Understanding Self-Forgiveness in Emotion-Focused Therapy: An Interpersonal Process Recall Study With Men in Recovery From Addiction

Persons with substance use disorders (SUDs) often act in ways that are harmful to others and incongruent with deeply held values and beliefs, which can result in painful thoughts and emotions related to critical self-evaluation (e.g., shame). In turn, substance misuse often serves as a maladaptive coping strategy that perpetuates a substance-shame cycle that further erodes meaningful connections and resources in life. Self-forgiveness and transformation of shame and related emotions might represent universal principles of psychotherapies for SUDs in such cases, in which clinicians help clients to move from avoidance-based coping and violation of cherished values into personal responsibility and values-consistent living. Focusing on Cornish's (2016) emotion-focused therapy (EFT) intervention with men in early recovery from chronic SUDs, this study attempted to examine these principles in the context of a specific context intervention designed to promote self-forgiveness. In turn, an interpersonal process recall approach was used to illumine clients' experiences and processes of self-forgiveness (or lack thereof) over the course of treatment. Drawing upon strategies from grounded theory and consensual qualitative research, three overarching thematic categories emerged from qualitative interviews at posttreatment: retreat (e.g., behaviors and related psychological processes involved in avoidance of painful emotion), reflection (e.g., owning regrettable actions/decisions associated with cycle of addiction), and rehabilitation (e.g., letting go of self-condemnation). Overall, these findings supported existing conceptions of self-forgiveness in cases of long-term addiction while offering possible mechanisms that could inform EFT and other evidence-based psychotherapies with clients who are seeking recovery from SUDs.