Ep 8: Self-forgiveness for nurses and midwives: The foundations

Posted November 28, 2022

Show Notes —

It is normal for people to make mistakes and it is also completely normal to feel guilty about it. However, dwelling on the past and excessively thinking about the future effects of what we did wrong will oftentimes make it worse.

It will greatly affect our practice, our overall health, and our relationships.

So, practicing self-forgiveness and self-compassion can provide relief, growth and empower nurses and midwives to move forward with their lives.

In this episode, Nathan Ilman talks about his journey to self-forgiveness and how we can start our journey toward it.

He provides a practical foundation for nurses and midwives in how to start thinking about and practicing self-forgiveness to enhance their wellbeing.


Many people have had an experience of doing something that they feel guilty about or even shame.

Self-forgiveness is something that we can learn about and a choice we can make to be kind to ourselves.

Whilst guilt can help drive positive behaviour, getting stuck in shame often does not, and becomes problematic.

Research literature shows that people who find it easier to forgive themselves tend to have better psychological and physical well-being.

On the other hand, people who find it hard to forgive themselves tend to experience high rates of mental ill health.

Genuine self-forgiveness involves a number of different steps. One is acknowledging our responsibility for the mistakes that have been made.

Ask yourself this question: By continuing to focus on what you did wrong, what effect is it having on your practice? Is it enabling you to be an effective nurse or midwife? Is it affecting your family life?

Letting go is a choice we can make and it is very empowering.

Set the intention to forgive yourself.

Self-forgiveness is a process. We can start again each day if we choose to.

When we give ourselves permission to forgive ourselves, it can open us to a range of possibilities.

Overthinking and being locked into the past keeps people trapped in a lack of self-forgiveness.

Do these three things to start your journey on self-forgiveness:

1. Acknowledge the thing that you’ve been hard on yourself about.

2. Make a verbal or written commitment that you’re going to start forgiving yourself.

3. Try out a self-forgiving pause.

Nurse Wellbeing Mission run online and in-person workshops for nurses and midwives where we train people in four key skill sets of self-forgiveness. This helps to overcome mistakes, set backs and moral distress. Drop us an email to find out more: nathan@nursewellbeingmission.com

Visit our website at: https://www.nursewellbeingmission.com

Join our free Facebook group here:



Transcription —

SPEAKERS: Nathan Illman

Welcome to the Nurse Wellbeing Mission podcast hosted by me Nathan Illman. This is the place where nurses’ and midwives’ well-being are at the top of the agenda. Each episode aims to help nurses and midwives around the world flourish through informative, inspiring, and practical content and conversations.


Welcome everybody to another episode of the nurse wellbeing mission with me Nathan Illman, clinical psychologist and founder of the nurse wellbeing mission. I’m so thrilled to be here today talking to you about a topic that I just find so fascinating. And so helpful to kind of break down into tools that can really change people’s life. So today, we’re going to be talking about self-forgiveness and self-compassion. And I’ve got a bit of a personal journey personal experiences as to why I enjoy using learning about these tools and sharing them with nurses and midwives, just from my own life because of how transformative I found these and the beneficial effect it’s had on my own well-being. So that’s going to be somewhere I’m going to start today. And then in the rest of this episode, I’m going to be talking to you about some of the foundations of self-forgiveness, some of the things we know from the research literature. And I’m going to be leaving you with a couple of practical points and takeaway things. For you to go from practice in your day-to-day life, there are actually a ton of tools that we can use the self-forgiveness, I’m not going to go into everything in this episode, because I just think it’d be quite overwhelming and too much to put into practice in one go. So I’m going to break this podcast down into several episodes, which will release over the course of the coming months. And something I want to let you know about right now is that we will have an online course around self-forgiveness for nurses and midwives coming up on our website. And that’s nursewellbeingmission.com. So head over to the website and check out the resources and materials we have there. And if you’re listening to this in the future, which most people will be, that course will probably be that to check out.


So it’s gonna kick us off then by talking a little bit about my own journey and experience with self-forgiveness it might put a bit of context to all this, or maybe think about your own life really. So I’m a clinical psychologist, I’m not a nurse, but I am a human being just like you listening to this. And all of us throughout the course of our lives, do things that we’re not necessarily proud of at times. And we can be really hard on ourselves. And this is something that happened to me when I was in my 20s. But a lot of time really beating myself up and criticizing myself, I’d had quite a lot of experience with growing up around mental ill health when I was younger, I experienced my own episode of severe depression when I was 21. And for a number of different reasons, sort of from the age of 18 onwards, I used to go out drinking and I was sort of using a lot of substances, basically. And this was something that weighed heavily on me or one of the things that weighed heavily on me during my 20s You know, it was a bit of a coping mechanism, but also a kind of escapism. But also just for fun, I was a young guy who just wanted to go out and enjoy life. And I used to criticize myself, I develop body image issues, eating issues, and would not forgive myself for this behavior that I just saw as really quite disgusting, and deplorable yet, I carried on doing it all the time. So for everyone listening, you may not have done the exact same thing as me. But I’m sure many people have had that experience of doing something, we’re not really happy with our own behavior, yet, we’ve kind of continued doing it. And then we feel some sense of shame about that, for less than or not good enough kind of doubting ourselves or being critical of ourselves. So this was a bit of a pattern or cycle for me that was ongoing during my 20s.


And I had no idea that self-compassion or self-forgiveness was a thing that I could use as a sort of skill set of tools that I could apply to myself and change my relationship with myself. And luckily, I discovered all this stuff. So when I was doing my clinical psychology training, and subsequently, I just took a real interest in it, read loads, attended workshops, listen to podcasts, and started meditating and learned that actually, self-forgiveness is a thing. It’s something that we can start to do. We can learn about business, there are different elements to it. And it’s a choice we can make to start forgiving ourselves and start to be kind to ourselves. And once I discovered all this stuff, helped me absolutely transform myself and my behavior. Several years after these, I’m now 35 and my life has just completely turned around. And also this is for everyone but I gave up drinking and gave up all that stuff that was causing me problems and a very healthy lifestyle hour and have a very healthy relationship with myself. And it’s thanks to all this stuff, which I’m going to start to talk to you about in today’s episode.


So why are self-forgiveness and self-compassion relevant for nurses and midwives? Well, you are all humans. And some of you may have had some kind of experience like myself, you may have engaged in some kind of behavior that perhaps wasn’t the most helpful when you were younger. Or maybe you’re continuing to do that right now. And actually, perhaps you’re very critical of yourself about it. And you see it as being something really bad. And that creates shame. So of course, anyone could have had these kinds of experiences. But there are also things very relevant and specific for nurses and midwives, about the role that you work in, that makes this stuff highly, highly relevant. So if we just think about the fact that at some point in your career, whether it’s during your training, or later in your career, you’re absolutely going to make some kind of mistake or error in your practice. And this could range from minor little things, it could be a really small medication error that you make. But it could also be something that is perhaps a bit more catastrophic. And there are loads of different areas within practice that we can make mistakes with, then be hard on ourselves, or very blaming towards ourselves. It could be an accidental breach of confidentiality, for example, can be a medication error, for example, but it could be something in the course of your day-to-day work. So for example, if you’re more senior nurse or midwife, you’re stressed burnt out overwhelmed. And one day you just snap out or you shout at one of your junior staff, or perhaps you do that several times, and you feel really bad about yourself for doing it.


So these are just a few examples of things that we might be really hard on ourselves for, and not forgive ourselves for. And of course, you’re all grown adults as well. So the further course of your life, there are other kinds of moral transgressions that people make that we’re very hard on ourselves for. Again, it could be three maybe lied to someone, for example, or it could be something like infidelity, within a relationship, these things do happen all the time. And what can be really problematic is that if we basically just stay within that shame, and those difficult, unpleasant emotions, and nothing changes, we don’t change our behavior. We don’t try and make reparations with other people. And so forgiveness is the skill that is involved in self-forgiveness and addresses all of these things.


So just want to talk a little bit about what we know from the research literature about self-forgiveness, I find this stuff fascinating. So what we know is that people who are hiring what we call treat self-forgiveness. So people who basically find it easier to forgive themselves for their transgressions tend to have overall better not only psychological well-being but also physical well-being as well. So things like cardiac function, heart rate, and heart rate variability are more optimized when we’re better able to forgive ourselves. Just think about that. It’s pretty amazing, isn’t it? Right? So this thing that all of us kind of have an intuitive sense that it’s a thing that we can do, and we do it to ourselves sometimes actually has a powerful effect on our well being our mind, and on our body. So it’s really essential, in my opinion, preventative tool for us to learn to be able to forgive ourselves and to be kind to ourselves in the face of difficulty, of course, it doesn’t just mean that we’re going to learn these skills, and then we can go off just doing whatever we want, and treating people badly and making errors and mistakes, just so we can just be kind to ourself and get through it and not change anything. What we know is that genuine self-forgiveness does actually involve a number of different steps, some of which, as you may be imagining, actually do involve acknowledging our role in some kind of mistake. So we need to acknowledge our responsibility, but not inflate that responsibility. We also need to understand exactly why it’s difficult for us, and what are our values. What was the thing that we kind of violated the value we violated when we made that transgression, and we have to deal with the difficult emotions that show up and if there’s somebody else involved in that mistake or that behavior? So for example, a patient if you made some kind of clinical error, then actually perhaps seek reparation with that person, and actually going to talk to someone having a conversation about something.


So I’ve just briefly mentioned some of the positive effects of being able to forgive ourselves. Conversely, what we find from the research literature is that people who are not very high in self-forgiveness so they find it difficult to forgive themselves or don’t routinely forgive themselves for things. These people tend to experience higher rates of mental ill health. So this could be Depression, higher rates of anxiety disorders, and just general lower overall kind of psychological well-being. And the way that the researchers think that this self-forgiveness stuff operates is that essentially what happens when we say we’ve made some kind of moral transgression is that it creates stress for us, to me, just think about yourself right now, perhaps you recently made some kind of mistake could have been some kind of negligence in your career, or it could have been like I mentioned before, you would just have been nasty to someone one time. And when we are thinking about this mistake or thing we’ve done over and over and over, it’s sort of physiological response to that is the stress response, right? It creates anxiety, it creates stress in our bodies. And of course, if we’re holding on to the past, to something that we’ve done before, that’s going to be a chronic stress response, it’s not going to be just on a couple of hours in one day is it’s going to be day after day after day. And I personally met a number of nurses and midwives who’ve really struggled for years with things that they’ve done in the past. And it’s because they’ve not been nor they’ve not found, or they’ve not been given these kinds of tools around self-forgiveness and self-compassion, to help let go of the past to the park and really become a prisoner for us if we don’t find these tools to help let go of it. And that prison creates stress. And that stress creates other mental health problems if we’re unfortunate enough to be trapped in that.


So I don’t want to be negative and pessimistic. This is actually all about being optimistic and positive. It’s great news that we know all this stuff about self-forgiveness. And in a moment, I’m going to start talking to you a little bit about where we start with all of this. So there are lots that we could cover. What I found from workshops I’ve delivered in the past to nurses, for example, is that actually just starting from the knowledge that self-forgiveness is a thing that I could actually do in practice, and then it might be relevant, that’s a good place for us to start.

Okay. So what I want to do in the next part of this podcast is actually to sort of do a bit of a practical walkthrough of an example for yourself, I want you to be thinking about this, as we’re going through it because every single nurse or midwife listening to this would have had some experience that perhaps they’ve been holding on to that was just harder than others to really genuinely forgive themself for, I’m going to recommend that perhaps you don’t use an example that has been perhaps a career-defining mistake for you. We’re thinking about learning a new skill. And this is learning a new skill, it’s kind of emotional regulation skills we’re talking about here, it’s always good to start with some of those perhaps mild to moderate intensity, just because it can be quite overwhelming when we’re really thinking about the things that are really the darkest things for us. Think about something you did recently that you just weren’t really happy about, you felt quite guilty about. And maybe you felt some shame, maybe you felt like, you know, less than I feel like a bad nurse for doing that. That’s the kind of thought that we might have. And when we’re feeling shame as well. I’m feeling bad as a person for doing that.


So just have a think about what it was you did in the situation you’re in. And to start off with, it’s just good for us to think about why is this part for us. Or why was that hard for me? Why do I actually feel any negative emotions about this situation? Because if you think about it, if we didn’t care about something related to that situation, we wouldn’t have these feelings. There’s plenty of stuff going on in your life that you do that you don’t feel emotions about, right? So we tend to feel things when something matters to us when it’s important to us. And this gets really into our values. So for example, let’s say you made a minor medication error, perhaps you gave a patient the wrong dose of insulin, for example, someone is diabetic, and maybe it just had some mild effect on that patient that you were left feeling really guilty about it, you felt really bad about yourself, and you were beating yourself up about it. Why is it that you care about that? Why are you having those thoughts or those feelings? What’s the value underneath that?


I imagine, I don’t know, you know, everyone listening to this, he’s doing this exercise, but I imagine it’s because you have values around providing excellent or high-quality patient care, it might be that you have values around precision, actually, whilst you’ve made this mistake, you actually really value being precise with your calculations with your dosages, and getting things right because of that, and if you if you’ve gone into nursing or Midwifery, there’s a very high chance that one of your core values is around compassion and helping people, helping to improve their health. And by making this mistake, unfortunately, it felt to you like you’ve done the opposite you harm someone, it’s likely that what we might call a violation of your value of compassion or helping people is what is creating those really difficult feelings and thoughts for you right now.


So this is a really good place to start, if I’m experiencing something that is really hard for me feeling stressed and feeling shame, and worrying about something I’ve done or said, please have a look at your values. Why are you feeling that way? What is it underneath that? So often, what can happen with these situations is we get sucked into a cycle of thinking about them over and over and over again, I can certainly remember this when I was working clinically, as a psychologist, there are a number of times when things happen in my clinical practice, where my mind just would not let go of things that I’d said or done. And it’s because my mind thought I made some mistake and did the wrong thing. And it was just giving me a hard time, right? I’m sure, pretty much everyone listening to this would have had a similar experience in their nursing or midwifery practice.


So something that’s really important to ask ourselves is, you know, by continuing to focus on what you did wrong, right. So by continuing to focus on the past, because that’s essentially what our mind is doing by focusing on the past, or by excessively focusing on the future sort of worrying about what is going to happen. What effect is that having on your practice now as a nurse or midwife? So is it enabling you to be an effective nurse or midwife in the here and now? Or is actually hindering you? Are you in your head? Are you because the stress and stuff that has been created actually mean that you’re just not engaged with the things that you need to be doing right now? Or is it affecting your family life, your home life stopping you from being the kind of partner or mom or dad that you want to be? And the answer is probably yes. But we’re up here, locked in that prison of the past or worrying about the future. It’s hard for us to be effective in the here and now. So this is a good point to start to sort of ask ourselves, Is that helpful? Right? Is this thinking about stuff? Has that been helpful? And is it worth me setting the intention of and moving in the direction of self-forgiveness instead? As a personal question for you to answer, but I know for me, the answer is always yes, I actually just need to let go of this. And that is actually a choice we can make. And I find that very empowering. And I hope you are too when you listen to this. It’s not about blaming ourselves for beating ourselves up. It’s about empowering ourselves in the here and now that we have a choice to let go of things acknowledge what we might have done wrong, and set the intention to forgive ourselves.


So in the spirit, I’m going to invite you now to listen to this to set the intention that you’re going to forgive yourself for this thing that you’ve been thinking about. Hopefully, you spend a few moments just acknowledging perhaps the destruction that your mind is causing you by not forgiving yourself for it. And perhaps you’ve thought about, maybe forgiving yourself, which would help you be the kind of nurse that you want to be moving forward. Now, self-forgiveness is known to be a personal journey and a kind of process, it’s not as often not something we can just do, click our fingers, do one brief practice like we’re gonna go through now. And then it just is done. You’ve probably all had that experience, and many of you probably have a bit of a worry about that as well, that isn’t going to listen to what Nathan is saying, but actually, I’m pretty sure tomorrow, I won’t be forgiving myself. But that’s why each and every day, we can come back to this place at this point. And we can start again if we want to if we choose to. We don’t have to, of course.


So I would really invite you to actually get a pen and paper out. Now if you’re able to do that. Obviously, if you’re driving, that’s not going to be possible. And you can also just do this in your head. But it’s really just writing a commitment to ourselves or making a commitment to ourselves that we’re going to start forgiving ourselves for this particular mistake or situation. So just saying out loud to yourself. Now, I will say myself, I, Nathan Illman am going to commit to forgiving myself, and then you follow that by writing down what it was whatever the situation or mistake was that you made, I’m going to commit to forgiving myself and using that as a starting point, the intention to forgive yourself. And what I found personally is that simply by doing that, sometimes that just opens up some of our inner natural resources we have for forgiving ourselves, you are giving yourself permission to forgive yourself. And sometimes that is what has been missing for us.


You’re an adult listen to this. You have many coping mechanisms yourself you’ve picked up through your life, some of which you’re probably not even aware of when we give when we give ourselves permission to forgive ourselves or to do something, it can suddenly open us up to this range of possibilities of things that we have internally. So that’s the starting point for you. The next thing I’m going to provide for you to practice is to actually just acknowledge the difficult emotions and thoughts that are showing up. And just a very brief practice to kind of help soothe that and to get the ball rolling even more with this forgiveness, right? So you’ve made a commitment, you’ve written it down, you maybe you’ve said it in your head. And here’s another sort of psychological practice that you can do that can be used to kind of greet the difficult thoughts and emotions that are attached to this event that you’re perhaps not forgiving yourself, or you’re being hard on yourself for, and this little practice is called a self-compassionate pause. But we can also call it the self-forgiveness pause as well if we like. So what we do is when we notice that we’re in a kind of storm of blame and shame in our mind, perhaps you’ve been overthinking something that you’ve done is to just take a seat, or you can do it standing, to disconnect yourself with the ground and just push your feet into the ground, take a couple of deep breaths in through the nose and out through the mouth. And make sure your exhale is longer than your inhale. Because that really helps to kind of soothe the body so.


I’m wanting to invite you to do is to just put a hand over your chest. So if you’re watching this video, you can see me I’ve got my hand over my heart. And this helps to create a sense of soothing and our bodies. And I’m just going to pretend for the moment that I’m experiencing lots of negative thoughts about myself about something that I did in the past, I’m going to pretend that perhaps I’m feeling stressed and feeling shame about what I did. I’m feeling like I’m a bad person for what I did. And what we’re gonna say to ourselves is, this is a moment of difficulty. This is a really tough moment. So first thing, take a deep breath. Okay, this is a really tough moment. I’m feeling what do you fear of feeling shame, I’m feeling stress. I’m having thoughts that I’m a terrible psychologist. Or maybe I’m having thoughts that am a terrible nurse.


The next part is offering kindness and forgiveness towards ourselves without violence. So you can say something like, may I be kind to myself at this moment? Or may I forgive myself for the thing that I did? May I be kind to myself, may I forgive myself for this thing I did. And then take another couple of steady breaths. And again, what you’re doing is you’re directing those inner resources, just like you’re directing kindness. This is the heart of self-compassion, acknowledging the suffering that’s happening, and directing kindness towards it. And with that added instruction of being explicit about forgiveness. And what I’d recommend is you just do that until you notice the kind of calming soothing effect of it, and then move on to something else. Because one of the things that we know about a lack of self-forgiveness is that overthinking is really the catalyst for that. It keeps people trapped in the lack of forgiveness or blame.


So once we’ve done this self-compassionate, poor, or self-forgiving pause, we’ve got we’ve acknowledged the thoughts and emotions, we set an intention to forgive ourselves, and we don’t really want to be sat there for too long because our mind might kick back in and he might get stuck in it again. So a brief pause, breathe, soothe, and then do something else. Preferably something you enjoy, right? Go off and make a nice cup of tea, or go and talk to someone that you really enjoy talking to, or someone you can trust to tell about what’s been going on for you.


Okay, so I really enjoyed DNS, like I said, I never come back and talk about more self-forgiveness tools. There are lots of other parts that are involved in the self-forgiveness process that we know from the research literature, and I’ve got my own practical personal experience and the stuff that I do with nurses. So I’m excited to come back and present those to you in another podcast episode. Just a recap, though, as a couple of things I invite you to go off and do right one is to acknowledge something that you’ve been holding yourself about. Two is to make that verbal or written commitment that you’re going to start forgiving yourself to actually just give yourself permission to forgive yourself for that thing, to open up your natural resources. And then three is to try out that self-compassion or self-forgiving pause. So feet on the ground, steady yourself, deep breaths, breathe out then exhale longer than inhale, noticing and naming the thought, and emotions. Acknowledge this difficult moment for you and offer yourself forgiveness and kindness. Thanks so much for listening today, everyone. I can’t wait to be back with you soon.