Isn’t it better to eliminate depression first, by psychotherapeutic means other than forgiveness, in a client prior to initiating forgiveness therapy?
Traditional psychotherapies are not necessarily as effective as forgiveness therapy. Therefore, it is best, in my opinion, to engage the client in forgiveness therapy, if this is chosen by the client. The depression then can lessen as the person continues on the forgiveness path.
I would say the biggest surprise was how effective forgiveness therapy is in the context of very deep trauma caused by other people’s unfairness. Forgiveness therapy seems to be even more effective in reducing clinical levels of anger, anxiety, and depression than other models of psychotherapy that preceded forgiveness therapy within the social sciences. As just one example, the Freedman and Enright (1996) study showed that incest survivors, upon forgiving, went from clinical levels of depression to non-depressed status and this continued at the one-year follow-up. The reference to this work is as follows:
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.
To me it is irrational to forgive. You are saying that you are not mad when in fact you are. So, forgiveness is a shell game, a kind of illusion or magic trick in which one wishes away the anger and internal discontent and then, presto, all of this is gone. Sorry, but I can’t accept this magic trick that you call forgiving.
I think the illusion actually is your belief that forgiveness is a trick. Is it a trick when randomized experimental and control group clinical trials show that as people take the time to forgive, their anger, anxiety, and even depression can go statistically below clinical levels and remain low months or even a year after treatment? Science done well is not a shell game. I urge you to look at the science. One place to start is the book for mental health professionals, Forgiveness Therapy, by Enright and Fitzgibbons (2015, American Psychological Association).
For additional information, see Forgiveness Research.
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.
- 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.
- Read the full, 24-page ELA study on Adverse Childhood Experiences.
- Learn more about Adverse Childhood Experiences on the Psychology Today website.
- Find out how toxic stress can have damaging effects on learning, behavior, and health across the lifespan at the Harvard University Center on the Developing Child.
- Read about Early Childhood Development on the U.S. Department of Health & Human Services Office of Early Childhood Development website.
My mental health professional seems to think that I have a genetic predisposition to psychological depression. If this is true, then biology and not past trauma is responsible for my current condition. Can I just forget about forgiving then under this circumstance?
Even if you have a biological predisposition to depression, forgiveness can help with the medication you might be taking. Think through your history of being treated unfairly from childhood to the present. You can do this by consulting the Forgiveness Landscape from my book, The Forgiving Life. If you identify certain people toward whom you still have considerable anger, then it would be good, if you so choose, to forgiven them. See if this aids your recovery from depression.
For additional information, see Why Forgive?