Does passage meditation foster compassionate love among health professionals?: a randomised trial

Abstract

An emerging scientific literature is investigating the construct of “compassionate love,” love that is “centered on the good of the other,” a construct empirically linked to physical and mental health. We evaluated effects of an 8-week, 16-hour programme for physicians, nurses, chaplains, and other health professionals, using nonsectarian, spiritually based, self-management tools. Participants were randomised to intervention (n = 30) or wait-list (n = 31). Pretest, post-test, 8- and 19-week follow-up data were gathered on six measures of prosocial qualities. Favorable treatment effects (p<0.05) were found for compassionate love (d = 0.49), altruistic actions (d = 0.33), perspective-taking (d = 0.42), and forgiveness (d = 0.61). Treatment adherence fully mediated effects on compassionate love. Furthermore, stress reduction mediated treatment effects on compassionate love, perspective-taking, and forgiveness; each also mediated gains in caregiving self-efficacy. This encouraging evidence suggests that nonlaboratory psychospiritual interventions can boost compassionate love to benefit the recipients and the larger society.

Keywords:

• health promotion
• spirituality
• religion
• altruism
• forgiveness
• empathy
• mediation

Acknowledgements

We gratefully acknowledge the grant support this work received from the Fetzer Institute of Kalamazoo, Michigan, and the U.S. National Heart, Lung, and Blood Institute (T32 HL07365-21). We also gratefully acknowledge the assistance of the Public Health Institute of Oakland, California, Exempla Healthcare of Colorado, and of assistant instructors Don Etter, Sandy Fasso, Anne Hedberg, Debra Parsons, MD, Pat Sabadell, Maura Sullivan, and Sharon Yablaz.

Notes

Notes

1. Spiritual models of personal significance were assessed by Oman et al. (2007) using the Spiritual Modeling Inventory of Life Environments (SMILE), which has psychometric properties, items, and assessment strategies as described by Oman et al. (2009). Question 7 asks respondents to identify by name up to two famous spiritual models from before 1900, and two from after 1900. Jesus, the Buddha, and Moses were the pre-1900 spiritual models most commonly reported as personally significant by a geographically diverse sample of US college students (N = 1010, Oman et al., 2009).

2. In the EPP, “putting others first” means putting the welfare of others ahead of one's own preferences, often referred to as “likes and dislikes.” EPP instructional materials argue that by putting others first, practitioners may experience heightened long-term well-being through freeing themselves from excessive self-focused attention and related compulsive behaviors. Initial motivation for EPP practice typically involves healthy, understandable, and partially self-directed goals, such as improved personal well-being. Over time, if attentiveness to others’ welfare becomes a habitual and integral part of character, then self-interested motivations may fall away, even as new satisfactions may arise. Post (2003) suggests that “if an altruist retires by the fireside late at night and has some sense of meaning and fulfilment as the result of the day's helping behaviors,” he or she can still be counted an authentic altruist “so long as he or she was not motivated by the sense of well-being that is retrospectively experienced” (pp. 59–60).

3. Between Exam 1 and Exam 4, all enrolled participants were mailed periodic 1-page newsletters (seven issues over 6 months) that reminded them about upcoming assessments and provided motivational material to encourage continued participation (e.g. health tips, summaries of scientific studies, and one or two aphoristic quotes from nondenominational spiritual sources). No further information about the intervention itself was provided. A standardised statement in each issue stated that the intervention's “core program consists of 8 spiritual tools. This newsletter contains a variety of other items we think will be useful but are not directly related to the core program.”

4. Exam 1 mean outcome levels were compared with US adult means derived from the 1998, 2002, and 2004 GSS (two forgiveness item means from Idler et al., 2003; 11 altruistic behavior and seven empathy item means from Smith, 2008, and two compassionate love items directly computed from GSS data). Study participants had higher baseline levels of compassionate love (M = 3.89 or almost most days) than US adults measured in 2002 (M = 3.50), about 6 months after the 2001 terrorist attacks, but slightly lower than US adults measured in 2004 (M = 4.12 in 2004). Participants also had similar empathic concern (M = 21.2, vs 20.9 in 2002/2004); somewhat lower spiritually motivated forgiveness (M = 2.84, vs M = 3.24 for US adults in 1998); and comparatively higher altruism, measured either as total actions per year (M = 100.3, SD = 69.1, vs M = 64.1 nationally), or as total types of action done at least once per year (M = 7.1 out of 11 types, SD = 2.1, vs M = 6.4, nationally, in 2002/2004).

5. Johnson scale items 1, 4, 5, 7, 8, 9, 11, 13, 14, 17, and 19 were used both here and in the 2002 and 2004 GSS (Smith, 2008), and modified versions of items 21, 22, 28, 30, 39, 40, 42, 46, and 47 were included here due to workplace relevance. Details are available from corresponding author.

6. Numerically similar and substantively unchanged effect estimates were produced by retaining all four exams but allowing for a separate treatment effect at the additional exam. However, the reduced dataset was more appropriate for analyses of statistical moderation and mediation.

7. In exploratory time-constant models, stress mediation of effects on forgiveness was clearly partial, rather than full. In models that included only Exams 1 through 3, all mediation criteria by stress of treatment effects on forgiveness were again satisfied (p ₂<0.05), but the adjusted treatment effect remained significant (p ₂ = 0.01) at 69% of its original magnitude.