Forgiveness, worthy of its name,
must forgive the unforgivable.
And is only humanly possible,
when we accept the nature of its impossibility
–Jacques Derrida (Reference Derrida2001)ON FORGIVENESS AND EXISTENTIAL GUILT
This editorial is written for you, for me, for all of us. It's for our parents and our children, our spouses, partners, friends, families, and neighbors. It's for our patients and colleagues and for the several billion human beings we will never know or encounter. It concerns the concept, act, and process of “forgiveness.” It concerns the imperative of forgiveness in human existence, an imperative in human existence made essential because it is at the root of our essence and existential being as humans living mortal, fallible, imperfect lives. It is an editorial/essay for this journal because forgiveness is what we are all called upon to grant ourselves when we face our mortality and confront the existential guilt that causes the despair we feel when we face our deaths and have no other recourse to remedy the uncompleted responsibilities, the lost possibilities, the potential never reached, the regrets, the pain, and the shame we caused others and ourselves while living a mortal, imperfect human life.
Frankl (Reference Frankl1969) wrote that the task of dying is to relieve existential guilt, and forgiveness; forgiving ourselves is the last refuge or recourse we have to achieve this imperative. End-of-life task completion (Steinhauser, et al., Reference Steinhauser, Alexander and Byock2009), in the forms of addressing unfinished business, and attempt to repair relationships, express love, and say goodbye are possible for some of us in the dying process, but ultimately it is our ability to forgive ourselves for merely being imperfect humans, subject to thousands of internal and external and transactional events beyond our full control, that allows us to deal with the despair of existential guilt.
DEFINING FORGIVENESS IN THE EXISTENTIAL SENSE
There are a number of conceptualizations, definitions, and synonyms for the term “forgiveness.” In political, spiritual, and transactional senses, forgiveness often involves concepts of admission of wrongdoing and guilt, apology, repentance, punishment, reparation, reconciliation, pardon (a gift), amnesty (to forget), grace, redemption, and accord. Forgiveness in these arenas is often predicated on conditions, change, and actions. But in the existential sense, Derrida (Reference Derrida2001) emphasizes that
In order to approach the very concept of forgiveness, logic and common sense agree for once with the paradox: it is necessary it seems, to begin from the fact that there is the unforgivable. Is this not, in truth, the only thing to forgive?…..if one is only prepared to forgive what appears forgivable, then the very idea of forgiveness would disappear….. Forgiveness forgives only the unforgivable.
In addition, there is an unconditional element to existential forgiveness. Derrida (Reference Derrida2001) writes:
If I say I forgive you on the condition that, asking forgiveness, you would thus have changed and would no longer be the same, do I forgive? What do I forgive? And Whom? What and Whom (Qui ou Quoi- Derrida's mantra on Being). Something or Someone? Does one forgive something, or rather does one forgive someone?
It is the unconditional nature of forgiveness that characterizes existential forgiveness; and the focus on forgiving the “who” that is central to forgiveness as a path toward the relief of existential guilt in the face of the finiteness of life, in the face of death.
FORGIVENESS AND UNCONDITIONAL LOVE
For those of us engaged in the clinical care of patients with life-threatening illness, confronting the proximity and inevitability of death, the awareness that both we and our patients live in the same existential boat with the same existential concerns becomes unavoidable. Not surprisingly, the challenges of how live fully while we are alive—to be able to accept the life that one has lived, and to face death with a sense of peace and equanimity—is a challenge we share with our patients. A challenge that is often unavoidable in a busy clinical practice, seeing many patients day in and day out. The stories of lives lived, paths untaken, choices not made, potential untapped, responsibilities that cannot be fulfilled because of suddenly shortened anticipated life trajectories. Time running out, regrets, mistakes, damage done to relationships, to careers, to lives where trust has been shattered. We've all yearned for forgiveness; some more than others. The confrontation with existential guilt that our patients face as they approach death is a significant clinical concern. Forgiveness, specifically self-forgiveness is paramount in the relieving the despair, shame, anger, depression, angst of existential guilt for our patients. Self-forgiveness can appear to be an insurmountable task for many. In my clinical experience, the barrier to Self-forgiveness appears to be the question of whether we ourselves are deserving of unconditional love. This is the challenge. Believing that we are worthy of unconditional love seems to be a prerequisite for self-forgiveness.
Many of us have experienced unconditional love in the act of loving someone else: a child, a parent, a grandparent, a sibling, a spouse, or partner. Unconditional love; love without conditions. I love my son, Samuel, unconditionally. My love for him only deepened when he was diagnosed with type 1 diabetes at age 12. I'd love him if he was short, tall, fat, thin, brilliant, brain damaged, an athlete, or wheelchair bound. I'd love him with one arm, no legs ….you get the picture. That's because, as Derrida would point out, I love my son for Who he is not What he is (the Qui not the Quoi). I love him, only him, the essence of him, the immutable, beautiful essence of him, with no conditions, no requirements. I can forgive him anything. I can forgive him the unforgivable. I can do this impossible task because I love the essence of him unconditionally. In terms of existential guilt, what is unforgivable is our human imperfection and our mortality. It's unforgivable and impossible to change. So only true “forgiveness” true self-forgiveness can we bestow upon ourselves if we feel we deserve unconditional love. Who bestows self-forgiveness on each of us? Well, we are never alone. We are in a lifelong, constant relationship with our “observing self.” That's who we are speaking to when we say “I hate myself!” That's who we have the most intimate love relationship with of all. So the existential question related to love and being is “do we love ourselves unconditionally? Do we love the Who or the What of ourselves? Do we love the essence of ourselves?” If my observing self loves the “who” or the essence of who I am, then 20 years from now when I am terminally ill and a patient at Sloan Kettering, lying in a hospital bed, bald from chemotherapy, cachectic, after losing 50 lb, incontinent of urine and feces and needing the nurses to change my diaper, lift me from the bed to a chair to feed me, my observing self will see my essence, (the who), and will love my immutable essence, unconditionally, regardless of all the what that has been altered or stripped away; and self-forgiveness will be possible and will save my peace of mind, and preserve the dignity and meaning in my life as I take my last breath knowing I could have done more, if I just had the time and strength.
