The effects of forgiveness on the heart

- This is an audio course. Thank you for listening. (gentle music) - Sounds True presents "The Science of Compassion: A Modern Approach for Cultivating Empathy, Love and Connection", with health psychologist and Stanford University lecturer, Kelly McGonigal. Our program continues with session nine, "The Healing Power of Difficult Compassion". - I'd like to start this session by telling you about what I think might be one of the most interesting studies on compassion ever conducted. This was a study of patients at a veteran's hospital in Madison, Wisconsin. All of the patients were men between the ages of 21 and 79, and all of them had been diagnosed with either some form of heart disease, or an elevated risk for heart disease. And each one of these men also carried a deep and unresolved psychological injury, a painful experience that continued to hurt and to haunt them, an experience that made them angry, frustrated, and agitated every time they thought about it. The researchers in the study asked each man to describe that incident in detail. And as they did so, they underwent a cardiovascular stress test. Now, in this kind of stress test, the experimenter injects a radioactive substance into a vein in your arm where it enters your bloodstream, and that radioactive substance then travels to your heart, where it is absorbed by the healthy heart muscle tissue. The experimenter can then scan the heart to see where the radioactive substance is concentrated. In this way, they can examine whether the heart is getting adequate blood flow. Areas of the heart that are not receiving adequate blood flow, they show up as cold spots, or dark spots on the radioactive scan. One of the main causes of heart disease is when areas of the heart fail to receive enough blood flow. Without enough blood flow, the heart doesn't have enough oxygen to continue to pump. And in fact, patients who show cold spots during a cardiovascular stress test, they're at significantly higher risk of having a heart attack over the next few years. Previous studies have shown that during psychological or physical stress, blood flow to the heart can be compromised. This is one reason why extreme stress or physical exertion can trigger a heart attack. And what the researchers in this study were interested in was would the men's anger, as they talked about these incredibly painful experiences, would that anger show up in the heart scans as cold spots? Does anger reduce blood flow to the heart? This is exactly what they observed. For example, one man who had a previous heart attack, he showed significantly reduced blood flow to the precise area of his heart that had been injured by his heart attack. Now here's what makes the study really interesting. The men then went through a brief forgiveness training program. And in this training, the men were taught to recognize and accept their anger and acknowledge, yes, they had been harmed. They were also encouraged to offer mercy or empathy, to offer compassion to the person who harmed them, even if they had no interest in or ability to repair that relationship. 10 weeks later, the men went through another cardiovascular stress test, again, while they were describing the experience that had caused them so much pain and anger. But this time, the experimenters had a much harder time finding evidence of anger in the patient's heart scans. Somehow, through forgiveness, the experience of talking about the painful event had become less unhealthy. Take for example, that man who had shown reduced blood flow to the very area of his heart that had been injured by a previous heart attack. When the experimenters looked at the heart scan after the forgiveness training, he showed a much smaller cold spot on his heart. Why is this study so important? Well, first, the bad news, it confirms something we've already discussed, that anger can be toxic. When you're angry, your body shifts into a state that is really not healthy, not just for your cardiovascular system, but also for your nervous system and your immune system. And this state can take a toll over time. In one study that followed men in the US for 35 years, they found that anger was the best psychological predictor of how long people lived. The more anger men reported, the more likely they were to die. Another study, which tracked older adults in the US found that unforgiveness, that is basically being committed to not forgiving other people, a commitment to holding onto grudges, this unforgiveness predicted declines in physical health over time. But also, this study suggests some really good news. As this study showed with the heart patients, we can transform anger through compassion. Or as Buddhist nun, Pema Chodron teaches, "We can use the poison as good medicine." Your own experience of anger, resentment, or even hate can be an opportunity to both open your heart and heal your heart. This session will focus on the benefits of, and the best strategies for finding compassion for people who have harmed you or harmed others. Along the way, I'll share with you some stories of forgiveness and compassion. These stories show that there are many ways to work with anger, and there's no one right way find compassion in difficult circumstances. When you have been hurt by someone, or feel anger and deep conflict, what kind of compassion is healing? One researcher who's dedicated her career to answering this question is Charlotte Whitley, a psychologist at Hope College. And her research was inspired by observing the fact that when people experience something painful, they tend to rehearse the hurt. They play it back in their minds over and over, kind of like when you push your tongue on a painful tooth just to make sure it still hurts. And the more people ruminate on these painful experiences, the worse they feel. She wondered if there was a way to think about the same painful events, but in a way that would help them move on, and maybe even find meaning in the experience. And so the strategy she chose is something that she calls compassionate reappraisal, and that's basically thinking about something from a more compassionate point of view. In a typical study, she'll ask people to think about a painful experience that still hurts them. Maybe they were betrayed by a colleague, or maybe they were rejected by someone they loved, maybe someone they cared about lied to them, or they felt like they were treated really unfairly. She asked them to think of a specific experience, and then asked them to think about that experience in a very specific way. She asked them to acknowledge the harm, and to think of whoever hurt them as someone whose behavior was bad. But she also asked them to think about this person as someone who might be struggling. And she asked them to think about whether that harmful behavior might reflect this person's own experience of suffering. Could the participant see the person as someone who needs to change or grow, and could the participant genuinely wish that this person experiences some kind of positive transformation or healing that might reduce the suffering that they add to the world, as well as reduce their own suffering? First, I think it's worth noting that people are generally able to do this, even though it's a little bit difficult. We may be reluctant to even engage in this kind of thinking, but that's different from being unable to do it. When we do try to see someone who hurt us as someone who is also hurting, it's a truth that most people can sense and connect to at some basic level. And when we do try on this compassionate point of view, it has immediate results. So one of the things that Whitley has looked at in her studies is she's actually put electrodes on people's faces to measure their facial expressions. And she's found that usually when people think about a painful experience, their brows furrow and their mouth draws down, and there's tension in the jaw. But when people take a compassionate point of view on the same experience, suddenly, you see activation of the smiling muscles in the face, and you see a relaxation of muscles that are associated with frowning and with anger. Participants also show a change in what's happening in their bodies. They show lower heart rate, lower blood pressure, while at the same time, higher heart rate variability. That's that synchronization between the heart and your breath, suggesting that when people take a compassionate point of view, they're both calming down the physiology of anger, and also activating the physiology of compassion. Participants also report feeling better. They report reduced emotional distress, reduced anger, reduced shame, and they also report more positive emotions, like hope, and gratitude, and even love. And importantly, they do say they they feel more compassion toward the person who hurt them. And many of them report feeling a heartfelt forgiveness. And this is from a single contemplation from a compassionate point of view. These are the immediate effects of compassionate reappraisal, but research shows that there are also longer lasting effects. In some studies, participants are asked to take this compassionate point of view once, but then they are asked to think about the same painful experience again and again, and a little later, to do it again without any instructions about how to think about it. And what the research shows is that over time, people feel less, and less distress when they think about it, with increasing levels of compassion and forgiveness. This suggests that when we are willing to take a compassionate point of view on a painful experience, a real transformation can occur. Now, Whitley has also compared compassionate reappraisal to another strategy you might be familiar with, that a lot of people use to try to deal with anger, and that is suppression, to push it down, to not feel it and certainly not to show it. And what she's found is that suppression and compassion have very different effects. When you try to simply suppress your anger, you can temporarily reduce your emotional distress, at least for a short time. But suppression does not induce the same positive emotions or the same forgiveness as compassionate reappraisal. Trying to suppress our anger might provide a brief escape, but only the compassionate point of view transformed the anger.