Angel Oak Tree, SC (1000+ years old). ©Serge-Skiba/Shutterstock
PSYCHIATRIC VIEWS ON THE NEWS
Amazing Grace! How sweet the soundThat saved a wretch like me!I once was lost, but now am found;Was blind, but now I see.
Forgiveness is the fragrance that the violet sheds on the foot that crushes it.
Like so many, I was struck, even dumbstruck, by the forgiveness conveyed so quickly, readily, and directly to the perpetrator by the family members of those killed in the Charleston Church tragedy. Indeed, this forgiveness was given with no conditions and no strings attached.
Forgiveness in history
As I continued to wonder about this from both a personal and professional perspective, I was sifting through work papers from pre-computer days. Serendipitously, I came across one that reminded me of the forgiveness conveyed on June 19, 2015. It was a 1-page paper. It is titled “Ten Great Moments in Forgiveness History.”1 Some of the moments in this list are:
• Eighth Century, BC: The Sabine women implore the Sabine men not to attack their Roman abductors, who are now their lawfully wedded husbands
• A.D. 29: Christ forgives from the cross
• 1990: Nelson Mandela, recently released after twenty years in a South African prison, tells a rally, “We especially need to forgive each other, because when you intend to forgive, you heal part of the pain, but when you forgive you heal completely”
I would now very tentatively suggest that the Charleston Church killings could possibly turn out to be the 11th great moment in forgiveness history. Why?
The more common reaction to other tragedies in the US has not been immediate forgiveness of perpetrators. If ever, forgiveness might occur much later.
Perhaps some of the difference is in the history of the African American churches. Historically, they were a precious spiritual and community resource for those subject to the traumas of slavery. Certainly, any principle of immediate forgiveness fit the message of Christ. As my colleague, Randall Levin, MD, suggested to me, it also might have been, practically speaking, the safest reaction, as any expression of anger might cause reprisal by slave owners and their successors.
Almost a decade ago, a much smaller, isolated, and different religious group, the Amish, immediately forgave the family of the man who killed five of their girls in a schoolhouse. The killer himself couldn't be directly forgiven in this case because he had also killed himself. The public was also stunned by this act of forgiveness, with some wondering if such forgiveness was actually unhealthy.2
Food for thought
- Does the act of forgiveness soon after severe trauma have widespread mental health implications?
- If indeed it worked for the prevention of debilitating PTSD, as some preliminary studies suggest, early forgiveness may upend our usual presumptions that forgiveness has to go through a long and arduous process
- As we approach August 2, International Forgiveness Day, let us let us keep Charleston in mind
From my own professional focus on cultural psychiatry, this recent expression of forgiveness was honest and heartfelt, but it didn’t mean that those forgiving were also not angry and did not want justice to be served.
Forgiveness and mental health
In treating PTSD, I often found that forgiveness of any perpetrator was the final step in the healing process for those who could do so. There is also ample research that forgiveness, after some time of processing and reflecting, is good for one’s health and mental health.3
However, we know very little about whether immediate or early forgiveness can possibly prevent mental disorders, especially as far as PTSD goes.
We know about what doesn’t work. The long-term benefits of so-called “debriefing” are now questionable. Clinical trials using the beta-blocker propanalol right after trauma have shown it is not effective.
A new preventive treatment under exploration involves sleep, or, more precisely, sleep deprivation.4 This seems counterintuitive, especially since it is so common to prescribe a sleeping pill for someone who can’t sleep after a major loss and/or trauma. This new research based on a laboratory study indicates that sleep deprivation right after imagined trauma helps to prevent the consolidation of memories of the bad experiences.
Similarly, the early forgiveness of trauma may turn out to be a counterintuitive measure. Could forgiveness also short-circuit the development of painful memories?
Forgiveness and the brain
My colleague Lawrence Richards, aka LKR, asked, “Is there a scientific explanation for how forgiveness might happen in the brain?” In searching for the answer, I found very little research on what might happen in the brain when one forgives quickly. Early research suggested that the frontal-limbic circuits mediate processes involved in forgiveness.5 Patients who received cognitive-behavioral psychotherapy for PTSD had further activation in the posterior cingulate area after “forgivability.”
Newer research uses novel script-driven mental imagery and functional magnetic resonance imaging (fMRI).6 In the results, immediate forgiveness was associated with positive emotional states, and the act of granting forgiveness was associated with activations in a brain network involved in empathy and the regulation of affect through cognition. This network comprised the precuneus, right inferior parietal regions, and the dorsolateral prefrontal cortex.
In the aftermath of real-life trauma, studying forgiveness is daunting. I cannot imagine the people in Charleston being given fMRIs shortly after their expression of forgiveness. It would be quite interesting, though, to see how they are doing emotionally after, say, a decade.
Nevertheless, early forgiveness of the perpetrator in severe trauma, if it indeed worked for the prevention of PTSD, would have widespread mental health implications and upend our usual presumptions that forgiveness has to go through a long process.
One has to wonder about the reverse process. Does early forgiveness of the perpetrator help the perpetrator’s mental health and/or morality? In other words, will the forgiveness expressed directly by the Charleston families to the perpetrator have a positive impact on the shooter and his loved ones? We do know that the kindness of those in the Bible study apparently made the perpetrator hesitate for perhaps an hour before shooting.
Forgiveness and society
As if the potential benefit of forgiveness is not enough, what about its potential effect on society if early forgiveness were more widely adapted? In Charleston, there were predictions of violence and riots after the killings. There was none. Could the model of early forgiveness help prevent retaliation when the opportunity is there?
Moral development has fallen behind scientific development. More, and early, forgiveness could be a moral enhancement. Although there has been a bit of reduction in overall violence, the means for unprecedented widespread destruction have increased. Perhaps forgiveness can be taught. Perhaps there will turn out to be medication that helps pave the pathways.
Whatever can help avert mental disorders and/or retaliation is so important to psychiatry and society. If early forgiveness helps do that, how could the aftermath of the Charleston tragedy not end up being one of the great moments of forgiveness in history?
As we approach August 2, International Forgiveness Day, let us let us keep Charleston in mind. As the governor of South Carolina said on July 9, the forgiveness of family members affected by the shooting inspired compassion on the part of citizens and politicians to take action and remove the Confederate flag today. The flag is associated with the racist ideology of the perpetrator, as well as the trauma of slavery, so taking it down may symbolize the elimination of negative emotional triggers that it evokes in many.
1. In Character, A Journal of Everyday Virtues by the John Templeton Foundation. http://incharacter.org/archives/forgiveness/ten-great-moments-in-forgiveness-history. Accessed July 8, 2015.
2. Kraybill D, Nolt S, Weaver-Zercher D. Amish Grace: How Forgiveness Transcended Tragedy. Jossey-Bass; 2010.
3. Luskin F. Forgive for Good: A Proven Prescription for Health and Happiness. San Francisco: Harper One; 2003.
4. Porcheret K, Holmes E, Goodwin G, et al. Psychological effect of an analogue traumatic event reduced by sleep deprivation. Sleep. 2015;38:1017-1025.http://dx.doi.org/10.5665/sleep.4802. Accessed July 8, 2015.
5. Stein D, Kaminer D. Forgiveness and psychopathology: psychobiological and evolutionary underpinnings. CNS Spectr. 2006;11:87-89.
6. Ricciardi E, Rota G, Sani L, et al. How the brain heals emotional wounds: the functional neuroanatomy of forgiveness. Front Hum Neurosci. 2013;7:839.