Cultivating Compassion: The A & C in G.R.A.C.E.

From the work of Roshi Joan Halifax, the acronym G.R.A.C.E is a tool for cultivating compassion.  It  calls for us to gather attention, recall intention, attune to self and other, consider what will serve, engage and end. Last month’s topic focused on the R/recalling intention as how to BE in order to support that which you desire to have (goal fulfillment).

Attuning starts with being present, which is the result of gathering our attention. Our nervous systems are continually engaging in what the late pain science pioneer Louis Gifford, PT dubbed an SSR mode: Sample, Scrutinize and Respond.  Our senses sample the inner and outer environment and provide input that is scrutinized by perceptual centers of the brain. Input generates output; a Response of action or inaction. As our body, mind and environment engage to create our conscious experience the SSR mode explains what is meant by attuning to self and other. Recall, the affirmation Be here Now is a self-care practice that is a precursor to attunement as is the practice of checking in with oneself via paying attention to input from the five senses. Attunement taps our sixth sense, intuition, as an ingredient in scrutinizing.

In integrative health circles, there is a call for health professions to make a significant perspective shift in how we attune to those we serve. The bigger question to aspire to in health care goes beyond “what is the matter with you” to embrace “what matters to you.”  This question forms the hub of a patient centered or, preferably, person-centered whole health approach to health care.  In this paradigm our participation with self-care demonstrates accountability to our health. Attuning to the what matters to you question is supported by applying mindfulness skills to the existence of the ongoing SSR process of human interaction. Recall mindfulness involves paying kind attention to whatever is happening, as it is happening, without judging the experience as good or bad.  Mindful observation of our own SSR process involves objective observation of the judgment likely to occur in our scrutinization phase that then motivates and colors our response in the interaction. In situations where what matters to the person we serve is considerably different from what matters to us, the compassion practice of non-judgement is an essential skill. Mindfulness skills of directing attention also assist in our attunement to the SSR process in others; recognizing our SSR processes are always co-mingling and co-emergent in shaping behavior.

Attunement also allows us to C/consider what will serve. In her classic book Kitchen Table Wisdom, Rachel Naomi Remen MD made an important distinction between health professionals engaging in service versus acting with helping or fixing derived from our conventional focus on the what is the matter with you question.  She teaches us that service fosters healing as it is a relationship among equals empowering all parties.  Service generates gratitude, a key to well-being.  Attunement is a somatic as well as a cognitive understanding of the answer to the what matters to you question for person-centered health care. It opens the door to meeting people where they are to actively listen to how they can be best served to support what matters most to them. Compassion involves both recognizing suffering and the motivation to act to relieve it. Motivation arises from the feeling of attunement. A simple informal practice is to pause momentarily each time there is a shift in your outer environment; home, vehicle, work, store, nature, etc. With curiosity and kindness, mindfully bear witness to your somatic experience of your SSR mode in each setting. Attune to the effect each environment you find yourself in upon breathing, posture, attentiveness and mood. Attuning to self is a skill that precedes attuning to others.