Over the past decade, with the rise in Positive Psychology as a field of study, gratitude has become an increasingly studied are of interest. Why? Well, proponents of gratitude have said that it can improve mood, health, comradery, relationship bonds, increase altruism, and potentially even part of a clinical intervention for depression! Gratitude has been on my radar for a few years now, and a practice I have incorporated into my life in varying levels of intensity. But recently, I saw a post where someone shared that their psoriasis had actually diminished and that they hadn’t had a flare in 6 months since picking up a daily gratitude practice!
Wow! That’s powerful I thought, and away I went, diving into what research actually has to say about the positive, negative, and neutral when it comes to gratitude.
First, it is important to acknowledge that there is not one universally accepted definition of gratitude and this can cause some confusion in researching it. Is it an attitude? A personality trait? An emotion? A reaction to a kind act? A behavior? A coping mechanism? A life orientation?
It has actually been studied as all of the above and is likely implicated in the variation in outcomes of studies exploring gratitude! To keep things broad at the beginning, let’s start where other reviewers of the literature have landed in saying, “Gratitude is a life orientation toward recognizing and appreciating the good; that is, a thankfulness for what is valuable and meaningful to you.” (Gratitude: Defined; Sansone & Sansone, 2010).
In embodied practice, Dr. Robert Emmons (see What good is gratitude? Online Lecture), a leading expert on the topic, says that gratitude:
Sounds pretty powerful, right? But what does the available research actually say about gratitude when it comes to our health and wellbeing?
Let’s take a look:
Research on gratitude:
Gratitude is consistently related to subjective/perceived well being and life satisfaction (Wood, Froh, & Geraghty, 2010; Sansone et al, 2010). As a construct, it appears to be related to but separate from similar markers of well being such as optimism and hope (Wood et al, 2010). It is (as we might expect) multifaceted, and includes aspects such as: individual differences in grateful affect, appreciation of others, a focus on what one has, feelings of awe in the presence of beauty, expressive behaviors, appreciation for the fact that life is short, a focus on the positive in the present moment, and positive social comparisons (Wood et al, 2010). One comprehensive review of the literature surmises that trait gratitude is made up of all of these factors, and the extent to which one experiences them with consistency, frequency, and intensity (Wood et al, 2010). This life orientation approach to understanding gratitude appears to account for the variety ways people recount experiencing it, not simply thankfulness for being on the receiving end of a favor, which, in fact, might actually detract from well-being by encouraging a feelings of indebtedness and an external orientation to life’s events.
The available research on gratitude consistently links it with positive, adaptive personality traits, including: emotional warmth; greater openness to feelings, ideas, and values; altruism; dutifulness; and achievement striving, and inversely relates to anger, hostility, and depression (as defined by Costa & McCrae). As mentioned above, studies have consistently positively linked gratitude with subjective and psychological (eudaemonic) well being. Beyond individual wellbeing, a large and growing body of evidence suggests that gratitude is strongly related to the factors implicated in relationship development and maintenance (Wood et al, 2010). The relationship between health and gratitude is relatively understudied; yet the available research suggests that gratitude is related to decreased stress and may be especially important in sleep quality; both of which we KNOW are strongly implicated in health and thriving. In one study, gratitude was related to total sleep quality, duration, latency, subjective quality, and daytime dysfunction (Wood, Joseph, Lloyd, & Atkins, 2009). Each of the aforementioned were specifically linked to gratitude via pre-sleep thought patterns (i.e., pre-sleep positive thinking). In addition to these lifestyle factors, there appear to be many clinical implications.
For example, one study (Kashdan, Uswatte,& Julian, 2006) examined gratitude in war veterans with and without PTSD. The results suggested that those experiencing PTSD had lower dispositional gratitude; and dispositional gratitude was significantly predictive of many aspects of well-being in those with PTSD over and above symptomatology and positive and negative affect. Additionally, in both groups, a daily practice of gratitude was uniquely related to each of the aspects of wellbeing measured. Many studies have examined these and similar constructs (e.g., thankfulness; eudaemonic wellbeing) in the context of epidemiological cohort studies and have found these traits to be predictive of significantly lower risk of depression, anxiety, and substance dependence and abuse later in life (Wood et al, 2010). Thus, gratitude as a life orientation and as a practice shows promise as an intervention for many clinical conditions, as well as a method of cultivating increased resiliency from them.
Limitations to consider:
Gratitude as a construct in wellbeing is again a relatively new topic of research; thus there is much room for further research and greater understanding. Currently, much of the research is observational (meaning we cannot draw causal conclusions) and cross-sectional (which only gives us a small snapshot of a particular population at one specific point in time). Gratitude shares a lot of overlap with other traits, although much of the research that has controlled for overlap shows that gratitude has a unique relationship with well being (e.g. above and beyond general positive affect). It is also unclear whether wellbeing causes gratitude or gratitude causes wellbeing; although here again, the experimental and longitudinal research that has explored this has demonstrated that it is gratitude that increases well being.
Great, so if gratitude appears to increase wellbeing, both immediately and over time, and is positively implicated in relationships, health, and thriving, how do we cultivate it? Can we? What’s the best way?
Let explore that!
There are a number of different ways to approach gratitude interventions, including:
Of these, daily gratitude lists are the most commonly reported in the literature, and appear to be comparable in effective as clinical interventions for certain conditions (e.g., body dissatisfaction; excessive worry), and with less attrition than traditional clinical interventions; they me also have a more lasting effect than other gratitude interventions (see Wood et al 2010). Grateful contemplation and writing and delivering a gratitude letter appear to have a more immediate positive effect on mood (see Wood et al 2010 for review). Their effectiveness must be tempered with the acknowledgement that many of these studies did not include a “true” control group (i.e., many of the control groups completed an activity that could have skewed the results in some way); yet, another review of the literature (Sansone et al 2010) cited a study where this was accounted for and the gratitude group showed increased well being as compared to the controls.
So, to be clear, the research is a bit like braving the wilderness; there is still much to be discovered. Yet what is available suggests that gratitude is consistently positively linked with many aspects of well being, is readily applicable in simple but effective exercises like a gratitude list, and stands to foster greater positive affect, health, relationships, and resiliency, across many ages and groups in society.
So, are there any groups for which gratitude could be counterproductive?
Actually, yes!! And Final topic of discussion!
When gratitude is counterproductive:
As you might suspect, this section is brief, but I feel, equally important to cover. Gratitude can backfire when:
Alright, there you have it! The deep dive on gratitude!
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*The information on this website is intended for educational purposes only. Please consult with your health care team before making any lifestyle changes.