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Effect of forgiveness on Physical Health

Definition(s) of Forgiveness

Forgiveness is frequently defined as “letting go off negative feelings related to the source of hurt”. Forgiveness has been defined, at least partially, as a reduction in negative affect toward an offender. The victim relinquishes ideas of revenge, and feels less hostile hostile, angry, or upset about the experience.

The Association of Forgiveness and Health

The association of forgiveness and health seems robust. It is apparent with more than one measure of forgiveness and of health.

Forgiveness, both as a state and a trait concept, was clearly related to physical health. The state assessment of forgiveness was associated with all five measures of health: symptom checklist, number of medications taken, and self-reports of sleep quality, fatigue, and somatic complaints. Trait forgiveness was also related to all five measures, but in every case accounted for less health variance than state forgiveness.

Therefore, the concurrent association between forgiveness and health seems robust across a variety of measures.

Research into the relationship between Forgiveness and Health

Although there has been substantial amount of research and evidence that supports the assumptions of negative effects that unforgiveness has on our health (or moreover the correlation between stress related to unforgiveness and consequently it’s negative effects)  in the past decades there seems to be a new wealth of research that also supports the counter statement – positive effects of forgiveness on one’s health and Well-being.

One of the studies that supports this has been conducted by Lawler, Younger, Pifery, Jobe, Edmondson and Jones in 2004 titled: The Unique Effects of Forgiveness on Health: An Exploration of Pathways

The purpose of their research was twofold.

-First, to examine the relationship between forgiveness and health.

- Second, to test five (5) theoretical mechanisms or ways by which forgiveness may affect health.

This particular study has concluded that positive effects of forgiveness were associated with five (5) measures of health. Four mechanisms or pathways by which forgiveness could lead to improved health (or fewer negative physical symptoms) were examined: spirituality, social skills, reduction in negative effect and reduction in stress.

Another research study that was established in 1998 under the leadership of Everett Worthington in a large nationally representative study documented that forgiveness was positively related to mental health and Physical health.

This research has shown that forgiveness is linked to mental health outcomes such as reduced anxiety, depression (mood) and major psychiatric disorders, as well as with fewer physical health symptoms and lower mortality rate s. In fact, researchers have amassed enough evidence of the benefits of forgiveness to fill a book; Toussaint, Everett Worthington and David R. Williams, PhD, edited a 2015 book, "Forgiveness and Health," that detailed the physical and psychological benefits.

Objectives of study and research

The study has been conducted in the period of five years with eighty-one (81) participants (19 men and 62 women – ranged age 27-72) using the laboratory interview approach followed and preceded by a questionnaire.

Working on the premise that forgiveness has a positive impact on one’s health, this study has proposed this (6) areas linking forgiveness to health.

These are:

1.     Decreased psychophysiological reactivity.

2.     Reduced interpersonal stress

3.     Reduced frequent/reoccurring stress

4.     Reduced constitutional weakness associated with hostility and health

5.     Increased healthy behaviours

6.     Positive transcendent Transcendent and Religious factors.

This has been further refined by Thoresen (2000) who also enumaretes six potential pathways  linking forgiveness and health:

1.     Decrease in chronic blaming, anger and hostility

2.     Reductions in chronic hyperarousal and/or allostatic load

3.     Optimistic thinking

4.     Self-efficiency to take health related actions.

Mechanisms of measure
 * ·      Physical health was measured with the Cohen-Hoberman Inventory of Physical Symptoms (CHIPS; Cohen and Hoberman, 1983). It assesses 40 common physical ailments that often bring patients into the health care system.
 * ·       Social skills were assessed with the Interpersonal Competence Questionnaire (Buhrmester et al., 1988) This scale assesses one’s level of competence in social situations across five domains; we included the subscales of management of interpersonal conflict (ICQCM) and the assertion of personal rights and displeasure with others (ICQNA).
 * ·       Negative affect was assessed with the Profile of Mood States (McNair et al., 1992), which includes recent feelings of tension, depression, anger, vigor, fatigue, and confusion.
 * ·       Religious and existential well-being scores (RWB, EWB) were derived from the Spiritual Wellbeing scale (Ellison and Smith, 1991). This scale was developed as a subjective quality of life measure and permits the measurement of both religious satisfaction as well as meaning in life, separate from a commitment to God.
 * ·       Stress was derived from the Perceived Stress scale (PSS; Cohen et al., 1983). This scale has 14 questions that assess experiences of stress in the last month.
 * ·       Blood pressure and heart rate were measured noninvasively with a Critikon Dinamap Vital Signs Monitor, Model 1846SX (Johnson and Johnson, Tampa, FL).

Relationship of Forgiveness and Cognition

Further research and study is found in the book: “Forgiveness and Health: Scientific Evidence and Theories relating forgiveness to better health” where Luskin, Goulet and Cavanagh provide a review in chapter 5. of evidence linking forgiveness to cognitive activity. They provide an extensive update and comprehensive review of what is now regarding forgiveness and brain activity with regards to cognition. They include measure of electro-encephalographic activity, positron emission tomography and functional magnetic resonance imaging.

Being forgiving can “pay off”, as Toussaint and colleagues found in a study exploring the relationship among Stress (biology), Psychological well-being and Forgiveness. They found, as expected, that people who had greater levels of accumulated lifetime stress exhibited worse mental health outcomes. But among the subset of volunteers who scored high on measures of forgiveness, high lifetime stress didn't predict poor mental health. The power of forgiveness to erase that link was surprising, Toussaint says. "We thought forgiveness would knock something off the relationship [between Stress (biology) and psychological distress Psychological distress], but we didn't expect it to zero it out," he says.

In another study, Toussaint followed participants for five weeks and measured how their levels of forgiveness ebbed and flowed. He found that when forgiveness rose, levels of stress went down. Reduced stress, in turn, led to a decrease in mental health symptoms.

Forgiveness is effective in various one-one-one interventions, especially affecting cognition,  including a study that showed it alleviated Depression (mood), anxiety and Posttraumatic stress disorder in women who have experienced spousal Emotional abuse. " Through these cognitive exercises, they begin to see the other person as a wounded human being, as opposed to stereotyping them and defining them by their hurtful actions ," Enright says.

Despite the differences in the interventions, both help to promote forgiveness and the mental health benefits that go along with it. In a meta-analysis Meta-analysis of 54 forgiveness studies, Everett Worthington found that both his and Enright's models helped people forgive and also improved their mental health.

Criticisms and Limitations

One of the criticisms reports a concurrent association between forgiveness and health, meaning that there is far more focus on negative effects of unforgiveness than positive effects of forgiveness and that the positive corelatio may not be direct, but rather indirect though impact on other mediators such as stress and anger which consequently affect health- therefore this relationship is not direct.

The current research has other limitations; for example, the sample was disproportionately female, therefore that it doesn't apply to other or majority of populations. It will be well, in future studies, to examine the roles of pathways in men and women at different ages and in different ethnicities. Negative affect may be the salient mechanism linking forgiveness and health in middle-aged, Caucasian women. Stress (biology), spirituality, or sympathetic reactivity may play stronger roles in different groups. Finally, as noted earlier, the forgiveness–health association may not operate in all contexts. Further assessment of offender–victim relationship, seriousness and type of event, and subsequent behavior of the offender may all play important roles in the connection between forgiveness and health.

Despite continuing interest in forgiveness and it’s benefits, few attempts have been made to systematically organise research describing the extent of positive psychological and health benefits of forgiveness. Some important questions remain unanswered even though some of the earliest theoretical attempts to connect forgiveness and health and well-being positioned its beneficial effects for major health problems such as Cardiovascular disease and cancer.

Outcomes and Conclusions

The study conducted by Lawler, Younger, Pifery, Jobe, Edmondson and Jones  suggests that this pathway most fully mediates the forgiveness–health relationship. Thus, health consequences of lack of forgiveness may be carried by increased levels of negative emotion. If there is a causal role between forgiveness and health, then reduction of anger, anxiety, and Depression (mood) may explain how forgiveness operates on the body.

At the time this study was published (2005) much less data was available to assess the association between forgiveness and Physical, Mental and Emotional health – or a positive effect of it. However, in the more recent years there is increasing amount of research and evidence that supports these and similar statements.

Further more evidence in support of positive relationship between forgiveness and health appears to be consistent. In addition, there has been several theoretical models that could explain this relationship- in particular the relation between forgiveness and it’s impact on cognition.