Cognitive-Based Compassion for the Mesothelioma Caregiver

Caregiver helping patient

I cut my teeth as a caregiver in the 1990s when my dad had mesothelioma.

So when my husband began having health problems a few years ago, I felt secure in my role as his caregiver. A few weeks ago, my husband and I had to travel a few hundred miles for an important diagnostic appointment.

The rain, road construction and traffic got the best of me that day. I felt my stress and blood pressure rise at the same time. I was aggravated, and I let it be known.

I was about five minutes into expressing my outrage when I saw him.

My husband was visibly affected by my tirade. His silence spoke volumes. The expression on his face ignited a sense of guilt in my heart. My husband was anxious about the test results and a little scared about the procedure.

I was being a jerk.

Where was my compassion? I guess I left it on the pavement somewhere alongside the interstate.

When it comes to being a caregiver, especially for someone with a debilitating disease such as mesothelioma, compassion is a skill that can sometimes get away from you.

Knowing What It Means to Be a Caregiver

As a graduate student in a clinical mental health program, I often encounter the familiar sentiment, “Counselor, know thyself.”

The words mean to keep your own emotions and feelings in check when serving others in a counseling capacity. This same sentiment applies to the caregiver experience.

Just as counselors emotionally prepare themselves to serve and support others, so should the caregiver.

The problem with my caregiver preparation is the stress of being a caregiver sometimes trumps my empathy. How does one become more compassionate in a real-world situation?

Stress influences our responses, even when we attempt to manage it. My husband needed me, but the stressful driving situation compromised my caregiver compassion.

I need to work on being more sympathetic. Perhaps building my compassion should be approached more spiritually and with more purpose.

Cognitive-Based Compassion Training

I suppose my guilt drove my research just a bit, but through my personal development efforts I came across an e-book that details Cognitive-Based Compassion Training, or CBCT.

This clinical intervention combines the innate human capacity for compassion with spiritual development to expand a person’s ability to be more compassionate toward others.

The implications of CBCT in the context of family caregiving could be significant. When employed as a wellness intervention for at-risk youth, some study participants experienced increased feelings of hopefulness and decreased anxiety.

Some also reported a better ability to manage stress and regulate emotions.

According to the book, it is possible to develop a stronger sense of compassion through training and practice. We already have a biologically founded capacity for compassion toward others. Through CBCT sessions, caregivers might learn to be more compassionate as they care for their loved one.

Steps of CBCT

The eight steps of CBCT focus on some of the following elements of mindfulness and spiritual development:

    • Developing Attention and Focus: Work on maintaining focus and fine-tuning attention to details. Methods of mindfulness don’t require perfection. Simply practicing is a step in the right direction.
    • Know Yourself: It is important to understand your innermost thoughts, emotions and reactions to others. Exploring yourself can be enlightening with regard to relationships with others, as well.
    • Self-Compassion: Recognize your biologically driven desire for happiness and well-being. Make a conscious decision to avoid mental states that work against the desire for happiness (such as my highway outburst).
    • Balance Under Stress: Relate to others on a heart-to-heart level. Finding this common ground promotes an inner balance that is necessary for spiritual development.
    • Appreciation and Gratitude for Others: Understand the interdependence in your relationships and how you rely on others. Consider the value of those you love and all you gain from having a relationship with them.
    • Affection and Empathy: Think about the suffering of others. Try to “walk in their shoes” and understand what issues other people face. By considering the personal experiences of others, one can extend affection and empathy.
    • Aspirational Compassion: When considering the adversity others endure, the newfound awareness spawns a growth in compassion. Through this empathic consideration, the seeds of compassion are sewn.
    • Active Compassion: Make a conscious shift from just feeling empathic toward others to taking a more active role in addressing their needs. Rather than simply thinking “Wow, how terrible!” in a situation, one will move toward saying “What can I do to help?”

CBCT is a clinical intervention utilized in a professional environment. However, trained counselors could incorporate the elements into caregiver support counseling. Some elements of compassion training are flexible and can be molded to meet the needs of any individual.

Lessons from My Caregiver Journey

When I participated in my dad’s care, my focus was primarily household duties.

As my husband’s caregiver, I accept a much more personal responsibility. I’d like to think I am a sensitive person and an attentive caregiver. But, I am human, and stress negatively affects me at times.

Our loved ones don’t hand us a training manual when we accept caregiver roles.

Caregiving is a learning experience. Sometimes it takes a mistake for us to get back on the right track. My lack of compassion when my husband needed me placed me on a path toward personal development.

Through some of the mindfulness practices illustrated in CBCT, I am learning how to focus my attention more on what matters, rather than the obstacles that stand in my way.

I am finding my balance and learning to be more compassionate toward the people I encounter.

Being a caregiver isn’t for the faint of heart. It requires a person to see with the heart rather than the eyes.


Melanie is currently pursuing a Master's degree at the University of the Cumberlands. She has a Bachelor of Science in psychology from the University of Phoenix. Her father was diagnosed with mesothelioma in 1992. She is dedicated to writing about her unique experience with the rare disease.

  1. Ozawa-de S., Negi, G.L. (2013). Cognitively-Based Compassion Training (CBCT). Retrieved from http://www.compassion-training.org/?page=download&lang=en#prettyPhoto.
  2. Reddy, S.D., et al. (2013) Journal of Child and Family Studies 22: 219. Retrieved from http://link.springer.com/article/10.1007/s10826-012-9571-7

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