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Forgive and Get Healthy

University professor Loren Toussaint wants to spread the tangible benefits of forgiveness.

Forgive yourself. Forgive your parents and siblings. Forgive your best friend. Forgive the jerk that cheated on you in high school.

Your life may actually depend on it.

At least, that's what Loren Toussaint's research seems to say. The ostensibly trivial act of forgiving can make you healthier and happier, but failing to forgive might pose a danger to your well-being, according to work by the Luther College psychology professor and other leaders in the promising interdisciplinary field of forgiveness.

Toussaint's laboratory, on a campus whose lush, green Driftless Area foothills are more Ivy League than Iowa, seems an unlikely location for an international hub of a burgeoning area of research. It comprises a trio of tiny rooms with a handful of computers and monitoring equipment, along with two black leather lounge chairs for experimental subjects.

And the bashful young professor, a self-described Iowa farm boy, acts the part. He looks like a lanky high school basketball player, and he's prone to earnestly dropping phrases like "by golly" into conversation. Yet Toussaint's enthusiasm and early successes have led to collaborations with giants of the discipline, including Harvard University sociologist David R. Williams and Stanford University professor Frederic Luskin, one of the field's founders.

Finding Roots
Though the concept of forgiveness has deep roots in Western culture, modern studies of it rose to prominence during the 1990s as academics began to tap new government and private funding. They examined subject matter ranging from resolving conflict between family members to helping survivors cope with the aftermath of brutal civil war in places like Rwanda.

Toussaint and others among the second generation of forgiveness experts built on that work to better understand why forgiveness is good for us. Now, they're translating scientific conclusions into projects aimed at helping Americans become healthier by forgiving.

The son and grandson of farmers, Toussaint majored in psychology at Minnesota's tiny Southwest State University, fascinated by the quest to understand why people acted the way they did. After graduate work in stress and coping at the University of Wisconsin-Milwaukee, Toussaint wanted to do more meaningful research - something more spiritual, in line with his upbringing in a fundamentalist Christian church.

He stumbled upon a few job postings seeking researchers to focus on forgiveness, a core tenet in Christianity. After studying forgiveness as a postdoctoral researcher at the University of Michigan and a brief stint at Idaho State, in 2004 he moved to Luther, a college with religious faith as part of its mission. It was the natural home for a professor like Toussaint, whose ideas and goals often arise from a spiritual foundation, but whose methods echo his secular counterparts.

"I have no problem being construed as someone who's interested in religious work or religious ideas. But what I do does not rest on theological assumptions. What I do rests on the data," says Toussaint.

He's since supervised a series of small lab studies examining forgiveness among different groups of people, from normal college students to victims of spinal cord injuries. Toussaint has also co-directed some of the largest epidemiological analyses searching for links between forgiveness and health. That work, along with comprehensive literature reviews, has Toussaint convinced that not forgiving can mean long-lasting stress, which causes mental and physical problems.

Take, for instance, Toussaint's own experiences during high school, when he dealt with emotionally painful taunting and teasing (though no more, he stresses, than most kids face).

"When somebody offends you, it's a pretty significant thing. You notice it. If it's significant enough that you notice it and can remember it, it must've been fairly traumatic, or you wouldn't remember it," he says. "These things don't just tend to go away."

In an ongoing relationship, such recollections might lead to interpersonal stress. In Toussaint's case, the actions of people he hasn't seen for two decades occasionally replay in his thoughts. "We have an amazing ability to retain that and play it back in vivid detail," he says.

Any time such an event runs through Toussaint's stream of consciousness, his body responds in similar ways to how it reacted 20 years ago when the incident first occurred - releasing stress hormones or raising his heart rate, probably not by as much as when it first happened, but by enough to matter.

A growing body of research demonstrates that long-term stress causes difficulties ranging from major depression to cardiovascular disease. Toussaint's theories connect forgiveness to those conclusions. Wrongs that go unforgiven, he says, become chronic stressors.

For an adult, a childhood skinned knee or broken arm may have long since healed, but without forgiveness, the emotional wounds of a brutal teenage breakup or other traumatic experience may remain. Unforgiving people are at up to 10 times the risk for mental illness as the forgiving and twice the odds of cardiovascular disease as the average population. Folk idioms such as saying a problem is "eating away at me" might not be far from the truth.

"We'd like to say those are just catchy phrases, metaphors," Toussaint says. "Those things are all too realistic."

Some of Toussaint's more recent studies examine how and why different types of forgiveness impact health. For example, psychologists have long known that men tend to be self-focused, and women are more other-focused. The same is true of forgiveness: Toussaint found that self-forgiveness is more protective of mental health among men, while forgiving others' actions is more protective for women.

Forgiveness Among the Ruins
He has begun to apply this knowledge to interventions. The most celebrated came in 2007, after an American who runs a Sierra Leone nonprofit asked Toussaint if forgiveness training could help residents of the West African country. The situation was extreme: Sierra Leone ranks among the world's least developed nations, and the civil war that ended in 2002 left tens of thousands dead and hundreds of thousands maimed or disabled. Toussaint and two students — with no graduate schools at Luther, professors often collaborate with undergrads on research — adapted a forgiveness education program that Luskin had used with victims of violence in Northern Ireland.

They traveled to Sierra Leone on a shoestring-budget grant to instruct a group of schoolchildren and their teachers, some of whom had seen their houses burned down or family members murdered. Toussaint's goal wasn't to get them to forget or excuse such behavior. He aspired only to teach stress-reduction techniques to change the way they felt about traumatic events and their perpetrators.

Before the first week of training ended, though, thieves broke into the school and stole a computer, among other supplies, along with cash for teacher salaries. The school was abuzz with these events, and Toussaint at first tried to use the forgiveness training to help them come to terms with what had happened. But he and his students soon fled, fearing for their own safety. Post-training surveys had to be smuggled out of the country in the ensuing months.

And yet, despite trauma piled upon trauma, the experimental results were encouraging. Compared with teachers who hadn't received training, those who completed the abbreviated course saw significant increases in benevolent motivation and gratitude, and lower levels of negative mood and anger, based on standard self-reported psychological measurements.

"If we can do this in Sierra Leone," says Toussaint, "We can do it anywhere."

Toussaint and Luskin saw it as a model program, and this fall, Toussaint will bring a similar curriculum to the Mayo Clinic in nearby Rochester, Minn. Working with a colleague from Luther's nursing school, Toussaint will conduct an intervention with Mayo patients who suffer from two diseases: chronic fatigue syndrome and the widespread pain disorder called fibromyalgia.

Both ailments are debilitating and life altering, but doctors often struggle to accurately diagnose them, shuffling patients from specialist to specialist and clinic to clinic over the course of months until they end up at a place like Mayo. It's a recipe for bitterness and resentment that may worsen the diseases' symptoms, which most physicians believe have at least some psychological component.

Because of time constraints, the training sessions will last just four hours per patient, but Toussaint thinks even such limited efforts will produce significant effects.

Interventions like these — and, indeed, just about any forgiveness research — raise a host of concerns that Toussaint can't yet answer. The field research has demonstrated a moderate correlation between health and forgiving or being able to forgive, but it's difficult to assess the strength of that relationship.

As Toussaint says, the statistical correlations between forgiveness and any given measure of health may be a 0.3 or 0.4 (on a scale of 0 to 1.0) — typical of psychology research, but not unassailable. In addition, there isn't enough longitudinal research (though Toussaint is trying to change that) to definitively suggest that the act of forgiving causes changes in health. In fact, at least one recent study shows the reverse effect — that happiness causes people to be more forgiving.

Toussaint's forgiveness interventions, as well as others by Luskin and University of Wisconsin psychology professor Bob Enright in places from Israel to California, do show more dramatic effects, but the researchers have all faced skepticism. Even the field's top investigators sometimes struggle to find funding. "Forgiveness is still a tough sell," says Luskin. "It has not been an easy road to get openness to it."

Toussaint often has conversations in which people tell him his theories don't resonate with the way they live their lives. Perhaps, he says, the reasons are cultural. "We live in a society that's largely governed by retributive justice and an 'eye for an eye' mentality," he laments. "I don't think our culture promotes forgiveness very well."

America isn't alone, though. Even the oft-praised South African Truth and Reconciliation Commission and other government-brokered programs seem more focused on emotional confrontations than forgiveness and understanding.

"They believe that through truth comes reconciliation, and through reconciliation comes peace. I would say that through truth often comes nothing but hurt," Toussaint explains. "The aim is good, but reconciliation requires forgiveness."

Toussaint has grand designs on expanding his work well beyond pilot projects. During the next few years, if the Mayo project functions as well as hoped, Toussaint wants to conduct large-scale forgiveness interventions with cardiovascular patients, diabetics, people with eating disorders and others who might benefit from the apparent health benefits of forgiveness. He and Luskin recently raised enough money to bring Sierra Leonean teachers to Stanford for more training, and they want to someday create an institute that educates thousands of people and tracks the outcomes.

Luskin will soon begin teaching psychotherapists to integrate forgiveness into their sessions with patients. Toussaint also sees hospital chaplains as logical people to help patients forgive for health. Eventually, he expects the concept to be as viable a method for helping to combat chronic illnesses as visiting a nutritionist.

To bolster the case that such ideas are worth funding, Toussaint continues to analyze data of ever-bigger epidemiological surveys and tests, including one that marries forgiveness data with stress hormone levels and blood panel measurements, and another that examines South Africans.

Toussaint knows that learning to forgive isn't easy. Even now, images of high school antagonists appear in his mind's eye once or twice per month. "Just because somebody studies something doesn't mean they do it," he says.

But Toussaint is consoled by the fact that people of all races, ages and ethnic groups have learned to forgive and improved their lives with relatively modest efforts. "Unlike in many other areas, you have a lot of control," he says. "It's really up to you."

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