Healing from the Inside Out

Healing from the Inside Out The chaplain at a cancer

by M ichael S . B arry

hospital shares what he’s learned

The past is not dead. In fact, it is not even past.

William Faulkner

about the relationship between

In my capacity as the director of pastoral care at Cancer Treatment Centers of America in Philadelphia, I conduct educational forgiveness programs for patients who self-assess as needing to forgive others, themselves, or, on occasion, God. My goal is to help cancer patients put their past in the past.

Because of the variables associated with ministering to a cancer patient population, I do not have the luxury of entering into a long-term therapeutic relationship with my patients.

Some are in treatment regimens that last for weeks, while others require only short-term outpatient chemotherapy treatment. Others treat for longer periods and either get better or enter a hospice program. Since I am only absolutely certain to see them during their three-day initial evaluation, my educational program is designed to be compact, focusing on what I consider to be the essence of forgiveness. I plant seeds and occasionally have the opportunity to enjoy seeing the fruits of my labors. After four years of research, including conducting countless forgiveness programs with many of our patients, I have reached the following conclusions, which will also serve as some initial disclaimers: • Forgiveneness does not cure cancer, but because it improves spiritual/emotional health, it boosts the immune system and is one of the body’s best coping mechanisms.

• Unforgiveness does not cause cancer, but it does cause stress that can lead to unhealthy habits — substance abuse, suppression of negative emotions, and poor self-care, to name a few — that are highly correlated to various diseases, including cancer.

Amazing Grace by April Mansilla

forgiveness and wholeness.

Case study: Jayne In June 2007, Jayne and her husband, Eduardo, had just dropped their children off at school and were driving home on a country road in central Mexico when they were surrounded by armed men, dragged from their Jeep at gunpoint, blindfolded, bound, and forced into another car.

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giveness issues with his captors. His happiness to be home with his family overrode any hatred, anger, or bitterness.

Jayne, on the other hand, was stuck in her desire for revenge.

She hated the kidnappers for what they had done to her family. Although she felt defenseless against these thoughts and feelings, Jayne knew that holding them inside would do her absolutely no good.Two years prior to the kidnapping she had been diagnosed with inflammatory breast cancer. With a regimen of conventional treatments, along with several holistic therapies, she had eventually been pronounced cancer-free and was happy to be alive. But the emotional trauma of the kidnapping threatened to change all that.

When her breast cancer returned in spring of 2008, Jayne was devastated but not surprised.

Twenty minutes later, Jayne was left on the side of the road with a ransom note. Eduardo was held captive for nearly eight months, most of the time in a box no bigger than a closet.

Naked, cold, and underfed, he was tortured with beatings, blinding light, and loud music day and night. He was shot twice at close range; several of his ribs were broken.

The criminals sent Jayne photographs of Eduardo, hoping to coerce her into handing over a multimillion-dollar ransom that she had no hope of paying. During these months, Jayne said she “felt the deepest kind of hatred for these people and what they were doing to me and my family. These thoughts became fantasies of all of the creative ways I could torture them, even kill them. My favorite one was of being a giant, female samurai, beheading all of them in one clean sweep of my sword.

Thinking about these things brought me great pleasure.”

As a survival tactic, Jayne hardened her heart, running on adrenaline like a soldier on the front lines of battle, afraid that if she let her guard down all would be lost. At times she would shake uncontrollably, but she could not shed a single tear.

At the end of January, Eduardo was released. At 90 pounds, almost half his normal weight, he was almost unrecognizable.

But he returned ready to jump into life, grateful for every breath of freedom, for all of the things that you and I take for granted. Strangely enough, he didn’t seem to have for-

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My Broken Heart by April Mansilla

A creative breakthrough The first time I met Jayne, she was wearing a pink bandana and her trademark straw cowboy hat to hide the loss of her hair. She was well aware of her need to forgive and to release all the negative emotion she kept bottled up inside. But like so many of us, she hadn’t figured out how. She needed direction in order to find the road to health and wholeness.

I’ll let Jayne tell the next part of the story.

“Dr. Barry heard my story and was compassionate, but to my surprise I didn’t get a whole lot of sympathy. I had kind of gotten used to having people cry when I told them the story; they would embrace me and mirror my feelings of injustice. Dr. Barry’s reaction was very different. It was nonjudgmental.The conversation was more about his wanting me to find peace again, which [would require] learning to feel empathy toward the kidnappers. At one point he even suggested that there might be some self-righteousness in what I was feeling. Well, that was the last thing I wanted to hear.

I wanted to hear about how right I was to feel the way I felt, how wrong and despicable they were, and that sooner or later there would be some sort of divine justice.”1 Jayne said she had tried to pray for the kidnappers but was at a loss to find empathy for them. “We lost our home, our business. We were devastated financially. We had to flee the country, leaving our belongings behind, everything we had worked for and built as law-abiding citizens. I lost my health from the months of stress, and my children are traumatized. How can I possibly find empathy for these horrible individuals who kidnap, destroy families, and harm and kill people for money?”

I never suggested that life was fair or that forgiveness would be easy. I reminded Jayne that, under the right circumstances, everyone is capable of great evil. No one is exempt — not Jayne, not you, not me.

“Look Jayne,” I said. “It’s not about them.They’ve moved

Eliacin Rosario-Cruz

on, maybe to the next victim. You’re still angry, and they probably haven’t given you a second thought. You are only harming yourself by holding on to this.”

Jayne left with a homework assignment. She was to go home and write a letter to the kidnappers who had thrust her life into chaos. She didn’t have to forgive them right then and there, and she didn’t have to conjure up eloquent words for some grand pronouncement of empathy and understanding. She simply had to tell them how she felt.

“It felt good to write it,” she told me at our next meeting.

“It really did. It felt like some kind of emotional release. But I’d feel even better if I had an address to send it to, and maybe just a tiny bit of anthrax.”

Funny — and honest — but not exactly what we were working toward, so I asked Jayne to do some more writing, to work a little harder to find that empathy. It doesn’t come from the head, I told her, but from the heart.

When she sat down to write for the second time, Jayne found herself stuck, not sure what she could say that hadn’t already been said.The cursor on the computer screen blinked at her silently. She decided to clear her mind and meditate on empathy. The answer eventually came to her, and when it did it took a surprising and inspired form.

“I decided to use my creativity to create a mental movie set. I imagined the kidnappers as babies. I’m a mother of three, and I adore children. I’ve often thought that all babies come into the world as blank canvases. I’ve seen as a mother how they absorb, like little sponges, information about the world around them. I saw these little babies in my mind, innocent and new, and then took them forward in the imaginary movie, creating what they must have gone through in order to ultimately become what they became, capable of doing what they do. I did this for each of them, one by one.”

Suddenly, after 90 minutes of stretching her mind and creating a script by which she could understand these men, she felt “an enormous wave of relief.” “I felt as if the weight of the world had just been lifted from my shoulders,” she said. “It was amazing. I felt so much lighter.”

Moreover, and much to Jayne’s surprise, she felt the most relief in the places where she had the disease. “I had gotten it off my chest,” she smiled. “Literally.”

Jayne felt terrific for the rest of the day. She had a smile on her face and a lightness in her step that were noticeable to everyone around her. Her chemotherapy infusions were easier to take. Most importantly, she had a renewed love of life and was ready to move into healing.

The lesson has stayed with her, and has begun to change the way she lives her life in subtle and not-so-subtle ways.

“Now, I remind myself daily to apply forgiveness to my everyday life — while driving, while in the grocery store, and at

home with my family. Every time I feel myself going into anger or judgment, I instead choose empathy and forgiveness.

I get better at it every day. Doing this has been life-changing for me and has had a ripple effect.”

Today Jayne speaks at governors’ conferences across the country and has shared her story of forgiveness and healing with magazine and television media (NBC’s Dateline will feature Jayne in February). She senses God’s hand upon her life in a new and mysterious way as more doors open for her to share her powerful story.

What is forgiveness?

I believe that everyone can experience the same life-changing feeling of lightness that Jayne describes. It isn’t going to look the same for everybody — which is perhaps one of the reasons that forgiveness has been overlooked and underused in a patient’s recovery process. This does not mean, however, that there aren’t any common threads among individual stories.

One woman tearfully approached me after a sermon I preached on forgiveness. She told me that when she learned what I was preaching on, she almost decided to skip church.

Instead she stayed, and during the sermon “something happened.” What happened can be explained spiritually as a “miracle,” for this is exactly what it is when a heart hardened by hatred is transformed (suddenly or otherwise) into a heart of flesh able to forgive.

On the other hand, I have worked for several months with people who were unable to get to first base. In one case, after

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months of work, a woman harbored just as much hatred against her father as when she had begun.

Your path to forgiveness may be similar to that of the woman who heard me preach on forgiveness — a change of heart at a moment’s notice. Or like Jayne’s experience, it may require a fresh and creative approach to discovering empathy.

There is no way of knowing how long it might take until you begin the process yourself.

Forgiveness is a one-sided emotional transaction where, in the canceling of a person’s debt, the person who forgives experiences a heartfelt sense of peacefulness.

To put it another way, forgiveness is being able to wish someone well and truly mean it, even though you may never want or need to see them again. Forgiveness does not require you to like someone or even to face them, but you can still find it in your heart to silently whisper these words to yourself: “I wish you well with your life, and I hope and pray you will cause no more damage to me or anyone else. Go in peace.”

The person who can speak those words acknowledges that harm has been done to him, is not excusing or trivializing it, refuses to be consumed with anger and thoughts of revenge, and leaves the righting of wrongs in the hands of those who have the responsibilities of mediating justice.That is forgiveness in its essence.

The goal, therefore, is to have the toxic feeling of hatred replaced with the more life-giving, less lethal, neutral feeling of love. This feeling is born out of a well-meaning, peaceful neutrality that allows you to wish those who have harmed you well — and mean it.

Rumination is one of the ways people attempt to understand what happened to them and why, as well as what life might have been like had had they not been victimized. Until our memories are healed through forgiveness, we will continually be impacted by what has happened to us.The truth is, even though the painful memory may not consciously come to mind, it has not disappeared. Memories are waiting below the surface and can be triggered by many things.

When we “chew” on our painful memories, they become a regular part of our consciousness. We think about ways to get even and find satisfaction in wishing our enemies ill or in fantasizing about harming them. A recent study revealed that thoughts of revenge trigger the production of endorphins, which mimic morphine.3 In other words, it feels really good thinking about “getting even.” If God desires us to forgive, why would he create such a biological mechanism? Because our feelings of vengeance are the same ones that cause us to seek justice and to right wrongs, reminding us that God is both a just God and a forgiving God. If we continue ruminating about the offense, we only end up hurting ourselves in the end. Every time we revisit the event or person who caused us harm, we relive it, along with all of the potentially harmful side effects. Time does not heal emotional wounds.

Christina M. Puchalski, MD, is the founder and director

Integrative healing Today’s best cancer treatments employ“integrative medicine”— a holistic approach that treats the mind and spirit as well as the body — and a hospital program relating to forgiveness fits this well. David Servan-Schreiber, MD, survivor of stage-IV brain cancer and author of AntiCancer: A New Way of Life, puts it this way: “In nurturing a patient’s will to live, the first step is locating and treating past traumas.”

My colleague Dr. Charlotte Witvliet, a psychology professor at Hope College who helped develop the forgiveness program I use with cancer patients, is a leading researcher in the field of forgiveness, particularly with respect to the physiology of forgiveness. She writes: In the wake of an offense, people often ruminate about the hurt, experience and express hostility toward the perpetrator, use hurtful strategies to cope with stress responses, and attempt to suppress one’s negative emotions and feelings of vulnerability.

Unforgiveness draws people like magnets to ruminate about

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Christo Rey by Claudia McKinney

past hurts, embellish those narratives with bitter adjectives and adverbs that stir up contempt, exhibit avoidance and revenge motivations, cogitate about negative features of the offender and offense, and even rehearse a repertoire of grudge and revenge plots.2

Larry Dossey, MD, is the author of numerous books on the topic of spirituality and health, including Prayer Is Good Medicine: How to Reap the Healing Benefits of Prayer. Dossey believes that the day will come when not recommending prayer to a patient will be considered medical malpractice.

There is ample evidence to suggest that prayer can and does matter at a number of different levels, including physical wellbeing. Likewise, credible evidence suggests a relationship between forgiveness and immune function.

I’ve seen too much, heard too much, and know too much about forgiveness and its health benefits to keep it to myself.

While forgiveness is an element present in all the major faiths and philosophies, as a pastor and a scholar I recognize that Christianity is the only faith that gives its adherents no option but to forgive. There is no wiggle room: “For if you forgive men when they sin against you, your heavenly Father will also forgive you. But if you do not forgive men their sins, your Father will not forgive your sins” (Matt. 6:12–15).

Echoing Jesus’ teaching, C.S. Lewis wrote, “If you don’t forgive you will not be forgiven. No part of [Jesus’] teaching is clearer, and there is no exception to it.” This teaching is as hard as it is unambiguous.

In my eight years of formal theological education at two prestigious theological seminaries, not once was I taught about the central importance of forgiveness.Yet we can observe the negative consequences of unforgiveness on the front page of any newspaper. After years of working with cancer patients, I am convinced that the church has done a poor job of teaching about forgiveness and its theological significance, much less about the biological implications of unforgiveness. A seminary that doesn’t equip pastors to teach people how to forgive leads to ill-equipped churches filled with spiritually — and physically — vulnerable parishioners.

When five Amish girls were murdered in Nickel Mines, Pa., and the community forgave the killer and reached out to his family, the media portrayed that as “the Amish thing to do.”

It ought to be the Christian thing to do, and it ought to be played out in churches across the nation.Yet we see people all the time who profess faith in Christ but are angry and bitter and full of hatred.

The cross of Christ means nothing apart from forgiveness.

My friend Malan Nel, a professor from South Africa, lived through the dark days of apartheid and later the attempt of nonviolent reform. He puts it this way: “You do not owe me an apology, but as a Christian, I do owe you forgiveness.”

of the George Washington Institute for Spirituality and Health and assistant professor at the George Washington University School of Medicine. She sums up the latest research by saying that unforgiving persons have increased anxiety, paranoia, narcissism, psychosomatic complications, heart disease, and incidences of both depression and callousness toward others.4 Furthermore, she writes that the act of forgiveness results in decreased anxiety and depression, better health outcomes, improved coping with stress, and increased closeness to God and others.

Sir Peter Medawar, the great British scientist and Nobel prizewinner in immunology, was once asked what the best prescription against cancer might be.“A sanguine personality,” he replied.5 If the best treatment for cancer is a more cheerful disposition, then unforgiveness may be what is sabotaging our best efforts to find healing and hope.

The price of unforgiveness Sometimes patients direct their anger at themselves, but most of the people who share their burdens with me disclose pain arising out of interpersonal relationships. Patients also share unresolved anger that grew out of painful memories of rape, murder, incest, kidnap and torture, tragic experiences like being an eyewitness to 9/11, mean-spirited family members, or mean employers and employees. The list is endless, and the unresolved pain is deeply embedded in their soul. The memories associated with their painful past have yet to heal, so they remain a part of their present.

There are only two options available for people who have experienced emotional wounds:They can leave their pain in the past, or they can continue carrying it with them. If they want to leave it in the past, they have no other option than to forgive the person who harmed them.

Some patients, when filling out the spiritual assessment form we use, reveal that they need to forgive God. These are the folks who identify with a statement such as “I feel punished by God” or “God is against me, not for me.” Patients who identify with these statements have a high mortality rate, which is understandable. If their theology tells them that God has given them this cancer, what are their odds of beating it?

It’s not my job to convince them otherwise, but with those patients who identify themselves as Christians, I can encourage them to back up a bit and analyze where that belief came from and invite them to reconsider.

Unforgiveness creates a sort of living hell for those caught in the web of anger and hatred. We suffocate ourselves and often do not even realize it.The carbon monoxide of hatred fills our lungs, numbs our joy for living, and, at its extreme, allows disease to destroy the person we are — not to mention the person we could have been.

Conclusion The experience of forgiveness is varied. God’s intervention into people’s lives is always shrouded in mystery. Over the years, Continued on page 37.

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“I tell you, love your enemies. Help and give without expecting a return. You’ll never—I promise—regret it. Live out this God-created identity the way our Father lives toward us, generously and graciously, even when we’re at our worst. Our Father is kind; you be kind.”

Want to be more generous?

In The Treasure Principle: Unlocking the Secret of Joyful Giving (Multnomah,2005), Randy Alcorn explores a simple yet profound truth that challenges the stereotypes of stewardship. Alcorn illuminates the liberating joy of giving and its impact, not only for today but for eternity as well.

Jesus (Luke 6:35-36; The Message)

say, ‘to be a blessing,’” says Mike Detroy.

“I can’t imagine living any other way,” agrees Jonathan Kopke.

For these donors the inconvenience of an audit is nothing compared to the joy they receive from living a life of extraordinary generosity.

“I give these people a lot of credit,” says Richard Westley, “to be able and willing to give that much.” n

In Generous Living:Finding Contentment through Giving (Zondervan, 1997), Ron Blue challenges and encourages Christians to live generously, addressing such topics as why it’s better to give than to receive, teaching children to give, how to give away money wisely and strategically, and how to make a will.

Karen Stiller is a freelance writer and editor based in Port Perry, Ont., Canada.

Healing from the Inside Out continued from page 29.

I have witnessed more than a few miraculous healings, both spiritually and physically. God can change our hearts in an instant if we are willing and he is ready.

Many of my colleagues in forgiveness research believe that “forgiveness is not a simple solution; the development of positive emotional, cognitive, and behavioral changes following an offense takes time and effort.”6 And while it can indeed take time and effort, time and effort are not the most important ingredients to forgiving. Motivation is the most important factor. Our faith can and should motivate us to want to forgive. The “gift” of cancer and other serious illnesses is that they can bring people face-to-face with their emotional pain, offering an opportunity to confront the past and seek healing of the heart, which can then profoundly affect our physical condition as well.

Millennia ago, Aristotle wrote these deeply profound words: “The best friend is the man who, in wishing me well, wishes it for my sake.” Is it possible to reach the emotional plateau

where we can truthfully offer well-wishes to those who have hurt us? n Michael S. Barry is a graduate of Princeton Theological Seminary and received his doctorate from Fuller Theological Seminary. He has authored three books about spirituality and health, particularly as it relates to cancer patients: A Reason for Hope, A Season for Hope, and The Art of Caregiving, all published by David C. Cook. He is currently working ohn a book called Let It Go! Stories of Cancer, Forgiveness and Healing from the Inside Out. He is director of pastoral care at Cancer Treatment Centers of America in Philadelphia. If you are interested in learning more about their short-term forgiveness intervention program, you may contact Dr. Barry at michael.barry@ctca-hope.com.

(Editor’s note: due to space limitations, the endnotes for this article have been posted at esa-online.org/Endnotes.)

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