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The Immediate and Delayed Cardiovascular Benefits of Forgiving

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Abstract and Figures

Background: The putative health benefits of forgiveness may include long-term buffering against cardiovascular reactivity associated with rumination. Although studies show short-term benefits of adopting a forgiving perspective, it is uncertain whether this perspective protects against repeated future rumination on offenses, which may be necessary for long-term health benefits. Also unclear is whether forgiveness offers unique benefits beyond simple distraction. Methods: Cardiovascular parameters (systolic blood pressure [SBP], diastolic blood pressure [DBP], and heart rate) were measured while 202 participants thought about a previous offense from an angry or forgiving perspective or were distracted. All participants were then distracted for 5 minutes, after which they freely ruminated on the offense. Results: Angry rumination initially yielded the greatest increase in blood pressure from baseline (mean [M] [standard deviation {SD}]: SBP = 9.24 [11.16]; M [SD]: DBP = 4.69 [7.48]) compared with forgiveness (M [SD]: SBP = 3.30 [6.48]; M [SD]: DBP = 1.51 [4.94]) and distraction (M [SD]: SBP = 4.81 [6.28]; M [SD]: DBP = 1.75 [3.80]), which did not differ from each other (p > .30). During free rumination, however, those who had previously focused on forgiveness showed less reactivity (M [SD]: SBP = 7.33 [9.61]; M [SD]: DBP = 4.73 [7.33]) than those who had been distracted (M [SD]: SBP = 10.50 [7.77]; M [SD]: DBP = 7.71 [6.83]) and those who previously focused on angry rumination (M [SD]: SBP = 12.04 [11.74]; M [SD]: DBP = 8.64 [12.63]). There were no differences for heart rate. Conclusions: Forgiveness seems to lower reactivity both during the initial cognitive process and, more importantly, during mental recreations of an offense soon thereafter, potentially offering sustained protection, whereas effects of distraction appear transient.
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The Immediate and Delayed Cardiovascular Benefits of Forgiving
Background: The putative health benefits of forgiveness may include long-term buffering against cardiovascular reactivity associated
with rumination. Although studies show short-term benefits of adopting a forgiving perspective, it is uncertain whether this perspective
protects against repeated future rumination on offenses, which may be necessary for long-term health benefits. Also unclear is whether
forgiveness offers unique benefits beyond simple distraction. Methods: Cardiovascular parameters (systolic blood pressure [SBP],
diastolic blood pressure [DBP], and heart rate) were measured while 202 participants thought about a previous offense from an angry
or forgiving perspective or were distracted. All participants were then distracted for 5 minutes, after which they freely ruminated on the
offense. Results: Angry rumination initially yielded the greatest increase in blood pressure from baseline (mean [M] [standard deviation
{SD}]: SBP = 9.24 [11.16]; M [SD]: DBP = 4.69 [7.48]) compared with forgiveness (M [SD]: SBP = 3.30 [6.48]; M [SD]: DBP = 1.51
[4.94]) and distraction (M [SD]: SBP = 4.81 [6.28]; M [SD]: DBP = 1.75 [3.80]), which did not differ from each other (p9.30). During
free rumination, however, those who had previously focused on forgiveness showed less reactivity (M [SD]: SBP = 7.33 [9.61]; M
[SD]: DBP = 4.73 [7.33]) than those who had been distracted (M [SD]: SBP = 10.50 [7.77]; M [SD]: DBP = 7.71 [6.83]) and those
who previously focused on angry rumination (M [SD]: SBP = 12.04 [11.74]; M [SD]: DBP = 8.64 [12.63]). There were no differences
for heart rate. Conclusions: Forgiveness seems to lower reactivity both during the initial cognitive process and, more importantly,
during mental recreations of an offense soon thereafter, potentially offering sustained protection, whereas effects of distraction appear
transient. Key words: forgiveness, cardiovascular reactivity, rumination, distraction, cardiovascular disease, emotion.
SBP = systolic blood pressure; DBP = diastolic blood pressure;
CVR = cardiovascular reactivity.
While forgiving has long been considered an important
moral virtue, it also seems to be beneficial for physical
health (1). Forgiveness has been associated with fewer reported
physical symptoms (2), fewer medications taken (3), a stronger
immune system (4), and reduced cardiovascular mortality (5).
Despite these robust findings, it remains uncertain whether for-
giveness is causally associated with these health benefits (6) and,
if so, through which mechanisms they are associated.
One possible mechanism connecting forgiveness to long-term
health is that forgiveness is associated with less strain on the
cardiovascular system. Studies examining trait forgiveness have
generally found this to be true. More forgiving people have lower
blood pressure at baseline (7) and also show faster cardiovas-
cular recovery after offense (8,7), yielding lower overall blood
pressure (2,9). Because these findings are based on trait differ-
ences, however, they cannot speak to whether forgiveness actu-
ally plays a causal role in these physiological responses (6).
To try to get closer to a possible causal relationship between
forgiveness and blood pressure, several studies have examined
state forgiveness by comparing physiological responses to for-
given and unforgiven offenses. Lawler et al. (2) interviewed
participants about a time of betrayal and assessed both trait for-
giveness and the extent to which participants had forgiven the
offender for that particular offense (state forgiveness). Those
with higher state forgiveness showed reduced cardiovascular
reactivity (CVR) during the interview, suggesting that forgive-
ness was beneficial. However, state forgiveness in this case
was again determined by the participants rather than by random
assignment; thus, it remains possible that some factor other
than forgiveness was responsible for buffered CVR.
Witvliet and colleagues (10) addressed this issue by con-
ducting a within-individual study. Participants were assigned
to imagine a hurtful incident from an angry perspective and
then from a forgiving perspective, for alternating 16-second
intervals over the course of several minutes. They found that
the intervals of angry, unforgiving thoughts were associated
with greater CVR than those in which participants adopted a
forgiving perspective, suggesting that forgiveness is associated
with cardiovascular benefits independent of the characteristics
of the forgiver.
Although this finding suggests that forgiveness strains
the cardiovascular system less than anger, it does not answer
whether forgiveness offers benefits beyond simply not engag-
ing in unforgiveness, a hyperaroused negative state marked by
angry rumination on offenses (c.f. Harris and Thoresen (11)).
Angry rumination has been associated with greater short-term
CVR (12) and greater long-term cardiovascular morbidity and
mortality (13,14); thus, anything preventing angry rumination
could be health protective. Distraction, for example, has been
found to facilitate cardiovascular recovery after stress compared
with rumination (12,15). It could be that any alternative to angry
rumination is beneficial and that forgiveness would be no better
than distraction. To our knowledge, no study has demonstrated
that forgiveness has cardiovascular benefits beyond those of
simple distraction.
For forgiveness to have meaningful effects on health, it is
likely that it must affect longer-term changes in emotions and
cognitions associated with an offense. According to the reactiv-
ity hypothesis, although isolated episodes of reactivity during a
stressor may not lead to disease, continued elevations in blood
pressure brought on by recurring rumination can build up over
time, straining the cardiovascular system and increasing risk
Psychosomatic Medicine 74:745Y750 (2012) 745
Copyright *2012 by the American Psychosomatic Society
From the Departments of Psychology (B.A.L., R.S.D., C.R.H., N.J.S.C.)
and Philosophy (D.N., P.-E.M.), University of California, San Diego, La Jolla,
Address correspondence and reprint requests to Britta A. Larsen, PhD, De-
partment of Psychology, University of California, San Diego, 9500 Gilman Dr,
La Jolla, CA 92093-0109. E-mail:
This research was supported by a University of California, San Diego Inter-
disciplinary Collaboratories Fellowship awarded to B.A.L., R.S.D., and P.-E.M.
Received for publication September 15, 2011; revision received March 19,
DOI: 10.1097/PSY.0b013e31825fe96c
Copyright © 2012 by the American Psychosomatic Society. Unauthorized reproduction of this article is prohibited.
of disease (16,13). The benefits of forgiveness may lie in its
enduring nature; forgiving may extend protection by changing
the way people think about the incident in the future. When
examining the possible health benefits of forgiveness, then, it
is important to examine physiological reactivity not only during
forgiveness or angry rumination interventions but also during
future mental recreations of the event. Although previous re-
search has examined the immediate cardiovascular effects of
adopting a forgiving perspective, no study has examined whether
engaging in forgiving cognitions changes responses to later con-
templation of offenses.
The purpose of the current study was to explore the car-
diovascular effects of engaging in forgiving or angry cogni-
tions surrounding an offense, examining reactivity both when
these cognitions are first initiated and, more critically, during
later unrestrained rumination. This study also sought to com-
pare the possible benefits of forgiveness and distraction during
these two periods to determine whether forgiveness offers ben-
efits beyond simple distraction.
Participants were 202 healthy undergraduates (168 women) recruited during
the summer and fall of 2010, ranging in age from 18 to 29 years (mean [standard
deviation] = 20.4 [1.6] years). Of the participants, 63% were Asian, 15.5% were
non-Hispanic white, 15.5% were Hispanic/Latino, and 6% were classified as
Participants received course credit in exchange for participation. The
University of California, San Diego institutional review board approved the study,
and participants provided written informed consent before participating.
Blood pressure and heart rate (HR) were monitored continuously using
an Ohmeda Finapres 2300 (TNO Biomedical Instrumentation, Amsterdam, the
Netherlands). This takes beat-to-beat measurements using an inflatable cuff
placed on the middle finger of the nondominant hand.
Before the baseline, participants filled out a survey assessing a variety of traits
associated with forgiveness, such as angry rumination and desire for revenge.
Nine of these items comprised a measure of trait forgiveness. Six items were
coded positively (e.g., ‘‘generally, I forgive those who hurt me,’’ ‘‘withholding
forgiveness is wrong,’’ and ‘‘I generally make peace with the people who hurt
me’’), and the other three items were reverse coded (e.g., ‘‘Iusually hold it against
people when they hurt me,’ and ‘‘when someone hurts me I feelresentment toward
the offender’’). All were rated on a Likert scale from 1 (not at all)to 5 (verymuch
so). These items showed good internal validity (>= 0.85) and were normally
distributed (mean [standard deviation] = 30.73 [6.1], range = 13Y45).
After filling out the trait forgiveness survey, participants sat quietly for
5 minutes to obtain baseline readings. Previous studies using a Finapres have
found that 5 minutes is sufficient to produce a reliable estimate of resting levels
because the Finapres produces readings with each heartbeat (12,17). Next,
all participants were asked to think of a time they had been hurt, betrayed, or
offended, preferably somewhat recently and involving a friend or acquaintance
rather than a stranger. They were told that they should select an incident but not to
think about it in any detail. Participants were randomly assigned to a conditionafter
choosing an incident to ensure that the condition did not influence their choice.
Participants then engaged in a 2-minute directed rumination task, in which
they thought about the hurtful incident from one of three assigned perspectives.
Forgiveness Condition
Participants were instructed to picture themselves forgiving the offender and
were offered the following strategies for doing so:
"Spend the next few minutes thinking about this incident, and picture
yourself forgiving the person involved. This could mean picturing yourself
simply letting go of hurt and anger and moving on, trying to see the incident
from their perspective or imagining what outside circumstances could have
influenced their actions, trying to see the good in the other person despite what
they did to hurt you, and imagining reconciling with them or anything else you
may think is important in forgiving. Be sure to keep your mind on the incident and
the process of forgiving the person."
Angry Rumination Condition
Participants were instructed to picture themselves being angry or offended
by the incident and were given the following ideas of things to focus on:
"Spend the next few minutes thinking about this incident, and picture
yourself being angry and offended. You could focus on several different parts of
being angry: think about their disregardfor your feelings,why their actionswere so
wrong or hurtful, and think of the ways you would liketo get revenge or things you
would have liked to say or do to them in return. Imagine holding onto the re-
sentmentand anger you felt when you werefirst hurt. Be sure to keepyour mind on
the incident and the hurt and anger it caused."
Distraction Condition
Participants were told not to think about the incident they had chosen but
instead to think about their activities the previous weekend in a nonemotional
way. This was designed to include a recall element like the other conditions but
without the emotional component:
"Spend the next few minutes thinking of everything you did last weekend. Try
to rememberit in as much detail as possible, walking yourself through eachhour of
each day from Friday evening to Sunday night. Do your best to actually picture
yourself in eachactivity, and remember all the people involved. Imagine the actual
activities themselves but do not focus on the emotions that may have been
Directed rumination was followed by a 5-minute recovery task during which
all participants looked through pictures of famous faces and highlighted the
ones they recognized. This was designed to distract participants from further
All participants, including those in the distraction condition, then engaged in a
2-minute free rumination task. They were instructed to once again think of the
hurtful incident they imagined before (or, for those in the distraction condition, to
imagine it for the first time) but were told to imagine it any way they wished:
"Think about the incident you recalled earlier. This time, I would like you to
think of the incident and exactly what happened. Walk through it like you are
going through it again. Focus on how you feel about the person or people
involved. (For those in the rumination or forgiveness condition, to be clear,you
no longer have to think about it in theway that we assigned to you earlier. That is,
think of or picture the incident however you want toVwhatever comes naturally to
you when you imagine it now). Walk yourself through the incident in your mind
describing what happened as though you were describing it to an outside party.
Again, it is important that, asyou sit thinking about it, you keep your focus on the
incident and the emotions it brings up."
Afterward, participants had another 5-minute recovery period during which
they filled out a brief survey and manipulation check. In prior studies looking at
poststress recovery, 5 minutes has been sufficient to assess the impact of vari-
ous interventions, such as rumination, distraction, suppression, music, and for-
giveness (2,7,12,15,18,19). Participants were then debriefed and excused.
Manipulation Check
To ensure that those in the rumination and forgiveness conditions had
thought about the incident in the intended way, they filled out a final survey
Because this was an ethnically diverse sample, we also ran our analyses with
ethnicity as a covariate. This did not change the results, and ethnicity did not
emerge as a significant covariate. There was also no main effect of ethnicity on
trait forgiveness.
These items were part of a separate, ongoing study related to trait differences in
forgiveness and will not be reported on.
B. A. LARSEN et al.
746 Psychosomatic Medicine 74:745Y750 (2012)
Copyright © 2012 by the American Psychosomatic Society. Unauthorized reproduction of this article is prohibited.
indicating the degree to which they engaged in cognitions indicative of angry
rumination or forgiveness during the directed rumination period. This included
items such as ‘‘I focused on the hurt and anger I felt’’ or ‘‘I tried to see the goodin
the other person.’’ These were entered into two separate scales to capture partici-
pants’ focus on forgiveness (seven items; >= 0.76) and on anger (six items; >=
0.75). Participants also indicated how much they thought about things unrelated to
the incident, such as social plans or school. All items were rated on Likert scales
from 1 (not at all) to 5 (very much). Because the questions centered on how
participants thought about the hurtful incident during the directed rumination pe-
riod, those in the distraction condition, who were instructed to think about
something entirely different, were not given the manipulation check because the
questions did not apply to them.
Data Reduction and Analysis
Cardiovascular parameters of interest were systolic blood pressure (SBP)
and diastolic blood pressure (DBP). HR was also included. For each measure, the
mean at baseline was subtracted from the mean for each period.
Manipulation Check
An analysis of variance (ANOVA) confirmed that those in
the forgiveness condition focused on forgiving thoughts sig-
nificantly more than those in the angry rumination condition
during directed rumination (F(1,132) = 13.25, pG.001). In
addition, those in the angry rumination condition focused on
angry thoughts significantly more than those in the forgive-
ness condition (F(1,132) = 33.0, pG.001), suggesting that the
manipulation was effective. The conditions did not differ in the
degree to which participants thought about things unrelated to
the incident (F(1,133) = 0.54, p=.46).
Participant Characteristics
Baseline readings for the three conditions are shown in
Table 1. There were no differences between conditions in base-
line SBP (F(2,145) = 0.95, p= .39), baseline DBP (F(2,145) =
0.05, p= .95), baseline HR (F(2,145) = 0.39, p= .68), trait
forgiveness (F(2,197) = 0.25, p= .78), or sex makeup (W
202) = 0.85, df =1,p= .65). Consistent with previous litera-
ture (9), women scored higher in trait forgiveness than men
(F(1,194) = 11.95, p= .001).
Cardiovascular Reactivity
Systolic Blood Pressure
To determine whether SBP changes throughout the study
varied by condition, a repeated-measures ANOVA was performed
on change in SBP from baseline during directed rumination, first
recovery, free rumination, and second recovery, with condition as
the between-individual factor. Data showed a significant inter-
action of time and condition on SBP (F(6,411) = 2.34, p= .031).
As shown in Figure 1, SBP was smallest during the directed
rumination period for those in the forgiveness condition, fol-
lowed by the distraction and then angry rumination conditions.
This replicates previous findings showing that, during directed
perspective taking, forgiveness is associated with lower blood
pressure than anger. During the free rumination period, those
in the forgiveness condition again showed the lowest blood
pressure, whereas those in the distraction and angry rumination
conditions showed larger blood pressure increases. This per-
sisted into the last recovery period.
Follow-up ANOVAs were then performed to test for sig-
nificant differences at each individual period. This showed a
significant effect of condition on SBP during directed rumi-
nation (F(2,137) = 6.49, p= .002). Planned comparisons be-
tween conditions revealed that those in angry rumination had
significantly higher SBP than both those in the forgiveness
(t= 3.47, df = 139, p= .001) and distraction (t= 2.58, df = 139,
p= .011) conditions, although these two did not differ from
each other (t= 0.89, df = 139, p= .38).
There was no difference between conditions in the first
recovery phase (F(2,137) = 0.91, p= .40). This is consistent
with findings showing that strong irrelevant distractors can
homogenize blood pressure levels across conditions (12).
Condition had a marginal effect on SBP during free rumi-
nation (F(2,137) = 2.77, p= .066), and planned comparisons
showed a significant difference between the angry rumination
and forgiveness conditions (t=2.30,df =139,p=.023).There
was also a marginal effect of condition on SBP during the last
recovery (F(2,137) = 2.50, p= .086), which in this case was
driven by a significant difference between the forgiveness and
distraction conditions (t=2.15,df =139,p=.033),withthosein
the forgiveness condition again showing the lowest reactivity.
To determine the influence of trait forgiveness on SBP,
we performed a median split on the trait forgiveness scores to
divide participants into high and low forgivers. A repeated-
measures ANOVA was performed using trait forgiveness (high
or low) as the between-individual variable and change in SBP
TABLE 1. Baseline Characteristics of the Forgiveness, Rumination, and Distraction Conditions
Forgiveness (n= 69) Rumination (n= 66) Distraction (n= 67)
Female, % 82.6 83.3 77.6
Trait forgiveness 30.3 (6.1) 30.8 (6.1) 31.1 (6.1)
Cardiovascular measures
Systolic blood pressure, mm Hg 110.6 (12.72) 107.5 (12.60) 107.6 (12.60)
Diastolic blood pressure, mm Hg 72.6 (11.3) 73.3 (11.3) 72.7 (11.3)
Heart rate, beats per min 78.8 (11.4) 77.0 (11.5) 77.2 (11.5)
Data are presented as mean (standard deviation) unless otherwise indicated. No between-group differences were significant.
We also ran analyses using trait forgiveness as a covariate. Trait forgiveness did
not emerge as a significant covariate, and including it did not change our results.
Psychosomatic Medicine 74:745Y750 (2012) 747
Copyright © 2012 by the American Psychosomatic Society. Unauthorized reproduction of this article is prohibited.
during the four periods as the within-individual variable. Al-
though those high in trait forgiveness generally had smaller
change scores throughout the study, there was no significant
difference between high and low forgivers overall (F(1,137) =
0.09, p= .77) and no interaction of trait forgiveness and time
(F(3,411) = 1.1, p=.35).
Diastolic Blood Pressure
A repeated-measures ANOVA, like that performed with SBP,
was used to determine if DBP changed throughout the study as
a function of condition. This again showed a significant interac-
tion of time and condition (F(6,411) = 4.37, pG.001).
As Figure 2 shows, the pattern for DBP was similar to that
of SBP, particularly for those in the angry rumination and
forgiveness conditions. Those in the distraction condition were
nearly identical to those in the forgiveness condition during di-
rected rumination and recovery but then rose to the level of
those in the angry condition during the free rumination period.
Analysis of DBP during specific periods showed a signifi-
cant effect of condition during directed rumination (F(2,139) =
4.67, p= .011). As with SBP, planned comparisons of condi-
tions showed that DBP was significantly higher in the angry
rumination condition than in the forgiveness (t=2.75,df =141,
p= .007) and distraction (t=2.53,df =141,p= .012) condi-
tions, which did not differ from each other. There was no effect
of condition during the first recovery (F(2,139) = 0.3, p=.74)
or free rumination period (F(2,139) = 2.3, p= .10), although
the forgiveness condition in this period was marginally lower
than the angry condition (t=2.05,df =141,p= .06). Again,
as with SBP, there was an effect of condition on DBP during
the last recovery period (F(2,139) = 3.11, p= .048). DBP in the
forgiveness condition was significantly lower than that in the
distraction condition (t=2.36,df =141,p= .02) and marginally
lower than that in the angry rumination condition (t=1.88,
df =141,p=.06).
As with SBP, trait forgiveness was not found to influence
DBP overall (F(1,139) = 0.69, p= .41) and showed no inter-
action with time across the study (F(3,417) = 0.04, p= .99).
Heart Rate
The same repeated-measures ANOVA was performed for
HR. The analysis showed no interaction of condition and time
on HR (F(6,420) = 0.98, p= .44). There were also no effects of
condition on any of the individual time points (for all, p9.2).
Consistent with previous findings, these data show that
imagining a hurtful event in a forgiving way leads to smaller
increases in blood pressure than imagining the same event from
an angry perspective. Importantly, however, these data also
show that engaging in forgiving cognitions can lead to changes
that outlast the rumination instructions and that thinking about
an upsetting incident from a forgiving perspective can protect
against later elevations in blood pressure. When freely thinking
about the incident, those who had engaged in forgiving cogni-
tions earlier showed the smallest elevations in blood pressure,
although they were given the same instructions at this time as
those who had been in the angry rumination condition. These
differences persisted into the second recovery period, despite
having no instructions to think about the incident at all. This
is the first study to show that focusing on forgiveness is protec-
tive not only in that moment but can offer recurring protection
by changing how individuals respond to subsequent rumina-
tion in the near future. Based on theorizing on the reactivity
hypothesis (20), it could be this recurring protection that leads
to long-term health benefits.
The free rumination period also showed that distraction
may not be an entirely effective way to deal with offense. Like
those who forgave, those who were distracted initially showed
lower blood pressure than those focusing on angry rumina-
tion. However, when they were allowed to freely ruminate on
Figure 1. Change in systolic blood pressure from baseline during each period of
the study, by condition (error bars represent between-individual standard error).
Figure 2. Change in diastolic blood pressure from baseline during each period of
the study, by condition (error bars represent between-individual standard error).
B. A. LARSEN et al.
748 Psychosomatic Medicine 74:745Y750 (2012)
Copyright © 2012 by the American Psychosomatic Society. Unauthorized reproduction of this article is prohibited.
the incident, their blood pressure rose more than did the blood
pressure of those in the forgiveness condition and continued
to increase into the recovery period. This pattern was especially
pronounced in DBP, which showed the distraction and forgive-
ness conditions to be essentially identical until free rumina-
tion, when the blood pressure of those who had been distracted
climbed to higher levels. Distraction, then, may be somewhat
protective while one engages in it but seems to be ineffective
as soon as it ends. The benefits of forgiveness beyond distrac-
tion may thus be most pronounced in subsequent mental rec-
reations of the event.
The observed blood pressure pattern suggests that those
who simply ‘‘let it go’’ or avoid thinking about an incident
may not get all the benefits associated with forgiving. Recent
work shows that that compassionate reappraisal is associated
with more benefits than emotional suppression while thinking
about an incident (21); the current data show that these bene-
fits may extend to subsequent rumination as well. When par-
ticipants are given time to process the event from a new
perspective, even briefly, it seems to alter the way in which
they think about the event in the near future. These data suggest
that simple cognitive exercises may be enough to initiate this
process. The strength of this effect is underscored by the fact
that the manipulation lasted only 2 minutes, taking a forgiving
perspective was a matter of assignment rather than choice, and
participants were specifically told they were not required to
take this perspective during free rumination. This demonstrates
that the benefits of forgiveness are not restricted to those high
in trait forgiveness (7,8) or those who self-report feeling state
forgiveness (2) but can extend generally to those assigned to
engage in temporary state forgiveness.
There are, of course, various questions not addressed by
these data. It is unclear, for example, which forgiving cogni-
tions were most effective. In designing interventions, it would
be useful to know which of the suggested strategies is most
effective in producing lasting forgiveness. Recent work has ex-
plored various strategies of reappraising a hurtful event, such
as focusing on compassion for the offender or focusing on the
benefits gained through the experience, both of which show
unique physiological and emotional benefits compared with
proaches to forgiveness result in greatest long-term health bene-
fits. A mediation analysis of elements of forgiveness and health
outcomes showed that reductions in anger did not fully explain
health benefits associated with forgiveness (23). Increasing pos-
itive emotions and cognitions, then, in addition to reducing
anger and hostility, may be necessary to achieving all the ben-
efits of forgiveness. In fact, Worthington and colleagues (24,25)
have suggested that replacing negative cognitions with positive
ones such as empathy and compassion is the very essence of
forgiveness. In this light, it would be useful to study the imme-
diate cardiovascular effects of different forgiveness strategies,
including those that simply reduce negative appraisals and those
that replace them with positive ones.
In addition, in our study, the ‘‘free rumination’’ period was
not entirely unconstrained because participants were still told
to ruminate on the hurtful incident. It is possible that forgive-
ness would be health promoting not only by reducing the car-
diovascular reactions to such thoughts but also by reducing
the probability of having such thoughts. Our study, then, might
underestimate the benefits. Future research could also explore
other effects of forgiveness, such as whether those taking on a
tive rumination or less willing to engage in it.
It is unlikely that results during free rumination were due to
physiological carryover from earlier rumination because condi-
tions did not differ after the first recovery period and those in
the distraction condition showed marked changes from the first
rumination period to the second. It is possible, however, that
differences in cognitions during free rumination were due to the
laboratory environment rather than real cognitive changes. For
example, participants in the forgiveness and angry rumination
conditions may have felt that they were obligated to continue
seeing the incident from the previously designed perspective
and that the results reflect a continuation of the earlier directed
rumination period. Although this is a concern, participants were
explicitly told that they did not have to think about the trans-
gression in the same manner as previously assigned and that
they should think about it in whatever way felt most natural.
Given these instructions, it seems likely that the effects seen here
were due to changes in their mental recreations of the event and
not due to direct influence of the earlier manipulation instruc-
tions. It is possible, however, that, because participants were in
the same context as during the initial rumination period, what-
ever was ‘‘most natural’’ was simply to think of the incident in
the same way they had before. It would be useful for future
studies to explore rumination across contexts, particularly out-
side the laboratory, to determine the strength of the forgiveness
Another drawback of the current study is that the time
limitations of the study period prevented assessment of long-
term changes in perspective or CVR. Given the rather short
time frame of our blood pressure monitoring, we cannot assess
whether the intervention had any permanent impact, and people
may revert after some time to habitual modes of thought. Some
work proposing a cycle of rumination and arousal would sug-
gest that changing the arousal associated with thoughts of an
event is likely to have ongoing benefits (14,26). Neverthe-
less, it seems that a clear next step is to investigate forgiveness-
associated effects on CVR further into the future to determine
how long lasting these effects really are. Such lasting effects
may only come after a more thorough intervention.
Finally, it is not clear whether imagining oneself forgiving
is the same thing as actually forgiving or whether they would
produce different results. This limitation is common across
the field (10,22,23) and calls into question whether the results
are truly generalizable. Still, in our study, even imagining for-
giving resulted in reduced CVR during subsequent rumina-
tion on the event, suggesting that imagining oneself forgiving
can yield cardiovascular benefits. In addition, it would also be
useful to replicate the current findings with a sample from
the general population because the current sample comprised
Psychosomatic Medicine 74:745Y750 (2012) 749
Copyright © 2012 by the American Psychosomatic Society. Unauthorized reproduction of this article is prohibited.
undergraduates, who may not be representative in the interper-
sonal offenses they experience, and was mostly women, who
tend to be more forgiving than men.
The reactivity hypothesis suggests that small changes in
CVR like those seen here can build up over time and result
in differences in health outcomes (16). However, additional
research is needed to determine whether modest differences
in the laboratory over a short period could translate to actual
differences in health outcomes. Our results do suggest a possi-
ble mechanism for health differences associated with forgive-
ness and indicate that, although forgiveness is often assumed
to benefit offenders, it seems that those who forgive can also
experience concrete benefits for themselves.
1. Friedman M, Thoresen CE, Gill J, Ulmer D, Powell LH, Price VA,
Brown B, Thompson L, Rabin D, Breall WS, Bourg E, Levy R, Dixon T.
Alteration of Type A behavior and its effect on cardiac recurrences on post-
myocardial infarction patients: summary results of the Recurrent Coronary
Prevention Project. Am Heart J 1986;112:635Y65.
2. Lawler KA, Younger JW, Piferi RL, Billington E, Jobe R, Edmondson K,
Jones WH. A change of heart: cardiovascular correlates of forgiveness
in response to interpersonal conflict. J Behav Med 2003;26:363Y93.
3. Lawler KA, Younger JW, Piferi RL, Jobe RL, Edmondson KA, Jones WH.
The unique effects of forgiveness on health: an exploration of pathways.
J Behav Med 2005;28:157Y67.
4. Seybold KS, Hill PC, Neumann JK, Chi DS. Physiological and psycho-
logical correlates of forgiveness. J Psychol Christ 2001;20:250Y9.
5. Kaplan BH. Social health and the forgiving heart: the Type B story.
J Behav Med 1992;15:3Y14.
6. Thoresen CE, Harris AHS, Luskin F. Forgiveness and health: an un-
answered question. In: McCullough ME, Pargament KI, Thoresen CE,
editors. Forgiveness: Theory, Research, and Practice. New York, NY:
Guilford; 2000:254Y80.
7. Friedburg JP, Suchday S, Shelov DV. The impact of forgiveness on cardio-
vascular reactivity and recovery. Int J Psychophysiol 2007;65:87Y94.
8. Whited MC, Wheat AL, Larkin KT. The influence of forgiveness and
apology on cardiovascular reactivity and recovery in response to mental
stress. J Behav Med 2010;33:293Y304.
9. Lawler-Row K, Hyatt-Edwards L, Wuensch KL, Karremans JC. Forgive-
ness and health: the role of attachment. Pers Relatsh 2011;18:170Y83.
10. Witvliet CVO, Ludwig TE, VanderLaan KL. Granting forgiveness or har-
bouring grudges: implications for emotion, physiology and health. Psychol
Sci 2001;12:117Y23.
11. Harris AHS, Thoresen CE. Forgiveness, unforgiveness, health, and dis-
ease. In: Worthington EL, editor. Handbook of Forgiveness. New York,
NY: Taylor & Francis; 2005:321Y34.
12. Glynn LM, Christenfeld N, Gerin W. The role of rumination in recovery
from reactivity: cardiovascular consequences of emotional states. Psychosom
Med 2002;64:714Y26.
13. Miller TM, Smith TW, Turner CW, Guijarro ML, Hallet AJ. Meta-analytic
review of research on hostility and physical health. Psychol Bull 1996;119:
14. Larsen BA, Christenfeld N. Cardiovascular disease and psychiatric comor-
bidity: the potential role of perseverative cognition. Cardiovasc Psychiatry
Neurol 2009:791017.
15. Neumann SA, Waldstein SR, Sellers JJ 3rd, Thayer JF, Sorkin JD. Hostility
and distraction have differential influences on cardiovascular recovery from
anger recall in women. Health Psychol 2004;6:631Y40.
16. Krantz DS, Manuch SB. Acute psychophysiologic reactivity and risk of
cardiovascular disease: a review and methodologic critique. Psychol Bull
17. Gerin W, Pieper C, Levy R, Pickering TG. Social support in social inter-
action: a moderator of cardiovascular reactivity. Psychosom Med 1992;54:
18. Chaf in S, Roy M, Gerin W, Christenfeld N. Music can facilitate blood
pressure recovery from stress. Br J Health Psychol 2004;9:393Y403.
19. Harris CR. Cardiovascular effect of embarrassment and effects of emotional
suppression in a social setting. J Pers Soc Psychol 2001;81:886Y97.
20. McEwen BS. Stress, adaptation, and disease: allostasis and allostatic load.
Ann N Y Acad Sci 1998;840:33Y44.
21. Witvliet CVO, DeYoung NJ, Hofelich AJ, DeYoung PA. Compassionate
reappraisal and emotion suppression as alternatives to offense-focused
rumination: implications for forgiveness and psychophysiological well-
being. J Posit Psychol 2011;6:286Y99.
22. Witvliet CVO, Knoll RW, Hinman NG, DeYoung PA. Compassion-focused
reappraisal, benefit-focused reappraisal, and rumination after an inter-
personal offense: emotion-regulation implications for subjective emotion,
linguistic responses, and physiology. J Posit Psychol 2010;5:226Y42.
23. Lawler-Row K, Karremans JC, Scott C, Edlis-Matityahou M, Edwards L.
Forgiveness, physiological reactivity and health: the role of anger. Int J
Psychophysiol 2008;68:51Y8.
24. Worthington EL Jr, Wade NG. The psychology of unforgiveness and
forgiveness and implications for clinical practice. J Soc Clin Psychol 1999;
25. McCullough ME, Worthington EL Jr, Rachal KC. Interpersonal forgiving
in close relationships. J Pers Soc Psychol 1997;73:321Y36.
26. Larsen BA, Christenfeld NC. Cognitive distancing, cognitive restructuring,
and cardiovascular recovery from stress. Biol Psychol 2011;86:143Y8.
B. A. LARSEN et al.
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... To explain my intuition, consider the last and most plausible candidate on the list. Imagine that Roger reads about the cardiovascular benefits of forgiveness (Larsen et al. 2012) and ceases to blame Martin solely for this reason. Again, this seems odd. ...
When we forgive, we do so for reasons. One challenge for forgiveness theorists is to explain which reasons are reasons to forgive and which are not. This paper argues that we forgive in response to a perceived change of heart on the part of the offender. The argument proceeds in four steps. First, I show that we forgive for reasons. Second, I argue that forgiveness requires the right kind of reason. Third, I show that these two points explain a common distinction between forgiving and letting go and, in doing so, solve a problem facing many accounts of forgiveness. Finally, I consider candidate reasons to forgive and argue that all of them are either the wrong kind of reason or are instances of a more general reason of the right kind, namely, a perceived change of heart.
... [2][3][4][5][6] Forgiveness of self and others has also been associated with physical health benefits, 7,8 a stronger immune system, 9 and reduced cardiovascular reactivity. [10][11][12][13] Nevertheless, physicians find self-forgiveness particularly challenging, 14 so acceptable evidence-based self-forgiveness tools to improve physicians' well-being are needed. [15][16][17] The aim of this study was to determine if a brief workshop teaching self-forgiveness to medical educators at a national conference would be acceptable, feasible, and improve immediate measurements of self-forgiveness. ...
Background Evidence suggests that forgiving one's self, others, and events improves relationships and self-esteem; reduces anxiety, depression, and stress; lowers blood pressure; improves cardiovascular health; and boosts immune function. Objective We determined the efficacy of a workshop to facilitate forgiveness in medical education professionals. Methods A 1-hour self-forgiveness workshop conducted by 4 facilitators was presented at a medical education conference in 2018. The workshop included a didactic presentation on forgiveness and Internal Family Systems; small group discussion on self-forgiveness concepts; a 15-minute guided imagery audio meditation on self-forgiveness; and postintervention small group discussion. The 18-item Heartland Forgiveness Scale (HFS), which measures forgiveness for self, others, and situations, was completed preintervention and postintervention (score range, 18–126). Results There were 91 participants, including graduate medical education managers and directors (61%), deans/clerkship directors (19%), and academic faculty/others (20%). Participants were from the South (20%), West (17%), Midwest (31%), and Northeast (32%) US regions. Baseline HFS scores showed that 53% were forgiving, 47% were neutral, and no participants had unforgiving tendencies. Total HFS score significantly increased (90.31 pre versus 95.7 post, P = .013), with significant increases in forgiveness of self (53% pre versus 73% post; P = .012; odds ratio = 2.47) and forgiveness of others (49% pre versus 69% post; P = .020; odds ratio = 2.3). Preintervention group discussion topics focused on guilt, shame, and barriers to forgiving, while postintervention discussions centered on challenges and benefits. Conclusions A brief guided meditation intervention with focused discussions was feasible and improved the immediate tendency to forgive.
... The discrepancy in the direction of the findings between the discussion and recovery phase is interesting; the recovery phase may be more likely to cultivate rumination as scholars have posited that the active discussion of a stressor may precede rumination that arises once recounting is finished (Lepore et al., 2006;Merritt et al., 2006). Laboratory analogue studies have found that rumination relates to poorer cardiovascular outcomes following stressors (Larsen et al., 2012;Radstaak, Geurts, Brosschot, Cillessen, & Kompier, 2011). Although the current study did not actively measure rumination in the recovery phase, rumination has been found to occur in periods directly following stressful events (Radstaak et al., 2011). ...
Multiracial people experience an accumulation of racial stress for both their minority and their multiracial identities, yet no research has examined the physiological impact of this stress. This within‐groups experimental study examined whether two race‐related stressors—identity invalidation and discrimination from family—affect cardiovascular reactivity for Black/White multiracial adults (N = 60). The authors found a Condition × Phase interaction effect indicating that discrimination from family affected blood pressure. Invalidation had no effect on blood pressure. Las personas multirraciales experimentan una acumulación de estrés racial tanto a causa de su identidad multirracial como de su identidad como minoría, pero no hay investigaciones que hayan examinado el impacto psicológico de este estrés. Este estudio experimental dentro de grupos examinó si dos factores causantes de estrés relacionados con la raza (la invalidación de la identidad y la discriminación por parte de la familia) afectan a la reactividad cardiovascular de personas adultas multirraciales blancas/negras (N = 60). Los autores hallaron un efecto de interacción Condición × Fase que indica que la discriminación por parte de la familia tuvo un efecto sobre la presión sanguínea. La invalidación no tuvo efecto sobre la presión sanguínea.
... Research indicates increased degrees of forgiveness are associated with positive physical and mental health outcomes, as well as general well-being (Thompson et al., 2005), life satisfaction, positive affect, and lower levels of anger, hostility, and stress (Brown & Phillips, 2005;Lawler et al., 2003;Maltby, Macaskill, & Day, 2001;Thompson et al., 2005;vanOyen Witvliet, Ludwig, & Vander Laan, 2001). In regards to health, forgiveness is inversely associated with physical symptomology, risky health habits (Lawler et al., 2003;Toussaint, Williams, Musick, & Everson, 2001;vanOyen Witvliet et al., 2001), blood pressure (Lawler et al., 2003), and cardiovascular reactivity to stress (Larsen et al., 2012;vanOyen Witvliet et al., 2001). Data suggest that rumination and forgiveness may be inversely related (McCullough, Bono, & Root, 2007;Thompson et al., 2005), and this relationship has been observed in both samples of Eastern and Western youth . ...
Background: Asian Americans are projected to represent 9-10% of the population by 2050. Asian Indian Americans are one of the fastest growing ethnic minority groups in the United States; however, this population remains significantly underrepresented in the health literature. Available research suggests Indian Americans demonstrate poor rates of healthcare access and illness monitoring, which increases risk of preventable illness. Research is needed that examines the beliefs, attitudes, and nuances of Asian Indian Americans in order to reduce health disparities and promote health. The purpose of this exploratory study was to examine how adverse childhood experiences relate to religiosity/spirituality (R/S), anger, and health outcomes in a sample of Asian Indian young adults (18-29 years old) currently living in the United States. Methods: Recruited through internet-based platforms, a sample of Asian Indian emerging adults (18-29 years) living in the United States (N = 138) completed an electronic questionnaire, which included measures of childhood adversity, religiosity/spirituality, anger, and physical health. Results: After adjusting for demographic variables, greater adverse childhood experiences significantly predicted a poor sense of meaning, purpose, and life direction (B = -.36,p < .001), greater distress related to religiosity/spirituality (B = .48,p < .001), greater tendencies to express anger in unhealthy ways (B = .51, p < .001), greater rates of previously diagnosed medical conditions (B = .37, p < .001), and greater degrees of physical illness symptoms over the past four weeks (B = .54,p < .001). Mediation analyses indicated that the detrimental effects of childhood adversity on one's sense of life purpose and direction were fully mediated by religious/spiritual struggles (a1b1 = - .145) and anger expression tendencies (a2b2 = -.16). Discussion: Overall, results provide a glimpse into the nuances of Indian youth's perspective on health, as well as potential areas of intervention in combating the effects of developmental adversity on health across the lifespan. Available from ProQuest Dissertations & Theses Global. (1970008650). Retrieved from
... Postconflict reconciliation between partners is common insofar as prolonged rumination over wrongs and clinging to conflicts can have negative psychological and physiological consequences (Witvliet et al. 2001). Engaging in forgiveness has been linked to immediate and long-term cardiovascular health improvement (Larsen et al. 2012), and individuals who forgive have better self-reported health and health habits (Allan and McKillop 2010). When accompanied by an apology, forgiveness and reconciliation reduce the stress of an interpersonal conflict, and increase an individual's perception of control over their life experiences (Witvliet et al. 2001). ...
Full-text available
Prior research shows that patterns of mate selection, attraction, and expulsion are the product of evolved sex differences in computational adaptations. Within long-term romantic relationships, men typically prioritize information relevant to a mate’s reproductive (i.e., sexual) value whereas women more often prioritize a mate’s willingness to invest romantic (i.e., emotional) resources into a stable pair-bond. Although these differences in preference are well established within mate selection and relationship maintenance literature, relatively fewer studies have examined differences in how men and women reconcile after romantic conflict. Using an act nomination procedure, the present research tests the prediction that men and women differ by which partner reconciliation behaviors they evaluate as most effective in resolving a romantic conflict. In study 1, participants nominated common reconciliation behaviors which were subsequently sorted into 21 distinct actions. In study 2, participants rated each behavior by how effectively it would resolve conflict if performed by their romantic partner. Overall, acts suggesting emotional commitment were expected to be rated as most effective. Men were expected to rate actions which signal sexual accessibility as more effective compared to women. Women were expected to rate acts which signal emotional accessibility as more effective compared to men (study 2). Results were largely consistent with our predictions, though notable deviations are documented and discussed within the context of contemporary romantic relationship research.
... Forgiveness therapy (Enright & Fitzgibbons, 2014;Worthington, 2005) has been used extensively in clinical and counseling settings. Practitioners have used forgiveness interventions with emotionally abused women (Reed & Enright, 2006), substance abuse patients (Lin, Mack, Enright, Krahn, & Baskin, 2004), couples (Rye et al., 2005;Ripley & Worthington, 2002), college students with past hurts (Goldman & Wade, 2012), and cardiac patients (Larsen et al., 2012). Metaanalyses have shown forgiveness interventions produce positive effects on mental health. ...
Full-text available
The aim of this study was to investigate maternal grief after losing a child in relation to forgiveness and posttraumatic growth. A sample of 60 grieving mothers from Slovakia completed the following battery: The Texas Revised Inventory of Grief, a modified version of the Enright Forgiveness Inventory, and the Posttraumatic Growth Inventory. The results showed a negative association between forgiveness and grief and a strong positive association between forgiveness and posttraumatic growth, which was not moderated by the time elapsed since the loss. Semistructured interviews were conducted with 12 mothers. The data were analyzed through Consensual Qualitative Research to gain deeper understanding of forgiveness and posttraumatic growth experiences after the loss of a child. Categories and subcategories are discussed.
This chapter argues that we forgive for reasons and that not just any reason is a reason to forgive. A complete account of forgiveness must explain which reasons are reasons to forgive and which are not and the aim of this chapter is to offer such an explanation. I suggest that distinguishing between forgiving and ceasing to blame for the wrong kind of reasons helps to solve some perennial problems about forgiveness. And I argue that the only reason to forgive is an apparent change of heart on the part of the offender about their offence and the quality of will behind it. At the same time, ceasing to blame for the wrong kind of reason is not necessarily a bad thing to do. No less than forgiving, it can be a valuable and important way of responding to the moral conflicts that shape our shared moral lives.
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Objetivo: Identificar na literatura as evidências disponíveis quanto aos benefícios do perdão em indivíduos com pressão arterial elevada. Método: Revisão integrativa da literatura realizada nas bases de dados PubMed, CINHAL, LILACS, BDENF e SCIELO nos meses de fevereiro e março de 2020. Para guiar o estudo definiu-se a questão norteadora: “Quais as evidências disponíveis na literatura sobre os benefícios do perdão em indivíduos com a pressão arterial elevada?”. Para sua elaboração, utilizou-se a estratégia PICO. Foram incluídos artigos originais em português, inglês e espanhol. Resultados: Identificaram-se 242 publicações das quais seis compuseram a amostra. Verificaram-se cinco diferentes benefícios a indivíduos com pressão arterial elevada após treinamento do perdão. Este estudo identificou 5 benefícios do perdão a indivíduos com pressão arterial elevada, cuja a frequência de citação nos estudos incluídos nessa revisão foi a seguinte: redução da pressão arterial cinco vezes; diminuição da frequência cardíaca três vezes. Conclusão: Considera-se como limitação da pesquisa a carência de estudos que abordem o objetivo proposto, não sendo possível avaliar de forma significativa os benefícios do perdão na saúde dos indivíduos hipertensos.
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The World Health Organization (WHO) understands health not only as the absence of disease, but also considers personal well-being. Forgiveness is a concept related to well-being and is generally conceptualized as the reduction of negative thoughts, feelings and behaviors, as well as the increase of positive ones, around the particular person involved or the situation of transgression. At the biological level, it has been linked to markers of lower physiological stress, with brain areas related to the theory of mind, empathy, emotional regulation, and neurotransmitters such as oxytocin and monoamines. It is also associated with better results in mental and physical health, mainly at the cardiovascular level. There are numerous interventions in forgiveness that have shown effectiveness, being the theoretical models with more evidence the Enright model and the REACH model. Given the potential benefits and few risks, the study and approach of forgiveness in clinical practice becomes a possibility that clinicians should consider to eventually reduce discomfort and increase the well-being of patients.
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Wrongdoing is inescapable. We all do wrong and are wronged; and in response we often blame one another. But if blame is a defining feature of our social lives, so is ceasing to blame. We might excuse, justify, or forgive an offender; or simply let the offence go. Each mode of ceasing to blame is a social practice and each has characteristic norms that influence when and how we do it, as well as how it’s received. We argue that how we relinquish blame, and how effective we are, depends on many circumstances only partially within our control. Like any norm-governed practice, one can do it well or poorly, appropriately or inappropriately, successfully or unsuccessfully. To successfully participate in a practice, one’s action must be done for the right reasons and secure uptake. We argue that social and material circumstances can compromise one’s ability to effectively cease to blame in the manner one prefers. But if one can fail, then one can lack access to particular ceasing to blame practices if one is regularly prevented from effectively relinquishing blame. However, uncooperative social and material circumstances do not only arise by chance. Our central argument is that circumstances of oppression can systematically compromise one’s ability and opportunities to effectively perform a variety of ceasing to blame practices. This deprivation is an insidious facet of oppression that is neglected both in theories of oppression and of forgiveness but which has significant implications for how we understand the power and purpose of forgiveness.
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Recent behavioral and biomedical research has suggested that psychophysiologic responsiveness (reactivity) to emotional stress may be a marker of processes involved in the development of cardiovascular disorders. The assessment of reactivity focuses on acute changes in functioning as opposed to the sole assessment of resting levels of variables. This article reviews evidence linking behaviorally induced cardiovascular and endocrine changes to coronary heart disease and essential hypertension. Particular attention is given to methodologic issues involving measurement. It is concluded that reactivity to stress is a construct with multiple dimensions: Different tasks and situations appear to elicit different patterns of physiologic responses. Further, an evaluation of evidence reveals that reactivity per se should currently not be regarded as a proven risk factor.Promising evidence does, however, justify continued laboratory and naturalistic, hypothesis-testing research. Recommended are methodologic studies to identify(a) the psychologic dimensions of stimuli that elicit reactivity in different subject groups, and (b) the patterns of physiologic responses produced. Such research would set the stage for epidemiologic studies to further examine relations between behavior and disease processes.
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This repeated measures psychophysiology experiment studied three responses to a past interpersonal offense (38 females and 33 males). We compared rumination with two offense reappraisal strategies. Compassion-focused reappraisal emphasized the offender's humanity, and interpreted the transgression as evidence of the offender's need for positive transformation. Benefit-focused reappraisal emphasized insights gained or strengths shown in facing the offense. Supporting the manipulations, compassion-focused reappraisal stimulated the most empathy and forgiveness, whereas benefit-focused reappraisal prompted the most benefit language and gratitude. Both reappraisals decreased aroused, negative emotion, and related facial muscle tension at the brow (corrugator). Both reappraisals increased happiness and positive emotion in ratings and linguistic analyses. Compassion stimulated the greatest social language, calmed tension under the eye (orbicularis oculi), and slowed heart beats (R–R intervals). A focus on benefits prompted the greatest joy, stimulated smiling (zygomatic) activity, and buffered the parasympathetic nervous system against rumination's adverse effects on heart rate variability (HRV).
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This within subjects experiment (28 females, 26 males) examined three responses to a past interpersonal offender. We contrasted offense-focused rumination with two subsequent, counterbalanced coping strategies: compassionate reappraisal and emotion suppression. Compassionate reappraisal emphasized the offender's human qualities and need for positive change. Emotion suppression inhibited the experience and expression of negative offense-related emotions. Offense rumination was associated with negative emotion, faster heartbeats (i.e., shortened electrocardiogram R-R intervals), and lower heart rate variability (HRV; i.e., the high-frequency component of the R-R power spectrum). By contrast, both compassionate reappraisal and emotion suppression decreased negative emotion in ratings and linguistic analyses, calmed eye muscle tension (orbicularis oculi EMG, electromyography), and maintained HRV at baseline levels. Suppression inhibited negative emotion expression at the brow (corrugator EMG) and slowed cardiac R-R intervals, but without forgiveness effects. Only compassionate reappraisal significantly increased positive emotions, smiling (zygomatic EMG), and social language along with forgiveness.
The cardiovascular effects of embarrassment and of attempts to suppress embarrassment were examined. In 2 studies, embarrassment was associated with substantial increases in systolic and diastolic blood pressure which monotonically increased over a 2-minute embarrassment period. In contrast, heart rate (HR) rose significantly during the 1st minute of embarrassment but returned to baseline levels during the 2nd minute. This pattern of reactivity may be distinctive. The effects of trying to suppress emotion in an interpersonal situation were also tested. Relative to the no-suppression group, suppression participants showed greater blood pressure during embarrassment and during posttask recovery. Suppression did not significantly affect HR. Possible mechanisms for these results, including passive coping, are discussed. Nonverbal behavior was also examined.
Attachment was examined for its association to forgiveness and health. Young adults were interviewed about a time of conflict with a parent; during rest and interview periods, readings of blood pressure and heart rate were taken. Participants completed surveys of forgiveness, attachment, relationship commitment, parental intrusiveness, and health. Analyses revealed strong associations among forgiveness, attachment, and health. Structural equation modeling indicated a strong, negative direct association between forgiveness and health problems, as well as an indirect association between attachment and health problems through forgiveness. Forgiveness groups differed on heart rate and systolic blood pressure. Psychological tension, created by unforgiveness in a close relationship, may lead to physiological indices of unease, as well as self-reports of physical symptoms, loneliness, and stress.
Unforgiveness and forgiveness are distinct. One cannot forgive unless unforgiveness has occurred, but one might reduce unforgiveness by many ways-only one of which is forgiveness. We present a model intended to further assist and guide subsequent empirical exploration. The model explains the personal, relationship, and environmental factors that lead people to either unforgiveness or forgiveness. Related areas are reviewed to stimulate as yet unexplored research and clinical efforts related to forgiveness. Clinical protocols for promoting forgiveness in enrichment, preventative, and therapeutic contexts are described.
Forgiveness is an important theological construct that impinges directly upon our ability to relate to others. Some research associates higher forgiveness with better mental health but little data exists which relates biological factors to forgiveness. This study correlated forgiveness scale scores of 68 community adults with a variety of immunological, psychophysiological and other physiological factors. Blood samples and physiological measurements were taken after a 30-minute rest period. In addition, participants completed a series of standardized assessments of anger, anxiety, depression, social desirability and coping styles. Higher levels of forgiveness correlated with better health habits, lower anxiety, lower anger, lower depression, and more task coping. In addition, people with higher levels of forgiveness had lower hematocrit levels, lower white blood cell counts, and higher TxPA levels. Lower forgiveness levels were correlated with higher T-helper/cytotoxic cell ratios. In general, results supported the hypothesis that forgiveness is positively associated with indices of good health. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Exploring possible relationships among forgiveness, disease, and physical health is truly at the frontiers of forgiveness research. To date, no controlled studies have demonstrated that forgiveness affects physical health outcomes either positively or negatively. This chapter elaborates on why people are encouraged to pursue research on health and forgiveness, discusses conceptual frameworks that are potentially useful in understanding the possible link between forgiveness and physical health, and considers some conceptual and methodological issues. The authors first comment briefly on the term "forgiveness" as used in this chapter. (PsycINFO Database Record (c) 2012 APA, all rights reserved)