For me, the highlight of this year's annual American Psychiatric Association meeting in Honolulu comes down to four words: Archbishop Emeritus Desmond Tutu.
Archbishop Tutu spoke at the Convocation of Distinguished Fellows to thunderous applause. Anywhere from 1,000 to 2,000 people attended, and his presentation was spellbinding. His most important message was about forgiveness. In relating tales about the Truth and Reconciliation Commission (TRC) in South Africa - which he chaired - he expressed his amazement at the courage of those who came before him. Countless people told about the horror that happened to them and their families. Yet, these same people were able to face the perpetrators and express their forgiveness.
I had heard the archbishop speak before. Last year, he spoke at the American College of Psychiatrists annual meeting in Fort Lauderdale, Fla. (Clinical Psychiatry News, May 2010, p. 9). During that speech, I also was struck by the power of his message.
For psychiatrists, this message is particularly meaningful. We should be practicing and teaching humane care and positive values. In Hawaii, Archbishop Tutu discussed the importance of these values. He also expressed something we all know: People have an amazing capacity for evil. However, when he saw so many people who should have been filled with hate and vengeance actually embrace their torturers and forgive them, he realized that the opposite is also true: Man is good. On this point, he ended his captivating speech. People can change, and men are good.
The retired Anglican archbishop's comments were so powerful, that at one point, I caught my breath and made a comment that led my friend, Howard Sudak, sitting next to me to say, "I feel a column coming on." At that point, I knew that I wanted to share my impressions about the presentation with my readers.
Archbishop Tutu offered five aphorisms that can help us in our work with patients:
1. "Nursing a grudge is bad for your health." As physicians, we know that countless studies show the truth of this statement. Take, for example, research conducted at the Veterans Affairs N.Y. Healthcare System that sought to investigate the relationship between trait forgiveness and cardiovascular activity among 99 normotensive participants. The investigators obtained cardiovascular parameters at 2-minute intervals during a 10-minute baseline period and a 20-minute recovery period. These parameters also were obtained at 1-minute intervals during a 4-minute anger recall task and a 4-minute serial subtraction task without harassment. For assessment of levels of forgiveness, the participants had been asked to fill out a self-measure of forgiveness before the procedure began (Int. J. Psychophysiol. 2007;65:87-94).
The investigators found that higher levels of trait forgiveness were predictive of lower diastolic blood pressure at baseline and faster diastolic blood pressure recovery "Findings suggest that forgiveness may be related to overall reductions in blood pressure levels and may aid in cardiovascular recovery from stress," they wrote.
However, interestingly, a study conducted by researchers at the University of Stellenbosch in Tygerberg, South Africa, found less definitive results. They looked at 134 survivors of human rights abuses who gave either public, closed, or no testimony to the TRC. The participants were given instruments that measured their exposure to abuses, other traumatic events, psychiatric status, and their forgiveness attitudes toward the perpetuators (Br. J. Psychiatry 2001;178:373-7). No significant association was found between TRC participation, current psychiatric status, or current forgiveness attitudes. However, low forgiveness was associated with poorer psychiatric health. In conclusion, they wrote that "truth commissions should form part of, rather than be a substitute for, comprehensive therapeutic interventions for survivors of human rights abuses. …