When you engage in compassion, and you hear a distressing sound, like someone calling for help, there is an activation in an area of the brain called the insular, which has to do with empathy and altruism, that is vastly more activated than in non-meditators.
Neuroscience has proven that similar areas of the brain are activated both in the person who suffers and in the one who feels empathy. Thus empathic suffering is a true experience of suffering.
Empathy is the faculty to resonate with the feelings of others. When we meet someone who is joyful, we smile. When we witness someone in pain, we suffer in resonance with his or her suffering.