Many years before I studied to become a physician, giving thanks for the blessings in my life was the first part of my morning prayers. Great Spirit, thank you for this day and thank you for my life. I still use this opening in my prayers, followed by a list of what I am thankful for on that particular day. I was taught by my Native American Medicine teacher it was important to give thanks before asking Creator for what I needed or wanted. It should not be surprising to me that Native Americans understood the importance of gratitude, long before there was the neuroscience to back it up.
A study by Wong et al. in 2018, found that when individuals undergoing psychotherapy added writing letters of gratitude to their therapy sessions, they reported significantly better mental health after four and twelve weeks, as compared to the control group who attended therapy sessions alone, and as compared to a group that wrote expressive letters about their feelings along with their therapy sessions. So, it’s not just the expressive writing that matters, it’s what the participants were writing and focusing on. Gratitude, or the recognition of a gift, whether from a person or a non-human source like nature, has the power to heal. For the last year, I have been sending a text of three things I am grateful for every morning to my two best friends. That and my journaling is how I start my day and is just as important as my twenty-minute meditation session right before I go to sleep at night. And I have so much to be thankful for.
I am grateful for my mind, for the ability to study and learn, for all the subjects I have learned about thus far in my life, and for all the things I am going to discover in the future. I am grateful for so many of my teachers: Mrs. Ferraro, my 5th grade teacher who saw how hard it was to transition into a new middle school and paid extra attention to me; Mr. Kreitzer, my 11th grade social studies teacher who taught a communications class called Peer to Peer, giving me a foundation for expression and mental health; Nancy Esposito, my college Poetry teacher who encouraged me to find my words; Jackie, my Native American Medicine teacher who helped me find my power; April Fong, my post-baccalaureate Biology teacher who challenged my experiment interpretations, making me a better scientist; and Dr. Jennifer Shen, the first doctor in my training to share with me a medical error that she had during her training, allowing me to accept my own humanity and capacity to make mistakes. I am grateful to all the teachers who wholeheartedly commit themselves to their students, despite the immense challenges of working in a dysfunctional educational system. And I am thankful for the medical students and residents who allow me to pass the torch by bestowing upon them the things I have learned about being a physician, insights not taught in the classroom or in textbooks.
Gratitude research has been increasing in the last several decades, with studies into what it is, what parts of the brain are associated with it, and theories about how it helps patients. Other research into the effects gratitude has on a person’s well-being shows positive affects across emotional, physical, and social or interpersonal domains. Gratitude can improve one’s mood, sleep, self-esteem, moral behavior, immune system, and resilience to trauma, all while decreasing pain, stress, envy, materialism, depression, and anxiety. This sounds just as powerful as the known benefits of exercise or moving one’s body, and yet it’s simpler; all I have to do is focus on what I am grateful for. While I have already adopted several different strategies to alleviate my own depression and COVID burnout, adding gratitude to my daily repertoire of healthy behaviors has allowed me to sustain my sense of well-being, despite the continued stress of working in medicine and witnessing so much suffering daily.
Something I’ve learned along the way is that it's also important to have gratitude for the struggles and dark times. It’s easy to be thankful for all the good in my life, the warm house I live in, the clothes on my back, the money in my bank account, the relative safety of my community (not living in a war zone), and the tremendous support I have in my life from those that love me. But what about the hard times? Can I find gratitude for the pain? Great Spirit, I thank you for everything you have given me, and everything you have taken away. I am grateful for my aging body, for the aches and pains that remind me I am alive and can move my limbs to climb small mountains. I am grateful for the fatigue I feel after a long day at work, or after a few hours of yardwork, giving myself permission to take a nap. I am grateful for my thirst and hunger, and even more so, for the food in my refrigerator and the fresh water I can drink at any, without a long walk to a well. I am grateful for the conflict I have had in my relationships, for they have taught me about myself and the ways I need to improve my communication. I am grateful for the friends and family I have lost due to estrangement, natural letting go, and even from death. For I have benefited from all my relationships, and the loss of them has reminded me how important it is to cherish what I have. There is so much for me to be grateful for, every day, every hour, every minute. Having gratitude has become an integral part of my wellness plan, and I hope it is for yours as well.