
There is an unfortunate trend in reflexology towards considering clients as defined by a clinical diagnosis, or reported condition. This stance of practice unfortunately often dictates the application of reflexology becomes a procedure – defined as a series of specific reflex points to be stimulated prescriptively. This form of practice clearly lacks any real empathic connection with the client. Dealing with client emotional content in reflexology can present a similar challenge – how can practitioners remain connected to the clients unique experience, and not assume the place of an authority figure?
Many reflexology practitioners quite understandably wish to develop their therapist tool box to include an awareness of how to safely utilise basic psychological interventions. The theoretical core principles contextualised as the therapeutic relationship certainly offers professional practitioners a safe means of developing more meaningful, empathically driven, interpersonal connections. Clients receiving this type of approach are also often more likely to engage in the co-operative healing process – prompted by feeling supported, involved, and active within the therapeutic relationship.
It is possible one of the main benefits of the reflexology package might the rapid focus of attention brought to the clients physical body responses (the felt sense). The inclusion therefore of any additional intervention capable of further promoting reconnection of the mind-body (psycho-soma) state (i.e. mindfulness activities/focused breathing/steeping the feet/tapping), can certainly complement the action of reflexology. On the other hand, some of the more directive psychological interventions – particularly those where focus is placed upon inner narrative and rational decision making (i.e. CBT type interventions) may well prove to be counter-productive to the action of reflexology (due to the singular focus of attention placed on cognitive processes), and should therefore be avoided.
A great deal of counselling and psychotherapy research suggests the most important factor in a successful therapy encounter is not the model of counselling or psychotherapy utilised, but rather the quality of the therapeutic relationship. Empathy and compassion are pillars of the therapeutic relationship. Within a good quality therapeutic relationship the client remains the expert in their own life and experiencing (promoting an active, rather than passive stance), and the practitioners role is to listen, empathise, and touch – perhaps just as nature intended.
Emotion in Touch
Researchers studying the affective aspects of tactile content suggest the brains insular cortex may play an important role in processing our emotional, hormonal, and affiliative responses to touch (Gallace and Spence, 2014). The insular cortex is believed to be involved in consciousness, and plays a role in diverse functions linked to emotion, and the regulation of homeostasis in the body. This part of the brain is believed to process signals arising from different sensory channels – and thus also helps to co-ordinate an appropriate emotional response to any given sensory experience.
Gazzola et al (2012) used fMRI scans to measure brain activity in individuals receiving interpersonal touch. This study was able to conclude that emotional and social components of touch are absolutely intwined with tactile sensations – and thus the experience of touch is affected by the individuals social evaluation of the person providing the touch (for details see interpersonal touch blog).
“The meaning of touch is something that goes far beyond the stimulation of the skins surface and this is why our experience of it is affected by our beliefs, or expectations (be they right or wrong), regarding who it is who is doing the touching, and why.” – Gallace & Spence (2014)
Only a few cognitive neuroscience studies have investigated whether skin to skin contact is processed by the brain in a different manner to touch applied by means of an inanimate object. One study (Kress et al., 2012) examined how the brain interpreted touch when delivered by the experimenter’s hand – compared to a touch delivered by a velvet covered stick.
The fMRI results from this study demonstrated that touch applied with the human hand elicited larger responses in the primary and secondary somatosensory areas of the brain. The research team were able to suggest this effect was at least partially mediated by the participants cognitive and emotional perception of human interpersonal touch.
Research carried out in the field of social psychology (Hertenstein et al., 2006 & Hertenstein et al., 2009) demonstrated that human beings possess an innate ability to impart and decode emotional content from fairly brief instances of interpersonal touch, at above chance levels (for details see interpersonal touch blog).
Many practitioners associated with mind/body modalities may have acknowledged for example, the impact of emotional distress on the function of the human digestive system. Certainly a large percentage of practitioners will have encountered the reflexology client so anxious in their disposition they complain of daily acid knots in the stomach – or the IBS client who reports distress regarding their child’s impending departure to university – or perhaps a change of role at work. New information explaining the function of structures such as the vagus nerve appear to be providing an element of scientific validation to many long held holistic beliefs.
The ancient prophecy of the Eagle and the Condor tells of human societies splitting to follow two very different paths. The path of the Condor is associated with the human heart, compassion, intuition, and the feminine. The path of the Eagle is associated with the human mind, logic, the physical world, and the masculine. The prophecy states after a 500 year separation (beginning around 1490) the potential would arise once again for the Eagle and the Condor to come together in the same sky – and in doing so, create a new level of consciousness for humanity.
“Until he extends the circle of his compassion to all living things, man will not himself find peace.” – Albert Schweitzer
The complex human brain has evolved to respond positively to the most subjective of therapeutic interventions – sympathy, compassion, and care.
In mammalian species acts of demonstrative compassion tend to involve tactile content (social grooming/interpersonal touch) – certainly a more objective and measurable concept.
The reflexology package seems perfectly constructed to provide both tactile physical stimulation – and the human qualities of compassion, empathy, and care – responses often craved during times of emotional distress.
Scientific validation of the mind-body connection is undoubtedly still in its infancy – but the concept is certainly alive and well within research communities. With exciting developments in cognitive neuroscience, and the merging of previously fragmented scientific disciplines (psychoneuroimmunology), perhaps it really is time for the Eagle and the Condor to share the sky once again?
The future certainly looks bright for reflexology.
During construction of this article I was greatly informed by the many excellent articles posted on the Greater Good Science Centre website: http://www.greatergood.berkely.edu
Gallace, A., & Spence, C. (2014). In Touch With the Future. The Sense of Touch from Cognitive Neuroscience to Virtual Reality. Oxford University Press: Oxford.
Gazzola, V., Spezio, M., Etzel, J., Castelli, F., Adolphs, R., & Keysers, C. (2012). Primary somatosensory cortex discriminates affective significance in social touch. Proceedings of the National Academy of Sciences of the United States of America.
Hertenstein, M., Holmes, R., McCullough, M., & Keltner, D. (2009). The communication of emotion via touch. Emotion.
Hertenstein, M., Keltner, D., App, B., Bulliet, B., & Jaskolka, A. (2006). Touch Communicates Distinct Emotions. Emotion.
Keltner, D., (2007)
Kress, I., Minati, L., Ferraro, S., & Critchley, H., (2012). Direct skin to skin vs indirect touch modulates neural responses to stroking vs tapping. Neurone port, 22, 646-651
Rogers, C. (1951). Client-Centred Therapy. London: Constable.