“To forgive is to set a prisoner free and discover that the prisoner was you.” — Lewis B. Smedes
I have a question I’ve been asking patients and their families for years, and the response never changes. I posed this question to a clinical audience of physicians, nurses, social workers and chaplains at the City of Hope International End of Life Symposium a couple of years back: “Show of hands: how many of you were told, at some point in your life, that you ought to forgive, that you ought to be forgiving? Nearly every hand goes up. Now: how many of you were taught how to forgive?” No hands came up.
That gap is telling and truly significant, and in my clinical and personal experience, one of the primary sources of unresolved suffering at the end of life. We assign forgiveness as a moral obligation, particularly in religious contexts, without ever providing instruction, without acknowledging that it is a skill, a practice, something that requires development over time the way any other capacity requires practice. All of us were told when young, and throughout life really: you need to forgive and move on. We tell people what they should do and leave them entirely alone with the how. Then we wonder why so many people arrive at their deathbeds still carrying what they’ve carried for decades.
I want to talk about what forgiveness actually is, what it isn’t, why self-forgiveness is maybe the best place to start, and how to begin practicing it before it becomes urgent.
Forgiveness is, and must be, a freely made choice to give up revenge, resentment, and harsh judgment toward a person who caused a hurt, and to strive instead toward compassion and generosity. That definition comes from the research of Enright, Freedman, and Rique, and it’s useful precisely because it is centered in, and requires, personal choice. Forgiveness is not something that happens to you. It is not a feeling that arrives when the conditions are right. It is an act of will, undertaken for your own sake.
Mark Twain said anger is an acid that does more harm to the vessel in which it is stored than to anything on which it is poured. Nelson Mandela said resentment is like drinking poison and hoping it kills your enemies. Both are pointing at the same clinical reality: unprocessed guilt, shame, and anger live in the body. They shape the quality of our lives and, when we run out of time to address them, they shape the quality of our deaths.
I have been at a great many trauma, illness and death-bedsides. Too many to count. I have witnessed reconciliation arrive in the final hours of a life and watched someone die with a perceptible release, the people around them changed by what just happened. I have also witnessed the other kind of death, the one weighted by things unsaid and unresolved, and I can tell you that the suffering that follows that death can endure for years in the people who survive it. What happens at the end of life is not only about the person dying. It radiates outward and onward.
The research supports this. A large meta-analysis published in 2015 found strong correlations between self-forgiveness and psychological well-being, and moderate correlations with physical health, across nearly eighteen thousand participants. This is not just qualitative territory. Forgiveness has measurable clinical, real-life consequences.
Before I go further, let me say clearly what forgiveness is not. It is not a single event. It is not condoning or justifying what was done to you. It does not require you to seek out or speak to the person who harmed you. And it cannot be done for someone else. Simon Wiesenthal’s book The Sunflower, which asks whether he should have forgiven a dying Nazi soldier for crimes committed against Jewish people, elicited responses from philosophers, theologians, ethicists, and survivors. The most consistent finding was that one can only forgive wrongs done to oneself. You cannot forgive on behalf of others, and no one can forgive on your behalf. And no one ought to tell another that he or she should forgive.
Which brings me to the piece that gets underemphasized: self-forgiveness probably has to come first. Not because we have wronged others more, but because it is the closest place to start the practice and often the hardest to do.
Maya Angelou said forgiveness is the greatest gift you can give yourself. It’s not for the other person. I think this is true, and I think most of us, especially those of us shaped by religious traditions that frame forgiveness as primarily something we extend to others, have the order wrong. The work begins inside. What stops us from forgiving ourselves? Usually some combination of guilt, shame, unexpressed grief, and a failure to recognize the cost of carrying all of it. Gandhi said it plainly: the weak can never forgive. Forgiveness is the attribute of the strong and if I can do it, it buttresses my own sense of strength.
The theologian Nadia Bolz-Weber once said that if we could capture shame as an energy source, it could replace fossil fuels. That’s not just a striking statement. It’s an accurate description of the mass of energy most of us have locked up in self-recrimination, shame over old failures, and accumulated regret. That energy can be redirected toward healing. Toward reconciliation. Toward what I’d call a more peaceful passage, both for the dying and for those who will grieve them.
So how do you actually do it?
I often use the American Buddhist teacher Jack Kornfield forgiveness meditation. This guides a person through practice of forgiveness for others, forgiveness for self, forgiveness of those who have hurt or harmed you. Remember, this is a practice, not a performance.
Dr. Martin Luther King Jr. said forgiveness is not an occasional act but a constant attitude. I’d add: start small. Choose minor failures, minor hurts. It is important to be extremely gentle with yourself when you do this. I recommend choosing something small to start with; like forgiving myself for not taking as good of care for my body as I could have. Or for not accomplishing all I wanted to with the day; or for losing my patience with my spouse for one thing or another. Practice and move on to something else, slowly choosing bigger incidents. Try choosing something another did to you or failed you in some small way and move on. If we can be forgiving of ourselves for small things, in time we can gain traction with the bigger stuff.
Build the muscle before you attempt the heavier lifts, the betrayed friendship, the disappointed child, the patient you couldn’t save, the family interaction that caused a rift that you could have managed better. The goal of the practice is not perfect outcomes. It is just getting better at the practice. You work at it, and over time the capacity grows.
Jack Kornfield describes the process as an easing of your own heart. We have all been harmed, just as we have all harmed others and ourselves. The forgiveness is fundamentally for your own sake, a way to gradually release the pain of the past and carry it no longer.
Forgiveness researchers describe a process with roughly four movements. The first is uncovering: getting honest about how the offense, whether against you or by you, has actually hurt and changed you, how much mental and emotional space it occupies. The second is decision: once you understand what not forgiving has cost you, you can choose to commit to the process. The third is work: developing empathy and compassion for yourself and, where applicable, for the one who caused harm. The fourth is deepening: finding some meaning in the suffering, recognizing that it connects you to a larger human experience rather than isolating you in a private one.
If you are a clinician, a physician, a doula, a social worker, a nurse: the people in your care are carrying this. Many of them are carrying it right to the edge. You don’t have to be a chaplain to ask about it, to create the opening, to refer to someone who can help. Starting earlier is always better than waiting until it becomes urgent because the hourglass of a life is nearly empty.
And if you are carrying something yourself, which most of us are: give yourself, as I sometimes say, a bolus of F vitamins. Start where you are. Start small. As the singer-poet Don Henley wrote, the heart of the matter, in the end, is forgiveness.