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Originally published Wednesday, February 13, 2008 at 12:00 AM

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Researchers say forgiveness can prevent disease, preserve health

University of Wisconsin psychologist Robert D. Enright, the guru of what many are calling a new science of forgiveness, calls this final step...

Los Angeles Times

Close your eyes and think of someone who has hurt you. The offense might be profound or small but deeply painful, a single arrow to your heart or a thousand wounding slights. The perpetrator might be a stranger — the guy who caused your accident. More likely, it will be someone close and trusted. The sister who killed herself. The parent who lashed out, the spouse mired in addiction, an unfaithful lover.

It might even be yourself.

Let all the anger, hurt and resentment you feel for that wrongdoer bubble to the surface. Seethe, shout, savor it. Feel your heart pounding, your stomach churning and your thoughts racing in dark directions.

OK, stop. Now, forgive your offender. Don't just shed the bitterness and drop the recrimination, but empathize with his plight, wish him well and move on — whether he's sorry or not.

University of Wisconsin psychologist Robert D. Enright, the guru of what many are calling a new science of forgiveness, calls this final step "making a gesture of goodness" to a wrongdoer. It's the culmination of a process that, he insists, "you've got to be able to see through to the end."

But why, exactly, would you do that? For the good of your soul? To hold the family or business together, to make the world a better place?

A growing corps of researchers thinks they have it. Forgiveness — a virtue embraced by almost every religious tradition as a balm for the soul — might be medicine for the body, they suggest. In less than a decade, those preaching and studying forgiveness have amassed an impressive slate of findings on its possible health benefits.

They have shown that "forgiveness interventions" — often just a couple of short sessions in which the wounded are guided toward positive feelings for an offender — can improve cardiovascular function, diminish chronic pain, relieve depression and boost quality of life among the very ill.

An AIDS patient who has forgiven the person presumed to have transmitted the virus is more likely to care for him or herself and less likely to engage in unprotected sex. Those more inclined to pardon the transgressions of others have been found to have lower blood pressure, fewer depressive symptoms and, once they hit late middle age, better overall mental and physical health than those who do not forgive easily.

Like proper nutrition and exercise, researchers say, forgiveness appears to be a behavior that a patient can learn, exercise and repeat as needed to prevent disease and preserve health.

"Who would have thunk it — that something locked away in religious culture could be turned into a secular training program," says psychologist Fred Luskin, director of Stanford University's Forgiveness Projects and a leading researcher in the field who teaches groups — many of them bound together in the workplace — to forgive offenses large and small. "It's a skill that can be taught."

Middle-age connection

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Psychologist Loren Toussaint of Luther University in Decorah, Iowa, and colleagues were the first to establish a long-term link between people's health and their propensity to forgive.

Their national survey, published in the Journal of Adult Development in 2001, found forgiveness rare enough: Only 52 percent of Americans said they had forgiven others for hurtful acts. But willingness of young respondents to forgive showed no link to health; that propensity began to make a difference as respondents approached middle age. The survey found that those 45 and older who forgave others were more likely to report having better overall mental and physical health than those who did not.

Efforts to put forgiveness to a rigorous scientific test have been funded largely by two philanthropies long associated with research on faith, religion and science: the Michigan-based Fetzer Foundation and the John Templeton Foundation of Pennsylvania, which effectively created the field in 1997 with a pledge of $2 million for research on forgiveness. The leading thinkers on the subject are clinical and academic psychologists whose devotion to the goal of forgiveness either springs from religious teachings or verges on the religious.

To many in mental health who fear that traumatized patients face pressure to forgive when doing so is premature or ill-advised, the new science of forgiveness is worrisome. "The whole Christian, 12-step mentality has permeated our culture, and the emphasis on forgiveness is part of that," says Jeanne Safer, a New York psychoanalyst and author of "Must We Forgive?" "For many patients, forgiveness is a double-whammy: First someone screws you, and then it's your fault you don't want to embrace them in heaven. I'm not against forgiveness; I'm against compulsory forgiveness with no choice. And I'm against 'forgiveness lite,' which keeps you from feeling the intensity of the experience, from deeply grappling with what's been done to you."

Among victims of incest — many of whom have turned blame inward or fear that forgiveness entails reconciliation with an abuser — pressure to forgive can be stressful and sometimes impossible, says Linda Davis, the executive director of Survivors of Incest Anonymous. "I always tell ministers, 'Don't use the F-word.' "

"You have to get to a place of acceptance," Davis says. "Forgiveness is a bonus. You don't have to get there."

Forgiveness of self

Scientific scrutiny has a way of upending pious notions, and the science of forgiveness is no exception. While much of the field's early work has focused on forgiveness of others, academic psychologists and clinicians are turning up evidence that forgiving oneself might have a more powerful effect on overall health and well-being.

Eruptions of anger at others have been shown, clearly, to increase the risk of heart arrhythmias, heart attacks and high blood pressure, says Dr. Douglas Russell, a Veterans Administration cardiologist who, in a 2003 study, found that the coronary function of patients who had suffered a heart attack improved after a 10-hour course in forgiveness.

But when anger is turned inward and directed at oneself, lack of forgiveness appears likely to have an ongoing, toxic health effect that might be even more corrosive to physical and mental health than anger directed outward.

"Sometimes people hurt us, and we move on, and it might fade," says Toussaint, the psychologist. As he has refined that work with better definitions of forgiveness, however, Toussaint says he has been surprised to learn that those who hold onto self-blame might suffer more.

"Forgiveness of self holds the more powerful punch," Toussaint says. "The effects are dramatic."

In work not yet published, Toussaint found that men who do not forgive themselves readily are seven times more likely to meet the full diagnostic criteria for clinical depression than men who do.

Highly self-forgiving women are three times less likely to have the symptoms of clinical depression — a risk factor for a host of ills — than their sisters who are prone to regret and self-blame.

Those more forgiving of themselves also sleep more and are in better overall health, he has found.

It's an effect that Toussaint has seen extensively — with related health effects — in combat veterans who come home unable to forgive themselves for what they did, or did not do, in battle. Other researchers have studied self-blame and forgiveness in cancer patients, those living with HIV/AIDS and victims of incest and abuse, many of whom blame themselves for their plight.

"The human mind is sometimes an instrument of misery. When you've done wrong to others and regret it, it bubbles up again and again," Toussaint says. "There's no escaping the perpetrator."

The early pioneers of the forgiveness field have focused largely on an unselfish, altruistic version of forgiveness — one that replaces ill will toward hurtful others with positive feelings. By contrast, while the health benefits of forgiving oneself for past mistakes or misdeeds may be considerable, there is arguably little altruism in it, says Safer, the New York psychoanalyst. Does that, she wonders, make it a less appealing object of research or a less worthy goal for clinicians to foster?

And then there is the complex relationship, for many people, between forgiveness of others and self-blame.

Some skepticism

Clinicians skeptical of forgiveness as a necessary endpoint of therapy say they are quick to recognize them: Many of those who are quickest to forgive others, often at the urging of a relative or clergy member, do so because they blame themselves for the bad things that have happened to them. Others forgive too quickly because they are unwilling to acknowledge their general feelings of shame and anger or simply because they feel unworthy of better treatment.

Safer calls this "fake forgiveness." It allows victims to continue blaming themselves, she says. And it's a dangerous side effect of what Safer sees as a bid to sell forgiveness as a panacea.

Jeffrey R., a Maryland man whose father sexually molested him and three siblings as children, acknowledges that self-blame and denial after the abuse has exacted a terrible cost on his family. Two older brothers — both of whom have refused to discuss their father's actions — have had seven heart attacks between them before the age of 60. One is a drug addict for whom a longtime stomach ailment now threatens to become deadly. Another lives alone, "eats unhealthy, lives unhealthy," says Jeffrey, a member of Survivors After Incest who spoke on condition that his full name not be revealed.

"When you have this background, you become very skilled at pretending things are OK, just ignoring it," Jeffrey says. Meanwhile, the guilt, shame and anger, he says, "are just consuming."

After nine suicide attempts and decades of contending with temper and suspicion toward others, Jeffrey says he's not ready to forgive the father who did it, the mother who looked the other way or the aunts and uncles who, after the abuse came to light, refused to discuss it.

His sister, who was raped by her father at 5, has embraced forgiveness, says Jeffrey, telling her brother God will judge their father. Jeffrey insists he's let go of the anger and bitterness caused by his abuse, and it "has saved my life."

But forgiveness on the same level as his sister's? "I'm not really there yet," he says.

Copyright © 2008 The Seattle Times Company

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