Forgiveness Therapy Proposed as Antidote for Traumatic Childhood Experiences

Forgiveness Therapy and forgiveness interventions developed by Dr. Robert Enright are being embraced in a just-released study as promising tools for effectively dealing with what the study calls a “major public health crisis.” 

Researchers at the Laureate Institute for Brain Research (Tulsa, OK) have teamed up with those at Stanford University (Stanford, CA) to study the life-long adverse impacts of Early Life Adversity (ELA). The study is titled Is There an Ace Up Our Sleeve? A Review of Interventions and Strategies for Addressing Behavioral and Neurobiological Effects of Adverse Childhood Experiences in Youth.” It was published just five days ago, March 13, 2020, in the empirical journal Adversity and Resilience Science.

ELA is the term for the negative experiences children may face or witness while growing up (sometimes also called Adverse Childhood ExperiencesACEs). These traumatic experiences include:

  • emotional, physical, or sexual abuse;
  • emotional or physical neglect;
  • living in a household in which domestic violence occurs;
  • growing up in household dealing with substance abuse or mental health problems;
  • instability due to parental separation, divorce or incarceration;
  • witnessing violence in the home; or,
  • having a family member attempt suicide.

Any of those traumatic experiences can lead to what child development specialists call “toxic stress” if encountered by children without adequate adult support. Toxic stress can disrupt early brain development and compromise functioning of the nervous and immune systems. The more adverse experiences in childhood, the greater the likelihood of developmental delays and other problems that can cause life-long complications.

In fact, psychologists say, adults with more adverse experiences in early childhood are also more likely to have health problems including alcoholism, depression, heart disease, diabetes and other chronic diseases as well as impaired cognitive and social development. The report suggests that many adult diseases are, in fact, developmental disorders that begin early in life.

The new ELA publication describes and evaluates existing evidence-based interventions and their outcomes including Forgiveness Therapy. Three of Dr. Enright’s peer-reviewed empirical studies were examined and cited for achieving commendable outcomes compared to those of a control group:

  • Female incest survivors (Freedman & Enright, 1996). Results: “significantly greater decrease in levels of depression and anxiety.”

  • Women diagnosed with fibromyalgia who had experienced at least two ACEs in their childhood (Lee & Enright, 2014). Results: “increases in forgiveness toward their abuser, lower levels of state anger, and improvements in physical health related to their fibromyalgia symptoms.”

  • Female Pakistani adolescents with histories of abuse (Rahman, Iftikhar, Kim & Enright, 2018). Results: Similar findings to the fibromyalgia study “suggesting that Forgiveness Therapy may uphold in a cross-cultural context.”

Those three intervention experiments by Dr. Enright and his research partners are the only Forgiveness Therapy examples cited in the 24-page ELA study that “have shown forgiveness therapy to be effective” in both physically and emotionally healthy ways. The ELA study also postulates that those interventions are effective because in Dr. Enright’s approach “the hypothesized mechanism behind forgiveness therapy involves cognitive restructuring of the abuser and events.”

Based on the evidence gather through this new ELA study, Forgiveness Therapy is one of the promising interventions for children who are experiencing toxic stress without appropriate support from parents or other concerned caregivers. That, they conclude, can help return a child’s stress response system back to normal while reducing negative mental and physical health outcomes later in life.

“Therefore, we conclude that they (Forgiveness Therapy interventions) are well-suited for and hold promise to exert immediate preventive and sustained changes in outcomes for maltreated youth.” – ELA study conclusion, March 13, 2020.


Why is this subject important? Why does it matter?

According to the World Health Organization, as many as 39% of children worldwide are estimated to experience one or more forms of early life adversity, placing a high economic burden on health-care systems—and society in general—through medical costs and lost productivity.


The mission of the Laureate Institute for Brain Research (LIBR) is to “develop novel therapeutics, cures and preventions to improve the well-being of persons who suffer from or are at risk for neuropsychiatric illness.” Dr. Namik Kirlic, the LIBR Principal Investigator for the ELA study, is a clinical psychologist who has devoted his professional life to studying ELA interventions and how to optimize their positive outcomes. Other team members for the ELA study include Zsofia Cohen (Dr. Kirlic’s Research Assistant) and Dr. Manpreet Singh, a psychiatrist and medical doctor at Stanford Health Care.

MORE INFORMATION:

In your intervention research, have you ever encountered a person who was made decidedly worse when going through the forgiveness process?

In our scientific studies, we have not seen any dramatic examples of people becoming decidedly worse once they willingly start the forgiveness process.  Some people do not change their levels of anger, anxiety, depression, or self-esteem.  This often is the case because the person has not spent enough time in the process and needs more of that time to effect the desired psychological change.  We have not encountered anyone, in a wide variety of settings (incest survivors, people in drug rehabilitation, people in maximum-security prison), who becomes more enraged as a result of truly being engaged in the forgiveness process.

For additional information, see Forgiveness Research. 

Is wanting to forgive for your own health selfish?  Is it effective?

Suppose you hurt your knee while running. Further suppose that you want to make an appointment at Sports Medicine to address the issue. Is this selfish? There is a large difference between being selfish (absorbed with yourself at the expense of others) and engaging in self-care (attending to your needs without neglecting others’ needs). Forgiving is good self-care. Our research shows a cause-and-effect relationship between learning to forgive and improvement in heart health for cardiac patients:

Waltman, M.A., Russell, D.C., Coyle, C.T., Enright, R.D., Holter, A.C., & Swoboda, C. (2009).  The effects of a forgiveness intervention on patients with coronary artery disease. Psychology and Health, 24, 11-27.

Our research shows a cause-and-effect relationship between learning to forgive and improvement in fibromyalgia symptoms:

Lee, Y-R & Enright, R.D. (2014) A forgiveness intervention for women with fibromyalgia who were abused in childhood: A pilot study. Spirituality in Clinical Practice, 1, 203-217. doi: 10.1037/scp0000025.

A recent meta-analysis showed a statistically significant correlation between degree of forgiveness and a host of different physical issues:

Lee, Y.R. & Enright, R.D. (2019): A meta-analysis of the association between forgiveness of others and physical health. Psychology & Health, 34, 626-643.

So, yes, forgiving does seem advantageous for one’s physical health.

For additional information, see Forgiveness for Individuals.

Forgiveness: “Groundbreaking Scientific Discovery”

A cutting-edge organization in California that sponsors groundbreaking scientific discoveries has launched a new service called Greater Good in Action and added forgiveness to its list of practices that can help you improve your social or emotional well-being or the well-being of others including your children.

The Greater Good Science Center (GGSC) at the University of California, Berkeley, not only studies the psychology, sociology, and neuroscience of well-being but also “teaches skills that foster a happier life and a more compassionate society–the science of a meaningful life.”

The Greater Good in Action initiative adds forgiveness to its list of established practices that include compassion, generosity, gratitude, honesty and others. It is a new addition to a service the organization began in July of 2017, called Raising Caring, Courageous Kids that is designed to help parents raise kids of high character who treat others with compassion and respect.

In its inaugural forgiveness practice called Introducing Kids to Forgiveness, Greater Good in Action cites the pioneering forgiveness work of psychologist Robert Enright, Ph.D., and psychiatrist Richard Fitzgibbons, M.D. (co-authors of Forgiveness Therapy, a manual providing instructions for clinicians who want to incorporate forgiveness interventions into their therapy with clients.

Horton Hears a Who teaches kids about self-worth.
This book by Dr. Seuss helps kids learn about        self-worth. It is one of nine children’s books incorporated into Dr. Enright’s 1st Grade Forgiveness Curriculum Guide.

Referencing Dr. Enright’s years of hands-on experience teaching children about forgiveness (he has developed 17 Forgiveness Curriculum Guides for kids in pre-school through 12th grade that are being used in more than 30 countries around the world), Greater Good in Action links readers to a separate dissertation on Dr. Enright’s insights into how to help children and adolescents learn and practice forgiveness.

That work concludes that “a wide range of studies have found that forgiveness programs can help kids of different ages feel better, strengthen their relationships, and improve their academic performance.”


Because conflict is inevitable, teaching children about forgiveness early on
may indeed be a path toward building communities
of people who prize and cultivate peace.

Maryam Abdullah, Ph.D., Parenting Program Director at Greater Good
and a developmental psychologist with expertise in parent-child relationships.


The practices provided by Greater Good in Action are for anyone who wants to improve his or her social and emotional well-being, or the well-being of others, but doesn’t necessarily have the time or money to invest in a formal program.   Through its free online magazine Greater Good, the GGSC provides articles, videos, exercises, quizzes, podcasts, workshops and more for parents and families to help them foster positive attributes like forgiveness in themselves and their children.

How Forgiving Are You? 
When someone does you wrong, are you more likely to turn the other cheek or slash their tires? Take the Greater Good Forgiveness Quiz to find out.

Have you or your colleagues worked on forgiveness with people who have significant mental health challenges, such as major depressive disorder or bi-polar disorder?

Yes, my colleague, the psychiatrist Dr. Richard Fitzgibbons, has case studies of this kind in our book, Forgiveness Therapy, 2015. Not all people who show major depression or bi-polar disorder are excessively angry with other people, but Dr. Fitzgibbons does screen for this. When people with significant mental health challenges show unhealthy anger caused by unjust treatment from other people, then Forgiveness Therapy is warranted and shown to be effective in these case studies.

For additional information, see Forgiveness Research.

A Reflection on Forgiveness and the Forgotten People

As I look out the window of the hotel in downtown London, awaiting a flight soon to the Middle East, I see a bustling populace moving quickly……except for one man who is shuffling along slowly, quite in contrast to the others. As I watch, he stops, faces a passerby, and obviously is asking for funds. He is ignored. He shuffles a few more steps, approaches another, and is met with the same non-response.

His pattern is repeated over and over. I counted at least 15 approaches and 15 rejections. He then disappeared from view. I think he was invisible to many that day, even to those who were within view of him.

How we bristle when rejected by a co-worker who is not showing respect today or by others who do not share our goals. The man, refused by others over and over, probably felt wounded by the rejections.

The dear man in London was continuously rebuffed, and he kept trying……until after awhile he simply stopped asking. This sequence of approach-and-avoidance reminds me of Ralph McTell’s now classic song, Streets of London (originally released in 1969 and re-released in 2017):

(c) The Bowes Museum; Supplied by The Public Catalogue Foundation

Have you seen the old man
In the closed-down market
Kicking up the paper,
With his worn out shoes?
In his eyes you see no pride
Hand held loosely at his side
Yesterday’s paper telling
      yesterday’s news…..

In the all-night cafe
A
t a quarter past eleven,
Same old man sitting there on               his own
Looking at the world
Over the rim of his teacup,
Each tea lasts an hour
Then he wanders home alone……

In our winter city,
The rain cries a little pity
For one more forgotten hero
And a world that doesn’t care.

The word “forgotten” catches my attention. That was the exact word used by imprisoned people serving life sentences with whom we spoke over a month ago. “Once you are here [in a maximum-security prison],” one gentleman explained to me, “you are forgotten.”

The forgotten people……

Yet, our forgiveness studies have taught me this: All people, regardless of circumstance, have inherent or built-in worth. The man, so continually rejected today on the street in London, has as much worth as the royalty in the palace. The one in maximum security prison for life has as much worth as the warden.

And in all likelihood, many of “the forgotten people” have stories to tell us of how they, themselves, were mistreated prior to their current plight. They have stories that include their own particular kind of pain, heartache, feelings that are part of the human condition. We need to hear those stories, to acknowledge their unique pain, their responses to that pain, and offer those suffering injustices from the past a chance to forgive. The forgiveness, for some, might be life changing as our science over the past three decades has shown for others.

We must not let forgiveness be the forgotten virtue.

We must not let the homeless and the imprisoned be the forgotten people.

Robert

The History of Forgiveness Therapy

The prominence of forgiveness and forgiveness therapy in the field of psychology over the past few decades has been well-documented in the scientific literature. Also well documented has been the pioneering and groundbreaking forgiveness work of Dr. Robert Enright within that movement. Here are pertinent milestones: