Setting the Stage for Compassion in the Clinical Encounter (Halifax/Back/Rushton):
1. Gather your attention:
Pause, breathe in, give yourself time to get grounded. Invite yourself to be present and
embodied, by sensing into a place of stability in your body. You can focus your attention on the
breath, for example, or on a neutral part of the body, like the soles of your feet or your hands as
they rest on each other. You can use this moment of grounding to interrupt your assumptions
and expectations. (A/A Axis: Attention)
2. Recall your intention:
Remember what your service to the patient is really about: to relieve the individual’s suffering
and to act with integrity and preserve the integrity of the other.
Recall the felt sense of why you have chosen to relieve the suffering of others and to serve in
this way. This “touch in” can happen in any moment. Your motivation keeps you on track, morally
grounded and connected to the patient and to your highest values. (A/A, I/I Axis: Affect,
Intention)
3. Attune by checking in with yourself, then the patient:
First notice what’s going on in your own mind and body. Then sense into the experience of your
patient; sense into what the patient is saying, especially emotional cues: voice tone, body
language. This is sense without judgment and an active process of inquiry, first involving
yourself, then the patient. Open a space in which the encounter can unfold, in which you are
present for whatever may arise, in yourself and in your patient. How you notice the patient, how
you acknowledge your patient, how your patient notices you and acknowledges you, all
constitute a kind of mutual exchange. The richer you make this mutual exchange, the more
there is the capacity for unfolding. (A/A Axis: Affect)
4. Consider what will really serve your patient by being truly present with your patient and letting
insights arise.
As the encounter with the patient unfolds, notice what the patient might be offering in this
moment. What are you sensing, seeing, learning? Ask yourself: What will really serve here?
Draw on your expertise, knowledge and experience, and at the same time, be open to seeing
things in a fresh way. This is a diagnostic step; also, the insights you have may fall outside of a
medical category. Don’t jump to conclusions too quickly. (I/I Axis: Insight)
5. Engage, enact ethically and then end the interaction: allow for emergence of the next step. (E/E
Axis)
Part 1:
Engage and enact
: Compassionate action emerges from the sense of openness, connectedness
and discernment you have created. This action might be a recommendation, an open question
about values, or even a proposal for how to spend the remaining time with this patient. You co-
create with the patient a dynamic, morally grounded situation, characterized by mutuality, trust and
consistent with your values and ethics; you draw on your professional expertise, intuition and
insight, and you look for common ground consistent with your values and supportive of mutual
integrity. (E/E Axis: Ethical Enactment)
What emerges is principled compassion: mutual, respectful of all persons involved, as well as
practical and actionable. These aspirations may not always be realized; there may be deeply
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