By Jeffrey Leman, MD

Dr. Leman

Gratitude: an emotion that we have all experienced, but what is it? The word Gratitude is from the Latin Gratia (meaning grace, graciousness, or gratefulness); that is a good starting point. Definitions in the literature that are helpful include:

“a thankful appreciation for what an individual receives, whether tangible or intangible. With gratitude, people acknowledge the goodness in their lives … As a result, gratitude also helps people connect to something larger than themselves as individuals–whether to other people, nature, or a higher power”

or another definition from psychiatry researchers, who define gratitude as:

“the appreciation of what is valuable and meaningful to oneself and represents a general state of thankfulness and/or appreciation”.

According to psychologist and leading researcher Dr. Robert Emmons, the feeling of gratitude involves two stages:

  1. First is the acknowledgment of goodness in one’s life. We affirm that all in all, despite the challenges, life is good and has many elements that make life worth living. The acknowledgment that we have something good gratifies us by its presence. This leads to the second stage….
  2. Second, gratitude is recognizing the sources of that goodness, which most frequently lie outside of ourselves — whether that be other people, our society or country, nature, or God. Emmons describes that at this stage, we not only recognize the goodness in our lives but who to thank for it — i.e., who made sacrifices so that we could be happy?

The two stages of gratitude comprise the recognition of the goodness in our lives, and then how this goodness came to us externally. Through this process, we intentionally recognize the blessings that enrich our lives.

A 2003 study by Emmons and McCollough found that keeping a daily gratitude journal leads to better sleep, reductions in physical pain, a greater sense of wellbeing, and a better ability to handle change. That is an impressive list of things all of us need desperately in these times of turmoil!

Delving deeper into the world of brain science, another study illuminates the immediate effectiveness of gratitude. In this 2008 study, subjects experiencing gratitude were studied under functional MRI, and it was found they were experiencing real time changes in their hypothalamus — that small but powerful part of our brains that directly influences sleep, eating and stress. Gratitude also stimulates those parts of the brain that is associated with the neurotransmitter dopamine — the “do-it-again” chemical that is responsible for creating new learning pathways. It turns out that gratitude could be the ultimate “happy pill” (drugs notwithstanding!).

The year of 2020 has been hard for everyone; that is an understatement. For me personally, the events of the past year, even without COVID and its consequences, have been particularly challenging. And yet, reminders to focus on the good, the blessed, the underserved things in my life have kept me buoyant; kept my head above the crashing waves. And not just to survive, but to thrive amid real challenges.

I am so grateful for so many things but primarily for my joyful and longsuffering wife, my forgiving family that keeps me laughing, my tremendously supportive colleagues at work, my sacrificing church family, and ultimately my loving, gracious God. When I slow down to recognize the goodness those entities bring into my life each day, it is hard to despair. Quite the opposite: despite hard things, the inevitable response as I enumerate so many good things, is celebration and hope.

This is a practice however, and one which takes some measure of discipline to maintain. While the specific implementation of such a discipline will be unique for each person, there are some basic principles that apply. The literature suggests benefits from starting one’s day with a written clarification or verbal articulation of several things for which we are grateful, either in a journal or enumerating them aloud to ourselves or in prayer. Subsequently closing one’s day in a similar fashion, looking back over the day to highlight those aspects for which we were the most thankful can also have a powerful influence in how we remember those things and keep them from being drowned out by the ubiquitous unpleasantries of life.

With sustained practice, gratitude does more than just give us an occasional warm fuzzy feeling, it seems to be “rewiring” our brains. It can perceptibly change the way we think, what we recognize and how we interpret our lives. While it is not as simple as a magic off/on switch, the literature (and the personal experience of many people, myself included) suggests that it can be a timely and much needed antidote for despair. And who could not use a more of that?

About the Author

Dr. Jeffrey Leman is the Family Medicine Residency Director and a Visiting Associate Professor of Clinical Family Medicine.