Forgive and your health won't forget

New research on forgiveness is spurring a shift in the medical treatment of patients.

There's no getting around it - forgiveness is good for you and holding a grudge is not.

While many people believe that to forgive someone is to let that other guy off the hook, maybe undeservedly, evidence is mounting that it's the one who stops holding a grudge who finds a new lease on life - and on health and well-being.

A growing body of research reveals that those who are forgiving not only have improved relationships, but fewer health problems and lower incidence of the most serious illnesses.

To be angry is not good for your health, says Herbert Benson, president of Harvard's Mind/Body Medical Institute. "Hatred is a banquet until you recognize you are the main course." Forgiveness reduces anger and stress, and 60 to 90 percent of all the business that comes to physicians is stress-related, he says.

Research also shows that people who receive training in forgiveness experience significant reduction in depression, and gain in self-confidence, vitality, and hope.

With such promising results, forgiveness, along with other mind-body research, is encouraging a fundamental shift in the treatment of patients and in the training of doctors, psychologists, and other caregivers.

The benefits of choosing forgiveness accrue in everyday life as well as in treating those in the most severe circumstances. For instance:

• After six years of deep hurt and hatred over a nasty divorce, Catherine O'Brien, a video producer at Stanford University, says she "was liberated by forgiving." A friend weary of listening to her grievances gave her a tape on forgiveness by Fred Luskin, a Stanford psychologist. When she listened to it, she says, "it was a light-bulb moment - it changed everything." She was able to get rid of her bad feelings, reestablish a relationship with her ex-husband, and, she adds, learn not to take things so personally in other situations.

• At a residential center for men with difficult cases of drug and alcohol abuse, a recent six-week training project in forgiveness showed significant results. Patients in the center's traditional rehab program improved but remained clinically depressed.

Those in forgiveness training "went from severe and moderate depression to a nondepressed state," says Robert Enright, professor of educational psychology at the University of Wisconsin, Madison. Four months later a retest showed the latter maintained their health and "were much more confident they would avoid drug abuse in the future."

Anger management for children

Dr. Enright, who is considered "the father of forgiveness research," began the first scientific studies in the late 1980s into a topic long considered the domain of religion. The latest research sponsored by the university's International Forgiveness Institute (IFI) shows the potential of forgiveness in treating particularly challenging cases:

• After a 12-week forgiveness program in Rio, Wis., sixth graders with high levels of anger became less angry, began cooperating in class, had fewer detentions and suspensions, and improved their grades, in comparison with a control group. The aim is to treat such children without using drugs.

• At Mendota Mental Health Center in Madison, men with mental illness who had committed serious crimes participated in a year-long forgiveness project. Usually such men cannot feel a sense of empathy toward their victims, Enright says. They were helped to look backward and forgive someone who had abused them in the past. "This gave them hope and higher self-esteem, and helped them understand [the feelings of] their victim; some have begun developing a sense of sorrow for what they've done," he says.

Mara Alper, a TV producer from Ithaca College in New York who is working on a documentary, interviewed four of the men during the project and a year later. "Forgiving seemed to defuse a huge amount of negative energy that was stored up," she says. "They felt much calmer, much slower to anger, and able to deal better day to day with their emotions. They are still, though, finding it hard to forgive themselves."

Enright says the IFI has also just completed the first study ever to show a cause-and-effect finding regarding physical health. Other studies have demonstrated relationships between forgiveness and health, but their project with cardiac patients at the Veterans Administration hospital showed significantly improved heart functioning three months following a 12-week forgiveness program.

Shift away from focus on disease

The forgiveness field is part of a fundamental shift evident in some scientific disciplines from focusing research on the negative, deficit, or disease model of human nature to studying the positive and thriving aspects of human nature as a basis for healing.

In therapy, psychologists have traditionally emphasized a nonjudgmental approach to the patient, and this, some say, has allowed patients to view themselves largely as victims. Dr. Luskin, who heads the Stanford Forgiveness Project, focuses in his public classes and training of therapists on showing people that they are not victims of the past but can take control of their lives.

"Life has thrown you a curve you weren't prepared to handle; now what?" he says, indicating his direct approach in an interview. He spent years being angry with his former best friend over a grievance, he says, and recognizes three components to a long-standing hurt: the exaggerated taking of personal offense, blaming the offender for how you feel, and the creation of a grievance story.

Now he says "forgiveness is a quality inside ourselves we all can access, and we are responsible for our own emotional condition."

It is also a skill that can be taught, and he spells out the steps in "Forgive for Good: a Proven Prescription for Health and Happiness" (HarperSanFrancisco, 2001), and on tapes like the one that helped Ms. O'Brien.

Both Luskin and Enright have projects working with people in Northern Ireland - Luskin with adults, and Enright with schoolchildren.

Several other researchers spoke last weekend in Boston at the latest Harvard Medical School course on "Spirituality and Healing in Medicine," which focused on forgiveness and its role in healing.

Everett Worthington, a clinical psychologist in Virginia and director of the national Campaign For Forgiveness Research, has studied issues of justice and how people close the "injustice gap" they feel when they are hurt. He found that a strong apology and/or restitution has a significant positive effect on their reactions and willingness to forgive; a weak apology can cause a negative reaction.

Michael McCullough, associate professor of psychology at the University of Miami, has looked at how people take away the motivation to be vengeful. His findings show that vengeful people get caught up in rumination, hang on to their anger, and fail to make an effort to change negative emotions for positive ones.

"A key finding is that entertaining fantasies of revenge - such as sitting in a car and thinking about getting back at someone - is accompanied by a lot of psychological strain," he says in an interview. "We still have to connect the dots on whether that has health effects."

Helping people exchange negative emotions for positive ones is now a central focus of training at Harvard's Mind/Body Medical Institute. Part of last weekend's course (the participants were largely health professionals and hospital chaplains) explored healing through contemplation and forgiveness. The institute teaches meditation, including the contemplation of positive qualities - such as appreciation, perfection, serenity, love - as a daily practice.

Health caregivers are encouraged to explore forgiveness and spiritual issues in their own lives, so they can give more compassionate help to patients.

"Sometimes problems are fixed technically, but healing doesn't occur on deeper levels," says Christine Puchalski, course director and assistant professor of medicine at George Washington University.

A panel of chaplains and practitioners from various religions - Christian, Jewish, and Muslim - shared their faith perspectives on forgiveness and healing. Honor Hill, a Christian Science practitioner from Dallas, said, "Loving your enemies is where the rubber of Christianity hits the road." She told of a young deaf woman with great bitterness toward her father who regained her hearing after finding forgiveness.

Later, when an audience member spoke of the necessity - along with the focus on individual healing - to consider the place of forgiveness on the societal level, the crowd erupted in applause.

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