title: Non-verbal communication of compassion: measuring psychophysiologic effects.
abstract: BACKGROUND
  Calm, compassionate clinicians comfort others. To evaluate the direct psychophysiologic benefits of non-verbal communication of compassion (NVCC), it is important to minimize the effect of subjects' expectation. This preliminary study was designed to a) test the feasibility of two strategies for maintaining subject blinding to non-verbal communication of compassion (NVCC), and b) determine whether blinded subjects would experience psychophysiologic effects from NVCC.
  
  
  METHODS
  Subjects were healthy volunteers who were told the study was evaluating the effect of time and touch on the autonomic nervous system. The practitioner had more than 10 years' experience with loving-kindness meditation (LKM), a form of NVCC. Subjects completed 10-point visual analog scales (VAS) for stress, relaxation, and peacefulness before and after LKM. To assess physiologic effects, practitioners and subjects wore cardiorespiratory monitors to assess respiratory rate (RR), heart rate (HR) and heart rate variability (HRV) throughout the 4 10-minute study periods: Baseline (both practitioner and subjects read neutral material); non-tactile-LKM (subjects read while the practitioner practiced LKM while pretending to read); tactile-LKM (subjects rested while the practitioner practiced LKM while lightly touching the subject on arms, shoulders, hands, feet, and legs); Post-Intervention Rest (subjects rested; the practitioner read). To assess blinding, subjects were asked after the interventions what the practitioner was doing during each period (reading, touch, or something else).
  
  
  RESULTS
  Subjects' mean age was 43.6 years; all were women. Blinding was maintained and the practitioner was able to maintain meditation for both tactile and non-tactile LKM interventions as reflected in significantly reduced RR. Despite blinding, subjects' VAS scores improved from baseline to post-intervention for stress (5.5 vs. 2.2), relaxation (3.8 vs. 8.8) and peacefulness (3.8 vs. 9.0, P < 0.05 for all comparisons). Subjects also had significant reductions in RR (P < 0.0001) and improved HRV (P < 0.05) with both tactile and non-tactile LKM.
  
  
  CONCLUSIONS
  It is possible to test the effects of LKM with tactile and non-tactile blinding strategies; even with blinding in this small preliminary study, subjects reported significant improvements in well-being which were reflected in objective physiologic measures of autonomic activity. Extending compassion is not only good care; it may also be good medicine.
  
  
  BACKGROUND
  US National ClinicalTrials.gov registration number, NCT01428674.
authors.affiliation: Social Science and Health Policy, Pediatrics, Center for Integrative Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA. kkemper@wakehealth.edu
authors.forename: Kathi J
authors.initials: KJ
authors.lastname: Kemper
authors.forename: Hossam A
authors.initials: HA
authors.lastname: Shaltout
mesh_terms: D000328:Adult; D001341:Autonomic Nervous System / Q000502:physiology*; D004645:Empathy; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D019122:Meditation; D009633:Nonverbal Communication / Q000502:physiology* / Q000523:psychology; D011603:Psychophysiology; D012063:Relaxation; D019124:Therapeutic Touch; D016896:Treatment Outcome; D055815:Young Adult