Why making self-forgiveness a part of your life will make you a better physician

“Your task is not to seek for love,
but merely to seek and find
all the barriers within yourself
that you have built against it.” ~ Rumi

Medical students have a tendency to be perfectionists. However, mistakes are an unavoidable and critical component of our training. If mistakes are inevitable, it follows that we must learn to be more forgiving to ourselves. It needs to be stressed that forgiveness is not forgetting – when mistakes are made, they need to be recognized and reflected upon so that they can serve as the foundation for improvement. However, we want to avoid ruminating on failures with no appreciable benefit. 

Forgiveness is much more than simply repeating a phrase – it is an active and involved process of cultivating compassion for yourself. Not only has research shown that self-forgiveness can predict health status in college students (1), but it has also been shown to positively correlate with empathy for patients amongst medical and nursing students (2). When we make mistakes, self-forgiveness promotes a more positive view of negative experiences, creating the opportunity for learning (3). The tendency to forgive yourself is also positively correlated with the ability to maintain good interpersonal relationships (4). In this way, investing in the practice of forgiveness and compassion may make you healthier and more empathetic when you are working with patients. 

So how do we cultivate forgiveness for ourselves? Self-forgiveness is often thought of as one facet of self-compassion and an easy to remember tool for cultivating self-compassion is using the acronym, RAIN, popularized by Dr. Tara Brach, a clinical psychologist and author. RAIN stands for:

Recognize – what is going on for you
Allow – the experience to be there just as it is 
Investigate – with kindness
Nurture – with self-compassion

When applying this RAIN framework in moments of self-criticism, we can begin by recognizing our critical inner voice that is present so frequently after making an error in the clinic, or in our personal lives. Allowing and accepting these critical thoughts is an important part of resolving to pause and honestly acknowledge judgements of ourselves and the pain that we might be feeling. Then, we investigate non-judgmentally – we can ask ourselves, how am I experiencing this self-criticism? What emotions are arising for me right now and how am I experiencing them in the body? Finally, we nurture ourselves. Compassion will naturally arise when we see our own suffering. Can you adopt the same attitude of forgiveness for yourself, as you might for someone very close to you?

Self-forgiveness is not easy, but it is an important part of working through mistakes that we might make during our training. Next time you notice self-criticism, consider giving this RAIN framework a test drive or try out this guided meditation by Dr. Tara Brach. 

References

1. Wilson T, Milosevic A, Carroll M, Hart K, Hibbard S. Physical health status in relation to self-forgiveness and other-forgiveness in healthy college students. Journal of Health Psychology. 2008 Sep;13(6):798-803.
2. KHODABAKHSH MR, MANSURI P. Relationship of forgiveness and empathy among medical and nursing students.
3. Wohl, M. J., Pychyl, T. A., & Bennett, S. H. (2010). I forgive myself, now I can study: how self-forgiveness for procrastinating can reduce future procrastination. Personality and Individual Differences, 48(7), 803–808.
4. Weinberg, M. (2013). The bidirectional dyadic association between tendency to forgive, self-esteem, social support, and PTSD symptoms among terror-attack survivors and their spouses. Journal of Traumatic Stress, 26(6), 744–752.