I remember one man particularly. Marcus, then in his early forties, was distressed and tearful every day. He seemed perpetually tormented by grief and absorbed by self-pity. "Help me! Help me!" He cried out over and over. He heard voices. His thought patterns were very disturbed and, despite adequate medication, he was incoherent and inconsolable most of the time. I asked my teachers about him, thinking that there must be something else to try; but I was only told not to worry. Everything that could be done for him had been and was being done. I was advised to concentrate my time and energies elsewhere, where they might be more productive. This made sense, but it left me unhappy.

About this time, I was introduced to an American who had joined the Dalai Lama's order of Tibetan Buddhist monks in India. I told him about Marcus and another patient who had been troubling me. The monk listened attentively. Then he asked, "Where is the suffering?" I told him about the hospital and the ward where the men were kept. He looked at me kindly, and repeated, "But, Larry, where is the suffering?"

It took a moment to realise he meant my suffering. "Here", I eventually said, pointing to my heart. "And why are you suffering?" the monk asked. I could not immediately think of an answer. "Why are you suffering, Larry?" he repeated softly.

I didn't know and shook my head. The wise monk answered for me. "You are suffering," he said, "Because you care."

This changed everything. I saw that my compassion - the cause of my distress - was a good, even noble thing, and that it was not chosen. It was deep-seated, an inescapable part of me, a vital aspect of my true self. I could immediately stop feeling unhappy about my distress and start feeling a measure of satisfaction with it. This made it easier to bear.

The monk said that an important part of my job, working with suffering people, involved learning how to protect myself and how to grow as a person, developing an increasing sense of emotional equanimity. He told me that the word ‘suffer'; usually meaning pain, either emotional, physical or both; has other meanings: ‘to experience' and ‘to allow'. Here was a clue about managing my own pain and distress: experience it and allow it, rather than try and avoid, ignore or suppress it. In this way the pain sort of becomes the medicine, the necessary transformative agent. Natural emotional healing processes eventually bring relief and release.

The monk wasn't teaching me Buddhism. He was simply teaching me how to be. His words and his kindness opened me up to an extremely valuable kind of wisdom. Feeling bad is not the problem. Feeling bad about feeling bad: that is often the problem. If you feel bad about feeling bad, you always try and resist. If you resist emotional pain, you strengthen it. If you suppress it, it will find a way to revisit you more forcefully until you take notice. If you allow it, embrace it even, it will both hurt less and release energy for you to discern and follow a wiser course of action.

The pain of compassion is emotional rather than physical, taking the form of any or all the emotions associated with threat and loss: principally bewilderment, anxiety, doubt, anger, shame, guilt and sadness. These feelings colour our thoughts about other people's distress, and drive our actions accordingly.

Compassion is accompanied by the desire to reduce suffering, and this is where wisdom comes in. We need the wisdom to speak and act appropriately, to avoid for example making things worse by over-reacting. Often, however difficult it seems, we do well to refrain from speaking and acting prematurely, fired up by anxiety, anger or guilt.

We need to be sure that we are genuinely motivated by compassionate fellow-feeling, rather than simply and selfishly wishing to diminish our own misery and misgivings. We may need to spend  time watching and listening, reflecting on the possible consequences - destructive as well as constructive - of what we are about to do to try to help. Brief reflection can take on many of the characteristics of prayer. It's legitimate whenever challenged to seek the blessing of a higher power, requesting strength, courage and wisdom. Prayer, for many, also brings renewal of hope.

In the face of suffering, we are wise at all times realistically to recognise our limitations. We may frequently have to admit being helpless and out of our depth. Compassion can really hurt then...a lot! The other person's pain and distress continue and it feels as if we can do nothing about it. It takes wisdom not to exhaust ourselves in futile activity and accept that we can do nothing. We can do nothing except be present to the pain and share it... But that is not ‘doing nothing'! It takes courage and generosity of spirit to stay closely in touch with another person's emotional and physical pain. It's a noble course of action. The sufferer, fearful of abandonment, feels valued and comforted, and is usually grateful. There is the possibility of gain for both parties.

Compassion, deeply-seated, is integral to each of us; part of the glue that bonds us together as families, communities and societies. It is not a choice. It cannot be deleted. It can be ignored... But it is much better acknowledged, accepted and embraced. Compassion really hurts...

But it's worth it.

Copyright Larry Culliford

Larry's books include ‘The Psychology of Spirituality', ‘Love, Healing & Happiness' and (as Patrick Whiteside) ‘The Little Book of Happiness' and ‘Happiness: The 30 Day Guide' (personally endorsed by HH The Dalai Lama)