Apologies and Their Relevance for Psychiatry
Key Takeaways
- Public contrition after empathy-based criticism illustrates how apologies may de-escalate conflict yet can be perceived as strategic, hollow, or ineffective in repairing relational ruptures.
- Clinical practice often limits apologies due to liability concerns, despite their relevance after interpretive missteps, documentation omissions, or other alliance-threatening errors.
Psychiatry probes why public apologies may manipulate or hinder forgiveness, and what humility and remorse reveal in conflicts from courts to clinics.
PSYCHIATRIC VIEWS ON THE DAILY NEWS
According to mainstream media headlines, Supreme Court Justice Sotomayor publicly apologized to her colleague, Justice Brett Kavanaugh.1 Such an apology was quite unusual, especially in its public nature. In consideration of whether law enforcement could conduct brief immigration-related stops in the Los Angeles are, she criticized him for his lack of empathy with the everyday day experiences of working-class individuals. She referred to how she was influenced by her own life experiences, coming from a background similar to many of the immigrants in question. Justice Sotomayor then apologized to him both publicly and privately.
Although Justice Kavanaugh has not responded to the apology publicly, despite having well-to-do parents, he did perform working class jobs when younger, including construction, cutting lawns, and serving meals to the homeless.
On the surface, that apology may seem welcome in the sense of any reducing undue tension between them, but as psychiatric consideration of apologies note, that is not always the case.2 For example, apologies can be used to try to manipulate a situation. Or they can seem insincere. Or they can ineffective in resolving a conflict.3
Perhaps many of us in psychiatry have had situations where apologies might have seemed warranted, whether in regard to our patients or colleagues. Often, the legal possibility of being sued constrains that. Most of the apologies I gave to patients is when I made a poorly worded interpretation or forgot something important in their histories. Justice Sotomayor’s response reminded me of our countertransference risks, that we can let our own history and problems adversely influence our patient care process. For patients with severe trauma, whether to finally forgive perpetrators who apologize is often an anguishing decision.
As far as colleagues go, I had 2 who apologized, but at the same time asked forgiveness. Often, the 2 processes are intertwined. Both examples had to do with their prior position of power over me and not helping me when they could have, to their own obvious advantage. Both came around the time of Yom Kippur, when asking for forgiveness is emphasized. One did it 2 years in a row! I readily gave the forgiveness but did feel that the apologies had some manipulative aspects for their own psychological and legal well-being.
Recently, a complex academic philosophical analysis of apologies came out of Germany.4 After World War II and the Holocaust, Germany did make apologies in regard to the Nazi regime and made some financial reparations. Apologies and forgiveness between countries and cultures often pave the way for a more peaceful future. The author provided a detailed and more critical view of apologies, including 2 points that he felt were counterintuitive: one is that apologies are morally problematic, and secondly, that apologies actually inhibit forgiveness. Instead, he emphasized humility, in the sense that a “truly humble offender” will not want to apologize because the offender is not concerned with the victim’s negative attitude toward them, and that the offender does not want to pressure the victim for forgiveness. Instead of apologies, expressing sincere remorse in taking guilt seriously is a suggested better way.
Has apology been common in your work in psychiatry? If so, any examples to share?
Dr Moffic is an award-winning psychiatrist who specializes in the social, cultural, ethical, spiritual, and religious aspects of psychiatry, and since 2012 is in retirement as a private pro bono community psychiatrist. A prolific writer and speaker, he has done a weekdays column titled “Psychiatric Views on the Daily News” and a weekly video, “Psychiatry & Society,” since the COVID-19 pandemic emerged. He has been an advocate and activist for mental health issues related to climate instability, physical burnout, and xenophobia, among other social justice causes, serving on many related local and national community and professional Boards. He serves on the Editorial Board of Psychiatric Times.
References
1. Marimow A. Justice Sotomayor apologizes for highly personal criticism of Justice Kavanaugh. New York Times. April 15, 2026. Accessed April 20, 2026.
2. Lazare A. On Apology. Oxford University Press; 2004.
3. Yamamoto K, Kimora M, Osaka M.
4. Hallich O.
