Episode 27 Shownotes - The Surprising Health Benefits of a Gratitude Practice
Hi, friends! Hope you are well. When I am recording this, it is Thanksgiving week. I am off this week, taking a breather from medicine to celebrate my 50th birthday. We almost always travel with our kids, but my husband and I decided to take some time and do something just the two of us. He is a surgeon, and with both of us in medicine, with Covid numbers rising, it is a good time to pause for a bit, get a bit of a breather, and reconnect. I think this time is really hard on couples with one or both in medicine, because there is so much stress at work. I am blessed to have parents that are willing and able to come and help out for a bit. But I wanted to leave you with a podcast and thought a Gratefulness one was a great idea for Thanksgiving week.
There is so much data on a Gratefulness practice today, and the benefits attributed to this are rapidly increasing. I want to outline some of the benefits, and then we will go through some of the studies supporting this data. A Gratitude practice has been shown to decrease stress, improve falling asleep and quality of sleep, improve interpersonal relationships, decrease materialism in teens, increase generosity in adolescents, decrease risk of heart disease, decrease symptoms of depression, increase scores in happiness, optimism, life satisfaction, resiliency, patience. It has been shown to decrease burnout rates and fatigue. In the corporate realm, it has been shown to increase job satisfaction and employee effectiveness. It is thought to be so important that Ivy League institution Yale University is now teaching a class on the science of well-being and happiness.
When someone wants to start a gratitude practice, I often get questions what is most effective. What I would say is what feels best and is the most likely way that you will stick to it is definitely the best. One of the most successful ways actually seems to be to write a handwritten note once a week to someone telling them what they have done that you are grateful for. This works wether or not you send the letter (although who doesn’t like mail, especially when it is telling you something nice!). Other ways that I think are good as well include be journaling with attention to things you are grateful for, a gratefulness meditation (I use the insight timer app), a counting of your blessings during prayer, or a list that you add 1-3 new things onto daily. Finding things daily helps our brain to be on the lookout for good things to write down, which actually trains our brains to recognize good things. This means the more you do it, the more good things you will notice. A quote I found insightful is from Martin Seligman – “When we take time to notice things that go right, it means that we are getting a lot of little rewards throughout the day.”
So what should you focus on when starting a gratitude practice? The things you are grateful for can be small or large, and in fact, it seems beneficial to look for both – things on a global scale, big things in your life, and also tiny daily things like a warm breeze, a perfect flower or a loved one’s smile. One thing that seems clear, this shouldn’t feel forced. If you tell yourself you have to have 5 things every day, and then berate yourself when you can’t find them on a really rough day, this can backfire.
Let’s go into a bit more detail about HOW a gratitude practice helps in our lives. One reason it is thought that gratitude helps with our experience of life that it gives a sense of coherence – how confident a person feels about life’s circumstances. It affects the degree people feel optimistic and in control of future events. In part, this may be through changing perspective of what is important, seeing what is truly important. It may bring clarity to what we want more of and what we can cut out of our lives without guilt. I wonder if part of all of this is that life is a bit of a self-fulfilling prophecy. If we are more optimistic, we often are actually creating a better life with our thoughts and actions. This practice can limit ruminating on the negative, and is very effective at shifting our attention to the positive.
From a medical standpoint, there is evidence on several fronts that a gratitude practice is beneficial. One of the things I think can not be underestimated is sleep. People with a gratitude practice have been shown to fall asleep faster, get back to sleep quicker and rate the quality of their sleep higher. There also have been multiple studies showing that a gratitude practice decreases symptoms of depression. In part, this is thought to be due to some degree of blocking of toxic emotions, decreasing stress and increasing resiliency. But this is not the only measurable health benefit. A study was done by Paul Mills at University of California San Diego looking at people with preexisting heart disease. Surprisingly, those who followed a gratitude practice had better heath and measurably lower levels of inflammation, which affects blood vessels especially!
It is clear how this benefits adults and older people. What about children and teens? One study looked at a group of adolescents in summer camp, and having half of them write letters of gratitude. In this study, the kids writing the letters were found to have significant decreases in materialism, and increases in generosity. A second study of high school students asked to keep a gratitude journal had the very interesting side effect of the students eating healthier diets in addition to having better outlooks. It seemed that gratefulness lead to wanting to treat their bodies better. A 2017 study by Wong and Brown divided students into 3 groups. It had students either write a letter of gratitude, reflect on their thoughts or feelings about a negative experience, or do nothing. The group that wrote the letters had significantly better mental health scores at 4 and 12 weeks, even if they did not send the letters!
Ok, so improvements in adults and children. What about in the workplace? Charles Schwab initiated a gratitude practice company wide. The results showed that there was an improvement in job satisfaction and employee effectiveness even if you require people to do it (meaning not just suggesting it). This surprised me because I thought if it was forced, it would backfire and actually make people less grateful, but surprisingly, even when you direct staff to do it, it seems helpful.
One of the things I found interesting is a bit of information on WHY this works. You may recall from prior podcasts that our brains are wired to seek pleasure and avoid pain. Things that create pleasure cause the release of a neurotransmitter in our brains called dopamine. Giving and receiving gratitude has been shown to release domapine, effectively releasing a shot of feel good hormone. Our brains love this chemical, so it makes sense that the more people do this, the better they feel, and the more they want to do this! Interestingly, this is the same chemical that we get from eating foods with sugar, having an alcoholic drink, shopping, and other activities with downsides to them. If you follow my weight loss work, you know that dopamine plays a big part in some of our bad habits, so it is really awesome to find another place where we can get a dopamine hit from a source with no downside to it!
It seems like this is all pretty new, and a bit Woo, but thoughts on gratitude go back literally hundreds of years. In 1759, philosopher David Hulme said “Of all crimes that human creatures are capable of committing, the most horrid and unnatural is ingratitude”. I thought this was a very bold statement, but in pondering it, I thought about what would happen if as a society, no one was grateful. I think that actually might be more devastating than if murder was more prevalent. Can you imagine if no one did anything for anyone else? That would be the result of no gratitude. This is sort of mindblowing for me. The answer to why this statement really is true seems to me to be in the data that gratitude improves prosocial actions and stregthens relationships. There is evidence that gratitude increases helping behaviors. (meaning people doing things for other people). Grateful people help the people who helped them AND strangers in similar amounts. In fact, it seems that reminding the people who helped them doesn’t drive them to help the people who helped them more, it drives them to help OTHER PEOPLE more.
From the standpoint of medical personnel and the public at large during a pandemic, gratitude has been shown to reduce burnout, decrease fatigue and increase resiliency. At a time when many physicians and nurses are in the midst of the greatest challenge of their careers, focusing on gratitude daily could help to alleviate some of this. One of the things I see medical people really focusing on is how many peole are not wearing masks. They see that as the public NOT being grateful for what they are doing. I would suggest that as a country, we try to change the focus a bit to what others outside of medicine are doing to help in all this mess. I see strangers helping their elderly neighbors by going to the grocery store for them. I see people making and giving away masks by the dozen. I see many, many people thanking those of us in medicine for what we are doing. I see people in pharma working 7 days a week, 18 hours a day, to help get us a vaccine as quickly as they can. I see so many people choosing to stay home, not go to bars, not get together in other people’s homes, and I am grateful to each and every one of them. In terms of the population at large, looking at what others are doing with gratitude could help to reduce some of the pandemic fatigue which seems to be leading to more risky behaviors as people just get worn out by all of the restrictions.
Finally, in a country that has seen so many issues, race, politics, climate and nature related, a gratitude practice has been noted to increase our patience, humility and wisdom. I think all of us in the world could use a bit more of that in this day and age.
This thanksgiving week, I encourage all of you. Don’t just look for things to be thankful for today. Consider making this a way of life. For your long term health and well being.
Take care, my friends. I’ll speak with you soon!
