The power of regret

Regret is as old as conscience itself, a staple of Bible stories and barroom confessions through the ages. Yet only recently have researchers begun to clarify its emotional impact, and learn how it affects our health and behavior.

“Especially after middle age, regret can become a very powerful factor in the way people think about themselves,” said Dr. William Callahan, an Irvine psychiatrist. “I hear it all the time: ‘I never got close to my children’ or ‘I promised myself I’d never be the reincarnation of my father, and I’ve become him.’ ”

They are the kind of laments, therapists say, that can turn us against ourselves for the rest of our lives.

Yet the common response -- to look away, to move on -- is neither psychologically healthy nor realistic, some psychological researchers say. Regrets can be emotional billboards, announcing who we are and what we most want. By changing the way we think about regrets, we can even alter their emotional impact. This evolving view is based partly on research, partly on the experience of psychiatrists caring for older adults. For these therapists, patients’ regrets are not necessarily a sinkhole of misery but a reservoir of personal history that can be used to relieve symptoms of depression and anxiety, especially in older adults.

Regret, said Dr. Daniel Plotkin, a geriatric psychiatrist in Los Angeles, “is a natural part of having lived a full and rich life,” often reflecting a history of many dilemmas and complex choices.

*

Learning from the past

Regrets are one form of the endless loop of what-might-have-beens that braids itself into the ongoing life narrative that runs in our heads, psychological researchers say. Some of these thoughts are benign and directly useful: The observation “I should have studied harder for that last test” can motivate people to work hard and score better the next time, research has shown.

It is the larger self-betrayals that permanently crimp our narrative tape: a marriage ended too soon, or too late; an educational degree left unfinished; a move across the country, away from aging parents. “Imagining what might have been is usually healthy; it’s one way we learn from the past,” said Neal Roese, an associate professor of psychology at the University of Illinois in Urbana-Champaign who studies how thoughts like regret influence behavior. “But there’s a big difference when something awful happens and we cannot repair it. That’s when we can get stuck in the negative emotions of serious regret.”

In some severely depressed patients, these memories can be overwhelming, and are best left alone, experts say. Probing regrets may only deepen their despair, and could prompt suicidal thoughts, said Dr. Joel Streim, a geriatric psychiatrist at the University of Pennsylvania.

But many people swimming in self-blame are likely making themselves ill. Preliminary evidence from an ongoing study of 120 older men and women suggests that serious regrets are associated with physical symptoms, such as migraine headaches and gastrointestinal problems, according to Carsten Wrosch, a researcher at Concordia University in Montreal.

In a study published this June, Wrosch and Jutta Heckhausen, a psychologist at UC Irvine, reported that the specific way we think about our regrets can significantly affect our emotional well-being. The healthiest approach varies with age, they found. The pair administered questionnaires on regret and mental health to 122 adults ranging in age from 20 to 87. Younger adults who scored high on measures of mental health tended to blame themselves for the behavior they regretted; they assumed they had full control of the situation. This makes sense, the researchers conclude: When we’re young, we still have plenty of opportunity to repair damage we’ve done, and regrets can motivate us to do so.

In contrast, older adults scoring high on the tests were more likely to give themselves a break. With little or no ability to take action to remedy the consequences of their mistakes, they apparently adapted by altering their perception of the regret; they no longer shouldered all the blame. If an estranged father had died before they could repair the relationship, for instance, these people told themselves, “I tried, but Dad never gave an effort”; or that Dad’s second wife “never wanted us to be close,” according to Wrosch. Spreading blame in this way defanged the memory and allowed them to think about their father without needless self-loathing.

*

Sharing the blame

It’s certainly possible that they’re deluding themselves, researchers say; but it’s preferable to excessive self-blame. The shadow of regret can hang so heavily that it obscures the many practical, even courageous decisions people did make when they were busy passing on their grand ambition or neglecting to save much money, psychiatrists say. According to Roese, studies of memory have found that people who consider multiple scenarios and explanations when recalling an event -- maybe Dad was afraid to reach out -- can more accurately reconstruct what happened. “In regret, you’re imagining only how your life could have been better,” he said. “You could just as well ask how it might have been worse. OK, so you didn’t write the novel. You decided to spend more time with your family instead. What would happen if you’d neglected your family? How would you feel then?”

In older adults this pondering over paths not taken is a natural and healthy part of reminiscence, in which people begin to see themselves as mortals doing their best to navigate uncertainties, rather than fools or villains, psychiatrists say. One of Plotkin’s patients, a former newspaper reporter in her 70s, lived for decades regretting that she hadn’t been a better mother. In the 1950s and 1960s, as her three daughters were growing up, she’d spent long hours at the office. The sensation of having neglected her children was so raw that she felt unworthy of moving with a daughter and family to Pennsylvania, despite an open invitation to do so. She hadn’t cared for them properly; why should they have to care for her? In therapy Plotkin helped her appreciate the value of the choices she had made: Her commitment to work was no substitute for being at home, but her success later stood as an inspiration to her daughters.

In a 1917 essay on the subject of loss, Sigmund Freud distinguished between two kinds of grief: mourning, the natural and psychologically protective sadness of letting go; and melancholia, the pathological self-flogging that occurs when people refuse to let go. Some psychiatrists view regret as a kind of grieving over lives unlived. “One way to think about it is that by nudging people off self-blame you can move them toward a life review that is more bittersweet and wistful, more sad than angry -- more like mourning than melancholia,” Plotkin said. In reviewing her life, the former news reporter was better able to forgive herself. She eventually moved east, spending her final years with her daughter and family.

*

Remorse as motivator

Because they so richly express the things we most want for ourselves, regrets can also move people to make changes they would otherwise never consider. In a recent study, psychologists Abigail Stewart and Elizabeth Vandewater analyzed in-depth interviews with some 200 female graduates of the University of Michigan and Radcliffe College. The graduates answered questions about regrets and life satisfaction in their 20s, again in their mid-30s, and then in their late 40s. Almost all of them had regrets, often about missed career opportunities. By their late 40s, about 65% of the women had acted to resolve that regret by taking night classes, completing a degree or doing part-time work, the researchers found. Compared to the other 35%, those who’d made life changes were significantly less likely to report symptoms of anxiety or depression, such as difficulty sleeping and feelings of worthlessness. “One woman told us in the first survey she married the wrong guy, and by the second survey she’d found someone else,” said Vandewater. “Now, that definitely counts as taking action.”

While getting a night-school MBA or remarrying may not be a solution for most of us, that doesn’t prevent psychiatrists from using patients’ regret to prompt more subtle but equally powerful life changes. One of Streim’s patients in Pennsylvania is a 94-year-old woman who withdrew from her grown children’s lives because she felt it best not to intrude. Discussing her regret over this decision, she saw that her instinct not to “impose” was denying her the kind of social contact and close personal connection she actually craves.

She has recently become close to several nurses, caregivers and others in the home where she lives. “She’s made the very best friends of her adult life, right now,” Streim said, “and she says she’s happier than she can remember.”

*

(BEGIN TEXT OF INFOBOX)

What people regret the most

Several research studies have surveyed middle-aged and older adults about the topic of regret. Based on those surveys, here are the top five most commonly cited regrets. (The quotations are examples of the types of regrets expressed by people).

1. Education: “I should have finished school”; “I should have learned Spanish.”

2. Career: “I never should have left that job”; “I never should have gone into medicine.”

3. Romance: “I married the wrong person for me”; “I should never have left my first husband.”

4. Family: “I should have spent more time with the kids.”

5. Spirituality: “I should have been more involved with my church or synagogue.”

Others frequently mentioned:

Health: “I should have quit smoking sooner”; “I should have taken better care of myself.”

Self-improvement: “I should have been more assertive”; “I should have been less stubborn.”

Finance: “I should never have sold my parent’s home”; “I should have bought that stock back then.”

Altruism: “I wish I had done more to help others.”

*

Source: Neal Roese, University of Illinois in Urbana-Champaign