THIS YEAR'S Spirituality & Healing in Medicine course, co-sponsored by the Harvard Medical School and other institutions, was held December 14-15 in Boston. The course once again brought together healthcare professional and pastoral caregivers, chaplains, ministers, Christian Science practitioners, and others interested in focusing on the subject of "The Importance of Forgiveness."

While to traditional healthcare professionals, forgiveness may seem an ancillary topic to the nuts and bolts of helping patients attain "wellness," to those involved in day-to-day spiritual care, forgiveness is a familiar and significant component in helping people rise out of anger and unhappiness. Fortunately for patients, it appears that helping people to forgive themselves and others is becoming a vital part of what's now being called in the medical world "compassionate care."

According to Dr. Herbert Benson, a Harvard cardiologist and director of the course: "Forgiveness plays an important role in each of our lives on a personal as well as societal level. Guilt and resentment can lead to poor health outcomes; forgiveness can help to heal hatred of self and others. Studies have shown that the act of forgiving can result in less anxiety, less depression, and increased self-esteem. It is also associated with physiological changes that are opposite to those of stress as well as those of hostility, anger, depression, and anxiety. When forgiving, there is decreased heart rate, blood pressure, and skin conductance levels."

Aside from the physical health benefits of learning to forgive, forgiveness from a spiritual perspective, is intrinsic to most faith traditions. And the beginnings of the field of medicine were deeply rooted in spiritual practices, including the necessity of treating the "whole" person—not just addressing physical symptoms, but taking into consideration belief systems, prayer, and one's spiritual history. As a number of the presenters at the course pointed out, discovering that a patient is harboring deep resentment, carrying a grudge for decades, or suffering from guilt over wrongs committed years earlier, can help care providers lift the weight of such oppressive thinking and thereby relieve many of the patient's physical pains or chronic health problems.

For the last eight years, the Harvard Spirituality & Healing in Medicine course has been exploring the relationship between medical practice and the role of spirituality in people's lives. Each years, speakers present convincing empirical evidence showing the impact a person's spiritual health has on physical health. By studying the impact of forgiveness or "unforgiveness," researchers are finding that many of today's patients are suffering from conditions that can be alleviated simply by the act of forgiving.

For example, Dr. Christina Puchalski noted that greater self-forgiveness brings increased self-esteem, lower levels of anxiety and depression, and a more positive view of life. On the other hand, she noted that the inability to forgive blocks hope and in so doing had a profound impact on health. She pointed out that if you can't forgive others, you become socially isolated. Puchalski went as far as to say that forgiveness may ultimately be our most powerful weapon in stopping violence. When we are able to empathize with those who have wronged us either personally or socially, such as terrorists and gangs, we can move beyond self-inflicted anxiety and pain to a freer and healthier way of life.

In one study, conducted by Dr. Fred Luskin of the Stanford Forgiveness Project, researchers brought to California a group of Protestants and Catholics from Northern Ireland who had each lost a close family member to violence in their country. During a five-week program, these individuals were "taught" how to forgive. They then returned to Ireland, and, six months later during the follow-up study, they were found to have improved their lives and to be happier, functioning at a much better level than before they started participating in the program. Studies such as these are leading more and more professionals in the healthcare field to take a subject like forgiveness much more seriously and to incorporate what these psychologists are discovering into their own medical practices.

The progress of this trend can be seen clearly in the rise in the number of medical schools now incorporating courses on spirituality and health. Puchalski noted that in 1992, out of 122 medical schools in the US only three were presenting courses on spirituality and health. Now 85 medical schools include these courses— and most of the courses are required. According to Puchalski, who teaches at The George Washington Institute for Spirituality and Health in Washington, D.C., "The environment in the medical community has changed a lot since 1992."

Another development that has become much more accepted in medical treatment is the acknowledgment by physicians that a patient has needs that require an interdisciplinary team of professionals. Today's physician is much more likely than ever before to recommend a patient receive pastoral care, either from a hospital chaplain, through some kind of counseling, or in visits with clergy. As Benson pointed out in his opening remarks, 60-90 percent of conditions that bring patients to a physician in the first place are stress-related. The need to attend to areas such as forgiveness, as well as addressing a patient's core beliefs and spiritual life, are now recognized as effective and important aspects of any treatment.

While Benson's comment that "what a patient believes is vital" may be a new component of contemporary medical treatment, it has always been foundational to Christian Science treatment. That is why it is encouraging from a Christian Scientist perspective to witness the growing realization among participants and speakers at these courses that physical symptoms can be healed by addressing the underlying spiritual issues—the patient's beliefs about reality.

Dr. Luskin, whose forgiveness project at Stanford University has yielded such positive results, spoke movingly about his role as a therapist in helping patients achieve a higher state of acceptance of themselves and the world. "My interest in forgiveness is pragmatic. It's aimed at reducing suffering. To me, that is the same as opening your heart," he said. "The world gives us plenty of opportunity to close our hearts. But you have to work at keeping it open. One of the languages of the heart is forgiveness. A heart that's open is one that has gratitude, sees beauty, reflects on kindness and upon the incredible richness of living in this country. When we live with these attitudes, forgiveness is not that far away."

And on the subject of "becoming what we think," which is actually about seeing reality, Luskin made these observations: "If you go around thinking about how you had a bad mother—pretty soon everyone begins looking like your mother. If you practice bringing love into your heart, people don't have as much power over you to hurt you. Give part of every day giving gracious thanks to family and friends. And pay attention to goodness in the present. Then good things begin to happen. The merciful qualities of our own hearts are the only antidotes to life's cruelties."

One the last day of the course, a panel discussion led by Rev. Natalia Beck included panelists representing Roman Catholicism, Islam, Judaism, and Christian Science. Honor Hill, a Christian Science practitioner from Dallas, Texas, spoke about the role of forgiveness in Christian Science practice, and specifically about the impact forgiveness can have on healing physical conditions.

Each of the panelists talked about his or her own faith tradition, its teachings on forgiveness, and how they apply these teachings in actual cases. It seemed especially significant that the course ended with spiritual leaders discussing the importance of laying a foundation of forgiveness. The gap between medicine and spirituality seemed to be closing, even if in small increments, as caregivers from many paths came together in the interests of all their patients, to learn from one another and to share experiences from the heart.