The science and application of gratitude

Most of us remember running down the stairs on Christmas morning, exuberant and exhilarated to find toys under the tree and sweets in our stockings. Few of us were able to pause, before, during or after ripping through red, white and green foiled paper and thank Santa for the abundance he had given. As adults we may not be that much different. Even though there’s wisdom that accompanies aging, there are also competing work and family demands, life stressors and the 24/7 news cycle interfering with our perspective-taking.

During the holidays we are reminded to count our blessings, bow our heads for the scrumptious gifts of food and friendship and raise a glass in toast to all good people and things. But, genuinely feeling and expressing gratitude is hard to do at the start of this festive holiday season and possibly throughout the rest of the year. It’s far easier for humans to make comparisons of other’s good fortunes and notice where our stack is lacking. It’s more common for us to forget to appreciate what we have and to assume that it will always be there. We sometimes even feel entitled to more. In our harried day-to-day functioning, we forget that life is much more of a gift than it is a burden.


This year, my best friend and statistician for 20 years, unexpectedly died. Stage four cancer that started in Richard’s colon quickly proliferated throughout his body, particularly his liver. He left behind a brilliant neurosurgeon wife, an adorable three-year-old son and a productive research career focused on understanding and treating the effects of traumatic stress in maltreated children. A few weeks before Richard died, I went to Houston for a week to care for him. As I watched the light go out in his life, I made a mental list of everything precious and fortunate in my own life. The inventory was very long. Sometimes it takes a loss like this for us to recalibrate and ground ourselves in what we actually have.

The study of gratitude has a long history in philosophy and theology. Jewish, Christian, Muslim, Buddhist and Hindu faiths are steeped in its promotion. But, gratitude was something that psychologists, like me, largely ignored.

 Over the past two decades, however, there has been a great deal of psychological study on gratitude. It’s now scientifically verified as a human strength, a key part of one’s strong psychological apparatus. Gratitude can be a short-term emotional state or an enduring attitude. In general, people with higher levels of gratitude report higher levels of psychological well-being and life satisfaction and lower levels of stress and depression. Gratitude can also positively influence our sleep and might even help improve our physical health by increasing cardiovascular and immune functioning. In addition, in a sample of over a thousand high school students, those with higher scores on gratitude had higher grade point averages, life satisfaction and social connections.

If gratitude is so good for us, it seems a no-brainer that we’d want to increase it in our lives. The most common strategies that psychologists have studied involve having people regularly engage in brief activities designed to encourage gratitude. 

This includes listing five things for which one is grateful several times per week for a given amount of time, or thinking about what someone has done for you and expressing it to them verbally or in a letter. But can something so easy to understand and complete really have such positive effects? 

There was some doubt in the research community as to whether fostering gratitude with short simple exercises could actually improve one’s psychological health. However, a more recent meta-analysis of 32 studies showed that gratitude interventions perform as well as other active psychological conditions, such as thought records or progressive muscle relaxation, in improving life satisfaction and mental health.

Most of these studies involved college students as opposed to people seeking treatment. Therefore, it’s likely that gratitude interventions shouldn’t be the primary or sole treatment for those with a diagnosable mental illness, like major depressive or post-traumatic stress disorder. For those with more serious mental health challenges, gratitude interventions are probably insufficient to bring about full recovery and could potentially be invalidating of the struggles they are experiencing.

While the science and intricacies of gratitude practice are still growing, there are some interesting connections and promise here. For those of us among the worried well or with problems of daily living, expressions of gratitude might be something to add to our life skills toolbox.

Joan Cook is a psychologist and associate professor at Yale University who researches traumatic stress and clinically treats combat veterans, interpersonal violence survivors and people who escaped the former World Trade Center towers on 9/11.