Metanoia from the Greek simply means to change one’s mind. It also means a spiritual conversion. While penance is associated with it in its more Christian interpretation, that would not be the case and not possible from a purely Buddhist perspective. In our individual lives we have made causes that we regret. If we are to seek forgiveness, it must come from the person impacted by those causes, and not some deity or force outside ourselves. We may even have cause to regret actions we have made against the environment, but again it is there that we should make efforts of repair. Learning to understand how our causes affect not only ourselves but others is part of taking the good medicine and making meaning.