We need to forgive and to feel forgiven by Dr Ira Byock

     We need to forgive and to feel forgiven by Dr Ira Byock

All the passages below are taken from Ira Byock’s book, “The Four Things That Matter Most”, published in 2004.


People’s need to feel forgiven—and to forgive—is a recur­ring lesson in every spiritual tradition. It has certainly been one of the main lessons I’ve learned in my own work. Peo­ple who are dying have shown me that our human capacity to forgive and to be forgiven is enormousTheir experi­ences reveal the practical power of forgiveness to enrich the lives of the people they leave behind.

In The Tibetan Book of Living and Dying, Sogyal Rin­poche writes: “All religions stress the power of forgiveness, and this power is never more necessary, nor more deeply felt, than when someone is dying. Through forgiving and being forgiven, we purify ourselves of the darkness of what we have done, and prepare ourselves most completely for the journey through death.”

We do not have to wait until we or someone we love is dying to practice forgiveness. The stories in this section of the book span situations that call for forgiveness even when it seems impossible. These stories suggest strategies to complete even the most deeply wounded relationship.

Many people confuse forgiveness with exonerationForgiveness does not excuse someone from doing some­thing wrong. It does not alleviate their guilt or lessen their transgression. Instead, forgiveness accepts the past as it was, embraces the present, and faces the future. Forgive­ness is a strategy for you to become free of emotional bag­gage. Hate, fury, recrimination, and blame weigh us down. The ball and chain of old wounds tethers us to the past and limits our ability to move forward with vitality.

Loved Ones Live On Inside Us

Please forgive me” and “I forgive you” can be the toughest two of the Four Things to say. And yet few of us will live a full life without the need to say both. The need to forgive and be forgiven simply means that we’re not per­fect. If we listen to our hearts we know that in the relation­ships that matter most there will often be instances of anger or, at least, serious misunderstandings that cause hurt. Sometimes the bad things and bad feelings that happen be­tween people are more serious. One doesn’t have to be Sig­mund Freud or Frasier Crane to realize that we live in a world filled with people in emotional pain.

My years of clinical work in palliative care and in emer­gency medicine have driven home, again and again, that, as we grow up and ageeach of us is emotionally scarred to some extent. Most of these injuries heal, but some don’tThese sore spots may be as mundane and beyond our control as feeling that we never lived up to a father’s unreasonable expectations, or that we aren’t tall enough or pretty enough. We might blame ourselves for never having followed or ful­filled a lifelong dream. Some old wounds from our youth may be mostly closed—or so we think, until a careless, casual remark by a parent, sibling, or close friend “picks the scab” and reminds us of the hurt we still carryThe wounds associ­ated with infidelities, lies, divorces, libels, and lawsuits tend to be open and obvious. And many people also carry wounds carved by physical, emotional, and sexual abuse.

It is no surprise then that forgiveness is so often at the heart of completing relationships and finding peace. We may need to forgive in order for the relationship to con­tinue and we may need to forgive to close the relationship in a healthy wayForgiveness is a passage to a sanctuary of wholeness, that nurturing place where we feel intimately connected to the people who matter most to us. It is a place of healing and transformation. In it, we feel the perfect full­ness of the present.

Emotional Healing

In medicine, healing refers to restoring a person to a nat­ural state of health and wholeness. Physical wounds occur when an accident or injury disrupts the integrity of a person’s skin and subcutaneous tissue. In cleaning the wound of dirt and infected tissue, the natural wisdom of the body is able to reestablish the tissue’s integrity. When it does, we say that the wound is healed.

A similar process occurs with emotional woundsHeal­ing is effected when the toxic material in the rift between two people has been cleansed and they are able to reestablish a sense of closeness. Forgiving is an act of cleansing that enables the wisdom within us to reach out and recon­nect with people we once loved.

One night over dinner, Carla, an old friend, and I were discussing my ideas for this book about saying the Four Things before good-bye. She told me a powerful story of forgiveness and its potential to transform us.

“The Sweetest Man”

Carla is a successful architect from Chicago, the wife of my friend Julian. Her father had died ten years earlier of pan­creatic cancer, just as my father had.

“Dad was dead in less than two weeks from his first real symptoms,” said Carla. “He was the sweetest man in the world—and one of the most unhappy.”

Carla’s description of growing up in the suburbs west of Boston in the 1950s evoked the kind of American family depicted in the Chevrolet ads of that era: her father in a checkered shirt, sweater vest, and dark slacks, smoking a pipe while he watered the lawn; her mother in a cardigan and pleated skirt, waving from the front door, holding a freshly baked pie; Carla playing hopscotch on the front walk and her younger brother, Paul, pulling his red Radio Flyer wagon; a happy active home life that revolved around bright, well-groomed children.

Carla’s father, Anthony Fornataro, was a hands-on fa­ther years before it was in vogue. By all appearances, he was successful and happy, and part of him undoubtedly was. He made a good living selling high-end orchestral instruments and reveled in hearing them played.

When he was young, Anthony had been a serious musi­cian, a cellist who practiced tirelessly in hopes of earning a chair in the Boston Symphony Orchestra. That was before the Depression put the cost of lessons out of reach and World War II infantry duty in France made practicing im­possible. After the war he took a job with an instrument company, temporarily he thought, but then he married and Carla came along, and his priorities changed.

Carla said she thought her father never really got over his lost dream of being a symphony musician. He always wrestled with his past and struggled inside himself with who he was and who he might have been. Carla said he bristled at the stereotype of Italian-Americans. He was physically big and burly, yet he was one of the best educated and most refined men she had ever known. A sure way to get him angry was to make jokes about the Mafia. He never let anyone call him Tony. He was Anthony, even to his clos­est friends.

Carla hadn’t realized how troubled her father was until she was in twelfth grade, when she found out that he was drinking secretly. Although she didn’t know how long it had been going on, it was obvious to her during her college years that he was sick and depressed. Paul caught more of the brunt of it, because he was younger and still lived at home. Carla described scenes out of Who’s Afraid of Vir­ginia Woolf?  when her parents visited her while she was in graduate school in New Haven.

“We’d go out to dinner,” she said, “and they would start drinking, arguing, and yelling awful things at each other in public. At first, I couldn’t believe that this was my family. But it became almost predictable.

“My father and I were always extremely close. We had a very special relationship. Dad really introduced me to art and design, and I shared his passion for music. It seems strange and even a bit unhealthy now, but when I was in college, we spoke on the phone almost every day, especially during his bouts of depression.”

I asked Carla if her father had ever sought help for his depression from a doctor or therapist. She explained, “The summer between my sophomore and junior years of col­lege, we had actually all gone to family therapy. The thera­pist had us `stage’ a play of our family. She gave us situations and we acted our roles. Dad was always center stage. He was the center of the family, and in many ways the core of our problems. Not that it was his fault. It wasn’t intentional, but he took a lot of energy.”

One day in February when Carla was 28 and in architec­tural school, she received a panicked call from her mother. Anthony had become violently ill, and had had to be rushed to the hospital. Carla raced home to be with her parents.

“When I got to the hospital,” Carla said, “Dad was in a semiprivate room on the second floor, under the care of his internist and good friend Sidney Levinson. By the next af­ternoon, the tests, including a CAT scan, showed that there was a tumor on his pancreas.”

Pancreatic cancer is deadly. By the time it is diagnosed, it is almost always too late to cure surgically, and no good treatment yet exists to stem its progressionThe pancreas is usually an unassuming organ, quietly going about its mun­dane tasks of releasing insulin and other hormones into the bloodstream to regulate blood glucose and excreting en­zymes into the duodenum to aid in digestion. Pancreatic cancers are rarely large but most are strategically located to cause maximum trouble, sitting at the juncture of the ducts draining the pancreas’s own enzymes and bile from the liver into the duodenum.

As they grow, pancreatic tumors can obstruct the flow of bile or keep food from passing through the intestine. Sometimes palliative surgery can help bypass those blocks, and occasionally chemotherapy and radiation therapy can slow the progression of the tumor. In Carla’s father’s case, medication for pain and vomiting, IV fluids, and “GI rest”—allowing his stomach and intestines a couple of days off from their constant chores of digesting and absorbing nutrients—were all that was urgently needed. “Sid had a local oncologist see Dad,” Carla said, “but there wasn’t much to be done. So, I’d just sit long hours with him.”

Paul was in the midst of exams, and scheduled to come a few days later, and Carla’s mother was dealing with some less serious medical issues of her own. So Carla spent a good amount of time alone with her father. “I would read to him, from the newspaper, and from a biography I had with me,” Carla said. “And I would lie on his bed with him and we’d just talk about anything and everything. This went on for a few days. He was too sick to go home, and he couldn’t eat; yet he was fairly comfortable. Some days we’d act as if nothing was wrong. It wasn’t that we were denying what was happening, we’d just choose not to dwell on it. I couldn’t really deny how bad things were, though. I re­member watching him sitting up in his hospital bed trying to write a letter. He couldn’t. His hand wasn’t steady enough. Knowledge and academic achievement were so much a part of who Dad was to himself. Well, I knew it was a sign of the coming defeat.”

As pancreatic cancer grows, the tumor sends out chemi­cal messengers that disrupt energy metabolism within cells throughout the body. The result is that patients with pan­creatic cancer may look as if they are being consumed from within, just as “consumptive” or tubercular patients do. They progressively lose weight and become terribly weak as energy that is normally available to maintain muscle mass and activity is sapped.

“But those days were also an incredible time,” said Carla. “Dad was actually more calm and composed than I can ever remember seeing him. He knew how difficult he’d been through the years. We certainly said the Four Things, lots of `I forgive you’s and `I love you’s, that’s for sure.”

“Did he actually apologize to you?” I asked, “or was it just implied?”

“It was more than implied. He said, `I’m sorry.’ He talked about how tough it had been for him and how emotionally sick he had been, and how difficult it had been for me. He apologized for being so needy. And I apologized for not being able to make it all better for him. I think that was the hardest thing for me as a person who loved him so much.”

“Did he ever leave the hospital?”

“Actually, he did come home for all of three days. He got out of Valley View on Saturday. I left that Sunday evening to go back to New Haven for a couple of days.”

“It must have been hard for you to leave.”

“It was hard, but by then we had said everything. We were on a whole new level of being together. His asking my forgiveness seemed to open up a deep well of tenderness in me. I just told him again how much I loved him and said again that I forgave him for everything. I said I’d see him on Thursday. And we hugged for what felt like hours. He said, `I love you, too, Miss Carla’—that’s what he called me. So, I definitely had precious opportunity to say the Four Things, and good-bye, to my dad. It was a very hard and a very wonderful thing.”

Carla’s father died just two days after she left, sooner than anyone expected.

“What about your brother?” I asked. “Do you have a sense of whether or not he was able to come to some sense of completion with your father?”

“I’ve always felt bad for Paul because he didn’t have the same quality of time I did with Dad that last week,” Carla reflected, shaking her head. “I think that in a lot of ways he’s still wrestling with Dad inside himself.”

Carla recalled a painful scene before she left Boston. The Celtics basketball game was on TV and Paul really wanted to watch it with his father. “Dad was just too ill, and simply not interested. But Paul’s feelings were hurt and they argued. Paul’s disappointment over the game echoed the times in his teenage years that Dad couldn’t be there for him, because of his depression. It tapped into Paul’s well of resentment. Then Dad died before they could talk through it. I don’t think Paul has ever entirely gotten over his anger toward Dad.”

The Ongoing Power of Memories

The contrast between Carla’s and her brother’s experience of their father’s dying is striking. Also striking is the differ­ent feeling each has of the personal, ongoing relationship with the memory of their father.

“People live on within us” is not just a pleasant nostrum from a Hallmark card or a metaphysical assertion. In tangi­ble ways, our relationships with the people we have lost through death continue. It’s natural for the most important people in our lives—our parents, brothers and sisters, spouses, children, and our closest friends—to become part of who we are. Death can’t change that; even death is not that strong. In many ways, both conscious and uncon­scious, people continue to influence our everyday percep­tions of the world and our sense of ourselves. And they continue to populate our dreams at night. They are an en­tirely normal, important part of our psyche and as such, they do live on within us.

From a psychological perspective, it is possible to com­plete relationships with people who have died. Most often, however, it’s a lot easier to do so when they are alive.

Carla and her father brought their relationship to com­pletion. She still draws comfort from the sense of resolution she and her father achieved. In contrast, Paul’s experi­ence is marked by a sense of things unresolved. He didn’t have the chance to talk with his dad the way that Carla had. And their father never had the opportunity—or didn’t take the opportunity—of saying to Paul some of the things, in­cluding “I’m sorry,” and “Please forgive me,” that he had said to Carla. Paul loved—and still loves—his father deeply. Most maddening for him is the feeling that things might have been resolved. Paul is caught between being unable to deny residual resentment toward his father and feeling small for the anger he carries because he realizes his father was as powerless against his depression as he was against his final illness.

Resolving this relationship may still be possible, but it is more difficult and typically takes much longer. In order to feel a renewed sense of connection with his father, Paul may have to find some way to feel that forgiveness, appreci­ation, and love have been sent, and received. A skilled counselor or spiritual teacher can help.

More than likely, in order for Paul to feel whole in his relationship with his father, he will also need to forgive himself. Like the rest of us, he will need to accept himself as he is—mistakes, regrets, and all—and go forward with compassion and love for himself and others. Truly forgiv­ing yourself is not easy in a culture that strives for perfec­tion, but it is something all of us should practice.

Learning that someone in our life is seriously ill can wake us to the need to say the things that would be left unsaid if death came suddenly—to either of us. Whether we make use of that opportunity—or not—can affect our life for years to come.

Carla is emphatic in applying the lessons from her expe­rience with her father to her relationships with her son and daughter. “Every day I make sure my children know how much I love them for who they are. When they were younger, especially after we’d had an argument, before they went to bed I’d take them by the shoulders, look in their eyes, and say, `I love you.’ To this day, every time I take a plane or train, I leave a note telling them where I’ll be and when I’ll be home. Every note ends with, `I love you to in­finity and back.’

“I’ve written letters to each of my children that are in our safe-deposit box. I tell them how much I love and am proud of them, and how confident I am in the choices they’ll make in life. I wrote, `If we were having an argument just before I died or if there are things left unresolved be­tween us, you can be sure that I know that our disagree­ments are tiny in comparison to our love. Please forgive me for not always understanding and for nagging and worrying too much. Being your mother is the best thing I ever did!”‘

Carla’s relationships with her children are healthy, and she strives to keep them complete on a daily basis. She does this because it is a practice in family wellness and in being present for them, in being there for them. But it is also a beautiful way of honoring her father and the lessons of his difficult life. [37-49]

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