A New Approach to Reducing Depression

“Forgiveness therapy targets and reduces unhealthy anger.”

Psychological depression occurs in at least 25% of all primary care patients in the United States and yet only about one-third of these are diagnosed as depressed.  Mental illness is not an isolated issue but is associated with such physical compromise as obesity, cardiovascular disease, diabetes, and cancer (American Psychological Association, 2017).  It is estimated that over 14 million people in the United States suffer from major depressive disorder (Depression and Bipolar Support Alliance, 2017).

The good news is that depression is a highly treatable disorder with medication and with such psychological approaches as Cognitive Behavioral Therapy (recognizing and stopping maladaptive thinking and replacing this with more adaptive thoughts and behaviors),  Mindfulness Therapy (being present to the symptoms and not letting troublesome thoughts drift to the past or future), and Behavioral Therapy (engaging in rewarding behaviors).

A new approach, Forgiveness Therapy, focuses on a sequence that is not a common practice in contemporary psychotherapies:

• Examine whether or not you have been treated unfairly, even cruelly, in the past.  Recognize this as unjust.
• Realize that emotional pain is a natural next step when reacting to such unfair treatment by others.  After all, you have a right to be treated with respect, even if this does not occur.
• If you do not find a solution to this emotional pain, eventually you may become angry at the situation and at the persisting pain.
• If you do not find a solution to the growing anger or the emotional pain, then you might develop what we call unhealthy anger, the kind that is so deep that it starts to affect sleep, energy levels, thoughts, and behaviors (Enright & Fitzgibbons, 2015).
• If the unhealthy anger persists, this can develop more deeply into symptoms of depression and anxiety.

The takeaway message from the above sequence is this: For some people, depression is not the only issue to be treated. Instead there are three other, central issues too often missed with traditional therapies: injustice(s) that happen but are not confronted; the emotional pain that ensues; and most importantly for Forgiveness Therapy, the unhealthy anger that fuels the depression in some people.

If you only focus on current medication or current thoughts or current symptoms, you may miss the actual cause of the depression, which could be a build-up of the unhealthy anger caused by emotional pain caused by injustice.

Forgiveness Therapy starts by examining the injustices in your life that may be compromising that life now.  Some people are surprised to learn that they still carry the emotional wounds, for example, from being bullied on the school playground, or being belittled by a parent years ago, or not being given a chance in the workplace when just starting out.  It is this kind of injustice that has to be uncovered and identified as hurtful in the present.

Next comes the challenge of admitting the depth of one’s anger. The norms of contemporary society, that good people do not get deeply angry, can get in the way of this identification, but it is vital to go more deeply than these norms to see if, in fact, the anger is deep, lingering, and harmful.  When unresolved anger from the past mixes with contemporary challenges, then the anger can intensify, compromising one’s well-being and thus leading to depressive symptoms.

At this point, a person may be ready to try to forgive because of this insight: My unhealthy anger is destructive for me.  To forgive is to start the process of being good to those who are not good to you.  It starts with the insight that the other is more than what he or she did to me.  We share a common humanity.  We even might share a common woundedness in that the person wounded me out of his or her own woundedness. Such insights can lead to a softer heart toward the other, which reduces anger to manageable levels, which can lead to a reduction in depressive symptoms.  The more that the unhealthy anger lessens, the more the depression can be reduced (Enright & Fitzgibbons, 2015; Freedman & Enright, 1996; Lin, Mack, Enright, Krahn, & Baskin, 2004).

 

Forgiveness Therapy is not a substitute for medication or for the implementation of other psychotherapies such as CBT.  Forgiveness Therapy can come alongside these well-tested approaches and give you added strength to deal with the depression and to reduce it to manageable levels.  Forgiveness Therapy is not for everyone.  Some just do not want to consider the paradox of offering kindness toward the unkind.  This form of therapy needs to be willingly chosen by the client.  It is new but tested both scientifically and clinically, and it works.

Do you have injustices, even from your distant past, that are getting in the way of your happiness?  If you start the process of forgiving those who have been cruel to you, perhaps the depression not only will be managed but reduced to a degree that may surprise you.

Posted in Psychology Today April 6, 2017

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References:

• American Psychological Association (2017, retrieved). Data on behavioral health in the United States http://www.apa.org/helpcenter/data-behavioral-health.aspx
• Depression and Bipolar Support Alliance (2017, retrieved). Depression statistics.
• Enright, R.D. & Fitzgibbons, R. (2015).  Forgiveness Therapy.  Washington, DC: APA Books.
• Freedman, S. R., & Enright, R. D. (1996).  Forgiveness as an intervention goal with incest survivors.  Journal of Consulting and Clinical Psychology, 64(5), 983-992.

• Lin, W.F., Mack, D., Enright, R.D., Krahn, D., & Baskin, T. (2004).  Effects of forgiveness therapy on anger, mood, and vulnerability to substance use among inpatient substance-dependent clients. Journal of Consulting and Clinical Psychology, 72(6), 1114-1121.

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Why You Might Have Low Self-Esteem and How to Cure That

“Believing the lie that you are less than you are must be seen and resisted.”

Too often when I work with people in Forgiveness Therapy, I see a familiar pattern.  First, the person has been treated badly by others.  If this has been severe or has occurred over a long period of time, then the person begins slowly to incorporate the other’s views into the self.  Eventually, this can become so entrenched inside of people that this lie about who they are becomes part of their identity. Once it is part of their identity, then it is hard to change.  In fact, people can become resistant to change because, after all, this is their identity.  It is who they think they are.  They would rather have a broken identity than to set out on a course of change that is unknown and scary.  Staying with brokenness is easier sometimes than confronting the anxiety of transformation.

And yet, that change is possible and welcomed when the new view of self is more wholesome, more true.  It is worth the initial anxiety to be free of the broken identity which could last for the rest of a person’s life.

Here is how to get started in transforming your self-esteem after you have been treated badly by others:

1)  Stand with courage in the truth: “I was wronged.”  If none of this is your fault, say that to yourself: “This is not my doing.  I did not bring this on myself.”

2)  Stand further in the truth: “Even though this person may have a bad view of me, I refuse to share that view of myself with this person.”  Resist the lie.

3)  As you stand in the truth, be aware of your strength in doing so: “I am enduring what I did not deserve.  I am stronger than I thought.”

4)  Commit to doing no harm to the one who harmed you.  As you do that, reflect on who you are: “I am someone who can endure pain and not return pain to the other.”

5)  Finally, conclude in the truth: “I will not be defined by the injustices against me.  I am more than this. I am someone who endures pain and is a conduit for good to others.”

Who are you now?

Posted in Psychology Today May 09, 2017

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Forgiveness: 3 Misconceptions

When I began 30 years ago to apply social scientific methods to the ancient moral virtue of forgiveness, my students and I ran into a rather large problem.  People were afraid to forgive.  When we probed this fear, we began to realize a common theme across the fearful.  They equated forgiving with automatically and dutifully going back into abusive situations.  “My spouse denigrates me.  If I forgive, then I go back for more……but I do not want to go back for more.  Thus, I will not forgive.”

It took us a while, but eventually we saw that to forgive is not the same as to reconcile.  Forgiveness, as with justice and patience and kindness, is a virtue, originating inside people as an insight (I can be good to those who are not good to me) and as a feeling of  empathy and compassion for the offending other, not because of the offense but in spite of it.  Forgiving behaviors flow from the insight and compassion.

Reconciliation, on the other hand, is a behavioral negotiation strategy in which two or more people come together again in mutual trust.  You can forgive and not trust a person in their weak areas (you do not lend money to the compulsive gambler even though you can try to be good to the person in other ways as a sign of forgiving).  You can forgive and not reconcile at all if the other remains abusive.

Forgiveness is not the same as reconciliation.  This insight opened the door for social scientific work on forgiveness for us because to forgive is not to create unsafe situations for the forgiver.

We now turn to two, what I call, Modern Misconceptions, the latest critiques of forgiveness, particularly Forgiveness Therapy, a new form of psychotherapy which emerged from the research journey begun three decades ago (Enright & Fitzgibbons, 2015).  These Modern Misconceptions are quite different from the early misconception because they target forgiveness itself—not fear—and are highly critical of this potentially life-changing virtue, even if practiced well and with patience.

Modern Misconception 1 goes something like this:  You who advocate for Forgiveness Therapy or Forgiveness Education with students (Enright, Rhody, Litts, & Klatt, 2014) ask way too much of forgivers.  You ask them to bear the burden of their own healing and that is not fair.  They already have been hurt so why ask them now to struggle after forgiveness?

Two burdens are theirs: the original offense and now Forgiveness Therapy.  Yet, as with the equating of forgiveness with reconciliation, this Modern Misconception has an error embedded within it.  It is not at all an added and unnecessary burden to help a person, whose heart is broken, to forgive.

Take a physical analogy to make the point clear.  Suppose James pushes Jeremy to the ground, dislocating his shoulder.  Is it unwise now to ask Jeremy to enter into a rehabilitation process to repair the shoulder?  Is it an added burden we should never ask because he is hurting?  It would seem that the unfairness lies, not in the encouraging of medical treatment, but the reverse—discouraging it because it will be rigorous and painful.

Is it not the same with Forgiveness Therapy for those who choose it?  The heart is broken, yes, because of the original unfairness.  If the person chooses rehab of the heart—Forgiveness Therapy—isn’t this repair good even though rigorous and painful?  The Modern Misconception might keep people from rehab of the heart and so it needs to be challenged.

Modern Misconception 2 has emerged from my giving 13 invited forgiveness talks in an area of the world plagued by a land dispute that is disrupting individual, family, community, and political peace.  The misconception unfolds this way:  You say that forgiveness is good, but how will it get my land back?  It will not get my land back.  Therefore, forgiveness is weak and ineffective.  I will have nothing to do with it.

My response is to give a multiple choice question to the skeptic.  Which of these two would you rather have:

1. You live for the rest of your life without getting your land back and you also live with a deep anger that disrupts your inner life and the life of those around you; or,
2. You live for the rest of your life without getting your land back and you are free of the deep anger that disrupts you, your loved ones, and your community?

Which do you choose?  In every case across the 13 lectures, the skeptic ends up choosing answer (B), living without the debilitating  resentment.  It is at that point that the person is willing to explore the subtleties of forgiveness without dismissing it.  Such exploration could, in the long run, save lives from psychological devastation.  The error in Modern Misconception 2 occurs when the person focuses exclusively on the original problem (land dispute) without even realizing that a second, just as serious, problem has emerged because of the land dispute—resentment entrenched in the heart.  Forgiveness can cure this second problem while not being able to solve the original problem.  Without seeing this, the person rejects forgiveness as weak.

Misconceptions…..they can drive a person away from forgiveness or become a stimulus for more thoroughly exploring what forgiveness has to offer.  Left unexplored, the Modern Misconceptions could leave some people without a path of healing that could have been theirs……if only they had explored more deeply.

Posted in Psychology Today February 18, 2017

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References:

• Enright, R.D. & Fitzgibbons, R. (2015).  Forgiveness therapy.  Washington, DC: APA Books.
• Enright, R.D. , Rhody, M., Litts, B., & Klatt. J.S. (2014). Piloting forgiveness education in a divided community: Comparing electronic pen-pal and journaling activities across two groups of youth. Journal of Moral Education, 43, 1-17.
  

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8 Reasons to Forgive

Forgiveness within psychology is relatively new, having emerged as a research focus in the later 1980’s (Enright, Santos, & Al-Mabuk, 1989). Over the next three decades, a host of studies have emerged within the mental health professions showing that Forgiveness  Therapy is beneficial for the client, for the one who forgives (Baskin & Enright, 2004; Wade et al., 2014). We have to be careful with these findings primarily because a false conclusion could emerge: Forgiveness is only for, or primarily for, the one who forgives; it has little to do with the one forgiven. This, actually, does not seem to be the case. A reflection on what forgiveness accomplishes, its purpose or goal, suggests at least 8 purposes to forgiving.

What does it mean to forgive? Although there may be different behaviors across the  wide variety of cultures to express forgiveness, in its universal essence, forgiveness can be defined as a moral virtue, centered on goodness, that occurs in the context of being treated unfairly by others. The one who then chooses to forgive deliberately tries to eliminate resentment and to offer goodness of some kind toward the offending person, whether this is kindness, respect, generosity, or even love.

The one who forgives does not automatically go back into a dangerous relationship. The forgiver can forgive and then not reconcile. The forgiver does not excuse the unfair behavior but offers goodness in the face of the unfairness. The forgiver should not think in “either/or” terms, either forgiving and abandoning a quest for justice, or seeking justice alone without forgiving. The two moral virtues of forgiveness and justice can and should be applied together.

With this understanding in place, here are at least 8 reasons to forgive. Which of these are in your conscious awareness when you offer this virtue to those who have wronged you?
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When I forgive, I do so:

1. to become emotionally healthier. Forgiving can reduce unhealthy anger.

2. to repair relationships as it helps me to see the other’s worth.

3. to grow in character because it can help me to become a better person.

4. to be of assistance, within reason, toward the one who acted unjustly. Forgiveness extends the hand of friendship even though the other may reject this.
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5. to help me to assist other family members to see that forgiveness is a path to peace.  Forgiveness for peace, in other words, can be passed through the generations.

6. to motivate me to contribute to a better world as anger does not dominate.

7. to help me to more consistently live out my own philosophy of life or faith tradition if that worldview honors forgiveness.

8. to exercise goodness as an end in and of itself regardless of how others react to my offer of forgiving. 

To forgive is to exercise goodness even toward those who are not good to you. Forgiveness is perhaps the most heroic of all of the moral virtues (such as justice, patience, and kindness, for example). I say it is heroic because which other moral virtue concerns the offer of goodness, through one’s own pain, toward the one who caused that pain? Do you see this—the heroic nature of forgiving—as you extend it to others?

Robert

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References:

• Baskin, T.W., & Enright, R. D. (2004).  Intervention studies on forgiveness: A meta-analysis.  Journal of Counseling and Development, 82, 79-90.

• Enright, R. D., Santos, M., & Al-Mabuk, R. (1989).  The adolescent as forgiver. Journal of Adolescence, 12, 95-110.

• Wade, N.G., Hoyt, W.T., Kidwell, J.E.M., & Worthington, Jr., E.L. (2014).  Efficacy of psychotherapeutic interventions to promote forgiveness: A meta-analysis.  Journal of Consulting and Clinical Psychology, 82, 154-170.

Posted in Psychology Today Apr 16, 2018

Your Forgiveness Landscape

First, what is a “forgiveness landscape”? This is an expression first used in my book, The Forgiving Life, to refer to all of the people who ever have been seriously unjust to you. When people first construct their forgiveness landscape, they often are surprised at: a) how many people are on the list and b) the depth of the anger left over, even from decades ago.

When we are treated deeply unfairly by others, the anger is slow to leave. If we push that anger aside, simply thinking we have “moved on” or “forgotten all about it,” sometimes this is not the case. The anger can be in hiding, deep within the heart, and the only way to get rid of it is surgery of the heart—forgiveness.

Would you like to examine your own forgiveness landscape to see how many people in your life are still in need of your forgiveness? You might want to write down your answers to the following questions.

First set of questions: Think back to your childhood. Is there anyone who was very unfair to you and if so, what is your anger level now on a 1-to-5 scale, with 1 signifying no anger left over and a 5 signifying lots of anger when you reflect on this person and the actions toward you.

More specifically from your childhood, are there any incidents from your father that still make you angry? From your mother? A sibling?

What about from peers or teachers; is your anger still high when you recall the incidents?

Second set of questions: Let us now focus on your adolescence. Follow the pattern from the first set of questions. Then let us add any coaches, employers or fellow employees, and romantic partners to the list. Are there people who still make you angry in the 4 or 5 range of our scale?

Third set of questions: Who in your adult life has made you significantly angry, in the 4 to 5 range of anger? We can add partner, any children, relatives, friends, and neighbors to the list.

Now please rank order all of the people from those who least offended you to those who most offended you. Now look at that list to see your forgiveness landscape. There is your work, right there in the list.

I recommend starting with people lower on the list. Forgive them first because they in all likelihood are the easiest to forgive because the anger is less. As you work up the list, you will gain in your expertise to forgive, which is good preparation for forgiving those on the top of the list—those who are the most challenging for you.

You can find more on this way of forgiving in the book,
The Forgiving Life, which walks you systematically through this exercise.

Enjoy the challenge. Enjoy the journey of forgiveness, which can set you free in so many ways.

Robert

Generalizing from the Particular to the Universal

You know how it goes.  You go into a department store and have an unpleasant encounter with the person at checkout…..and you never go back there again.  The particular incident has given you a bad feeling for the entire organization.

You break up with a boyfriend or girlfriend and, at least for a while, you think that no one really can be trusted.  This one relationship makes you mistrustful of such relationships in general.

Generalization.  It can help us when the generalization is true and can distort reality for us when false.  For example, when we touch poison ivy in one woods, it is wise to avoid it in the next….and the next.  The effects of poison ivy generalize regardless of which plant we touch.  On the other hand, one boyfriend’s bad behavior does not predict another person’s behavior.  In this case, generalization closes down our mind and heart when there is no need for this.

When you are hurt by someone, you have to be careful not to generalize this to many, most, or all others.  Not everyone is out to hurt you.  Such generalization can form the unhealthy foundation for a world view that is pessimistic and inaccurate.  Has this happened to you?

If so, it is time to fight back against this.  Try saying the following to yourself as a way to break the habit of a false view of others:

I have been wounded by another person. For today, I will not let his/her wounds make me a bitter person who thinks negatively about people in general. I will overcome any tendency toward this by seeing others as having special worth, not because of what they have done, but in spite of this.  We are all on this planet together; we are all wounded.  Not all are out to wound me.

Robert

From your own experience, what is the most difficult part of the forgiveness process?

Our research tells us that the decision to forgive is the most difficult.  I think it is because, for those who have rarely practiced forgiving, this is a large transition in their lives. They are walking through a door, the forgiveness door, that offers something new. Change can be difficult for many people and this change, in beginning to see an offending person in entirely new ways, can lead to doubt and even to a reworking of one’s own identity (Who am I now that I am starting to practice forgiveness?).