Training in compassion improves the well-being of relatives to people with mental illness

Being a relative of a person with a mental illness can be very burdensome. It can feel like a great responsibility, and many people struggle with feelings of fear, guilt, shame and anger. A new study from the Danish Center for Mindfulness shows that eight weeks of training in compassion can significantly improve the well-being of relatives. 

Compassion is a human quality that is anchored in the recognition of and desire to relieve suffering. In other words, compassion occurs when we come into contact with our own or others' suffering and feel motivated to relieve our own or others pain.
"After completing the course, the relatives had increased their well-being on several parameters. They could deal with the illness in a new and more skillful way, and we saw that the training reduced their symptoms of depression, anxiety and stress," says psychologist and PhD student Nanja Holland Hansen, who is behind the study.

And the positive results were maintained after a six month follow-up.

"The relatives learned that the more they turn towards what is difficult, the more skillful they may act. For example, relatives often try to 'fix' the problem or the challenge – so as to relieve their loved ones of what is difficult. That’s a huge pressure to constantly deal with, and very few people can bear it," says Nanja Holland Hansen.

Living with chronic fear

She goes on to explain that training in compassion helps people to find the strength and courage to bear pain and suffering when life is difficult. It may seem both sensible and intuitive to guard yourself from the confrontation or avoid what is difficult and unpleasant. But this is the paradox of the training, explains the researcher. Because it is precisely actions and thoughts like these that shut down our compassion and thereby maintain the suffering. 
"Fear and grief are emotions that take up a lot space for relatives of people with mental illness. For example chronic fear, which is a real fear that parents of a child with schizophrenia have about whether their child is going to commit suicide, or whether a child with autism will ever enjoy a 'normal life'," explains Nanja Holland Hansen and continues:

"Our suffering is maintained inside of us when we don't work with it. To avoid feeling pain, we may resort to behaviour such as working too much or buying things that we don’t need. It’s therefore in all these everyday actions that our compassion training becomes important and can be used to help alleviate what is difficult," she says.

No one escapes

The purpose of training in compassion is thus more than just feeling empathy or worrying about another person. 

"Not a single person can completely avoid experiencing painful things in their life. In this way we’re all the same. But what isn’t the same for everyone is our ability to deal with the pain and suffering we experience. Training programmes in compassion have been developed because the research shows that we can train and strengthen our mental health. With systematic training of compassion, we generate more attention – and understanding of – our own thoughts, feelings and behaviour. And this helps us to develop the tools and skills to engage in healthier relations with ourselves and others," she explains. 

A total of 161 relatives of people with mental illness participated in the study. This makes the study one of the largest of its kind in the world, and also the first scientific randomised clinical trial carried out with relatives in Denmark. The relatives were between 18 and 75 of age and were family members to people with various psychiatric disorders such as e.g. ADHD, schizophrenia and depression. 

Meditation as homework

The relatives met once a week in groups of twenty participants over an eight-week period. Each session lasted two hours and was structured with small group exercises, large group discussions, instruction in the theme of the week and meditation. The homework consisted of twenty minutes of daily meditation.

"There is definitely a shortage of offers for these relatives. They’re often told that they should remember to take care of themselves, but they haven’t learned how to. We found that those who were involved in the study received the tools for precisely this," says Nanja Holland Hansen.

The results have just been published in the scientific journal JAMA.

"My hope is that local authorities and regions can offer this type of intervention for relatives. It should be an option and could easily be incorporated into our healthcare system. Economically and socially, a healthy person going on sick leave solely because he or she is a relative is a huge loss," says the researcher.

Background for the results

• The study is a randomised clinical trial. The test subjects/participants had fifty percent probability of being allocated to either the intervention group or the control group. The allocation was based on a computer algorithm.
• The study is financed by the Danish Center for Mindfulness and Aarhus University.
• The scientific article can be read in JAMA.

Contact

Psychologist, Research Assistant & PHD student Nanja Holland Hansen
Aarhus University, Department of Clinical Medicine and
The Danish Center for Mindfulness
Mobile: (+45) 2213 1805
Email: nanjahh@clin.au.dk


Centre Director, Associate Professor & PhD Supervisor Lone Fjorback
Aarhus University, Department of Clinical Medicine and 
The Danish Center for Mindfulness
Mobile: (+45) 9352 1996
Email: lone.overby.fjorback@clin.au.dk