To Understand Compassion We Must Recognize Suffering
Further reflections on compassionate care in the field of ABA
This week I want to dive in to compassion just a little bit more.
Let’s start with a handy dandy definition from Google “sympathetic pity and concern for the sufferings or misfortunes of others”.
Let’s break it down into 3 parts.
For the first part: “sympathetic pity and concern…”
We have to have sympathy. We have to have concern.
The first part is important. It’s a real problem if we don’t understand what sympathy and concern are. It’s a double problem if we can’t feel those feelings for someone who is suffering.
Sympathy, empathy, and whatever goes with it are emotional energies. Emotional phenomena.
In my time in ABA and over the thousands of people I’ve met in the field, I don’t know that I’ve run into many BCBAs who weren’t empathetic or sympathetic. Many people possess those qualities. Those who didn’t seem to possess those qualities didn’t last long. Sympathy and concern for the vulnerable are what makes this field tick. And it’s hard to engineer sympathy and concern for someone who is incapable of doing it.
And I’ll move on—rather unconventionally—to the last part, which I addressed LAST week.
“...of others.”
Compassion has to be directed to someone else…to someone who is other. We talked about how compassion can’t be compassionate if it isn’t chiefly aimed at the learner or the client. Performative compassion is not compassion. Weaponized compassion is not compassion. Both seek the to serve the performer rather than the individual that is being helped. In the world of social media where a tiny post can go viral overnight, performative compassion can fast track one to deification. It’s easy to get carried away.
And that brings us to the middle part.
“...for the sufferings and misfortunes…”
If there is room for discussion, it needs to be here.
Hopefully, we all agree that sympathy and concern are good things…catalysts, in fact, for making things work. Hopefully, we’ll all agree that compassion has to be directed toward the client or learner, or it’s not compassion. But it’s the subject of suffering or misfortune that makes things hard. It’s not simply that we need to exact sympathy for others…it’s that we have to do it in the presence of suffering and misfortune. And that means understanding what sufferings and misfortunes are in the first place. And this is hard. Because—believe it or not—suffering and misfortune can be complex.
Why is it hard to understand?
Well, I won’t go through all the reasons, but one stands out:
For growth to occur, some kind of discomfort or struggle is usually at play.
It’s one of those controversial facts of life. We usually aren’t good at things right away. We get frustrated in the beginning and experience a certain degree of discomfort in learning a new skill. This discomfort is eventually alleviated in learning it. If that skill is worth anything, it will open valuable doors for us in the future. It may even contextualize our original discomfort, minimizing it’s aversiveness in our own memory.
My muscles are put in a state of excruciating discomfort (but minor suffering) when I work out, but I do it, they grow back stronger, my body is better off physically, and—despite the original pain I felt—I return for another workout because the delayed reinforcer (physical health) is far greater than the immediate discomfort.
Rates of correct responding are almost always lower in the beginning stages of teaching any skill with our learner. If reinforcement is differential and contingent on some kind of specific response from them (in any capacity) that is just beyond their grasp, it will undoubtedly generate some kind of discomfort, frustration, and ratio strain for that learner, until we can get our learner over the hump. If it doesn’t, we might not have the right reinforcer.
Because of this push-and-pull relationship between discomfort and growth, things can get weird. And we’re prone to making important mistakes along the way that deter skill development and increase suffering for ourselves and our learners.
Somehow, we might end up concluding that discomfort (or minor suffering) is good for a learner in and of itself. This discomfort will build character. The world is a cold place, this kiddo needs to learn to live with discomfort. Because extinction bursts may precede progress, we might look for ways to introduce extinction bursts (even when we don’t see progress). Implicitly, discomfort may begin to stand alone as the end goal. Implicitly, the clinician, caregiver, or teacher may begin to actually pursue situations that are discomforting to the learner. And, as a result, discomfort is no longer a symptom on the road to skill acquisition, but a goal unto itself. Treatment ceases to be about growing skills that contribute to the happiness and freedom of the learner. Instead, treatment has the potential to be about introducing discomfort and winning power struggles. In the end, very few life changing skills are taught. Tragically, a learner’s discomfort morphs into their larger, prolonged suffering.
That’s the extreme we’re most familiar with—and most often try to guard against (as we should).
Now for the other extreme.
Avoiding that discomfort—and wanting to avoid it for the sake of our learners—is likely rooted in our own sympathy for the learner. That’s pretty awesome. We have to allow for assent, we say. We want to avoid suffering at all costs for our learner. Ironically, suffering may slip through the backdoor and blindside us (and—more importantly—them).
I’ll never forget about the story I heard about a BCBA who went through an entire six month authorization having run no more than six total trials…in the name of assent. Surely, this person’s head and heart were in the right place. They didn’t want to see the learner suffer. They were likely fully onboard with the compassionate approach. But, could there have been a side effect?
Taken to an extreme, this may have inhibited or prevented the growth in skills that could have drastically increased the learner’s well-being, freedom, and happiness in the long run. And if we’re avoiding the teaching of these precious skills, are we aiding and abetting their future suffering? If we don’t possess a sympathy for the learner’s future suffering, are we truly compassionate? Are we neglectful?
My point is this. Our field will thrive as we develop an understanding of compassion in regard to the individuals we’re responsible for helping—and I think we’re getting there. But none of that will work until we develop a keen recognition and understanding for discomfort. How we interpret it. The role it plays (if it plays a role at all). How we respond to it. And the point at which a discomforting situation turns into something more serious—suffering.
Let me hear ya! Reach out with your thoughts.
“Taken to an extreme, this may have inhibited or prevented the growth in skills that could have drastically increased the learner’s well-being, freedom, and happiness in the long run. And if we’re avoiding the teaching of these precious skills, are we aiding and abetting their future suffering? If we don’t possess a sympathy for the learner’s future suffering, are we truly compassionate? Are we neglectful?”
Thank you for your openness on this sensitive topic. We cannot ignore this important element of clinical decision-making.