Research indicates that forgiveness can positively impact physical and mental health. Yet, few studies explore the impact of forgiveness on trauma survivors. Existing studies suggest that forgiveness can be beneficial. However, these few studies have small sample sizes and are often conducted or funded by forgiveness advocates. If we can’t rely on the research, clinicians must ask themselves, “Does forgiveness benefit trauma survivors as a part of their recovery?”
Can CBT Truly Benefit Trauma Survivors?
To find an answer, consider this question, “Does CBT — frequently used in the treatment of trauma survivors, benefit their recovery?” The answer is yes and no. Some survivors do, while others do not. The same applies for forgiveness. Some survivors benefit from forgiving their offenders, while others do not. There is no universal treatment for trauma. There is not one intervention that works for all survivors. If forgiveness may or may not benefit survivors in their recovery, could incorporating it into treatment harm them? And by “incorporating” it into treatment, I am referring to those instances when the therapist does so, not at the request of the client, but because they believe it will be beneficial. By “harm” I suggest that survivors could potentially:
end therapy prematurely and not resume with a new therapist for years (as seen below in the cases of Marcus and DeAndre)
continue to sacrifice their safety to forgive (which April, also below, was able to avoid)
avoid, postpone, or try to skip vital emotional processing, which is often necessary for trauma recovery (such as with DeAndre)
repeat old patterns of self-sacrifice, or pleasing their offenders to support their safety (continuing the flight, freezing, or fawn response)
encourage silence, preventing survivors from embracing their narrative and sharing it with others, which can support recovery
interfere with reporting dangerous people to the authorities if needed
After 15 years as a trauma psychotherapist, I’ve discovered that when forgiveness is pressured, recommended, or even encouraged, it can cause harm in any of the forms noted above. I assume that many well-intended clinicians believe that trauma survivors will progress in therapy if, and perhaps only if, they forgive. These clinicians may unintentionally cause damage when they advocate forgiveness in circumstances where it doesn’t meet the needs of survivors.
“Forgiveness Was Never for Me; It Was Always for Them”
Marcus experienced emotional abuse as a child from ages 6-12. His father would scream at him, call him derogatory names, or ignore him for weeks. At age 14, he began instigating physical fights at school and was suspended. Therapy was recommended. When Marcus disclosed the abuse, his therapist encouraged him to let go of his anger by forgiving his father. There was no exploration of Marcus’ capability, readiness, or willingness to forgive. Instead, it was determined by the therapist, the school, and the family that Marcus needed to forgive so that he would stop physically assaulting others. A few months after starting individual therapy, Marcus participated in his first and only family therapy session with his father. Under the watchful eye of Marcus’ therapist, his father gave a one-minute apology for six years of emotional abuse, and Marcus sheepishly replied, “I forgive you.”
Since that family therapy session, Marcus was not allowed to express anger directed at his father, mother, or anyone else. When he did, people would say to him, “What are you so angry about? Didn't you forgive him?” and “It’s time to move on.” Five years later, at age eighteen, Marcus ended all communication with his parents.
“Please, don’t ask me to forgive them,” 32-year-old Marcus told me during his first therapy session since he was 14. “Forgiveness was never for me; it was always for them.”
“Deal,” I said without hesitation. “We are officially taking forgiveness off the table.”
“Really?”
“Yeah, we don’t have to focus on forgiveness. What would it be like if we focused on what you need instead?”
Marcus looked shocked. He glanced around the room with fluttering eyes. Then, he placed his head in his lap and cried.
For the next five years, Marcus learned to embrace, express, and process his anger, fear, and grief. Then, gradually, he experienced authentic forgiveness. This was never the focus of our treatment. Instead, it was an organic result. When he ended therapy with me, Marcus decided not to reestablish contact with his parents, whom he hadn’t spoken to in 14 years, a reminder that forgiveness is not the same as reconciliation. Marcus focused his efforts on the people he believed could provide safe and trusting relationships.
“Women Are Supposed to Always Forgive, Even If It Kills Them”
April began therapy when she abruptly left her physically and financially abusive husband. It was her third attempt at leaving and what she called “My last Hail Mary.” She moved out of the state with her children and ceased communication with her husband. She worked with an attorney and a case worker to pursue a divorce and full custody. Yet, her family members and friends encouraged her to resume communication with her husband, and at times passed messages along to her from him. They had good intentions. They didn’t want her to return to her husband; they wanted her to experience an uncontested divorce to minimize the financial burden and to participate in co-parenting to support the childrens’ relationships with both parents. When April began therapy, her therapist, who was not trained in working with survivors of domestic violence, agreed with them.
In therapy April was encouraged to consider reestablishing contact with her husband to experience relationship closure by embracing forgiveness. Her therapist wanted her to “not have long-term trauma symptoms,” as April recalled. Therapy consisted of April learning coping skills to use when she was ready to reestablish contact with her husband and visualization exercises to help her to be open to forgiveness for the sake of her children. A month later, April ended therapy and all communication with her family and friends. Two months later, her case worker recommended that she work with a trauma-trained therapist, and she agreed to participate in a consultation call with me.
“If I talk to him, I’ll go back,” April said in a tone that sounded angry, but all I heard was fear. “If I go back, he will kill me, or I’ll kill myself. You need to understand that.”
“I get it. You have no plans to reestablish contact. All communication will go through your attorney or case worker. Is that correct?” I asked.
“Yes. It’s like, people don’t get it. Women are supposed to always forgive, even if it kills them.”
April agreed to try trauma therapy with the understanding that she could end treatment at any time. She didn’t. Instead of reestablishing communication with her husband and seeking forgiveness, April’s therapy focused on establishing safety. With a trauma therapy recipe consisting of EMDR, Somatic Experiencing, Internal Family Systems work, self-defense classes and support groups, April learned to create and maintain safety in her new home and city with new friends. Three years later, she resumed contact with a few family members and friends who were receptive to following firm boundaries regarding their interactions with her and her ex-husband. At that time, her ex-husband had ceased contact with all of April’s family and friends, had given April full custody of the children, ended contact with his children and remarried.
“I Thought Forgiving Her Would Save Me”
DeAndre’s mother would become rageful without warning. She’d scream, mock and belittle her children and damage property. As a result, he developed a fear of anger, as his childhood experiences taught him that anger was an unsafe emotion that should be avoided. He learned to suppress feelings and expressions of anger and was considered an easygoing guy. Yet, his relationships lacked closeness, and at 27 years old, DeAndre began therapy for the first time.
DeAndre and his therapist discovered that his anger and fear prevented him from engaging in healthy conflicts, establishing boundaries, and presenting his authentic self in adult relationships. This avoidance caused a lack of vulnerability and closeness, leaving him feeling isolated. DeAndre’s therapist recommended that he engage in conflicts with others to achieve forgiveness. The therapist suspected that DeAndre would feel safer with his anger if he could do something healthy with it, which would be forgiving. As a result, DeAndre became a prolific forgiver. He forgave his mother, his friends, and everyone who had ever wronged him. He didn’t require acknowledgment, accountability, or apologies from his offenders. He quickly forgave them. After a year, he ended therapy because his relationships did not improve, he continued to feel isolated, and thought that people were taking advantage of his easy-going, forgiving nature.
Twelve years later, DeAndre was married with children. He began therapy with me to address his lack of boundaries in his relationships.
“I feel angry for a few minutes,” he said in the session.
“What happens after those few minutes?” I asked.
“I don’t feel anything,” DeAndre described. “That’s when I forgive them and move forward.”
After working with DeAndre, it became clear that he was not forgiving; he was dissociating. Experiencing anger was so overwhelming that his mind and body could not tolerate it for more than a few minutes at a time. DeAndre and I focused on increasing his tolerance and feelings of safety related to anger. As therapy progressed, he discovered that he was angry at his mother for her abuse. He resented his extended family members for not protecting him. He was also disappointed in himself for being unable to protect his younger sisters from his mother’s rage.
“The truth is, I haven’t forgiven her,” he said. “I thought forgiving her would save me from my anger, but it didn’t. It just helped me avoid it for forty years.”
Two years later, DeAndre was able to experience anger for extended periods and safely express this anger to others. Once he discovered his anger did not harm others, he could engage in conflicts and establish boundaries in his relationship with less fear. He was now participating in closer relationships with his sisters, wife, and children. When DeAndre ended treatment, he had not forgiven his mother, but that was never the goal.
***
If forgiveness can harm trauma survivors, what should mental health clinicians do? Clinicians should not force, encourage, or recommend forgiveness. Instead, they should allow trauma survivors to decide or discover their needs regarding forgiveness. Survivors might choose to forgive, or they might embrace organic forgiveness. Survivors might choose to withhold, resist, or forgo forgiveness. Some survivors might not be capable of authentic forgiveness no matter how hard they try, and others may wish to take forgiveness off the table. The giving or withholding of forgiveness is a choice that should always be left to the survivor.
Questions for Thought
What are your thoughts about the author’s approach to forgiveness with trauma survivors?
What is your approach to integrating forgiveness into your own trauma work?
Can you think of instances where forgiveness helped the client? Can you think of instances where forgiveness did harm instead?
File under: The Art of Psychotherapy, Child & Adolescent Therapy
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Can CBT Truly Benefit Trauma Survivors?
To find an answer, consider this question, “Does CBT — frequently used in the treatment of trauma survivors, benefit their recovery?” The answer is yes and no. Some survivors do, while others do not. The same applies for forgiveness. Some survivors benefit from forgiving their offenders, while others do not. There is no universal treatment for trauma. There is not one intervention that works for all survivors. If forgiveness may or may not benefit survivors in their recovery, could incorporating it into treatment harm them? And by “incorporating” it into treatment, I am referring to those instances when the therapist does so, not at the request of the client, but because they believe it will be beneficial. By “harm” I suggest that survivors could potentially:
end therapy prematurely and not resume with a new therapist for years (as seen below in the cases of Marcus and DeAndre)
continue to sacrifice their safety to forgive (which April, also below, was able to avoid)
avoid, postpone, or try to skip vital emotional processing, which is often necessary for trauma recovery (such as with DeAndre)
repeat old patterns of self-sacrifice, or pleasing their offenders to support their safety (continuing the flight, freezing, or fawn response)
encourage silence, preventing survivors from embracing their narrative and sharing it with others, which can support recovery
interfere with reporting dangerous people to the authorities if needed
After 15 years as a trauma psychotherapist, I’ve discovered that when forgiveness is pressured, recommended, or even encouraged, it can cause harm in any of the forms noted above. I assume that many well-intended clinicians believe that trauma survivors will progress in therapy if, and perhaps only if, they forgive. These clinicians may unintentionally cause damage when they advocate forgiveness in circumstances where it doesn’t meet the needs of survivors.
“Forgiveness Was Never for Me; It Was Always for Them”
Marcus experienced emotional abuse as a child from ages 6-12. His father would scream at him, call him derogatory names, or ignore him for weeks. At age 14, he began instigating physical fights at school and was suspended. Therapy was recommended. When Marcus disclosed the abuse, his therapist encouraged him to let go of his anger by forgiving his father. There was no exploration of Marcus’ capability, readiness, or willingness to forgive. Instead, it was determined by the therapist, the school, and the family that Marcus needed to forgive so that he would stop physically assaulting others. A few months after starting individual therapy, Marcus participated in his first and only family therapy session with his father. Under the watchful eye of Marcus’ therapist, his father gave a one-minute apology for six years of emotional abuse, and Marcus sheepishly replied, “I forgive you.”
Since that family therapy session, Marcus was not allowed to express anger directed at his father, mother, or anyone else. When he did, people would say to him, “What are you so angry about? Didn't you forgive him?” and “It’s time to move on.” Five years later, at age eighteen, Marcus ended all communication with his parents.
“Please, don’t ask me to forgive them,” 32-year-old Marcus told me during his first therapy session since he was 14. “Forgiveness was never for me; it was always for them.”
“Deal,” I said without hesitation. “We are officially taking forgiveness off the table.”
“Really?”
“Yeah, we don’t have to focus on forgiveness. What would it be like if we focused on what you need instead?”
Marcus looked shocked. He glanced around the room with fluttering eyes. Then, he placed his head in his lap and cried.
For the next five years, Marcus learned to embrace, express, and process his anger, fear, and grief. Then, gradually, he experienced authentic forgiveness. This was never the focus of our treatment. Instead, it was an organic result. When he ended therapy with me, Marcus decided not to reestablish contact with his parents, whom he hadn’t spoken to in 14 years, a reminder that forgiveness is not the same as reconciliation. Marcus focused his efforts on the people he believed could provide safe and trusting relationships.
“Women Are Supposed to Always Forgive, Even If It Kills Them”
April began therapy when she abruptly left her physically and financially abusive husband. It was her third attempt at leaving and what she called “My last Hail Mary.” She moved out of the state with her children and ceased communication with her husband. She worked with an attorney and a case worker to pursue a divorce and full custody. Yet, her family members and friends encouraged her to resume communication with her husband, and at times passed messages along to her from him. They had good intentions. They didn’t want her to return to her husband; they wanted her to experience an uncontested divorce to minimize the financial burden and to participate in co-parenting to support the childrens’ relationships with both parents. When April began therapy, her therapist, who was not trained in working with survivors of domestic violence, agreed with them.
In therapy April was encouraged to consider reestablishing contact with her husband to experience relationship closure by embracing forgiveness. Her therapist wanted her to “not have long-term trauma symptoms,” as April recalled. Therapy consisted of April learning coping skills to use when she was ready to reestablish contact with her husband and visualization exercises to help her to be open to forgiveness for the sake of her children. A month later, April ended therapy and all communication with her family and friends. Two months later, her case worker recommended that she work with a trauma-trained therapist, and she agreed to participate in a consultation call with me.
“If I talk to him, I’ll go back,” April said in a tone that sounded angry, but all I heard was fear. “If I go back, he will kill me, or I’ll kill myself. You need to understand that.”
“I get it. You have no plans to reestablish contact. All communication will go through your attorney or case worker. Is that correct?” I asked.
“Yes. It’s like, people don’t get it. Women are supposed to always forgive, even if it kills them.”
April agreed to try trauma therapy with the understanding that she could end treatment at any time. She didn’t. Instead of reestablishing communication with her husband and seeking forgiveness, April’s therapy focused on establishing safety. With a trauma therapy recipe consisting of EMDR, Somatic Experiencing, Internal Family Systems work, self-defense classes and support groups, April learned to create and maintain safety in her new home and city with new friends. Three years later, she resumed contact with a few family members and friends who were receptive to following firm boundaries regarding their interactions with her and her ex-husband. At that time, her ex-husband had ceased contact with all of April’s family and friends, had given April full custody of the children, ended contact with his children and remarried.
“I Thought Forgiving Her Would Save Me”
DeAndre’s mother would become rageful without warning. She’d scream, mock and belittle her children and damage property. As a result, he developed a fear of anger, as his childhood experiences taught him that anger was an unsafe emotion that should be avoided. He learned to suppress feelings and expressions of anger and was considered an easygoing guy. Yet, his relationships lacked closeness, and at 27 years old, DeAndre began therapy for the first time.
DeAndre and his therapist discovered that his anger and fear prevented him from engaging in healthy conflicts, establishing boundaries, and presenting his authentic self in adult relationships. This avoidance caused a lack of vulnerability and closeness, leaving him feeling isolated. DeAndre’s therapist recommended that he engage in conflicts with others to achieve forgiveness. The therapist suspected that DeAndre would feel safer with his anger if he could do something healthy with it, which would be forgiving. As a result, DeAndre became a prolific forgiver. He forgave his mother, his friends, and everyone who had ever wronged him. He didn’t require acknowledgment, accountability, or apologies from his offenders. He quickly forgave them. After a year, he ended therapy because his relationships did not improve, he continued to feel isolated, and thought that people were taking advantage of his easy-going, forgiving nature.
Twelve years later, DeAndre was married with children. He began therapy with me to address his lack of boundaries in his relationships.
“I feel angry for a few minutes,” he said in the session.
“What happens after those few minutes?” I asked.
“I don’t feel anything,” DeAndre described. “That’s when I forgive them and move forward.”
After working with DeAndre, it became clear that he was not forgiving; he was dissociating. Experiencing anger was so overwhelming that his mind and body could not tolerate it for more than a few minutes at a time. DeAndre and I focused on increasing his tolerance and feelings of safety related to anger. As therapy progressed, he discovered that he was angry at his mother for her abuse. He resented his extended family members for not protecting him. He was also disappointed in himself for being unable to protect his younger sisters from his mother’s rage.
“The truth is, I haven’t forgiven her,” he said. “I thought forgiving her would save me from my anger, but it didn’t. It just helped me avoid it for forty years.”
Two years later, DeAndre was able to experience anger for extended periods and safely express this anger to others. Once he discovered his anger did not harm others, he could engage in conflicts and establish boundaries in his relationship with less fear. He was now participating in closer relationships with his sisters, wife, and children. When DeAndre ended treatment, he had not forgiven his mother, but that was never the goal.
***
If forgiveness can harm trauma survivors, what should mental health clinicians do? Clinicians should not force, encourage, or recommend forgiveness. Instead, they should allow trauma survivors to decide or discover their needs regarding forgiveness. Survivors might choose to forgive, or they might embrace organic forgiveness. Survivors might choose to withhold, resist, or forgo forgiveness. Some survivors might not be capable of authentic forgiveness no matter how hard they try, and others may wish to take forgiveness off the table. The giving or withholding of forgiveness is a choice that should always be left to the survivor.
Questions for Thought
What are your thoughts about the author’s approach to forgiveness with trauma survivors?
What is your approach to integrating forgiveness into your own trauma work?
Can you think of instances where forgiveness helped the client? Can you think of instances where forgiveness did harm instead?
File under: The Art of Psychotherapy, Child & Adolescent Therapy