Forgiveness and the bottle: promoting self-forgiveness in individuals who abuse alcohol

Psychological interventions to promote self-forgiveness: a systematic review

BACKGROUND

Being able to forgive one's own wrongdoings improves the health and well-being of a person. People find it difficult to forgive themselves due to different reasons. It is essential to enhance the ability to accept one's deeds and thereby enhance self-forgiveness. The current systematic review's objective is to comprehend the application and efficiency of numerous interventions that improve self-forgiveness.

METHODS

The search was done on electronic databases such as PubMed, ERIC, Web of Science, PsycNet, Science Direct, and Google Scholar. The initial search yielded 399 articles. After the duplicate removal, 19 articles met the eligibility criteria. Two studies were identified through related references. Thus, 21 articles were finalized for review. The study adhered to the PRISMA recommendations for systematic reviews.

RESULTS

The 21 finalized articles varied in method, participants, research design, duration, measurement tools used, and observed outcomes. Thirteen of the 21 finalized articles followed interventions specifically designed to promote self-forgiveness. Interventions are seen to be applied at both individual and group levels.

CONCLUSION

The review categorizes the interventions into self-directed and group. The self-directed interventions, notably those based on Enright's process model, demonstrate its efficiency in nurturing self-forgiveness. Self-forgiveness interventions are also found to be effective in promoting other positive psychological and clinical variables. Further implications and future research avenues are outlined.

Self-Compassion and Self-Forgiveness in Alcohol Risk, Treatment and Recovery: A Systematic Review

INTRODUCTION

Self-compassion and self-forgiveness are two self-focused, positive coping approaches that may reduce risk of problem drinking and/or aid in treatment/recovery from alcohol use disorder. The present systematic review aimed to evaluate support for the unique and complementary roles of self-compassion and self-forgiveness in alcohol outcomes.

METHODS

A systematic literature search yielded 18 studies examining self-compassion, 18 studies examining self-forgiveness and 1 study examining both constructs in alcohol outcomes.

RESULTS

Findings suggest greater self-compassion and self-forgiveness relate to lower likelihood of problem drinking. Self-forgiveness was considerably more researched in treatment/recovery outcomes than self-compassion; self-forgiveness-based interventions appear able to improve drinking-adjacent outcomes, and self-forgiveness may increase across various alcohol treatments. Finally, research suggests that associations of self-compassion and/or self-forgiveness with alcohol outcomes could be driven by numerous factors, including coping-motivated drinking, depression, psychache, social support perceptions, mental health status and/or psychiatric distress.

CONCLUSIONS

Self-compassion and self-forgiveness both appear protective against harmful alcohol outcomes. Nevertheless, many questions remain about the role of self-forgiveness and, particularly, self-compassion in alcohol treatment and recovery outcomes. Future research should examine whether targeted interventions and/or adjunctive therapeutic supports designed to increase self-compassion or self-forgiveness can reduce alcohol use disorder symptoms to facilitate alcohol treatment and recovery success.

Spiritually Integrated Group Psychotherapy for First Responders: Forgiveness, Trauma, and Alcohol Use

First responders (e.g. firefighters, law enforcement, paramedics, corrections officers) experience high rates of comorbid posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD). Despite the relevance of both spirituality and forgiveness to PTSD and AUD among first responders, spiritually integrated group interventions for this population are rare. This article discusses a forgiveness session of a spiritually integrated group psychotherapy protocol for first responders (SPIRIT-FR) in acute psychiatric care. This brief group psychotherapy intervention includes (a) psychoeducation about the intersection of PTSD, AUD, and forgiveness (b) discussion of the relevance of forgiveness to PTSD and AUD, and (c) the integration of spiritual beliefs and behaviors to move toward forgiveness. We discuss relevant clinical theory as well as the potential clinical application of this protocol.

Assessing self-forgiveness through the Enright Self-Forgiveness Inventory in the Spanish population: a validation study

Introduction

Self-forgiveness has been a complex construct to define, which has resulted in a shortage of instruments that adequately measure it as a process. In Spain, until now there is only one validated instrument to measure self-forgiveness, for this reason the present study aims to validate the Enright Self-Forgiveness Inventory (ESFI).

Method

A sample of 276 people (84 men, 192 women) aged from 18 to 25 years, completed the Enright Self-Forgiveness Inventory (ESFI) after its adaptation to Spanish, as well as the Enright Forgiveness Inventory-30 (EFI-30), the Narcissistic Personality Inventory (NPI), the Short form of Social Desirability Scale (M-C SDS), the Scale of psychological wellbeing (RYFF) and the Depression, Anxiety and Stress Scale-21 (DASS-21).

Results

The Confirmatory Factor Analysis showed a good fit for the original six-factors structure (CFI = 0.93, TLI = 0.92, RMSEA = 0.063). The results showed good psychometric qualities (both validity and reliability) and association between self-forgiveness and social desirability, depression, anxiety, narcissistic traits, and purpose in life as expected theoretically.

Discussion

The ESFI-30 shows good psychometric properties within the Spanish context and is an appropriate instrument for evaluating self-forgiveness for research and clinical intervention. As a primary goal, the abstract should render the general significance and conceptual advance of the work clearly accessible to a broad readership. References should not be cited in the abstract. Leave the Abstract empty if your article does not require one - please see the "Article types" on every Frontiers journal page for full details.

Self-forgiveness, Guilt, Shame, and Parental Stress among Parents of Children with Autism Spectrum Disorder

A mixed-method approach was used to explore and compare self-forgiveness, guilt, shame, and parental stress in parents of children with autism spectrum disorder (ASD) and parents of neurotypical (NT) children. The data were obtained by the Heartland Forgiveness Scale (Thompson et al., 2005), Guilt and Shame Experience Scale (Maliňáková et al., 2019), Parental Stress Scale (Berry & Jones, 1995) and by open-ended questions. The research sample consisted of 143 parents of children with ASD and 135 parents of NT children from Slovakia. The regression analysis confirmed that guilt, shame, and self-forgiveness explained 23% of the variance in parental stress, while the only significant negative predictor was self-forgiveness. Furthermore, shame mediated the pathway between self-forgiveness and parental stress in parents of children with ASD. Parents of children with ASD experience more shame than parents of NT children. The qualitative analysis obtained a more comprehensive understanding of both groups. Parents of children with ASD mostly experienced shame in regard to their child's inappropriate behavior or it being misunderstood by society, while parents of NT children mostly did not feel ashamed of their parenting. Acceptance, social support, religious beliefs, and love from the child were the most often mentioned factors helping self-forgiveness in parents of children with ASD. We highlight the importance of self-forgiveness as a potential coping mechanism for parental stress and suggest focusing on negative aspects of shame in parents of children with ASD.

Effectiveness of Interventions in Reducing Substance-Related Stigma: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

The purpose of this study was to undertake a quantitative analysis to determine the effectiveness of interventions designed in reducing different types of stigma (self-stigma, social stigma, and structural stigma) for the substance use. This study followed the Cochrane Handbook for Systematic Reviews of Interventions guideline. This study followed the Cochrane Handbook for Systematic Reviews of Interventions guideline. Systematic searches were conducted in PubMed, Science Direct, Web of Science, Scopus, and MEDLINE. These electronic databases were searched research published in English from date of their inception to July 15, 2021. Randomized controlled trials that evaluated interventions on stigma associated with substance use were included. Studies should include at least one stigma outcome involving self-stigma, social stigma, or structural stigmatization. Ten randomized controlled studies were included. The overall Hedges'g for the interventions' impact on reducing stigma was 0.301, 95%CI = [-0.154- 0.755], p = 0.195, that there was no statistically significant difference. However, the meta-analysis showed that interventions had no significant impact on self-stigma [0.682, 95% CI=(-0.015-1.380), p = 0.055] and social stigma [0.198, 95% CI=(-1.271-0.876), p = 0.718] but had a small but significant impact in favor of the experimental group on reducing structural stigma [0.360 (95% CI= 0.156-0.564), p = 0.00]. According to subgroup analyses, there was no difference in the effects of stigma according to the type of intervention, the number of sessions, or the type of group. The interventions for reducing stigma related to substance use are promising. It seems to have a small but significant positive impact on structural stigma.

Guilt in alcohol use: A systematic review

For decades, alcohol use disorder has been investigated in an attempt to understand its processes and implications. However, among all of the factors involved in alcohol use disorder, the role of guilt in alcohol use remains poorly explained, with many contradictory results. Therefore, the purpose of this review is to conduct a systematic analysis of the literature from 1990 to 2022 to review the studies investigating the link between guilt and alcohol consumption. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method, 31 studies were included in this review. The results of this work enable to highlight the plurality of guilt that has been studied in the literature. Grouped in two categories: state guilt and trait guilt, they seem to have diverse implications towards alcohol use or misuse. Guilt proneness seems to act as a protective factor towards alcohol use, except for the few studies conducted on a clinical population. Numerous studies indicated that state guilt is deleterious toward alcohol use, even if some results are contradictory. Furthermore, this work allows us to shed light on the limits of the studies currently carried out, and thus to propose new directions for future studies.

Integrative couple treatment for pathological gamblers with an emphasis on forgiveness processes: A case study with three couples

Gambling's impact on a couple's relationship is an essential element in the gambling disorder (GD). Gamblers tend to lie to their partner to conceal the extent of their gambling problems and debts, which can lead to a serious relational transgression for the couple. One promising avenue is a couple treatment focusing on forgiveness processes. The objective of this study was to determine whether the Integrative Couple Treatment for Pathological Gamblers (ICT-PG) with an emphasis on forgiveness processes helped couples to enhance these processes. A Single-Case Research Design (SCRD) was used with three couples in which one of the members had a GD. The results highlight the importance of jointly analyzing the forgiveness processes between the gamblers and their partner, which constantly influenced each other. These promising results illustrate the relevance of integrating forgiveness processes in treatment for couples where one of the members has a GD.

The Mediating Role of Forgiveness and Self-Efficacy in the Relationship Between Childhood Maltreatment and Treatment Motivation Among Malaysian Male Drug Addicts

Studies have reported high rates of childhood maltreatment among individuals with drug addiction problems; however, investigation about the potentially protective factors to mitigate the effects of maltreatment experiences on motivation to engage in addiction treatment has received less attention. This study aims at exploring the mediating effects of forgiveness and self-efficacy on the association between childhood maltreatment and treatment motivation among drug addicts. A total of 360 male drug addicts (mean age = 33.34, SD = 7.25) were recruited from three mandatory inpatient rehabilitation centers in Malaysia. Participants completed a package of self-report questionnaires including measures of childhood maltreatment experiences, forgiveness, self-efficacy, and motivation for treatment. The analysis conducted using the structural equation model (SEM) revealed that childhood maltreatment significantly predicted lower treatment motivation, while forgiveness and self-efficacy played a fully mediating role regarding the effect of childhood maltreatment on treatment motivation. In conclusion, these findings suggest that combining the element of forgiveness and self-efficacy in treatment programs appears to benefit the drug addicts with childhood maltreatment history.

Social Exclusion, Self-Forgiveness, Mindfulness, and Internet Addiction in College Students: a Moderated Mediation Approach

Internet addiction is a growingly prevalent behavioral addiction that causes numerous psychosocial problems. Investigating the causes and consequences of Internet addiction is fundamental to comprehend and prevent it. Therefore, the current study provided protective and promotive factors for undesired effects of social exclusion on Internet addiction. The study examined a moderated mediation model to test whether mindfulness moderated the mediating role of self-forgiveness in the association between social exclusion and Internet addiction among young adults. The participants of the present study included 358 undergraduate students attending a state university in Turkey. They ranged in age from 20 to 28 years (M = 21.89, SD = 1.95). The participants comprised 206 (57.5%) female and 152 (42.5%) male college young adults. Overall, the study findings indicated that self-forgiveness mediated the relationship between social exclusion and Internet addiction, and mindfulness moderated the mediating role of self-forgiveness in this association. Contending with negative outcomes of social exclusion and Internet addiction, and mitigating and buffering roles of self-forgiveness and mindfulness provide important implications to design prevention and intervention services for reducing Internet-related addictive behaviors.

Women in Christian Substance Abuse Treatment; Forgiveness, Attachment Styles, and Improvements in Co-occurring Mental Health Symptoms

The purpose of this study was to explore the efficacy of The Recovery Center at Shalom House Ministries and examine the relationship(s) between forgiveness, attachment styles, drug and alcohol abuse, self-reported mental health symptoms, and cognitive functioning. Participants (N = 118 women) attended Shalom Recovery (2016-2018). Statistically significant improvement was found between entrance and the 3-month mark on all measures, with 67.9% completing the program. Findings indicated that the revenge motivations correlated with depression, self-esteem, anxiety, and avoidance of intimacy with God, but only this latter scale contributed to a multiple regression model on revenge motivations at program entry.

A Professional Development Workshop to Facilitate Self-Forgiveness

BACKGROUND

Evidence suggests that forgiving one's self, others, and events improves relationships and self-esteem; reduces anxiety, depression, and stress; lowers blood pressure; improves cardiovascular health; and boosts immune function.

OBJECTIVE

We determined the efficacy of a workshop to facilitate forgiveness in medical education professionals.

METHODS

A 1-hour self-forgiveness workshop conducted by 4 facilitators was presented at a medical education conference in 2018. The workshop included a didactic presentation on forgiveness and Internal Family Systems, small group discussion on self-forgiveness concepts, a 15-minute guided imagery audio meditation on self-forgiveness, and postintervention small group discussion. The 18-item Heartland Forgiveness Scale (HFS), which measures forgiveness for self, others, and situations, was completed preintervention and postintervention (score range, 18-126).

RESULTS

There were 91 participants, including graduate medical education managers and directors (61%), deans/clerkship directors (19%), and academic faculty/others (20%). Participants were from the South (20%), West (17%), Midwest (31%), and Northeast (32%) US regions. Baseline HFS scores showed that 53% were forgiving, 47% were neutral, and no participants had unforgiving tendencies. Total HFS score significantly increased (90.31 pre versus 95.7 post, P = .013), with significant increases in forgiveness of self (53% pre versus 73% post; P = .012; odds ratio = 2.47) and forgiveness of others (49% pre versus 69% post; P = .020; odds ratio = 2.3). Preintervention group discussion topics focused on guilt, shame, and barriers to forgiving, while postintervention discussions centered on challenges and benefits.

CONCLUSIONS

A brief guided meditation intervention with focused discussions was feasible and improved the immediate tendency to forgive.

Religiously or Spiritually-Motivated Forgiveness and Subsequent Health and Well-Being among Young Adults: An Outcome-Wide Analysis

This study performs an outcome-wide analysis to prospectively examine the associations of forgiveness (including forgiveness of others, self-forgiveness and divine forgiveness) with a range of psychosocial, mental, behavioral and physical health outcomes. Data from the Nurses' Health Study II and the Growing Up Today Study (Ns ranged from 5,246 to 6,994, depending on forgiveness type and outcome) with 3 or 6 years of follow-up were analyzed using generalized estimating equations. Bonferroni correction was used to correct for multiple testing. All models controlled for sociodemographic characteristics, prior religious service attendance, prior maternal attachment and prior values of the outcome variables. All forgiveness measures were positively associated with all psychosocial well-being outcomes, and inversely associated with depressive or anxiety symptoms. There was little association between forgiveness and behavioral or physical health outcomes. Forgiveness may be understood as a good itself, and may also lead to better subsequent mental health and psychosocial well-being.

Longitudinal Relationship between Forgiveness of Self and Forgiveness of Others among Individuals with Alcohol Use Disorders

Previous research has suggested that forgiveness of self and forgiveness of others might function differently over the course of addiction recovery. However, we know little about the longitudinal process of these dimensions of forgiveness for individuals addressing alcohol-use disorders. Increased knowledge would inform the content and sequencing of intervention strategies. Three hundred and sixty-four individuals managing alcohol dependence participated in a 30-month longitudinal study, reporting their capacity to forgive self and to forgive others every 6 months. Findings indicated that a) participants were more forgiving of others than themselves, b) both types of forgiveness increased over time, c) forgiveness of self increased more rapidly than forgiveness of others, and d) while increases in both types of forgiveness predicted increases in the other type, the effect of forgiveness of others on forgiveness of self was twice as strong as the reverse effect. Implications for facilitating forgiveness in treatment are discussed.

Longitudinal Differences in Spirituality and Religiousness between Men and Women in Treatment for Alcohol Use Disorders

This study compares men and women with alcohol use disorders on levels and trajectories of spirituality and religiousness over 30 months while controlling for critical covariates. Men (n=92) and women (n=65) entering abstinence-based treatment were assessed for drinking behavior, spirituality, and psychosocial variables in a longitudinal panel study. Multiple regression tested for baseline differences and multi-level models tested for differences from baseline to 6 months (early recovery) and from 6 to 30 months (later recovery) in seven dimensions of spirituality/religiousness. Between baseline and 6 months, women had higher scores than men for forgiveness of others and lower scores than men for negative religious coping. Between 6 and 30 months, the acceleration of positive change in self forgiveness was significantly greater for women than men. Differences in negative religious coping and forgiveness might relate to differences in shame and guilt and their resolution by gender. Future research should examine whether gender differences in spirituality serve as an asset to women as they pursue addiction recovery.

Understanding the relationship between domestic abuse and suicide behavior in adults receiving primary care: does forgiveness matter?

This study examined the interrelation of domestic abuse, forgiveness of self, forgiveness of others, and suicide behavior in a community sample of 101 patients receiving primary care from a clinic in the southeastern United States. As expected, it was found that more frequent experience of domestic abuse was associated with more frequent suicide behavior. Results from conducting mediation analyses and using bootstrapping techniques provided support for a model in which the relationship between domestic abuse and suicide behavior was accounted for by forgiveness of self, but not by forgiveness of others. The article concludes with a discussion of some of the implications of the present findings for practice and the study's limitations.

Self-Forgiveness in the Recovery of Israeli Drug-Addicted Mothers

It has been suggested that self-forgiveness plays an important role in the process of recovery from addiction, especially for women, but this issue has been largely overlooked in the research. This study explored self-forgiveness from the perspective of 25 recovering drug-addicted mothers associated with the same therapeutic community, either as current residents in the course of recovery or as past residents who maintained recovery. The participants were interviewed in a dual-research design (35 interviews) that enabled comparative-longitudinal examination of the self-forgiveness process. Qualitative methods were used to identify the emotional, cognitive, and offense-related factors associated with self-forgiveness regarding mothering patterns during addiction. The results indicated that self-forgiveness involves cognitive flexibility by using the disease model, creating new constructions of motherhood, and changing mothering patterns. Furthermore, self-forgiveness is accompanied by diminishment of guilt and enables construction of a new shame-free identity. The findings may inform self-forgiveness interventions in the addiction field.

Maladaptive social self-beliefs in alcohol-dependence: a specific bias towards excessive high standards

BACKGROUND

Emotional and interpersonal impairments associated with alcohol-dependence have been recently explored, but the distorted cognitive representations underlying these deficits remain poorly understood. The present study aims at exploring the presence of maladaptive social self-beliefs among alcohol-dependent individuals, as these biased self-beliefs have been recently shown to play a crucial role in the development and maintenance of other psychopathological states (social anxiety and depression).

METHODOLOGY/PRINCIPAL FINDINGS

Twenty-five recently detoxified alcohol-dependent participants and 25 matched controls filled in self-report questionnaires evaluating maladaptive social self-beliefs, interpersonal problems and several comorbid states (anxiety, social anxiety, depression). As compared to controls, alcohol-dependent individuals showed higher scores than controls for the three subcategories of maladaptive social self-beliefs (high standards, conditional beliefs and unconditional beliefs). Our key finding was that when comorbidities were controlled for, alcohol-dependence was associated with a specific bias towards exaggerated high standards in social contexts. Moreover, these high standards beliefs were strongly correlated with interpersonal problems.

CONCLUSIONS/SIGNIFICANCE

These results provide the first insights into the influence of cognitive biases on interpersonal problems in addictive states, and suggest that maladaptive self-beliefs could have a central influence on the development and maintenance of alcohol-dependence.