Dr. Tony Fernando is the kind of friend or doctor you want to have in your corner on a blue day.

The Filipino psychiatrist was awarded the highest honor by the New Zealand Medical Award (NZMA) last December 2015 for his inspiring and pioneering work in medical compassion.

The NZMA said, “His inspirational talks to medical students and many groups around New Zealand have improved the happiness of both patients and carers, and have had an immeasurable positive impact on the health of New Zealanders. The focus of medicine today is being transformed from a disease-centric approach into a preventive, holistic approach that takes into account people’s overall wellbeing. Tony’s work with medical professionals— particularly those in training— is helping this process.”

Doctor Fernando trained in medicine in the Philippines before completing his Psychiatry studies in New York and Pennsylvania.

He is a consulting psychiatrist in Auckland, a senior lecturer in Psychological Medicine at the University of Auckland, and also runs a private practice in insomnia medicine.

True to his nature and profession, he has a comforting and reassuring presence. We caught up with him over lunch one day while he was visiting family and friends in Manila.

I asked him why some people seem to exhibit no compassion at all.

“You cannot really force people to change,” he said. “From a compassionate perspective, you can say, ‘I wish that person eventually realizes his ways,’ but we really can’t do anything about it. Or if you have faith, you can say, ‘I pray that that person will understand what is going on in his or her life.’ But that’s all you can do.”

Doctor  Fernando defined compassion as recognizing someone’s suffering and wanting to do something about it.

“But some people equate compassion with being a doormat,” he noted. “No, that isn’t right. Some people say, ‘I want to show compassion to my husband or boss. So if he wants to abuse me, let him abuse me.’ That’s being stupid. If you really want to help that person, you may have to push back.”

From within

Stress in any relationship happens when one is forced to change, but we all know that change must come from within.

“For people who don’t want to change,” he said, “there’s nothing you can do but manage your own response.”

He continued: “One response is to get angry and berate them as if they are listening, but actually they are not. Another option is to cut off that person from your life. Another response, which is harder, is to notice what’s going on, and to realize that this person is suffering, and that he or she doesn’t know what to do, so that’s why he or she is being difficult. So you think: I cannot do anything about it, but I can be compassionate.”

Such thinking requires skill, which will often require a mind shift. “You can also create circumstances that might awaken a positive response in the person, so that he or she might learn. You can be kind and generous. Kindness is very potent ammunition against anger. But again, not to the point of being a doormat.”

On women who base their entire self-worth on their partner or family: “There’s nothing wrong with service, but it becomes problematic if her husband is abusing her. Not doing anything will allow the perpetrator to continue doing harm, which is actually bad for the perpetrator himself because he also suffers. But equally, if not more harmful, is the suffering it inflicts upon the family. Allowing the abuse to go on is very misguided compassion.”

Backbone

True compassion, Tony stressed, requires backbone. “It’s easier to be soft under the guise of kindness, but in fact you’re not being kind, you’re taking the easier way out. True compassion requires pointing out what’s wrong. If compassion is defined as the wish to relieve people of their suffering, then we have a responsibility to correct what’s wrong.”

Compassion can be something as simple as a wish, and it begins with empathy. “Empathy is seeing a homeless person and acknowledging his suffering. The difficult thing about empathy is that if I feel sad for that person, then the sad parts of my brain are lighting up and I’m starting to mirror the sadness.

“Compassion is a step further; when I see someone suffering, I shift to a compassionate state by praying that the person gets better, or by  doing something about it.

“From feeling negative, when we shift into a compassionate state, we start feeling better. We still feel bad, but we start feeling that something can be done.”

Doctor Fernando said it is important to teach children mindfulness and gratitude. “The mind tends to focus on what’s missing, on what we don’t have, on what is wrong. It’s for survival. But it becomes problematic when we let it get out of control.”

Distribution

Is everyone born with compassion? Like intelligence, there seems to be a difference in the levels one is born with.

“It’s hard to rule out modeling, or genetic flukes, in the same way that there are just some people who lack compassion from birth,” he said. “There’s a study that shows that three percent of CEOs have been diagnosed with an antisocial personality. The whole conscience thing is now being mapped out in terms of circuitry. It’s a very interesting field of study—compassion, empathy, how people relate to one another and what factors influence these behaviors.”

Compassion, of course, is not only an outward act, but must be directed to the self, as well.  “People beat themselves up when things are not going right,” he noted.

Women, especially mothers, are very good at this. “They say,  ‘I didn’t do enough for my child.’ And it takes a while to unlearn this behavior. Self-compassion is so important, but not everyone is capable of it.”

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