The forgiveness cure

It took Dr Robert Enright 36 years to get his research proposal to test forgiveness therapy among prisoners in a maximum security prison approved, but by 2020, its time had come. 

“Once we finally got it in after being rejected for grants at least five times, this study in maximum security prison has now been shown to be the strongest set of data for emotional healing ever published in the correctional context,” he says. 

The very idea of helping prisoners forgive childhood abuse, rather than seek forgiveness for their crimes, was so abhorrent to some that Enright, recognized as a pioneer in the study of forgiveness who has twice been nominated for a Nobel Peace Prize, says he was originally seen as a “total embarrassment” to the granting agency.

“What we have to deal with is what I call the paradox of forgiveness: we have to get people to accept that no matter how outrageous forgiveness seems, it’s not outrageous at all,” he says. For University of Wisconsin-Madison professor Enright, forgiveness is a moral virtue that must ultimately involve extending mercy to the offender as an undeserved gift. It’s a challenging definition that has its critics.

“A lot of times we see that people who are most resistant to forgiveness, clinically, are actually the most hurt. They’ve been so hurt that forgiveness is seen almost as an abomination,” he says. 

“So the resentment builds up, the hatred builds up, and therefore the anxiety and depression can build up. We have found that when you have been gravely hurt by others, forgiveness really is the treatment of choice.”

Since the first rejection of Enright’s prison proposal, the science of forgiveness has exploded into a multidisciplinary field that has produced over 3,000 published articles showing forgiveness of transgressions, from minor hurts to major crimes, has a range of physical and mental health benefits. Many of those benefits have been associated with reductions in stress. 

A UCLA study that monitored 332 people between 16 and 79 years old for five weeks, for instance, found their stress levels rose and fell in proportion to resentment and anger, but decreased when forgiveness was practiced.1 The same psychologists found that cumulative lifetime stress among 148 young adults was linked to increased mental health problems, but that correlation was lessened and in some cases almost erased by forgiveness.2

The 24 male prisoners in Enright’s 24-week study were particularly good test material because they were, quite literally, captive subjects. By learning to forgive, the men’s anger and depression fell below clinical thresholds. Their anxiety also fell, and their empathy grew. Six months later, the improvements were still apparent.3

A similarly remarkable result was recorded after elderly terminally ill cancer patients underwent a four-week program of forgiveness therapy. They improved on all psychological health measures, including hope for the future, even though they had six months or less to live.4 Both sets of results validate an intangible quality of forgiveness: that it improves wellbeing regardless of life circumstances.

The toxicity of resentment

Rumination, says Dr Everett Worthington, is what psychologists call the “universal bad boy of mental health.” Forgiveness researchers have identified this unwanted form of obsessive thinking as one of the chief results of the unhealed emotional wound of an old transgression or injustice.

“Rumination is related to anger disorders, depression, anxiety, post-traumatic stress disorders, obsessive-compulsive disorders,” says Worthington, an emeritus professor at Virginia Commonwealth University. “When we forgive, it quiets a lot of that rumination down, so there are more benefits in terms of psychological wellbeing and happiness … as opposed to holding on to grudges.”

Worthington and Enright have become adept at distilling decades of research into relatable language. Phrases like “holding a grudge” stand for anger that calcifies into long-term resentment, hostility and a desire for revenge. Ruminating on an old transgression is a symptom of what researchers call “unforgiveness.”

“Unforgiveness is a stress response that people have, and the body attempts to deal with it a lot of different ways,” Worthington says. “Our sympathetic nervous system gets turned on, [we] get that fight-and-flight reaction more often, cortisol gets generated and can become high at a basal level.” 

Chronically high levels of the hormone cortisol increase vulnerability to illness and disease and compromise the immune system down to the cellular level by disrupting the balance of signaling proteins called cytokines, he says.

High cortisol can even shrink the brain, including the hippocampus, the domain of memory and learning. In 2018, researchers from Harvard Medical School published a study showing that among a large group of healthy middle-aged adults, the participants—especially women—who had high blood cortisol levels over time had poorer memory and reduced brain size.5  

At Worthington’s lab in Virginia, his team measured cortisol levels in the saliva of 39 people at either end of a relationship quality spectrum. Those with unhappy relationships had higher baseline levels of cortisol and were less willing to forgive.6 

Researchers at Michigan’s Hope College monitored the blood pressure, heart rate, facial muscle tension and sweat gland activity of a group of subjects when asked to think about someone who had mistreated or offended them. Predictably, their stress reaction soared. However, when the group practiced forgiveness, it returned to a normal baseline.7

The explanation, according to Worthington, is that forgiveness activates the parasympathetic nervous system, which moderates the hyperarousal caused by the sympathetic nervous system. 

“Humans are unique in the extent to which they can mobilize the stress response for sustained, psychological reasons,” Robert M. Sapolsky, professor of biology and neurological sciences at Stanford University, writes in Handbook of Forgiveness (Routledge, 2019), “and Westernized humans are unique in living well enough and long enough to pay the price for this.” 

High levels of cortisol can also attack the cardiovascular system. A meta-analysis of 25 studies by researchers at University College London revealed a strong connection between anger sustained over time and heart attacks, especially for men.8 

In another study, nuclear imaging showed that 32 cardiac patients assigned interpersonal forgiveness sessions became emotionally healthier as well as developing better functioning arteries after 10 weeks.9 “Basically, if you get an opportunity not to hold a grudge,” Worthington deadpans, “it’s better not to.”

To forgive or not to forgive

“To forgive is to assume a larger identity than the person who was first hurt,” the poet and philosopher David Whyte once observed, “… and through a kind of psychological virtuosity, extend our understanding to one who first delivered [the blow].” It’s a sentiment that perfectly captures the healing arc of Enright’s forgiveness therapy program, a clinical intervention sanctioned by the American Psychological Association. At the heart of this model is the understanding that forgiveness is a choice. 

Some critics argue that forgiveness risks letting the perpetrator off the hook, but Enright says it does not mean forgetting, nor does it imply reconciliation. Citing Aristotle, he says forgiveness and justice are complementary. In an ideal world, the offender would confess and express remorse, but the paradoxical strength of forgiveness is that it does not require an admission or apology in order to heal. 

In one clinical trial, forgiveness therapy was put to the test by a group of 20 women who had been emotionally abused by their former spouses. The process of mourning, letting go of resentment and forgiving over a period of almost eight months resulted in significant improvements in anxiety, depression, PTSD symptoms and self-esteem.10  

In describing the results of a 14-month treatment of 12 abuse survivors overseen by University of Northern Iowa professor Suzanne Freedman,11 Enright says the therapy involved decoupling the offending person’s identity from their actions. and in the process freeing the survivor from identifying with the trauma. “We have found that it’s very easy for those who have been brutalized by others to define themselves by those events. So they are almost frozen in time,” he says. 

“We are not excusing those actions, they were horrendous, but there’s a humanity to that other person that we need to take into account. It’s the same thing with the forgiver, because at the end of the day, forgiveness reconstructs personhood both in you and in the other.”

Sorry seems to be the hardest word

Another paradox of forgiveness is that the more blatant the offense, the more likely it will be denied by the perpetrator. Harriet Lerner, a clinical psychologist and author of 12 books, attributes that to the connection between self-worth and shame. 

An offender mired in self-loathing does not have the capacity to separate the offense from their identity. Yet, receiving a sincere apology is one of the most powerful factors that elicits forgiveness. Apology and/or restitution lead to greater empathy for the wrongdoer and less anger.12 

Lerner, who has been studying apologies for over 20 years, says there is huge cultural pressure to forgive even more egregious offenses, but letting go and forgiveness have been conflated in the research. “Not everyone is capable of radical forgiveness, nor does everyone strive for it,” she writes in Why Won’t You Apologize: Healing Big Betrayals and Everyday Hurts (Gallery Books, 2017). “There is nothing lesser or closed-hearted about the person who seeks alternative strategies to releasing themselves from life-draining anger, bitterness and pain.”

Worthington’s five-step therapeutic model breaks down forgiveness into two types. The first is a “behavioral intention statement,” in which a choice is made to treat the offender as a valued and valuable person. He calls this “decisional forgiveness.”

“The problem is that people can make a sincere decision to treat the person differently, carry it out for the rest of their lives, and still feel enormous emotional and motivational upset when they think about the issue,” he says. 

For some couples, for instance, “unforgiveness” becomes part of a vicious cycle. A review of 17 empirical studies of forgiveness in marriage concluded that compromise between partners has a tendency to turn into competitiveness and keeping score after a betrayal.13 Complicating matters is that after a conflict, each partner “encodes and recalls harm-doing events in self-serving ways,” the authors write. 

When the intention to forgive and change behavior alone isn’t enough, Worthington defines a deeper type of forgiveness: emotional forgiveness is the replacement of negative emotions with other-oriented emotions such as empathy, sympathy and compassion. 

Forgiveness therapy

Dr Fred Luskin, director of the Stanford University Forgiveness Project, places forgiveness on a continuum of grief. According to him, genuine forgiveness can only take place after the painful process of working through all the stages of grief, and forgiveness itself is not a one-off act. 

“To become a forgiving person, we have to practice forgiving smaller grievances. Then, when a bigger insult comes, we are ready, willing and able to deal with it,” writes Luskin in Greater Good  magazine. “We cannot end the cruelty on this planet. What we can do is forgive the unkindness that comes our way and put energy toward meeting our positive goals. Then we can help others do the same.”

Enright says forgiveness therapy works where other therapies and practices have failed partly because it is not compressed within a time frame that suits quick correlational studies. “Suzanne Freedman, when she did her study with incest survivors, had 54 weeks one-on-one, an hour a week with the survivors until they said they were done,” he says. 

Enright’s forgiveness therapy model is a 20-step process, but its pathway follows four main phases. First, people acknowledge that they have been treated unjustly, and that they are hurt and angry. Second, they come to terms with the definition of forgiveness. This is the point of choice, and therapy cannot proceed without a conscious decision to forgive. 

The third step is “cognitive forgiveness”—beginning to think of the offender as a whole person. The final and most difficult step is emotional forgiveness, which means extending mercy and compassion to the offender. 

Eighteen years after the incest survivors study, one of the 12 women said it remained a guiding influence in her life. “Forgiveness is not just an act—it’s a way of life,” she said. 

“My strongest beliefs are not necessarily religious ones, but ones rooted in Mother Theresa’s idea that, ‘We cannot hate someone whose story we know.’” Perhaps this was an example of poet Whyte’s “psychological virtuosity,” using the powers of empathy and imagination to make a bold leap into another’s experience.

To err is human …

Until the watershed work of the Truth and Reconciliation Commission at the end of apartheid in South Africa, there had been a dearth of research on forgiveness, which has been attributed to religion’s monopoly on the concept. 

Worthington’s own faith not just in forgiveness but in God was tested on the crucible of the unimaginable when his mother was brutally murdered by an intruder on New Year’s Day in 1996. 

“Trying to forgive my mom’s killers was like standing in a storm on top of Mount LeConte. My instinct was to huddle down in pain,” he wrote in Christianity Today. Worthington was able to forgive, but not without prayer that helped him weather his “spiritual crisis.” 

Associate professor of psychology at Baylor University Jo-Anne Tsang found that people who identified as religious were not necessarily more forgiving of relatively recent transgressions, but were more forgiving over time.14 Loren Toussaint, a professor of psychology at Iowa’s Luther College, led a team that found that among a group of 1,500 Americans, older and middle-aged people were more forgiving than younger adults.15 

Furthermore, those who were more forgiving experienced greater health and wellbeing benefits, and they also reported feeling  more forgiven by God. This association between forgiveness and better health has been replicated in another study of over 1,600 Americans.16

The relationship between forgiveness, religion, scriptural interpretation and prayer is forbiddingly complex, but one George Fox University study found a potential area of common ground.

The authors write that devotional time spent in prayer is a decentering experience that moves the individual from self-absorption to reflect on the offender’s humanity.17 This other-oriented focus or empathy is not just a psychological construct, but has been linked to specific areas of the brain involved in forgiveness.

Wired for forgiveness?

When British researchers Peter Woodruff and Tom Farrow attempted to map the neurology of forgiveness, they found that when people either empathized or forgave, similar areas of the limbic centers of the brain were activated. When asked to think about the fairness of transgressions, however, the subjects found it harder to forgive, and those emotional centers were less active.1

These results suggest a distinction between reasoned judgments, usually associated with the cortex, and the areas of the brain associated with empathy and social cohesion when someone chooses to forgive.

In The Forgiveness Project: Stories for a Vengeful Age (Jessica Kingsley Publishers, 2016), author Marina Cantacuzino cites the case of Susan Lawler, whose father killed her mother in 1999, to show that even a small amount of empathy is necessary for forgiveness.

Thirteen years after the murder, Lawler visited her father, diminished by multiple heart attacks, in prison. She was overcome by compassion.

Lawler writes: “I’ve come to believe that we all have good and bad in us; we’re all figuring life out as best we can. When people make the wrong choices, they are figuring it out, too. Forgiveness is not about forgiving the act but forgiving the imperfections inherent in all of us.”

Luther College professor Loren Toussaint called such acts of generosity “heroic forgiveness.” But are we predisposed to forgive?

In 2018, a team of British psychologists ran a series of experiments with over 1,500 subjects that shed light on the general human inclination to forgive.2 The participants observed two strangers choose whether to administer electric shocks to another person for money. The “good” stranger mostly refused, while the “bad” stranger took advantage of the opportunity.

The subjects were quick to adjust their negative impression of the “bad” stranger when they witnessed an occasional generous act. In short, they doubted that the person was truly bad.

“The brain forms social impressions in a way that can enable forgiveness,” Yale psychologist Molly Crockett said about the study. “We think our findings reveal a basic predisposition toward giving others, even strangers, the benefit of the doubt. The human mind is built for maintaining social relationships, even when partners sometimes behave badly.”

The instinct to absolve wrongdoing to maintain a relationship is partly why critics claim such contrived forgiveness can be damaging. A study published this year in the Journal of Personality and Social Psychology found that people judge loved ones less harshly after unethical behavior compared to strangers or acquaintances, but that seemingly forgiving attitude came at a cost: they suffered more guilt, shame and embarrassment when someone close to them acted immorally.3

The South African truth and reconciliation experience

After apartheid was dismantled in South Africa in the early 1990s, the new government set up the Truth and Reconciliation Commission in 1996 as a public body to hear testimonies of human rights violations and, in some cases, grant amnesty and reparations.

The Commission used the strategy, also echoed in Lerner’s work, to end the “injustice gap” felt by the victim/survivor by truth-telling on both sides and the victim receiving an apology.Speaking at a hearing into the Bisho massacre in the Eastern Cape in 1996, the late Archbishop Desmond Tutu, the commission chairman, told the audience: “[We] are people who know that when someone cannot be forgiven there is no future.” The statement became a credo that cut across the religious-secular divide.

Stellenbosch University professor Pumla Gobodo-Madikizela uses a word from the Xhosa language—the most widely spoken African language in South Africa—to evoke a deeper meaning for the kind of empathy that allowed the victims of brutal crimes to forgive the perpetrators. 

Loosely translated as “umbilical cord,” inimba means much more. Gobodo-Madikizela, who served as a member of the Truth and Reconciliation Commission, told Iranian-American author Zara Houshmand that she first understood its significance when a woman whose son had been murdered used it after coming face to face with the police informer responsible.

“His vulnerability evoked for her the nakedness of an infant in the womb,” recounts Houshmand in “Ubuntu and the Politics of Forgiveness” (ubuntudialogue.org). “She felt empathy for the mother who gave birth to him, who had named him Tibelo, which means ‘prayer,’ and who would have been pained to know of his deeds.” 

For Gobodo-Madikizela, inimba embodies a form of empathy central to the South African way of life called ubuntu, succinctly defined by Archbishop Tutu as: “I am because we are.”

The social good

As an unabashed optimist, Enright wants such recognition of our interdependence to be the norm, not an outlier in a polarized world. “We do forgiveness education in conflict zones around the world for that reason,” he says. “A major problem of not healing from that is passing it on to one’s children, who then pass it on to their children.”

Northern Ireland has been just one of the global hot spots that Enright and the International Forgiveness Institute have taken their research. After two studies showed a significant reduction in anger among students in Belfast,18 researchers moved the teaching of a forgiveness curriculum from schools to parents at home. In the end, the parents internalized the content and proved more forgiving than their children on the study measures.19

Arguing for a new paradigm, Enright cites intergenerational studies showing that the children of Nazi concentration camp survivors inherited higher levels of emotional stress than their parents. 

“We’re just saying, you practice moral virtues in your life all the time: patience, tolerance, justice. Why can’t we add one more moral virtue that has been totally ignored in secular society? Forgiveness. If we did, there would be a qualitative shift in relationships within families, between partners and, I think, communities. It’s way overdue.”

A study by researchers at Cardiff University on the role of forgiveness in family relationships supports this view. Forgiveness modeled by parents was linked to more expressiveness in the family, less conflict and anxiety, more cohesiveness and better marriage.20

“There’s an intangible sense of legacy that most people don’t think about,” Enright says, “and in fact, if our children can inherit our anger, and our grandchildren’s grandchildren can inherit that anger, is it possible that they could inherit our greater softness, our compassion and our love?”

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