This blog series (Don’t be a Cock, be a CHICKEN) is about how we create the kind of leadership values which enable teams to thrive and organisations to flourish, whist providing brilliant care. So far we’ve looked at Curiosity, Humility and Inclusivity. Now we turn our attention to Compassion.

Compassion literally means ‘to suffer with’. To be with someone in their own pain/difficulty/circumstance. To lead with compassion means that we need to be present and take a keen interest in how other people are doing. Compassion doesn’t happen at pace. It requires time and presence.

We need compassion in our public services more than ever. At a time when our services feel overwhelmed, it’s so easy for us to suffer with compassion fatigue. We need compassion towards those we serve and we need to create compassionate teams. I recently wrote a blog for the brilliant Clinical Leaders Network about what it takes to cultivate compassionate leadership. So, in this blog, I’m going to focus on what it means to live with compassion towards those we serve in our communities, day-in, day-out. And this requires us to re-examine our values and who or what we value and why.

Someone asked me recently what three things I want my kids to know. I wrote about it in my book, Sick Society. For me, it’s pretty straightforward. I want my kids to know:

  • I love you unconditionally
  • I see you for who you are
  • You are always welcome in our home (or in other words – you belong here)

I think this is the basis of all good care. And so, I want my patients to know that I love them. Yes! And for the record, I don’t think that’s unprofessional. I think it’s the foundation of any positive, human relationship.

Tenzin Gyatso, the 14th Dalai Lama put it this way:

“Love and Compassion are necessities, not luxuries. Without them, humanity cannot survive.”

To choose the way of compassion is to accept people for who they are. To be their friend, not their judge. And therefore compassion allows me to see people as they are. I see the whole of them, not just the the issue they are dealing with. I see their journey and their trauma. I can’t walk in their shoes, but I can draw alongside them and listen deeply, with kind and fascinated eyes. And I can be with them in their own story and situation. And so they know, when they are with me, they are welcome in the shared space we inhabit, for the time we have together. Compassion helps us to recognise that we belong to each other and with each other. Compassion enables me to see their innate worth and power, so that I don’t trespass over their sacred ground.

Thomas Merton examines this through a lens of interconnectedness:

The whole idea of compassion is based on a keen awareness of the interdependence of all these living beings, which are all part of one another, and all involved in one another.

As a clinician, compassion means that I’m not there to take over. Compassion allows me to be with. To find out what really matters to the person in front of me. To help them explore a range of possibilities and to facilitate the space for them to make empowered choices. Compassion creates space for personalised care. But compassion also moves me to action.

Wolfgang von Goethe shows that compassion is not just a feeling:

“Knowing is not enough; we must apply. Willing is not enough; we must do.”

In other words, compassion is love in action.

Henri J.M Nouwen says:

“Compassion asks us to go where it hurts, to enter into the places of pain, to share in brokenness, fear, confusion, and anguish. Compassion challenges us to cry out with those in misery, to mourn with those who are lonely, to weep with those in tears. Compassion requires us to be weak with the weak, vulnerable with the vulnerable, and powerless with the powerless. Compassion means full immersion in the condition of being human.”

But how do we create compassionate cultures, especially in our fast-paced, over busy health and care systems and other public services?

Again, Nouwen is honest about how complex this is:

“Let us not underestimate how hard it is to be compassionate. Compassion is hard because it requires the inner disposition to go with others to places where they are weak, vulnerable, lonely and broken. But this is not our spontaneous response to suffering. What we desire most is to do away with suffering, by fleeing from it or finding a quick cure for it.”

To do this, we need to create compassion for ourselves. In the midst of our tiredness, busyness and often sense of overwhelm, being compassionate towards ourselves is vital. We don’t always bring the best of ourselves into every situation. Giving ourselves time and space, being conscious of and caring for our own needs, allows us to keep our compassion for others switched on. Having the humility to receive compassion and care from others is also important. Letting other people see and be attentive to our own wounds and needs is vital. We can’t continually be compassionate towards others if we don’t also receive the compassion of others. When we treat ourselves with compassion and receive the compassion of others, it resources us to be compassionate towards others and with others. And this enables us to create more compassionate teams, who together make a more compassionate world. Me with you. You with me. Together we wade through the pain and complexity of life and find joy in the mess.

Compassion means that we cross the dividing line to sit with our ‘other’ and to be changed by them in the process. This takes, curiosity, humility and the desire to be radically inclusive. To be compassionate people, we must be determined to build friendship across difference in solidarity and celebration.

Share This:


The Rise of Antidepressants

The BBC ran a news piece today about the massive rise in use of antidepressants in England and Wales over the last 10 years. And depending on which study you believe between 1 in 11 and 1 in 6 people in England are now on an antidepressant (though we must remember, that antidepressants can be used for other conditions like pain management and irritable bowel syndrome – IBS). In the USA, antidepressants are now the second biggest group of prescribed drugs.


So, what should we conclude? Well, firstly, it is good news that it has become much more acceptable for people to talk about struggling with depression, anxiety and other mental health issues. It is good that people are going to see their GP when they feel depressed and anxious, rather than just trying to cope with it. So, we mustn’t now necessarily insinuate that the increase in prescriptions is a bad thing, because firstly, that can heap shame on those who are taking them, which is unhelpful at so many levels and also, we need to remember that there is actually a good evidence-base behind anti-depressant medication. They really do work – I’ve seen that again and again for my patients, who choose to go on them, and for sure, I would love to see more psychological therapies available on the NHS, as an alternative or as an adjunct to medication. Waiting lists are currently far too long for such therapeutic interventions and many people choose medication because they cannot afford to pay for therapy or indeed to wait several months for the help they need. We don’t report the use of antihypertensives to control blood pressure negatively and so we need to be careful about taking a dim view of medications which help improve mental health.


However, when so many in our society are struggling with anxiety and depression to this extent (and it’s really positive that we’re talking about it and that people are getting help), we need to ask ourselves some big questions about the root causes of this and what we can do as a nation to improve our mental health. One of all time favourite quotes is that of Archbishop Desmond Tutu, when he says:


“There comes a point, where we have to stop just pulling people out of the river. We need to go upstream and find out why they are falling in.”


So, in the rest of this blog, I’m going to explore some root causes, whilst recognising that for many people, endogenous depression (i.e. a neurochemical cause in the brain) IS the root cause, and therefore their depression may not have any other roots to it.  I’ve also done this vlog (which I did for mental health awareness week) about what depression is and some of the things that can help.


But in looking for root causes, let’s start at the beginning. I’ve written on this blog a number of times about the impact of Adverse Childhood Experiences and the impact of Trauma on our lives. So many of us live with unhealed pain, which over time eats away at us and makes it harder for us to remain mentally well. Many of us go through trauma and are able to survive it better than others, but that is because we’ve had other things in our lives at the time which have helped us navigate the storm. However, we need to recognise more the massive reality of trauma in our lives, so that we can face it, and find healing together. This is one of the reasons why I’ve co-written ‘The Little Book of ACEs’ with some friends and colleagues, here in Morecambe Bay. There is a free PDF version of it, if you click here. You may also find this inspiring talk by Jaz Ampur-Farr, herself a survivor of significant trauma, really helpful. Jaz is joining us in Morecambe Bay very soon, to explore some of these issues.


We must also be brave enough to recognise that we have a complex corporate history, which shapes our identity and we have a society, which is by no means equal or fair. Prof Bev Skeggs, and Prof Imogen Tyler, two of the foremost sociology professors in the UK/world right now, are writing so powerfully about this. It’s well worth digging into their work, and I am so excited that they are here at Lancaster University, in Morecambe Bay, and will be exploring some of these issues with us in more depth over the next few months. We cannot underestimate how injustice, poverty, and inequality impacts our mental health.


Stress has a hugely negative impact on our mental health. Our work patterns have become so manic and busy and our weekends often so full, that we have forgotten how to rest, how to stop, how to switch off and take notice of the beauty all around us – of the things which really matter. This takes a huge toll on us. The girl guides took part in a fascinating survey about what causes them stress and feeds mental health issues. The number one factor was the pressure they feel to do well at school. Our very systems and the treadmill of the exams are making our young people unwell. The idea of slowing down and learning to switch off from our ever faster, consumerist world, seems laughable to so many of us – and yet I would argue that this is one of the greatest causes of our ill-being. We have created an economy which treats people like fodder for the economic machine and is literally killing the planet around us – another underlying huge but often unrecognised cause of our stress. We must rebuild an economy based on wellbeing. It’s why I’m so excited that we’ll be welcoming Prof Katherine Trebeck to Morecambe Bay in the next few weeks.


Another causative factor of our growing mental illness in society, perhaps caused by all the busyness, is loneliness and isolation. Despite our many frantic activities, and social networking, 20% of the UK population say they feel lonely, but that jumps to between 50 and 75% of people over 75. We were made to be in relationship. When we are disconnected from community, we become sad and low. We need to remember how to love people, and also to be loved. Our disconnection is leading to increased separation, suspicion of others and a rise in racism and hatred. This is in no way good for our mental health. Valerie Kaur explores this so powerfully in her incredible TED talk on revolutionary love. We need to reimagine a society in which relationship is at the core of our being together. Hilary Cottam’s work is so vital in helping us recover this. Again, Hilary is coming to the Bay in the coming months to help us dig deeper as a community into these ideas.


I am so glad that we are talking about mental health so much more seriously. I am glad that people are able to take medication that can help them and that the stigma is being broken. I am hopeful though that we can recognise together just how broken our society is, and how our current political and economic systems (including our beloved health system) cannot fix this. Perhaps, in learning to be together in the dark, when we cannot see the light, wrestling with the complexity of our pain, healing our trauma and reimagining our future, we might find that our need for medication decreases.



Share This:


Recovery From Addiction – Podcast

Tweet Here is the lastest edition of the ‘Black Swan Podcast’ – available on iTunes, Spotify, Alexa and   This one is with my good friend, Dave Higham, founder and CEO of ‘The Well’ – an incredible community of recovering addicts, here in Morecambe Bay. This one focuses on Dave’s own story through addiction [Continue Reading …]


Black Swans and Poverty

Tweet Here is a copy of the speech I recently gave at Morecambe Food Bank when Heidi Allen MP and Frank Field MP came to be with us and to listen to the community here in Morecambe Bay about our experiences of poverty. There were some incredibly moving testimonies from community commissioners of the poverty [Continue Reading …]


A Fallow Year

Tweet This coming year of 2019, I am letting my garden have a rest – letting the ground be fallow. It gives space for the soil to replenish and to have its nutrients restored.   I am personally trying to allow much more space this year for contemplation, silence, reflection and the deeper work of stillness. [Continue Reading …]


Facing Our Past, Finding a Better Future – Adverse Childhood Experiences

Tweet This week I had the privilege of listening to Prof Warren Larkin, advisor to the Department of Health on Adverse Childhood Experiences. This is something I’ve written about on this blog before and Warren has made me more determined than ever to keep talking about this profoundly important issue. This blog draws on his [Continue Reading …]



Tweet Here is a beautiful piece of prose that I have found really helpful over the last year – well worth a read and some time to reflect:   SPEED   Speed has compensations.  Speed gets noticed.  Speed is praised by others. Speed is self-important.  Speed absolves us.  Speed means we don’t really belong to [Continue Reading …]


The Extraordinary (Healing) Power of Forgiveness

Tweet There are many times when people come to see me, as a GP, and I cannot find a physical cause for their pain. There are various other conditions when people have what we call “medically unexplained symptoms”. For others, they can get stuck in a rut with their mental health and feel unable to [Continue Reading …]


Embracing Weakness

Tweet Last weekend, I spent the weekend with my wife and a bunch of close friends, immersing ourselves in the enneagram. It’s something I’ve done a bit of before and highly recommend it! The enneagram is an ancient way of understanding the human personality, our instincts, gifts, struggles and strengths. There are several different perspectives [Continue Reading …]


A Conversation in Response to ‘Living with Illness’

Tweet After my last blog post, I got a couple of responses from people who felt I misrepresented them. I am always happy when people come back to me in discussion. We are never changed if we cannot receive challenge or we do not really encounter ‘the other’. So here is a conversation between me [Continue Reading …]