Psychotherapy, Religion, and Brain Effects of Trauma - Part II

In the first part of this post, we established three fundamental things:

• You are healed from PTSD if you no longer meet the criteria for the diagnosis.
• Psychology, as a science, proposes hypotheses which can be tested in the natural world.
• Religion also proposes hypotheses, but fundamentally about the supernatural world, where hypotheses cannot be tested.

Let’s add one more fundamental idea: religious traditions can, and do, propose many things about the natural world. Some of their most notable propositions are ethical in nature, and in this context one finds the idea that forgiveness is a good thing.

Forgiveness as a value has a long and honored tradition in the Abrahamic religions (Judaism, Islam, and Christianity). If we consider that religion, like all traditional culture, functions in part as a kind of “memory” for a people – identifying and preserving important ideas, understandings, and directives, then a reasonable case can be made that we should seriously consider the idea of forgiveness.

But Does Forgiveness Matter in Healing PTSD?

In considering this, I suggested caution in my previous post. The problem is that religion and science have different ways of achieving trust in an idea – different ways of “knowing.” Religious tradition honors tradition and authority. That isn't necessarily bad. It’s just not the same as way of knowing employed in science, which employs formal empirical validation. When translating an idea from one way of thinking to another, we need to be conscious of this shift in perspective. Mixing up ways of knowing can lead to confused thought and poor outcomes, should that thought be acted upon.

Advocating the goodness of something is not the same as acting to bring it about. Advocacy is a verbal activity. Does it get results? If so, is this a cost-effective way of getting those results, or is there a better way? Religion, as a social institution just doesn't take up these questions, and has no validated way of answering them. They are empirical questions and for such things we must turn to science.

Forgiveness as an Individual and Social Value can Be Evaluated

It’s helpful to make a strong distinction between the source of an idea and its subject. Forgiveness, as a human act, derives from traditional religious thought, but its subject (relative to human action) is inherently on the natural world. It can therefore be observed, measured, analyzed – IF we can give it a good definition, one that offers us aspects we can measure. Thinking of forgiveness in this, admittedly, unusual way makes it possible to consider its importance to healing in posttraumatic stress disorder (PTSD).

We should note that forgiveness has been valued in secular contexts, also. Psychologist Seligman (2004, p. 1380), notable for his contributions to positive psychology (the psychology of happiness), has identified both forgiveness and gratitude as a path to increasing good feelings about one’s past.

Forgiveness and “Unforgiveness” as Seen in Psychology

A small group of academic research psychologists have taken up the benefits of forgiveness as a topic for their research, but only recently. In 2000, it was noted that there existed "no evidence . . . linking forgiveness to physiology, health, or disease (Thoresen, Harris, & Luskin, 2000). That year, “unforgiveness,” the problem to which forgiveness is the remedy, was defined as a group of complex and simple emotions and feelings “resentment, bitterness, hostility, hatred, anger, and fear” directed toward a source of injury (Worthington, Sandage, & Berry, 2000, in Harris & Thoresen, 2005, p. 321). Following the analysis of Nathanson (1994), I will focus on the last two affects (feelings) - fear and anger, rather than the more complex and derivative emotions preceding them in that list.

I want to emphasis, at this point, that I have learned in my clinical work with PTSD that anger never occurs without fear preceding it, and that fear is a spontaneous product of the perception of a threat. This causal chain model has great practical application: remove the threat-experience in the mind, and there is no cause for fear, and thus no anger. This has profound implications, given the central nature of fear in unforgiveness.

Injury, Fear, and Anger and Forgiveness

We now have a connection between injury, the fear and anger it produces in all animals, and forgiveness as a conceptual remedy. Injury changes the brain, and forgiveness is to be conceived of as changing it back. Why does this matter? At the least, a chronic anger state is uncomfortable. Beyond that, a certain percentage of people act out their anger, and seldom with constructive result. It seems likely that forgiveness, and specifically “letting go of the anger,” has been proposed as a solution to the dangerous potentials (to the individual and to others) associated with anger that persists.

We are now ready to look at the question of the negative consequences of sustained unforgiveness and the positive consequences of forgiveness, both in general and with particular focus on intervening in PTSD. As often happens when we focus intently on an important subject, there are some surprises, all of which I will take up in the final instalment of this series.

References.

Harris, A. H., & Thoresen, C. E. (2005). Forgiveness, unforgiveness, health, and disease. In Handbook of forgiveness (pp. 321–334). New York, N.Y.: Routledge.

Nathanson, D. L. (1994). Shame and Pride: Affect, Sex and the Birth of Self. New York, NY: W W Norton & Co.

Seligman, M. E. P., Parks, A. C., & Steen, T. (2004). A balanced psychology and a full life. Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences, 359(1449), 1379–1381. doi:10.1098/rstb.2004.1513

Thoresen, C. E., Harris, A. H., & Luskin, F. (2000). Forgiveness and health: An unanswered question. In M. E. McCullough, K. I. Pargament, & C. E. Thoresen (Eds.), Forgiveness: Theory, research, and practice (pp. 254–280). New York, N.Y.: Guilford.

Worthington, E. L., Sandage, S. J., & Berry, J. W. (2000). Group interventions to promote forgiveness: What researchers and clinicians ought to know. In M. E. McCullough, K. I. Pargament, & C. E. Thoresen (Eds.), Forgiveness: Theory, research, and practice (pp. 228–253). New York: Guilford Press.

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