By Dr. Dalinda Reese
The “unfairness” of life is a reality that all of us experience in one way or another. We get hurt. Someone treats us poorly. Someone or something special to us moves away or is taken from us. Relationships end. We get sick. What was once normal to us is now gone…. Such are the vicissitudes of life. How we respond can have a huge impact on our well-being.
Enter forgiveness. Really? Is that important? you might ask. It is. Isn't that just a way of excusing bad behavior? Isn't that saying whatever happened was okay or didn't matter? Isn't that just another way of religion making us feel bad about ourselves? I don’t think so.
For eons talk about forgiveness has belonged to the religious realm, but if we can appreciate religions as wisdom traditions, perhaps we can look more closely and openly at what is being said. Clergy, theologians, and philosophers in the earlier part of the 20th century expanded the dialogue on forgiveness. Simon Wiesenthal's book, The Sunflower: On the Possibilities and Limits of Forgiveness, first published in 1969 by Schocken Books, is a classic example of this. Over fifty global leaders, writers, philosophers, spiritual leaders — all luminaries in their own right — were asked to explore and respond to Wiesenthal's questions about his experiences as a prisoner in a concentration camp. While imprisoned, Wiesenthal was summoned to the bedside of a dying Nazi soldier who confessed his atrocities against Jews and asked Wiesenthal for forgiveness. Difficult questions indeed with no easy answers. We may not even have a paradigm that can hold the pathos of those questions.
By the second half of the 20th century, and especially since the 1980s, social scientists have looked at forgiveness through an empirical lens, bringing its exploration from the theoretical, philosophical realm into the measurable realm. All research requires, among many considerations, a definition of terms, determining what to measure, how to measure it, and then deciding what those measurements mean. Yet research on an inter-dynamic and connected “whole” is always limited. By dissecting a matter, we risk losing or missing important aspects. Despite these limitations, the study of forgiveness has provided understandings and tools that may be useful to our lives and to our sense of well-being.
To begin with a basic definition, forgiveness is a change from a negative attitude or behavior in response to a person or event to a neutral or positive attitude or behavior in response to the same person or event. It other words, forgiveness is getting unhooked from a grievance cycle. It is making peace with life’s hurts. Forgiveness is not forgetting, denying, excusing, condoning, or pardoning. It is not pretending something didn’t happen. Forgiveness is not even reconciliation. Although reconciliation can happen, it is not the goal of, nor is it necessary for, forgiveness. Forgiveness is peace and freedom now from a past hurt. Forgiveness is freedom from a pain-perpetuating entrapment.
In general, observational studies suggest that forgiveness correlates with fewer depressive symptoms, a greater sense of well-being, and better health. One study of 1,500 older Americans showed that unconditional forgiveness was associated with fewer mental/emotional and somatic depressive symptoms and a greater sense of life satisfaction and well-being (Krause and Ellison, 2003). Another study of 1,232 older Americans showed that conditional forgiveness (“I will forgive only if…”) was associated with a greater risk of all-cause mortality (Toussaint et al., 2012). A study at Duke University showed that HIV-positive patients with higher forgiveness scores also had evidence of better immune function (Owen et al., 2011). Although not a study of forgiveness, the largest prospective study of aging and health in North America suggests that an adaptive coping style (for example, not being stuck in a grudge) is one of the top predictors of being well at age 80 (Vailliant, 2010).
Interventional studies, in which forgiveness is discussed and taught, suggest that we can learn to forgive and improve our health and well-being. One of the largest of these studies is Dr. Fredric Luskin’s Stanford Forgiveness Project, in which 259 adults who held a grudge (harbored unforgiveness) participated in a series of six weekly small group educational sessions with practice homework between the sessions. Measurements before, immediately after, and several months after the intervention included: degree of emotional hurt, degree of anger, psychological and emotional well-being, likelihood of forgiving offenses, and degree of forgiveness toward offender. This and smaller studies by Dr. Luskin showed that learning to forgive decreased anger and hurt, increased likelihood of forgiveness, improved emotional and psychological health, and a perception of increased health. Interestingly, Dr. Luskin notes that time will decrease the pain of an offense, but forgiveness seems to be important for improving psychological and emotional health. The benefits of forgiveness seem to have staying power. Learning to forgive builds on itself and continues to have a positive impact on how one relates to life’s challenges.
Other interventional studies affirm the positive effects of forgiveness on health. For example, people with coronary artery disease can have episodes of cardiac ischemia (lack of blood flow to areas of the heart) that are related to anger-recall. One study showed that ten weekly forgiveness sessions could significantly decrease how much ischemia is present with anger-recall (Waltman et al., 2009). A study of patients with high blood pressure suggested that learning to forgive may normalize blood pressure in those who have high levels of anger (TD Ellis et al., 2006). And in a small study of women with fibromyalgia who had been abused in childhood, a 24-session individualized forgiveness program increased both forgiveness and overall health (Lee and Enright, 2014).
Forgiveness interventions can vary greatly. In essence, what they seem to have in common is: (1) a clear description of what forgiveness is and especially what it is not, (2) increasing awareness of the ways we habitually think and feel about offenses, (3) and recognizing and further developing our own resources to facilitate forgiveness.
There does need to be safety and also some “distance” from the acute pain and grieving triggered by the offense before talking about forgiveness. Then, the first step in forgiveness is to know exactly how you feel about the offense and to be clear about what was not okay. With that clarity you can explore, understand, and dispute the underlying thought patterns, beliefs, and expectations that keep you stuck. In addition to this cognitive understanding, regular mind-body practices are necessary to help you recognize and grow your heart-centered resources (awareness, mindfulness, presence, gratitude, compassion, loving-kindness, resilience, strength, and such). This allows you to respond, rather than reflexively react, to your perceptions and experiences. Together, the head and heart can help transform the grievance cycle and release the power it has over you.
Life gives us plenty of opportunities to forgive. When I first became involved with forgiveness work, I realized that there were many things in my life that I had indeed forgiven. My own personal spiritual practices had sustained me and facilitated forgiveness of the more egregious hurts that I experienced. The more I work with forgiveness training, the more I see. Forgiveness can involve small things or large things. It can be general or specific. There can be layers and overlaps. It seems once I’ve mastered one thing another presents itself!
A personal example occurred in 2012, shortly after I moved to Ann Arbor to join the holistic practitioners at Bio Energy Medical Center (BEMC). Most of my medical career had been in Virginia, where I had moved after medical school in Ann Arbor to do my internship and residencies. I had taken a six-year hiatus from clinical practice. During that time, I was living in Canada, pursuing latent interests, recovering from burnout, and “re-tooling” to a more holistic form of medicine. As I began working at BEMC, I started having a deep, intense, and persistent right neck and shoulder pain — like a meat hook lodged along the right side of my neck and into my shoulder.
I sought out some craniosacral therapy (energy sensitive, light touch manual therapy). The therapist held her hands over my shoulder and asked if the pain might be related to unforgiveness. The question jarred a response into my consciousness: yes. I knew it had to do with resentment, but not toward any specific person or event. Rather it was a smoldering rage against my whole medical education. My pain and underlying anger surfaced as I was beginning a new practice of medicine in the same place where I had begun my medical education so many years ago. I had survived medical school, but at tremendous personal cost to my sensitive, creative, and introverted self.
I shared this experience with several trusted friends who gently listened and offered their loving support and observations. My goal in forgiveness was to (very literally) release the pain and to hold on to the strength I had discovered. The forgiveness was not immediate, nor was the resolution of the pain. However, with consistent breath and heart awareness work, with cognitive work that included journaling and creative expression, I was able to focus on what had kept that silenced part of myself alive and strong. Within a couple of months, my relationship to that grievance story had shifted and I had forgiven. The neck and shoulder pain was also gone.
As a physician, I understand how what we think, experience, and feel all affect our breathing, heart rate, heart rate variability, blood pressure, hormones, and which areas of the brain and body get the most blood flow and oxygen delivery. With my training and personal experience in spiritual direction, forgiveness work, and resilience, I am equally convinced that our internal physiology influences our perceptions and experiences. Forgiveness is one of our most powerful tools. Listening to the “wise heart” allows us to respond rather than reflexively react. It enables true well-being: mind, body, and heart.
Dalinda Reese, M.D., M.T.S., is a holistic physician, a Lev Shomea (Listening Heart) trained spiritual director, and a master’s degree candidate in spiritual care and psychotherapy. She has been offering forgiveness workshops since 2011.