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What research says about forgiveness and mental health, physical well-being

With President Nelson’s emphasis on forgiveness, the Church News talks to 3 researchers who have done definitive work on forgiveness and health

By Sydney Walker Sept 10, 2023 4 a.m. EDT

A mother hugs her daughter outside among trees.

Members

What research says about forgiveness and mental health, physical well-being

With President Nelson’s emphasis on forgiveness, the Church News talks to 3 researchers who have done definitive work on forgiveness and health

By Sydney Walker Sept 10, 2023 4 a.m. EDT

Editor’s note: This is part three in a three-part series on what research says about forgiveness. Read part one and part two.

At a Harvard University forgiveness conference in April, an international research team shared results of a preprint study involving 4,598 participants from five countries with a history of conflict — Colombia, Hong Kong, Indonesia, South Africa and Ukraine.

The Templeton World Charity Foundation, which funded the research, said the study represents “the largest exploration of forgiveness science to date.”

In the randomized controlled trial, individuals who completed a self-directed forgiveness intervention workbook saw an increased ability and disposition to forgive, a reduction in depression and anxiety symptoms, and an increase in flourishing. Aspects of flourishing include happiness and life satisfaction; mental and physical health; meaning and purpose; and social relationships.

This study is part of a growing body of research that shows how forgiveness is related to mental health and physical well-being — a field of research that has exploded in the last few decades.

With President Russell M. Nelson’s recent emphasis on forgiveness for members of The Church of Jesus Christ of Latter-day Saints, the Church News spoke to three psychologists who have done definitive work on forgiveness and health.

President Nelson’s plea for and example of forgiveness

Defining forgiveness

The workbook used in this recent global study is based on the REACH forgiveness model created by Everett Worthington, a licensed clinical psychologist and professor emeritus at Virginia Commonwealth University. REACH stands for recall the hurt, empathize with the offender, offer the altruistic gift of forgiveness, commit to forgive and hold on to forgiveness.

Worthington explained why the results of this study are significant: “Altogether, the six different sites [in five countries] had more participants complete the workbooks than all intervention studies ever done seeking to promote forgiveness put together. We believe that this study indicates that people all over the world can use a cost-free, scientifically vetted forgiveness protocol and experience forgiveness, freedom and health.”

Worthington — a renowned leader in the field of forgiveness research — believes there are four types of forgiveness: divine forgiveness, self-forgiveness, person-to-person forgiveness and societal forgiveness (this Church News series is examining person-to-person forgiveness).

While forgiveness has been defined by researchers in various ways, a widely accepted definition is replacing ill will toward an offender with good will. Forgiveness does not imply forgetting, condoning, excusing or denying hurtful behaviors.

According to Worthington, there are two kinds of person-to-person forgiveness: decisional forgiveness and emotional forgiveness.

Decisional forgiveness involves making a decision to forgive a personal offense, let go of angry and resentful thoughts and treat the offender with dignity. This is what psychologists call a behavior intention statement, not necessarily a behavior, Worthington said. “The fact is I can sincerely make a decision to forgive someone and still feel unforgiveness, emotions like resentment, bitterness, hostility, hatred, anger, fear.”

Emotional forgiveness involves replacing those negative emotions with positive feelings like compassion, sympathy and empathy. Research shows that this kind of forgiveness is where most health benefits are. “Emotional forgiveness affects our mental health and physical health directly,” he said.

Worthington also noted that forgiveness and reconciliation are not the same. Forgiveness gives some motivation to reconcile, but not everyone may reconcile.

“If somebody is bullying me and beating me up and is going to continue tomorrow to beat me up, I can forgive them because that happens inside me. That’s a decision. That’s an emotional change. But I may not want to follow through on a desire to reconcile because it’s not safe or prudent or possible. Reconciliation takes two people,” he explained.

How forgiveness can affect marriage and family relationships

How anger affects the body

Anger is a feeling associated with unforgiveness, or not forgiving. Worthington identified some of the dangers of chronic anger on the human body:

“Anger has a lot of psychological things that go along with it, such as elevated blood pressure, elevated heart rate, decreased heart-rate variability. … One of the other parts of anger is going to be that our hormones get involved. Adrenaline and cortisol get shot into our bloodstream.

“There’s nothing wrong with adrenaline and cortisol — they pump us up, they get us ready to deal with stress — but if it’s chronically elevated, cortisol in particular, it’s really seriously disturbing to our body systems.”

Such body systems include the sympathetic and parasympathetic nervous systems, immune system, cardiovascular system, gastrointestinal system and reproductive system, he said.

“Basically every system in the body is negatively affected by chronically high cortisol,” Worthington continued. “So anger, if not dealt with, can end up affecting pretty much all of our body. And we’re not even talking about our mental health or our relationships or our spiritual life. That’s just physical.”

Forgiveness and physical well-being

Charlotte Witvliet is a professor of psychology at Hope College — a private Christian liberal arts college in Holland, Michigan — who has studied forgiveness and its emotional and physiological side effects for 25 years.

Witvliet pointed out that the forgiveness responses she has studied in her lab have been crafted to guide people through options that fit well with accountability.

“These are responses a person can have from a position of safety, and none of these minimize the wrong that was done in any way. … We need to make sure that people who have borne the weight of experiencing injustice toward them are able to live in freedom from ongoing threat or harm,” she said.

One of Witvliet’s earliest studies looked at what happened when people nursed grudges and rehearsed painful memories compared to when they cultivated empathy and imagined granting forgiveness toward real-life offenders.

When activating forgiving thoughts, “they had much lower sweat responses,” she said. “They had lower heart rate and blood pressure responses. They had less tension at the brow and under the eye. After that study, we just kept going.”

Witvliet and fellow researchers developed a “compassionate reappraisal approach,” which, in her words, is to “focus on the offender’s humanity, see their wrongdoing as evidence that they need positive change and then desire that good change for them.”

“It’s something that’s very ‘other’ focused,” she explained.

In contrast to rumination — reliving the hurt and its impact — those who engaged in compassionate reappraisal experienced reduced indicators of stress, including lower heart rate, she said. Other side effects of compassionate reappraisal, which induced greater empathy and forgiveness, included an increase in other positive emotions and corresponding decreases in intense and negative emotions.

“We have some evidence that cardiac indicators of what’s called the sympathetic nervous system — your fight or flight response of survival — is quieted down in conditions that prompt more forgiving responses,” Witvliet said.

Evidence has also shown that rumination impairs a cardiac indicator of the parasympathetic nervous system’s calming response, whereas compassionate reappraisal prompted a response similar to relaxation baseline levels, she said. In other words, forgiveness through compassionate reappraisal could be just as calming as relaxation tasks.

Those who are more forgiving may also sleep better. In a study published in Frontiers in Psychology last year, “we found that when people engaged in compassionate reappraisal before bed — instead of ruminating — they had less sleep delay, better sleep duration and fewer sleep disturbances because of intruding thoughts about the offense,” Witvliet said.

Forgiveness and mental health

Worthington calls rumination “the universal bad boy of mental health” because “it is implicated in depression, anxiety, obsessive compulsive disorders, some personality disorders, anger disorders and post-traumatic stress disorder.”

“It’s not good for us. Don’t do it,” he said of rumination. “But that’s easy to say, not so easy to do. That’s why I think forgiveness can help, because it does take away a lot of that pressure to ruminate.”

Loren Toussaint is a professor of psychology at Luther College, a private Lutheran liberal arts college in Decorah, Iowa. The focus of most of his research has been to document the benefits of forgiveness.

“They certainly, without a doubt, show better mental health,” Toussaint said. “Depression levels come down, anxiety levels drop, symptoms of trauma come down.

“I’m not saying that you’re going to erase trauma through forgiveness, but the symptoms of trauma — the kind of hypersensitivity, the over-activation of many of these kinds of thoughts, and recurring imagery-type things — that starts to ease. Even things like phobia-type symptoms, fearful symptoms, those symptoms come down.”

While people who are more forgiving seem to have a decrease in negative mental health, they also seem to have an increase in their positive mental health, Toussaint said.

“Things like overall measures of happiness, positive mood, measures of flourishing that generally combine things like your mental and physical health, along with several measures of happiness and well-being — when you look at these kind of aggregate global measures of overall well-being and quality of life, all of those things seem to be improved by forgiveness,” he said.

And the research expands beyond the United States, he added. “Growing evidence is showing this is true in Caribbean culture, African culture, Asian culture. Around the globe, there seems to be a very consistent connection between forgiveness and improved functioning on kind of a happiness, flourishing quality of life level.”

Episode 152: Forgiveness expert Loren L. Toussaint on the health benefits of forgiving

Toussaint co-authored a study that examined lifetime stress exposure and forgiveness levels on mental and physical health in young adults. Associations between stress and mental health were weaker for those who exhibited more forgiveness.

“What we found is that people who reported being very low in forgiveness showed the classic connection between stress and depression … [while] people who were the highest in forgiveness showed no correlation between stress and depression,” Toussaint said. “That’s something that we followed up in a couple of different ways, in a couple of different studies, and we keep finding this.”

Similar to the way social support can provide a buffer or insulation from the ravages of daily stress, research has found that forgiveness can too, Toussaint said.

“Forgiveness is good for your health, yes. But it also helps protect you from those things that are not good for your health that you probably can’t avoid. So it has kind of a dual role in that way. It’s a protective coping mechanism.”

For example, those who forgive may have a better memory. “As you get older, your memory starts to fade a little bit. But what we found is that for people who are more forgiving that age-related decline in memory deficits is far less than it is for those that are the more unforgiving types,” Toussaint said.

And those who are more forgiving may live longer. A study of adults in the U.S. ages 66 and older found that forgiveness adds a positive benefit to one’s lifespan — after controlling for religious, socio-demographic and health behavior variables. “We found that people are somewhere in the neighborhood of maybe 25 to 50% more likely to still be living three years later, if they’re more forgiving than not,” Toussaint said.

More about the forgiveness research series

This Church News series explores what research says about forgiveness, in light of President Russell M. Nelson’s recent emphasis on forgiveness for members of The Church of Jesus Christ of Latter-day Saints. The series includes:

Part 1: The Prophet’s plea for and example of forgiveness
Part 2: How forgiveness can affect marriage and family relationships
Today — Part 3: What research says about forgiveness and mental health, physical well-being