Forgiveness and chronic pain: a systematic review

Forgiveness is becoming increasingly recognized for its role in healthcare, having shown promising effects in patients suffering myriad diseases, from coronary artery disease to HIV to breast cancer.

To review the current literature examining forgiveness and its relationship specifically to chronic pain.

In July 2019, a search was carried out of electronic databases (Academic Search Complete, AMED, Biomedical Reference Collection, General Science, Medline, PsycArticles, PsycInfo, Social Sciences Full Text and SPORTDiscus). Further results were obtained from reference lists. Inclusion and exclusion criteria were applied using PRISMA guidelines for systematic reviews.

The initial search yielded 354 results, and after duplicates were removed and inclusion and exclusion criteria applied, the final result was seven papers to be reviewed. Of the seven papers reviewed, five showed a relationship between lower levels of forgiveness and either increased experience or decreased tolerance for pain. One paper showed higher levels of empathy improving pain levels and suggests that forgiveness could enhance this experience of empathy. One study resulted in a higher level of pain among patients with higher forgiveness scores, although it was qualified that this particular patient population had a higher attachment anxiety, which may have impeded their ability to utilize forgiveness therapy.

There is an association between the capacity to forgive and the experience of chronic pain. Further research should examine forgiveness as an intervention in a population of chronic pain patients to explore this relationship further.