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.