Mental Health & Counseling

The Effect of Compassion

March 12, 2021

Cause and Effect: The Human Condition and the Power of Compassion

Com·pas·sion (/kəmˈpaSHən/) noun

“A feeling of deep sympathy and sorrow for another who is stricken by misfortune, accompanied by a strong desire to alleviate the suffering.”

A hurricane hundreds of miles over the ocean produces certain effects. An earthquake miles under the surface of the earth moves houses and shatters glass. A towering cloud of ash rising from a tall mountain tells of extreme heat way down under. We see the effects and do not question that something happened at a deeper level to cause the effect. 

Doth not nature teach us? Humans are also cause and effect beings. The surfaces we see, the exteriors, the facades, are products of something going on under the surface. 

We are given to quick judgment regarding appearance and actions of people. We see an obese person and may easily judge them to be ignorant of healthy food choices and perhaps “given to appetite.” We meet someone who has depression or anxiety and conclude that they must be an individual who may be harboring guilt or unforgiveness, or lacking in faith and only need a closer walk with God. We hear the word homosexual or gay and immediately experience inward revulsion and abhorrence. We see an alcoholic staggering down the street and equate his addiction with weakness and a lack of self-control. The list of our judgments and stereotypes is almost as long as the list of maladies that affect the human race. 

We default to snap judgments, critical appraisals, and petty prejudices based on our environment, upbringings, and biological predispositions. We can easily slip into righteous indignation, quoting scripture or religious dogma to justify our conclusions. We withhold monetary funds from the needy if we suspect they may spend it on anything other than the items scripted by our worldview. 

How many times do we speak to someone on the phone whom we’ve never seen and create a picture in our minds of what that person looks or acts like. How many times do we meet someone for the first time and unconsciously judge them, become intimidated by them, or envy them based on appearance or first impression only. By seeing someone only one time we can create stories about them, stories that affect how we see them, how we interact with them, and what we tell others regarding them. 

The examples used above of obesity, depression, homosexuality, and addictions are conditions that we often react to in a visceral way. These are only a few of the many often misunderstood human conditions, but will serve the purpose to explore very briefly what happens beneath the surface and how true compassion makes the courageous journey beneath the surface to understand our fellow man. 


A couple of years ago I cared for a patient who was morbidly obese. In the process of my assessment, I asked her if she was diabetic. She became upset and said, “You think that just because I’m overweight I’m a diabetic. Well, I’m not!” Stereotypes are difficult to overcome. 

To be sure, obesity can be caused by a lack of self-control. It can be caused by bad habits and food choices. But there are a myriad of issues surrounding obesity that go beyond the simple diagnosis of “lack of self-control.” The truth is that two people can eat the exact same thing and one gains weight and the other does not. Each human has a unique biological metabolism. Some diets work for some, some work for others; often three people on the same diet respond differently. 

Obesity may have come about through what is known as “comfort eating,” or eating to drown out other problems, such as depression or feelings of inadequacy or rejection. Heredity also plays a role in metabolism. Medications can cause obesity as well, and unfortunately there are conditions where obesity is a side effect that must be endured. However, we often don’t ask ourselves the question of why; rather, we default to a negative perspective. 

In the past my work in inner city hospitals has brought me into contact with people who live in ghetto precincts with very limited means. The majority of these patients are classified as obese. Even though these unfortunates live inside a large city they actually dwell within something called a “food desert.” This means that they have no access to healthy food. They are unable to drive and unable to access supermarkets other than low cost dollar and convenience stores. The food available to them is of the fast food or convenience store type. Think what you wish regarding this situation, the fact is that their obesity is rooted in a much deeper problem that moves rapidly into the realm of a political and socioeconomic morass. 

Compassion makes no difference between excess adipose tissue or lean muscle mass. Compassion says I care about you and want to know your story. Compassion asks what has brought you to this point? Compassion says I love you no matter what. Only then do doors open and if help is needed, it becomes accepted and effective. 


The emergency room techs wheel her into my intensive care bay, the soft wheeze and swoosh of the mechanical ventilator matching the rise and fall of her chest. Her black hair is matted, her arms flopping as they move her onto the bed, her face blank, unmoving, eyes closed. She had been found on the bathroom floor, an empty bottle of pills close by, suicide an apparent last attempt at control. As the family files in, the dynamics of poverty, domestic violence and estrangement flash across their faces like neon advertisements for dysfunction and despair. Her medical history reveals a litany of problems, major depressive disorder topping the list. 

Depression has many causes but is often an effect of something happening much deeper beneath the surface. It can be an effect of loss, grief, trauma, guilt, abuse, or a lack of empowerment. Genetics, temperament, and personality all can predispose a person to depression. 

To realize that the brain is a physical organ like the heart or the liver is important. This can both simplify our understanding of depression and, at the same time, make it more confusing and complex. The brain as an organ has neurotransmitters, arteries, and complex networks of cells that require thousands of metabolic interactions in order to function. Why would we think that all these components would never suffer a malfunction? Some types of depression are simply a dysregulation of neurotransmitters, too much or too little. In these cases medications can regulate the flow and emotional equilibrium is regained. 

In the case where a background of loss, grief, trauma, guilt, or lack of empowerment provides the source of the malady, the equation is much more complex. Abuse and trauma during formative years, for example, can cause actual physical changes to the brain that can affect every area of life.  Until we have walked in a depressed individual’s shoes, we must understand that it is very unlikely we understand the depth of their suffering. 

Compassion does not judge; compassion seeks to understand and get to “where” a depressed person is. A compassionate person is an active and attentive listener. This is where the journey to understanding begins. Only when a person feels heard and understood can he or she then become open to instruction and advice. Perhaps the depression is caused by a spiritual malattunement or guilt. We won’t get anywhere, even from a spiritual standpoint, until we have gained the trust of that person and they feel safe to share the inner secrets and moving of their heart. Compassion is the father of trust and once trust is gained, bridges are built to healing and hope. 


The alcoholic in my care that night was a nice guy. I had cared for him before, a “frequent flyer” as nurses say. But as he began to go through withdrawals he became more and more violent, cursing and threatening to kill whoever came close. As he thrashed in his bed it finally got to the point where it took five or six nurses to hold him down, some almost on top of him, dodging his strong-armed fists. As two tied down his arms and legs, another gave him a sedative. These battles are not uncommon for health care workers. It is also not uncommon to become jaded by this type of patient, to become weary of their behaviors and “refusal” to change. We see and deal with the behaviors but often do not think beyond this. It turns out that this man I cared for was a veteran and suffered from post-traumatic-stress disorder.   

Stroll Vancouver’s Eastside, Chicago’s Southside, or LA’s skid row. On one street corner, stretched out beside a garbage can, is a young lady, tattoos running up and down her arms, black ink substitutes for identity, a needle still in her arm.  On the other corner is an old man, stringy gray hair matted and wet, smoking and taking another drag from a long-necked flask as he stumbles towards the dark, ratty club. We see the tattoos, we see the stumbling, the needles, the wretchedness of it all. Inwardly we shudder, outwardly we avert our eyes. 

Healthcare worker or not, do we ever ask what sort of current causes the waves we see on the surface? What could bring a man or woman to this level of abject misery? According to the National Center for Post-Traumatic Stress Disorder and the Department of Veterans Affairs, 75% of people who survive abuse and/or violent trauma develop substance abuse problems. Up to 33% of survivors from accidents, illnesses and natural disasters report alcohol abuse. According to the Adverse Childhood Experience study, which was based on 17,000 patients, there is direct correlation between severe childhood stress such as abuse, domestic violence, neglect, having a mentally ill or substance abusing parent and various types of addictions. Addiction is the desire to feel better and trauma is often the root cause. 

The old person you see stumbling down that Southside street in a drunken stupor could very likely be a veteran who saw action in some military conflict. The young lady with the needle in her arm is most likely, according to research, the victim of sexual or physical abuse. The prostitute on the corner seeks the acceptance, affirmation, and love she did not receive as a child. It is unusual to see a person raised in a healthy environment, with positive influences and godly nurture, given to addiction. 

Showing true compassion in these cases can be challenging. Compassion does not condone the action but it does understand that there is more to the story than the flying fists, the threats, the angry words. Compassion sees beyond these things. And beyond compassion lies kindness and patience. 

A kind gesture can reach a wound that only compassion can heal. 

Steve Maraboli

Homosexuality and Same-sex Attraction 

This is one issue that we, especially as men, react to in a more visceral way than any other, and we are quick to respond with disgust, abhorrence, and even anger. How could men or women choose to be that way? How could they do such things? Our inherent homophobia causes us to recoil and shudder and then, because we don’t understand it, we can easily resort to snap judgment, unkind statements, avoidance, and even mockery. We tend to simply avoid such persons if we can help it. Homophobia is our default setting.

Homosexuality, same-sex attraction, gay. These terms all have differences, but for the purpose of this article, where space is limited, we will keep it very general. Whatever the case, this segment of the population is probably the most misunderstood in society. In the age we live in this has been even more confused by the outspoken gay rights movement, the flagrant excesses of celebrities, and all that lifestyle entails. Leave that where it is. Rather, look closer, into our own circles: the young brother leading songs; the middle-aged brother who just brought an inspiring introduction; the brother with the large family and a successful business. Any one of these brethren could be dealing with same-sex attraction and homosexual temptation and you would never realize it. You may even think this is not a part of our Christian community. Please think again.

We believe, and recent research backs this up that God did not create a man or woman with homosexual orientation; that is, they were not born with it. So, the next question naturally should be, then where does it come from? It should be very clear in our minds that same-sex attraction, in almost all cases, is not a choice of that individual.  It is almost always a product of a combination of influences that include biologic predispositions (nature), upbringing (nurture), and adverse childhood environments (abuse and rejection, for example). A typical example of the history of a same-sex individual is as follows: a smothering, overprotective or narcissist mother; a withdrawing, absent, abusive, or non-affirming father and a boy who is emotionally and temperamentally sensitive. It is also common to find (especially in the presence of healthy parenting that does not fit the above criteria), cases where the boy has been sexually abused by men outside the immediate family. It is generally understood that a boy’s yearning for fatherly affection, affirmation, and attention—in the presence of certain predispositions—turn sexual during puberty resulting in homosexual urges and attractions.  

The anguish and pain an individual with same-sex attraction goes through is difficult to fathom from a heterosexual standpoint. Their default emotion is shame. A profound sense of rejection and the overwhelming fear of discovery hound their every step. They develop facades and self-protective adaptations. They feel they are living a lie and if anyone would ever find out they would be ostracized and rejected outright. Furthermore, they have heard the anti-gay comments, they have internalized the default homophobia, and they have felt the abhorrence.

It is true that the Bible places a special judgement on homosexuality. To act out on homosexual impulses is clearly a sin and must be treated as such. It must be understood, however, that homosexuality is a maladaptive behavior and an unhealthy yearning springing from a much deeper need. To those who do not act on their homosexual impulse and stay faithful to God, same sex attraction and lust remains a temptation, not a sin. Compassion understands that these men, should they open their heart and reveal their struggle, crave confidence, affirmation, and trust. 

Compassion moves towards this problem, not away from it. To move away only alienates these individuals more and only proves the lie they have told themselves most of their life: I really am worthless, shameful, and unlovable. Compassion is willing to walk the road with them, listening to their struggle and seeking the underlying cause. Healing for these men is possible but requires trusted and dedicated mentors who are secure in their masculinity and able to see much deeper than the surface. 

Compassion and Sin 

The obese, the depressed, the addicted, the homosexual. Any one of these maladies can produce actions that are sinful. Sin is sin.  This is not an attempt to explain away sin or use psychology to excuse sinful behavior. But is it wrong to ask the deeper question of what makes a person do what he does? We are all carried away at times with our own lusts. We are all fallen creatures. We are all tempted and in weak moments we fall. However, it is good to be aware that sometimes a recurring problem or negative behavior reveals a much deeper need, a need that may be physical, emotional, or psychological. That need can have a spiritual cause or basis. But that need also may spring from a maladaptive past. 

People who have been raised by fathers and/or mothers who did not appreciate or affirm them will often suffer profound effects on their emotional wellbeing. Children who have suffered trauma in its many forms can also experience lifelong difficulties. Trauma becomes branded on their child hearts, burning a wound that profoundly affects physical brain development. If these effects are not recognized and if healing is not sought, this emotional suffering leads to unhealthy behaviors which can often result in sin. We then see the surface effects. We can choose to react to the surface and the symptoms or we can go deep, reflecting on the cause, the current that controls. 

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