Influence of gratitude on well-being

Dr. Randhawa Deepti Bhardwaj Aditi

Introduction
Gratitude is essentially the recognition of the unearned increments of value in one’s
experience—the acknowledgment of the positive things that come our way that we did not
actively work toward or ask for. The International Encyclopedia of Ethics defines gratitude as
“the heart’s internal indicator on which the tally of gifts outweighs exchanges,” a definition that
echoes the notion of unearned increments. The connection to the concept of gifts is a natural
one. Having gratitude helps us to enjoy life more. It can break through huge barriers and reduce
our stress loads, give us more confidence and help us to meet our goals- no matter how big they
may be. Gratitude is a positive emotion, which is really important because it serves a purpose.
Gratitude as a virtue is integral to our well being. According to the Merriam-Webster Dictionary,
gratitude is simply “the state of being grateful”. A more helpful definition comes from
the Harvard Medical School, which says that gratitude is:
“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” One idea comes 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” (Sansone & Sansone, 2010).

A virtue that is deemed integral to wellbeing, however, is understudied in the social sciences.
This abandonment might be attributed to a more general negligence of research into positive
emotions (Linley et al., 2006). Regardless, the previously disregarded construct has received
calls to explore its potential to improve well-being (Gable & Haidt, 2005). Burgeoning evidence
on gratitude and human flourishing suggested there is a need to understand how and in what
ways it brings advantages into the life of the practitioner (Emmons & McCullough, 2003;
Emmons, 2012). There are various interpretations of the construct within the field of gratitude
research. Some claimed that gratitude manifests from two information-processing stages, which
firstly requires the individual to have an awareness of positive experiences, and subsequently
attributing these positive experiences to an external source (McCullough, Kilpatrick, Emmons, &
Larson, 2001).

2 stages of gratitude:

According to Dr. Robert Emmons, the feeling of gratitude involves two stages (2003):

First comes the acknowledgment of goodness in one’s life. In a state of gratitude, we say yes to
life. We affirm that all in all, life is good, and has elements that make it not just worth living, but
rich with texture and detail. The acknowledgment that we have received something gratifies us,
both by its presence and by the effort the giver put into choosing it.

Second, gratitude is recognizing that some of the sources of this goodness lie outside the self. At
this stage, the object of gratitude is other-directed; one can be grateful to other people, to
animals, and to the world, but not to oneself. At this stage, we recognize not only the goodness in
our lives, but who is to thank for it, and who has made sacrifices so that we could be happy.

The two stages of gratitude comprise the recognition first of the goodness in our lives, and then
of the source of that goodness that lies outside of ourselves. By this process, we recognize
everything and everyone that makes us who we are in our best moments.

Some studies have been done proposing that gratitude encompasses beyond an interpersonal
appreciation of another person’s help. An example demonstrated by Graham and Barker (1990),
was asking young children to identify circumstances a person would feel most grateful. They
presented participants with videos observing another child successfully completing a task under
two conditions – either being assisted by an adult, or working independently. Participants were
hypothesized to identify more gratitude for the subject who was offered help. Interestingly, their
findings showed that participants reported the subject who worked independently feel most
grateful compared to those who received assistance. This suggests that gratitude may emerge
from sources like appreciation of one’s capabilities, or of circumstances that allow successful
culmination of work.
Gratitude is a selfless act. Gratitude acts are done unconditionally to show to people that they are
appreciated, not because people are looking for something in return; however, that is not to say
that people do not return the favor. Gratitude can be contagious, in a good way.
One concept that fits well into the blueprint of gratitude is catharsis. Catharsis is the process in
which an individual releases strong emotions. For example, after a stressful or traumatic event,
crying provides a means for such a strong release; thus, rendering the activity cathartic. It is in a
similar fashion that catharsis works with gratitude. To illustrate this, consider the following.
The guilt associated with failing to meet obligations may cause a person to show gratitude to
another whom they have let down, in an attempt to release that guilt. The acts following that
event are meant to show the deep appreciation that the friends have for each other. Additionally,
in a more solitary way, possessions left from passed loved ones may provide a sense of serenity
that enables the new owner to reflect with gratitude on that object. The use of gratitude serves as
an agent of catharsis, and both parties feel satisfied in the end.
The other possible explanation of how gratitude functions is reciprocity. Reciprocity, a concept
that originated from social psychology, is about the exchanging of actions. In regard to gratitude,
it is the exchange of positive emotion. Someone performs an act of gratitude for another person,
and in turn, that person may be motivated to do something gracious for the former person, or
continue the favor for a stranger. After all, acts of gratitude aren’t only for people that you
know! A common contemporary phrase that people are familiar with is, “paying it forward.”
Though, paying it forward does not obligate you to reciprocate if you cannot, but it does spread
positivity via gratitude.

Gratitude: state or trait

Gratitude is regarded as either a trait (dispositional) or state. As a trait an individual practices
gratitude as part of their daily life (McCullough, Emmons, & Tsang, 2002), gratitude is also
considered a character strength, which if not among the top character strengths of an individual,
can be developed (Peterson, & Seligman, 2004). The emotion a person experiences from another
individual’s expression of gratitude is referred to as state (Watkins, Van Gelder, & Frias, 2009).
This put forth the notion that an interaction might exist between trait and state gratitude in
determining a person’s life-orientation (Emmons, McCullough, & Tsang, 2003; Watkins,
Woodward, Stone, & Kolts, 2003). Levels of trait gratitude can be measured using GQ-6 or the
GRAT; nonetheless, the GQ-6 is a more common tool in assessing individual’s dispositional
gratitude (Watkins, 2004). Gratitude Adjectives Checklist (GAC), on the other hand is used to
evaluate levels of state gratitude (McCullough et al., 2002). It contains three adjectives –
‘appreciative’, ‘grateful’, and ‘thankful’, which investigates the time spent reflecting upon the
feeling of gratefulness. Theoretically, viewing life as something to be thankful for is anticipated
to be strongly associated to well-being. Wood et al. (2010) demonstrated that individuals with
low well-being attribute their successes to factors that are uncontrollable, brief, and due to the
course of others’ actions, which in turn generate depression, anxiety, and negative emotions.
This finding is supported by the reformulated learned helplessness theory and attribution theory
that postulate well-being (and psychopathology) arises from how individuals interpret their life
happenings. Gratitude is said to be the antithesis of Beck’s (1976) negative cognitive triad (i.e.
negative in self, world, and future). Consequently, assessing gratitude at both trait and state
levels can be an important determinant to understand its interaction with well-being.
Gratitude practice can be a catalyzing and relational healing force, often untapped in clinical
practice.

Techniques to in cooperate gratitude

Gratitude visits: this strategy requires an individual to write a letter to a benefactor to show
appreciation for their kindness. The underlying assumption of this exercise is that people may
often say “thank-you” but fail to demonstrate the actual depth of their gratefulness to the
benefactor (Rashid, 2009). Hence, this exercise aims to encourage expression of thankfulness for
the received goods. In Seligman et al.’s (2005) findings showed that participants who composed
and later delivered the gratitude letter had a boost in happiness compared to the placebo
condition that was instructed to write about their early childhood memories. Though the gratitude
visit yielded the largest effect sizes, the effects faded substantially over a month. It is plausible
that writing just one gratitude letter was insufficient for sustained happiness. Toepfer (2009)
extended the design to writing three gratitude letters; his findings revealed that participants who
completed wrote multiple letters demonstrated higher cumulative effect for both gratitude and
happiness index scores compared to non-writers. Contrary to these studies, Lyubomirsky et al.
(2011) removed the psychological realism of the exercise (i.e. removal of letter delivery) yet,
results indicated that individuals experienced an improvement in well-being. Mailing out a
‘thank you’ letter may appear effective for the first few occasions; one can imagine repetitive
action could become stale. Future investigation should compare the impact of “delivery versus
non-delivery” of the gratitude letter and assess the level of impact based on to whom one writes.

ADEPT: The possibilities of gratitude within clinical contexts can be viewed within the
framework of accelerated experiential dynamic therapy (ADEPT; Fosha, 2005; Russell & Fosha,
2008). Gratitude is inherently relational and occurs in response to being esteemed and affirmed
by the other leading to expressions of love and tenderness toward the other. Within this
theoretical perspective, gratitude is one of the “healing effects” that are part of a broader
category of positive transformational feelings. The other-directed healing effects of gratitude,
love, and tenderness arise in interpersonal contexts and facilitate the process of bringing closure
to old hurts that, in turn, alleviates emotional suffering. According to ADEPT, the healing effects
arise when we feel recognized, affirmed, and esteemed; strengthened to do what was once too
frightening to do before; and when we become aware of the aspects of emotional experience that
were previously feared or blocked from awareness. As such, gratitude often becomes an
important dynamic between therapist and client after such experiences; in addition, the healing
power of gratitude from patient to therapist can be drawn upon to facilitate the therapeutic
encounter, and to enliven the capacity of the patient to not only feel gratitude but also to express
it. In this manner, the patient benefits from the co-created therapeutic space to advance treatment
and his or her sense of self.

Grateful contemplation: is another technique that involves participants to either think or write
about what one is grateful for in a more casual manner. In Watkins et al.’s (2003) study, one
group of participants were instructed to list several summer activities that they were thankful for,
whereas another group were told to list things they wanted to do but were not given the
opportunity. In this seemingly five minutes intervention, those who were thankful for the
activities over the summer reported less negative affect compared to their counterpart. Coherent
with other similar findings (Henrie, 2007; Koo, Algoe, Wilson, & Gilbert, 2008), this simple
technique has important clinical implications for therapists to induce immediate positive mood
among dysphonic individuals.
Gratitude lists: is a technique among all gratitude interventions, this approach is widely used
and examined (Wood, Froh, & Geraghty, 2010). More specific than the grateful contemplation
method, it requires participants to record grateful thoughts in a daily or weekly journal. Emmons
and McCullough (2003) carried out three experimental studies which assigned participants to
keep a gratitude journal. The first study randomly assigned students to three conditions – (i)
gratitude condition (i.e. listing five things they were grateful for), (ii) hassles condition (i.e.
listing five hassles), and (iii) life events condition (i.e. listing five events that has affected them)
for the past one week. Students in these three conditions were required to complete the task
along with other measures that assessed coping behavior, mood, physical distress and global
appraisals for 10-week. Findings revealed that those assigned in the gratitude condition reported
being more grateful, optimistic, and had fewer physical complaints compared to the hassles and
life events condition. The second study adopted a two weeks daily gratitude journal-keeping
exercise, and the hassles condition was replaced with a social-downward comparison group (i.e.
participants were encouraged to think about how they were better off than others). Participants in
the gratitude condition exhibited increased positive affect and altruistic behavior compared to
other conditions. However, the second study failed to replicate the findings for health benefits.
Extending the study to three weeks (i.e. third study), which focused on adults with
neuromuscular disease, these participants were randomly assigned to either the gratitude
condition or control group. Those in the gratitude condition demonstrated marked enhancement
in positive affect and life satisfaction. Other benefits include improved sleep quality, more time
spent on exercising, and greater bond with others. The lack of follow-up in Emmons and
McCulloughs’ (2003) study makes it impossible to determine how long the effects lasted for the
gratitude condition compared to other conditions. The study was revised by Froh, Sefick and
Emmons (2008) which included a three weeks follow-up. In the post-test and follow-up,
participants in the gratitude condition were found to experience greater gratitude, higher
satisfaction with school experience, and reduction in negative affect compared to the hassles and
control group. Physical benefits and perceived quality of interpersonal relationship remained
insignificant. A similar replication by Seligman et al. (2005) which required participants to keep
a daily journal to reflect and write on the positive events that happened during the day showed a
boost in happiness and alleviated depressive symptoms over a six-month follow up. Another
study conducted by Lyubomirsky, Sheldon, and Schkade (2005) found evidence that the
frequency of the happiness-enhancing intervention plays a role in therapeutic outcome. However,
Lyubomirsky et al.’s (2005) study showed that participants who kept a once-per-week gratitude
journal received greater benefits than those who kept frequent gratitude journal (i.e. three times
per week). Perhaps a systematic comparison of the “dosage” for these interventions would allow
future recommendations to be made with confidence.

Implications

Gratitude as a discipline involves a conscious choice. I can choose to be grateful even when my
emotions and feelings are steep and hurt and resentful. It is amazing how many occasions present
themselves in which I can choose gratitude instead of a complaint. I can choose to be grateful
when I am criticized, even when my heart responds in bitterness . . . I can choose to listen to the
voices that forgive and to look at the faces that smile, even while I still hear words of revenge
and see grimaces of hatred. Does gratitude work as a psychotherapeutic intervention? The
evidence to date suggests that it does. Gratitude is a key, underappreciated quality in the clinical
practice of psychology, its relevance deriving from its strong, unique, and causal relationship
with well-being. Clinically relevant positive characteristics such as optimism have a long lineage
in clinical and health research, and have already been integrated into established practice. The
inclusion of measures of gratitude and appreciation into randomized controlled trials of clinical
treatments may demonstrate whether the treatment is effective in increasing positive
functioning—a too often overlooked outcome in clinical research that has primarily, and
sometimes exclusively, focused on therapy’s ability to reduce negative functioning. Having
rarely been the focus of process-oriented clinical interest, a major therapeutic resource has gone
untapped. Relatively easy techniques can be included to increase gratitude alongside existing
clinical interventions. Social scientists have developed gratitude-based interventions in an
attempt to maximize humans’ positive experiences in life. Research has verified that
experiencing and expressing gratitude provide a peaceful mind, satisfying relationship with
others, and happiness in general (Watkins et al., 2003). However, because of the dearth of
evidence on psychological techniques for improving well-being, the encouraging findings
reported in gratitude studies to promote overall positive human functioning remains speculative
without rigorous experimental validation (Slade, 2010). Evidence mounting that positive mental
health plays a substantial role in the onset of illness and recovery rate, the WHO urges health
services to incorporate elements of positive health into operation at several dimensions (e.g.
individual-community; physicalmental, etc.), in particular to any health prevention and
intervention programs (Vázquez, Hervás, Rahona, & Gómez, 2009). Beyond the realm of illness
or disorder, the ability to enjoy life and handle adversities is equally important. Therefore, the
importance of this study is to examine the impact of grateful thinking on psychological well-
being, thereby instilling awareness among social science research about the benefits and practical
implications of gratitude. Some of the aforementioned studies did not assess whether the
proposed gratitude interventions actually fostered gratitude among participants. Owing to that
reason, results from previous studies can be questioned: What were the levels of gratitude before
and after intervention. A number of rigorous, controlled experimental trials have examined the
benefits of gratitude. Gratitude has one of the strongest links to mental health and satisfaction
with life of any personality trait—more so than even optimism, hope, or compassion. Grateful
people experience higher levels of positive emotions such as joy, enthusiasm, love, happiness,
and optimism, and gratitude as a discipline protects us from the destructive impulses of envy,
resentment, greed, and bitterness. People who experience gratitude can cope more effectively
with everyday stress, show increased resilience in the face of trauma-induced stress, recover
more quickly from illness, and enjoy more robust physical health. Taken together, these results
indicate that gratitude is incompatible with negative emotions and pathological conditions and
that it may even offer protection against psychiatric disorders. Gratitude has been scientifically
examined at the level of emotion by asking people to cultivate it through journaling exercises
(Emmons & McCullough, 2003). A research by John B. Nezlek, David B. Newman and Todd M.
Thrash (2016) on relationships between gratitude and well-being has concerned between-person
level relationships, and this research suggests that increasing people’s feelings of gratitude can
increase their well-being.

Scholars have noted that gratitude has happiness-bestowing properties (Emmons & McCullough,
2003). This can be explained using Fredrickson’s (2001) broaden-and-build theory, which states
that positive emotions broaden thinking and attention. According to Fredrickson (2004),
gratitude broadens through innovative reciprocity which builds enduring personal resources (e.g.
psychosocial, spiritual, and physical skills), and consequently enhances individual well-being.
Conclusion