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On Apology
Reviewed by JOEL YAGER
Am J Psychiatry 2007;164:685-686. doi:10.1176/appi.ajp.164.4.685
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by Aaron Lazare. New York, Oxford University Press, 2004, 320 pp., $24.00.

What a pleasure to read a book by a prominent psychiatrist that bubbles with wisdom. Aaron Lazare, M.D., Chancellor and Dean and Professor of Psychiatry at the University of Massachusetts Medical School, previously gifted the field with seminal research on the “negotiated encounter” between clinicians and patients. In part as an extension of that work—in this erudite, edifying and deeply satisfying volume—he now focuses on processes of apology as key transactions in human affairs. Beginning with the observation that articles about apologies in popular media have more than doubled in the past decade, he identifies several contemporary factors contributing to this increase. One such factor being that apologies are necessary as the world flattens to help diverse individuals and groups get along if they are to work together successfully. And thanks to the ubiquity of media, virtually every cell phone is now a video camera, so that potentially embarrassing and offending acts that were previously private have suddenly become public. Perhaps there is now more out and about to apologize for.

In select subcultures, cultures, and alpha-male-dominated social classes, the idea of having to apologize has sometimes been abhorrent, indeed shamefully dishonorable, leading certain prominent historical figures to publicly condemn the idea of apologizing, regardless of the offense. But times are changing. Now, given the groundswell in acts of apology and advocates for apologizing in certain prominent and very public subgroups, we may be witnessing a deep shift in cultural values and behavioral norms. Lazare’s take is that the art of apology, always important in human conduct, is likely to become even more important to assure future social harmony among individuals, groups, nations, and transnational aggregations.

Having established this premise, Lazare formulates his analyses based on more than 1,000 acts of apology, from episodes in his personal and family life, clinical practice, and demanding administrative positions in complex organizations to publicly documented apologies in today’s media and historical and religious sources. He is both a scholar and a skilled practitioner. First, he carefully deconstructs virtually every aspect of these transactions—linguistic, developmental, intrapsychic, interpersonal, cultural, political, historical, philosophical, and religious. From these inquiries, he then fashions concise, largely face-valid, testable, theoretical models as well as field-tested techniques for offering apologies and for mediating apologies between offending and offended parties. Woven throughout the book are valuable pointers on what constitutes genuine and effective apologies and how this may be achieved.

The book focuses on what you might call “the offended-offender relationship”: those intersubjective fields encompassing key intrapsychic and interpersonal events that can consume victims with humiliation, shame, guilt, and rage, and sometimes perpetrators with humility, remorse, repentance, and redemption. In the best possible humanistic scenarios, these transactions can lead to genuine forgiveness. Within this broad interactive space, numerous types of offenses exist—from thoughtless blunders to intentional violations, personal versus impersonal affronts, single acts versus ongoing offenses, those causing trivial damages and slights versus unforgivable offenses such as intentional genocides.

Offended parties vary in sensitivity from self-blaming victims to prickly grudge-seekers and grudge-holders. Similarly, offenders and their apologies vary in important ways—from sincere, heart-wrenching remorseful confessors to half-hearted, coerced, apologists; from private face-to-face acts of truly humbling apologies to staged, indirect acts that reek of insincerity (such as having an excuse-laden letter read to a news-conference by a spokesperson). And there are “apologias” that serve more to justify offensive actions than to apologize for them. Apologies may occur immediately or delayed in time, contributing to personal rituals of restoration as through steps 8 and 9 of 12-step programs or through national rituals of reconciliation as in the post-Apartheid public political rituals in South Africa.

On the “offended” side of the equation, Lazare identifies seven needs that offended persons and groups hope to satisfy through apology to varying degrees. These include needs for restoration of dignity, acknowledgment that the offender actually shares important core values held by the offended party (such as respect for treating individuals with dignity), truthful explanations as to why the offense was perpetrated, assurances of future safety, exculpation from blame (i.e., assuring that the offense was not somehow the offended party’s fault in the first place), revenge and/or restitutive justice, and reparations.

On the “offender” side, motivations to apologize stem from intrapsychic needs to alleviate guilt and shame in order to restore an inner sense of peace and/or from externally motivated adaptive needs, such as the cost of doing business to meet social expectations in order to move on, to preserve social harmony. Lazare’s insightful analyses of failed and unconsummated apologies show how these misguided stumbles may leave the offended party feeling even more offended, hopeless, and further enraged. In essence, this section offers a helpful guide of what not to say and what not to do. He also discusses why certain individuals and groups are unwilling and/or unable to apologize.

Although this book transcends psychiatry per se, implicit are hosts of clinically relevant questions that beg further study. What accounts for the fact that males seemingly have a harder time than females in apologizing? What temperamental and developmental factors related to pride, narcissism, rigidity, sociopathy, and so forth contribute to the maladaptive impairments of the prone-to-offend personality, the easily-offended personality, and the incapable-of-apologizing personality? Given how important apology is in clinical situations, dispute resolutions, and legal transactions, should clinical training in many human-service fields mandate core competencies in how to apologize, in teaching others how to apologize, and in mediating apologies? (Indeed, Lazare proposes that an apology-oriented curriculum might benefit “ethics” and “communications” education in high schools, colleges, and religious schools.)

At the same time, you can’t read this book without reflecting on numerous apologies waiting out there to be delivered, from those involving your own interactions with family, friends, patients, and colleagues to those involving larger human aggregations, up to and including nations and transnational ethnic and religious groups. Lazare’s analyses bring welcome clarity to offenses that constantly occur at each of these interacting levels. He adds considerably to our understanding of what might be done and difficulties likely to be encountered in efforts to resolve long-standing offenses ranging from minor humiliations to truly horrendous ongoing policies and activities.

A must read for clinicians of all stripes, the book will also stimulate, provoke, and possibly change ways of doing business for a much wider audience, virtually anyone engaged in reciprocal relationships. When you read it, I have no doubt that you’ll think of family members, friends, colleagues, and public figures to whom you’d like to send gift copies, with certain sections underlined.

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