Depression eTherapy Health care Seattle Therapy

When You Can’t Forgive

With the tenth anniversary of the 9/11 on the weekend, many Americans have been reflecting upon the loss of friends, family, and colleagues in New York and Pennsylvania. I also spotted a post on Facebook, raising the question of the numbers of civilians (including women and children) who have been killed in Iraq and Afghanistan due to war. When someone is the cause of hurt, we have a variety of reactions. Some people respond with deep grief, vowing to live a life of which their dead loved ones would be proud. Others respond in revenge and rage, vowing not to rest until those who hurt us are caught, jailed, or their lives obliterated from this planet. While there is no way to measure the amount of hurt you have experienced at the hand of another human being, what is the real cost to you, psychologically and physically, when you can’t forgive?

Does PTED have merit? [image scrubbed for foul language]

Doctors Micheal Linden and Andreas Maercker recently published a book, “Embitterment: Societal, Psychological, and Clinical Perspectives”, to help shed some scientific attention on something many of us have experienced at some level, and yet has received no official diagnosis to date. Currently the physical and psychological symptoms of Embitterment have been referred to as Post Traumatic Embitterment Disorder, but you won’t find it in the DSM (Diagnostic Statistical Manual). It has all the elements of a person who appears stuck on blaming someone else for their feelings of  humiliation, helplessness, hopelessness, or loss, and can’t seem to integrate his or her experience with values, beliefs, and actions that allow the person to “move on”.

When You Can’t Forgive

What happens when a person has PTED (or can’t forgive)?  While this isn’t a scholarly description of the lack of forgiveness,  you’ll likely hear, see, and feel the following:

1. Feelings of bitterness, rage, helplessness, and hopelessness are expressed, even months and years after the initial incident or insult.

2. Physically, the immune system can be compromised. Disease and illness increases in the bitter person.

3. A rise in blood pressure and incidence of heart disease, even in a person who no family history, or at an earlier age than expected.

4. All the symptoms of stress appear in the bitter person. A person who is bitter is engaged in a battle that already happened, yet like those with PTSD (Post Traumatic Stress Disorder), continue to fight an imagined war inside. A person may believe the event could happen again, or that he or she is still in some kind of danger. When the “fight or flight” response stays activated over a long period of time, you should expect to see the same symptoms as you would in person who is exhausted and stressed.

5. Personal relationships take a toll. When a person holds onto blaming someone else for their current condition, loved ones closest to a bitter person can feel the intensity of his or her depression, anger, frustration, or humiliation. Friends and family may wish to withdraw from the embittered person, or mount a united front to try to help the embittered person drop his or her resentment.

I was surprised to hear that initial findings from these researchers and others suggests that the physical effects of embitterment can simulate the long-term negative effects on the heart of smoking cigarettes. If those findings prove consistent, it would appear that there are more even more reasons to find a way to let go of resentment before it has a firm and deleterious hold on you. Perhaps, being bitter is one big heart attack, just waiting to happen. And letting go is like scraping out the fat that was once choking the life out of us.

You can find more information about the proposed PTED on

What do you think? Should forgiveness or “letting go” remain personal decision, or should helping professionals consider including a diagnosis of PTED for consideration when encountering a bitter and resentful client? Is there a point when bitterness can be measured as a clinical signifier to the rist of heart disease and stroke?