Issues in Mental Health Nursing, 35:562–564, 2014 Copyright © 2014 Informa Healthcare USA, Inc. ISSN: 0161-2840 print / 1096-4673 online DOI: 10.3109/01612840.2014.918473
COMMENTS, CRITIQUE, AND INSPIRATION COLUMN
Forgiving, but not Necessarily Forgetting Michelle Cleary, RN, PhD Associate Professor, School of Nursing and Midwifery, University of Western Sydney, Sydney, Australia
Jan Horsfall, PhD Independent Research Advisor, Sydney, Australia
Edited by Mona M. Shattell, RN, PhD DePaul University, School of Nursing, Chicago, Illinois, USA Edited by Michelle Cleary, RN, PhD University of Western Sydney, Sydney, Australia How can forgiveness be relevant to mental health nurses? Possible answers include when working with clients who are angry or depressed who focus on the harm another person has caused them, especially if the harm was not intra-familial violence, where the perpetrator is likely to re-offend; or when working with those involved in workplace incidents where an individual has created distress among coworkers. This column provides an overview of the definitions of forgiveness and unforgivingness; discusses the antecedents, processes, and consequences associated with forgiving another; and briefly addresses issues surrounding self-forgiveness. Forgiveness is becoming an increasingly hot topic in mental health-related disciplines, partly due to its potential benefits for health and well-being (Lawler-Row, Karremans, Scott, EdlisMatityahou, & Edwards, 2008). Models of forgiveness mostly focus on how individuals, couples, and families manage their hurt and resentment vis-`a-vis a relationship conflict or issues (Sandage & Jankowski, 2010), and it may be the case that when significant relationships are under duress that forgiveness is more closely connected to well-being (Toussaint & Friedman, 2009). Forgiveness also is an aspect of Judeo-Christianity, Islam, Hinduism, and Buddhism, and consequently many believers of these faiths are, at least, acquainted with its value from seminal sacred texts where forgiveness is advised (Webb, Toussaint, & Conway-Williams, 2012).
Address correspondence to: Michelle Cleary, School of Nursing and Midwifery, University of Western Sydney, Locked Bag 1797, Penrith NSW 2751. E-mail: [email protected]
In the workplace there are three types of unforgiving responses: vengeful (i.e., taking retaliatory actions against the transgressor); avoidant (i.e., work absenteeism, leaving the organization, or taking early retirement); and active grudge-holding (i.e., seeking opportunities to cause trouble for the offender by looking for wrong-doings) (Worthington et al., 2010). These are all forms of unforgiveness—and a range of resentful or vengeful actions, such as gossiping, betraying a confidence, or undermining the work of others will all lead to group disaffection and an increasingly malfunctioning workplace. Unforgiveness is fuelled by bitter, resentful, angry, and unhappy ruminations, constituting a vicious unresolved cycle. Conditional forgiveness involves engaging the transgressor in an attempt to forgive him or her. The two common forms of conditional forgiveness are requesting or demanding an apology, or asking or imploring the perpetrator to promise not to repeat the transgression. Seeking conditional forgiveness may be even unhealthier than unforgiveness for those who have been offended, as Toussaint, Owen, and Cheadle (2012) found it to be a significant predictor of mortality. Thus authentic forgiveness is a unilateral intrapersonal process that is not contingent on any hoped for appeasing behavior from the transgressor. Hurtful transgressions can be difficult to forgive even with an apology. When relationships are not repaired after a transgression, smoldering negativity can disrupt the group and engender worries about security and the future, with a subsequent loss of productivity (Cleary, Hunt, & Horsfall, 2010; Cleary, Hunt, Walter, & Robertson, 2009; Cleary, Walter, Horsfall, & Jackson, 2013). It is not uncommon for people to look for a new job as a consequence of unresolved incidents that precipitate interpersonal distress or involve discrimination or other forms of injustice. Being able to consider forgiveness at the group level could be important for reconciliation, especially in situations of lengthy ethno-political-religious conflict (Myers, Hewstone, & Cairns, 2009) and after discernible inter-group workplace conflict. The processes involved in forgiveness are complex, and involve letting go of negative or destructive feelings towards
562
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the transgressor, generating pro-social attitudes toward her or him, and relinquishing hurt, resentment, and self-blame (Hong & Jacinto, 2012; Sandage & Jankowski, 2010). According to Worthington and colleagues (2010) there are two types of forgiveness—decisional and emotional, and both involve intrapersonal processes. Decisional forgiveness involves the cognitive intention of behaving toward the perpetrator in more positive and less negative ways, and although a choice is made for forgiveness, negative emotions (e.g., anger, sadness) can continue to be experienced. Emotional forgiveness includes progressing towards replacing unforgiving feelings with those that are more positively other-oriented, such as sympathy or empathy. It is hypothesized that decisional forgiveness could lead to changes in emotion and, thus, behavior, and emotional forgiveness may feed into constructive changes in feelings and motivation, also leading to behavior changes (Worthington, Witvliet, Pietrini, & Miller, 2007). Among others, Enright and colleagues (1998) identified four broad phases in the extended process of forgiveness: (1) uncovering: being aware of problems, such as anger and personal pain; (2) deciding: recognizing the need for resolution via alternative pathways; (3) working: using cognitive processes, such as reframing, and emotional processes, such as empathy and acceptance; and (4) deepening: finding meaning and contextual understanding (Webb, Dula, & Brewer, 2012). Regardless of the definitions and hypothetical models, Myers, Hewstone, and Cairns (2009) conclude that forgiveness is a process that engages attitude (cognition) and emotions, resulting in the diminution of the desire for retaliation and facilitating cathartic expression of feelings, such as hurt, anger, and fear. In their meta-analysis of forgiveness research, Fehr and colleagues (2010) revealed that cognitive aspects account for more variance than emotional or constitutional factors. In a qualitative and quantitative analysis of research on forgiveness antecedents and consequences, Riek and Mania (2012) provide an excellent up-to-date overview. Agreeableness has the largest impact on forgiveness and state empathy is the second strongest predictor for forgiving another. However, empathy was not a significantly stronger correlate than most other social-cognitive factors, indicating that en masse these are the most powerful antecedents of forgiveness and most amenable for therapeutic intervention. Overall, the reviewers were concerned that moderators, such as self-esteem and commitment, have been insufficiently explored (Riek & Mania, 2012). Forgiving another does not equate to weakness, nor does not it preclude reasonable expressions of anger or attempting to redress an injustice (Gassin, Enright, & Knutson, 2005). Nor are we suggesting that all wrongdoings are forgivable. Unforgiveness and anger are not only associated with poor physical and mental health outcomes, but contribute to ongoing nonresolution within the aggrieved person (Hirsch, Webb, & Jeglic, 2012). Forgiveness is attributed with increasing positive coping and emotional responses, and improving interpersonal and
563
mental health functioning (Webb, Toussaint et al., 2012). It involves an increase in positive response towards the transgressor, but does not necessarily involve friendliness, reconciliation, or restitution: Instead it is a reasoned process undertaken unilaterally, that is, entirely irrespective of transgressor contingencies (Myers et al., 2009; Webb, Toussaint et al., 2012). Forgiveness also has the potential to defuse anger and hostility, and when it is sincere, the stress created by the hurtful event can be substantially reduced (Lutjen, Silton, & Flannelly, 2012). Not forgiving others—or oneself—is associated with poorer mental health and lower life satisfaction (Macaskill, 2012). Forgiveness enables a person to be more productive and adaptive, therefore investing or redirecting energy toward facilitating health, instead of being depleted by excessive ruminations, stress, and negative emotions (Svalina & Webb, 2012). The process of self-forgiveness differs from that of forgiving others for wrongdoing. The former involves processing guilt and shame and possibly self-loathing; forgiveness of others is also a self-process, but it is more about addressing personal thoughts and feelings to diminish interpersonal negativity. The literature notes that self-forgiveness may be more difficult than otherforgiveness because it involves self-compassion and many of us can be self-critical when we have erred (Toussaint & Friedman, 2009). On a cautionary note, at least one publication expresses concern that self-forgiveness may be related to over-confidence and narcissism, bypassing appropriate self-responsibility, acknowledgment of the transgression, and remorse, and these authors therefore consider self-acceptance preferable to selfforgiveness (Vitz & Meade, 2011). In summary there are overlapping definitions of forgiveness but they all involve cognitive processes relating to selfresponsibility, developing an understanding of the situation from a range of perspectives (reframing), and drawing on generous other-oriented emotional resources, such as empathy, to diminish feelings of bitterness, resentment, or hostility. Thus, even though the hurt was precipitated by the behaviors of another, the processes of forgiveness are intra-personal and independent of the post-incident actions of the transgressor. Declaration of Interest: The author reports no conflicts of interest. The author alone is responsible for the content and writing of the paper. REFERENCES Cleary, M., Hunt, G. E., & Horsfall, J. (2010). Identifying and addressing bullying in nursing. Issues in Mental Health Nursing, 31(5), 331–335. Cleary, M., Hunt, G. E., Walter, G., & Robertson, M. (2009). Dealing with bullying in the workplace: Toward zero tolerance. Journal of Psychosocial Nursing and Mental Health Services, 47(12), 34–41. Cleary, M., Walter, G., Horsfall, J., & Jackson, D. (2013). Promoting integrity in the workplace: A priority for all academic health professionals. Contemporary Nurse, 45(2), 264–268. Enright, R. D., Freedman, S., & Rique, J. (1998). The psychology of interpersonal forgiveness. In R. D. Enright & J. North (Eds.), Exploring forgiveness (pp. 46–62). Madison, WI: The University of Wisconsin Press.
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Fehr, R., Gelfand, M. J., & Nag, M. (2010). The road to forgiveness: A metaanalytic synthesis of its situational and dispositional correlates. Psychological Bulletin, 136(5), 894–914. Gassin, E. A., Enright, R. D., & Knutson, J. A. (2005). Bringing peace to the central city: Forgiveness education in Milwaukee. Theory into Practice, 44(4), 319–326. Hirsch, J. K., Webb, J. R., & Jeglic, E. L. (2012). Forgiveness as a moderator of the association between anger expression and suicidal behaviour. Mental Health, Religion and Culture, 15(3), 279–300. Hong, Y. J., & Jacinto, G. A. (2012). Six step therapeutic process to facilitate forgiveness of self and others. Clinical Social Work Journal, 40(3), 366–375. Lawler-Row, K. A., Karremans, J. C., Scott, C., Edlis-Matityahou, M., & Edwards, L. (2008). Forgiveness, physiological reactivity and health: The role of anger. International Journal of Psychophysiology, 68(1), 51–58. Lutjen, L. J., Silton, N. R., & Flannelly, K. J. (2012). Religion, forgiveness, hostility and health: A structural equation analysis. Journal of Religion and Health, 51(2), 468–478. Macaskill, A. (2012). Differentiating dispositional self-forgiveness from otherforgiveness: Associations with mental health and life satisfaction. Journal of Social and Clinical Psychology, 31(1), 28–50. Myers, E., Hewstone, M., & Cairns, E. (2009). Impact of conflict on mental health in northern Ireland: The mediating role of intergroup forgiveness and collective guilt. Political Psychology, 30(2), 269–290. Riek, B. M., & Mania, E. W. (2012). The antecedents and consequences of interpersonal forgiveness: A meta-analytic review. Personal Relationships, 19(2), 304–325.
Sandage, S. J., & Jankowski, P. J. (2010). Forgiveness, spiritual instability, mental health symptoms, and well-being: Mediator effects of differentiation of self. Psychology of Religion and Spirituality, 2(3), 168–180. Svalina, S. S., & Webb, J. R. (2012). Forgiveness and health among people in outpatient physical therapy. Disability and Rehabilitation, 34(5), 383–392. Toussaint, L., & Friedman, P. (2009). Forgiveness, gratitude, and well-being: The mediating role of affect and beliefs. Journal of Happiness Studies, 10(6), 635–654. Toussaint, L. L., Owen, A. D., & Cheadle, A. (2012). Forgive to live: Forgiveness, health, and longevity. Journal of Behavioral Medicine, 35(4), 375–386. Vitz, P. C., & Meade, J. M. (2011). Self-forgiveness in psychology and psychotherapy: A critique. Journal of Religion and Health, 50(2), 248–263. Webb, J. R., Dula, C. S., & Brewer, K. (2012). Forgiveness and aggression among college students. Journal of Spirituality in Mental Health, 14(1), 38–58. Webb, J. R., Toussaint, L., & Conway-Williams, E. (2012). Forgiveness and health: Psycho-spiritual integration and the promotion of better healthcare. Journal of Health Care Chaplaincy, 18(1–2), 57–73. Worthington, E. L., Greer, C. L., Hook, J. N., Davis, D. E., Gartner, A. L., Jennings, D. J. . . . Toussaint, L. (2010). Forgiveness and spirituality in organizational life: Theory, status of research, and new ideas for discovery. Journal of Management, Spirituality and Religion, 7(2), 119–134. Worthington, E. L. Jr., Witvliet, C. V. O., Pietrini, P., & Miller, A. J. (2007). Forgiveness, health, and well-being: A review of evidence for emotional versus decisional forgiveness, dispositional forgivingness, and reduced unforgiveness. Journal of Behavioral Medicine, 30(4), 291–302.
Copyright of Issues in Mental Health Nursing is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
COMMENTS, CRITIQUE, AND INSPIRATION COLUMN
Forgiving, but not Necessarily Forgetting Michelle Cleary, RN, PhD Associate Professor, School of Nursing and Midwifery, University of Western Sydney, Sydney, Australia
Jan Horsfall, PhD Independent Research Advisor, Sydney, Australia
Edited by Mona M. Shattell, RN, PhD DePaul University, School of Nursing, Chicago, Illinois, USA Edited by Michelle Cleary, RN, PhD University of Western Sydney, Sydney, Australia How can forgiveness be relevant to mental health nurses? Possible answers include when working with clients who are angry or depressed who focus on the harm another person has caused them, especially if the harm was not intra-familial violence, where the perpetrator is likely to re-offend; or when working with those involved in workplace incidents where an individual has created distress among coworkers. This column provides an overview of the definitions of forgiveness and unforgivingness; discusses the antecedents, processes, and consequences associated with forgiving another; and briefly addresses issues surrounding self-forgiveness. Forgiveness is becoming an increasingly hot topic in mental health-related disciplines, partly due to its potential benefits for health and well-being (Lawler-Row, Karremans, Scott, EdlisMatityahou, & Edwards, 2008). Models of forgiveness mostly focus on how individuals, couples, and families manage their hurt and resentment vis-`a-vis a relationship conflict or issues (Sandage & Jankowski, 2010), and it may be the case that when significant relationships are under duress that forgiveness is more closely connected to well-being (Toussaint & Friedman, 2009). Forgiveness also is an aspect of Judeo-Christianity, Islam, Hinduism, and Buddhism, and consequently many believers of these faiths are, at least, acquainted with its value from seminal sacred texts where forgiveness is advised (Webb, Toussaint, & Conway-Williams, 2012).
Address correspondence to: Michelle Cleary, School of Nursing and Midwifery, University of Western Sydney, Locked Bag 1797, Penrith NSW 2751. E-mail: [email protected]
In the workplace there are three types of unforgiving responses: vengeful (i.e., taking retaliatory actions against the transgressor); avoidant (i.e., work absenteeism, leaving the organization, or taking early retirement); and active grudge-holding (i.e., seeking opportunities to cause trouble for the offender by looking for wrong-doings) (Worthington et al., 2010). These are all forms of unforgiveness—and a range of resentful or vengeful actions, such as gossiping, betraying a confidence, or undermining the work of others will all lead to group disaffection and an increasingly malfunctioning workplace. Unforgiveness is fuelled by bitter, resentful, angry, and unhappy ruminations, constituting a vicious unresolved cycle. Conditional forgiveness involves engaging the transgressor in an attempt to forgive him or her. The two common forms of conditional forgiveness are requesting or demanding an apology, or asking or imploring the perpetrator to promise not to repeat the transgression. Seeking conditional forgiveness may be even unhealthier than unforgiveness for those who have been offended, as Toussaint, Owen, and Cheadle (2012) found it to be a significant predictor of mortality. Thus authentic forgiveness is a unilateral intrapersonal process that is not contingent on any hoped for appeasing behavior from the transgressor. Hurtful transgressions can be difficult to forgive even with an apology. When relationships are not repaired after a transgression, smoldering negativity can disrupt the group and engender worries about security and the future, with a subsequent loss of productivity (Cleary, Hunt, & Horsfall, 2010; Cleary, Hunt, Walter, & Robertson, 2009; Cleary, Walter, Horsfall, & Jackson, 2013). It is not uncommon for people to look for a new job as a consequence of unresolved incidents that precipitate interpersonal distress or involve discrimination or other forms of injustice. Being able to consider forgiveness at the group level could be important for reconciliation, especially in situations of lengthy ethno-political-religious conflict (Myers, Hewstone, & Cairns, 2009) and after discernible inter-group workplace conflict. The processes involved in forgiveness are complex, and involve letting go of negative or destructive feelings towards
562
COMMENTS, CRITIQUE, AND INSPIRATION
the transgressor, generating pro-social attitudes toward her or him, and relinquishing hurt, resentment, and self-blame (Hong & Jacinto, 2012; Sandage & Jankowski, 2010). According to Worthington and colleagues (2010) there are two types of forgiveness—decisional and emotional, and both involve intrapersonal processes. Decisional forgiveness involves the cognitive intention of behaving toward the perpetrator in more positive and less negative ways, and although a choice is made for forgiveness, negative emotions (e.g., anger, sadness) can continue to be experienced. Emotional forgiveness includes progressing towards replacing unforgiving feelings with those that are more positively other-oriented, such as sympathy or empathy. It is hypothesized that decisional forgiveness could lead to changes in emotion and, thus, behavior, and emotional forgiveness may feed into constructive changes in feelings and motivation, also leading to behavior changes (Worthington, Witvliet, Pietrini, & Miller, 2007). Among others, Enright and colleagues (1998) identified four broad phases in the extended process of forgiveness: (1) uncovering: being aware of problems, such as anger and personal pain; (2) deciding: recognizing the need for resolution via alternative pathways; (3) working: using cognitive processes, such as reframing, and emotional processes, such as empathy and acceptance; and (4) deepening: finding meaning and contextual understanding (Webb, Dula, & Brewer, 2012). Regardless of the definitions and hypothetical models, Myers, Hewstone, and Cairns (2009) conclude that forgiveness is a process that engages attitude (cognition) and emotions, resulting in the diminution of the desire for retaliation and facilitating cathartic expression of feelings, such as hurt, anger, and fear. In their meta-analysis of forgiveness research, Fehr and colleagues (2010) revealed that cognitive aspects account for more variance than emotional or constitutional factors. In a qualitative and quantitative analysis of research on forgiveness antecedents and consequences, Riek and Mania (2012) provide an excellent up-to-date overview. Agreeableness has the largest impact on forgiveness and state empathy is the second strongest predictor for forgiving another. However, empathy was not a significantly stronger correlate than most other social-cognitive factors, indicating that en masse these are the most powerful antecedents of forgiveness and most amenable for therapeutic intervention. Overall, the reviewers were concerned that moderators, such as self-esteem and commitment, have been insufficiently explored (Riek & Mania, 2012). Forgiving another does not equate to weakness, nor does not it preclude reasonable expressions of anger or attempting to redress an injustice (Gassin, Enright, & Knutson, 2005). Nor are we suggesting that all wrongdoings are forgivable. Unforgiveness and anger are not only associated with poor physical and mental health outcomes, but contribute to ongoing nonresolution within the aggrieved person (Hirsch, Webb, & Jeglic, 2012). Forgiveness is attributed with increasing positive coping and emotional responses, and improving interpersonal and
563
mental health functioning (Webb, Toussaint et al., 2012). It involves an increase in positive response towards the transgressor, but does not necessarily involve friendliness, reconciliation, or restitution: Instead it is a reasoned process undertaken unilaterally, that is, entirely irrespective of transgressor contingencies (Myers et al., 2009; Webb, Toussaint et al., 2012). Forgiveness also has the potential to defuse anger and hostility, and when it is sincere, the stress created by the hurtful event can be substantially reduced (Lutjen, Silton, & Flannelly, 2012). Not forgiving others—or oneself—is associated with poorer mental health and lower life satisfaction (Macaskill, 2012). Forgiveness enables a person to be more productive and adaptive, therefore investing or redirecting energy toward facilitating health, instead of being depleted by excessive ruminations, stress, and negative emotions (Svalina & Webb, 2012). The process of self-forgiveness differs from that of forgiving others for wrongdoing. The former involves processing guilt and shame and possibly self-loathing; forgiveness of others is also a self-process, but it is more about addressing personal thoughts and feelings to diminish interpersonal negativity. The literature notes that self-forgiveness may be more difficult than otherforgiveness because it involves self-compassion and many of us can be self-critical when we have erred (Toussaint & Friedman, 2009). On a cautionary note, at least one publication expresses concern that self-forgiveness may be related to over-confidence and narcissism, bypassing appropriate self-responsibility, acknowledgment of the transgression, and remorse, and these authors therefore consider self-acceptance preferable to selfforgiveness (Vitz & Meade, 2011). In summary there are overlapping definitions of forgiveness but they all involve cognitive processes relating to selfresponsibility, developing an understanding of the situation from a range of perspectives (reframing), and drawing on generous other-oriented emotional resources, such as empathy, to diminish feelings of bitterness, resentment, or hostility. Thus, even though the hurt was precipitated by the behaviors of another, the processes of forgiveness are intra-personal and independent of the post-incident actions of the transgressor. Declaration of Interest: The author reports no conflicts of interest. The author alone is responsible for the content and writing of the paper. REFERENCES Cleary, M., Hunt, G. E., & Horsfall, J. (2010). Identifying and addressing bullying in nursing. Issues in Mental Health Nursing, 31(5), 331–335. Cleary, M., Hunt, G. E., Walter, G., & Robertson, M. (2009). Dealing with bullying in the workplace: Toward zero tolerance. Journal of Psychosocial Nursing and Mental Health Services, 47(12), 34–41. Cleary, M., Walter, G., Horsfall, J., & Jackson, D. (2013). Promoting integrity in the workplace: A priority for all academic health professionals. Contemporary Nurse, 45(2), 264–268. Enright, R. D., Freedman, S., & Rique, J. (1998). The psychology of interpersonal forgiveness. In R. D. Enright & J. North (Eds.), Exploring forgiveness (pp. 46–62). Madison, WI: The University of Wisconsin Press.
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Fehr, R., Gelfand, M. J., & Nag, M. (2010). The road to forgiveness: A metaanalytic synthesis of its situational and dispositional correlates. Psychological Bulletin, 136(5), 894–914. Gassin, E. A., Enright, R. D., & Knutson, J. A. (2005). Bringing peace to the central city: Forgiveness education in Milwaukee. Theory into Practice, 44(4), 319–326. Hirsch, J. K., Webb, J. R., & Jeglic, E. L. (2012). Forgiveness as a moderator of the association between anger expression and suicidal behaviour. Mental Health, Religion and Culture, 15(3), 279–300. Hong, Y. J., & Jacinto, G. A. (2012). Six step therapeutic process to facilitate forgiveness of self and others. Clinical Social Work Journal, 40(3), 366–375. Lawler-Row, K. A., Karremans, J. C., Scott, C., Edlis-Matityahou, M., & Edwards, L. (2008). Forgiveness, physiological reactivity and health: The role of anger. International Journal of Psychophysiology, 68(1), 51–58. Lutjen, L. J., Silton, N. R., & Flannelly, K. J. (2012). Religion, forgiveness, hostility and health: A structural equation analysis. Journal of Religion and Health, 51(2), 468–478. Macaskill, A. (2012). Differentiating dispositional self-forgiveness from otherforgiveness: Associations with mental health and life satisfaction. Journal of Social and Clinical Psychology, 31(1), 28–50. Myers, E., Hewstone, M., & Cairns, E. (2009). Impact of conflict on mental health in northern Ireland: The mediating role of intergroup forgiveness and collective guilt. Political Psychology, 30(2), 269–290. Riek, B. M., & Mania, E. W. (2012). The antecedents and consequences of interpersonal forgiveness: A meta-analytic review. Personal Relationships, 19(2), 304–325.
Sandage, S. J., & Jankowski, P. J. (2010). Forgiveness, spiritual instability, mental health symptoms, and well-being: Mediator effects of differentiation of self. Psychology of Religion and Spirituality, 2(3), 168–180. Svalina, S. S., & Webb, J. R. (2012). Forgiveness and health among people in outpatient physical therapy. Disability and Rehabilitation, 34(5), 383–392. Toussaint, L., & Friedman, P. (2009). Forgiveness, gratitude, and well-being: The mediating role of affect and beliefs. Journal of Happiness Studies, 10(6), 635–654. Toussaint, L. L., Owen, A. D., & Cheadle, A. (2012). Forgive to live: Forgiveness, health, and longevity. Journal of Behavioral Medicine, 35(4), 375–386. Vitz, P. C., & Meade, J. M. (2011). Self-forgiveness in psychology and psychotherapy: A critique. Journal of Religion and Health, 50(2), 248–263. Webb, J. R., Dula, C. S., & Brewer, K. (2012). Forgiveness and aggression among college students. Journal of Spirituality in Mental Health, 14(1), 38–58. Webb, J. R., Toussaint, L., & Conway-Williams, E. (2012). Forgiveness and health: Psycho-spiritual integration and the promotion of better healthcare. Journal of Health Care Chaplaincy, 18(1–2), 57–73. Worthington, E. L., Greer, C. L., Hook, J. N., Davis, D. E., Gartner, A. L., Jennings, D. J. . . . Toussaint, L. (2010). Forgiveness and spirituality in organizational life: Theory, status of research, and new ideas for discovery. Journal of Management, Spirituality and Religion, 7(2), 119–134. Worthington, E. L. Jr., Witvliet, C. V. O., Pietrini, P., & Miller, A. J. (2007). Forgiveness, health, and well-being: A review of evidence for emotional versus decisional forgiveness, dispositional forgivingness, and reduced unforgiveness. Journal of Behavioral Medicine, 30(4), 291–302.
Copyright of Issues in Mental Health Nursing is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
