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
- 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.
Reflections on Three Young Men and Their Recent Suicides
I am sitting here in a workshop far from my home in the United States. All of the participants are in small groups discussing themes of forgiveness for the self, for home, and for school. The place will remain anonymous to keep the information here private.
I just recently had a meeting in a school and the principal was unsettled about three recent suicides by young men just out of high school. They attended school in that very area of the city where this principal works.
“The community is rocking from this,” the principal said. “It is taking us time to adjust and the helping professionals are being kept quite busy with those who are mourning the loss.”
It is important that we not stand in judgement of the three men who took their lives. And so the point of this essay is not to judge the act of suicide or to judge the young men. Instead, the point is to ask a central question: What was in each of their hearts as they decided that this life is not worth living? What misfortunes or even injustices came to visit them so that their hearts were broken? Could the pain in their hearts have been healed?
I write with a sense of urgency because, where I currently am in the world, the suicide rate is high for young men such as these. Too many of the young men in this community are thinking and feeling that this life is not worth it. There is too much pain, too much alienation.
My urgency centers on this: There is a cure for hopelessness borne out of alienation and unjust treatment and that cure is forgiveness. Forgiveness can cure a shattered heart. Forgiveness can cure a sense of hopelessness and a sense that life holds no meaning or purpose.
Forgiveness can reduce resentment and give a person the meaning that life can be about loving….even when others are not loving you. Forgiveness can give a person purpose as he or she strives to put more love into the world today than there was yesterday. A person who is alienated and broken, if introduced to forgiveness, can begin to reduce pain and to love more……and to see that life, indeed, is worth living.
I am perplexed by this question: What if each of these three hurting young men had sound forgiveness education in their elementary and high school education?
Would they not only be alive today but also be alive with hope and love and purpose?
We need forgiveness education…………..now.
The Dilemma of Cyberbullying: What Is the Solution?
A teenage girl received a series of texts allegedly from her boyfriend in which she is severely demeaned. Her reaction is to take her own life. The boyfriend never wrote the texts. His account was hacked for the purpose of cyberbullying.
Cyberbulling is a relatively new term to signify aggressive communication through the electronic media of cell phone texting, email, and social networking sites on the Internet. It is an insidious problem because it is too often anonymous, goes viral (spread to many others), and the victim feels powerless. Those who engage in cyberbullying are less easily identified than those who punch someone in the face.
So, what can we do about all of this? Of course, we can warn our children as StopCyberbullying does (the first cyberbullying prevention program in North America). We can call for more vigilance so that those who engage in this behavior are more easily identified, as is suggested in the film Submit the Documentary.
Justice is a vital part of cleaning up this problem. Yet, this is insufficient. The seeking of justice (punishment, arrest, or other form of fairness) is a temporary protection, but it is not a solution. We need to get to the heart of the matter which is the heart of those who engage in such destructive behavior.
Those who cyberbully have enraged hearts. They are displacing their anger onto others. They are wounded. If we only see their behavior, then we are missing the punchline that they are wounded inside. We can constrain behavior through justice and we can cure wounded hearts through forgiveness.
In previously posted blogs, we already have discussed the necessity of our forgiveness education anti-bullying guide for teachers, school counselors, psychologists, and social workers being in as many schools as possible. The uniqueness of this guide is that it deliberately targets the anger in the heart of those who bully. The principle behind the guide is this: Emotionally-wounded people wound others. We have a way to help bind up these emotional wounds through forgiveness education. We help those who wound others to heal from the wounds inflicted previously on them, thus reducing their motivation to wound others. The information for this guide is available in the IFI Education Store.
Yet, what do we do in the case of cyberbullying? We must recall that those who do this are not easily identified. Oh, yes they are. Although we do not catch them in the act of punching someone in the face, we can identify them because the overly-angry tend to wear that attitude on their face, in their words, in the trouble they find in school….over and over. Of course, not all who are excessively angry engage in cyberbullying. Yet, those who cyberbully likely come from this group of the excessively angry. We have to cast our intervention-net widely in this age of cyber-anonymity.
School counselors, psychologists, and social workers please take note: When you have in front of you a student who is entrenched in rebellion, in verbal aggression, in indifference to school itself, please presume that this person of inherent worth has a wounded heart. Consider presenting the contents of our anti-bullying curriculum to him or her individually or in a group for those showing such symptoms. You are indirectly covering cyberbullying if you do this. The more you can target the angry students, the more you may be either preventing or remediating cyberbullying behavior.
The stakes are way too high to ignore this advice. Your “yes” to mending the wounded hearts of students in your school through helping them to forgive could, quite literally, save lives.
Should We Talk about Forgiveness in the Context of a Loved-One’s Suicide?
While in Northern Ireland last week, I gave two invited talks on the topic of forgiveness in the context of a loved-one’s suicide. Suicide, especially among young-adult males, is a serious and growing problem there. I made the point that there are at least four scenarios with moral import surrounding this issue:
1) Some people who have lost loved ones in this way will reason that suicide is not immoral. Therefore, they will see no need to forgive because no injustice occurred;
2) Some people who have lost loved ones in this way will say that suicide is not immoral, but they are most likely in denial because their reasoning is not clear and their emotions are raw and angry;
3) Some will say that suicide is always wrong because it is always wrong to take an innocent life, including one’s own;
4) Some will say that the act of suicide itself is not morally wrong, but the consequences of doing so are wrong because those left behind have had love taken from them.
My linking forgiveness with suicide will have direct relevance for those in situations 2-4, but not in situation 1 above. Those in situation 2 might get very angry at me (and some did) for even mentioning the issue of morality and forgiveness in the context of suicide because they harbor worry (about the loved one’s eternal salvation, as an example) and they may harbor some guilt (in that they did not do enough to prevent it). People in this situation 2 want to distance themselves from the worry and/or the guilt. A talk on forgiveness and suicide does not help them to distance from these issues.
Those in situations 3 and 4 tend to seek relief for their own bitterness and anger. They are often angry at the deceased and they can be angry at others who did not do more to help. They also can be angry with themselves for a number of reasons, including their extreme emotions such as hatred or their reasoning that they could have done more. In these cases, it seems that it is worth hypothesizing that forgiveness education and therapy could be helpful in restoring emotional well-being.
What I found interesting is that some (a rare few) in situation 2 were adamant against my speaking at all about this topic. They were offended by the talk. It is as if I have no right to speak about a link between suicide and forgiveness and no one else has a right to hear about it or to work in a psychological sense on their own emotions.
So, here is my recommendation. Let us respect each person as a person and let us respect each one’s choice to hear or not to hear such information. Some will choose not to hear, but they should not condemn those who do. Some will choose to hear, but they should not condemn those who wish not to hear.
This is an important and sensitive area. We must move forward to help those who seek help through forgiveness and we must do so with gentleness and respect for all.