Some people could be given an entire field of roses and see the thorns in it. Other could be given a single week and only see a wildflower in it. Perception is a key component to gratitude. And gratitude is a key component to joy. - -Amy Weatherly
In this November/December editorial, I must admit that my favorite holiday is Thanksgiving. This year, I have been reading about the "science" of gratitude. I know ... gratitude is such a buzzword today that it almost takes all the fun out of using it. But maybe there is more to it than just a buzzword; in fact, there seems to be more to gratitude than just platitudes!
Sometimes it is good to take a step back and define an opposite or antonym of a concept to see the entire range. The following words are often cited: ingratitude, thanklessness, ungratefulness, or "entitlement." Then there are the "thieves" of gratitude such as envy, materialism, narcissism, cynicism, or my personal favorite, the blame game. Certainly, listening to current events can also have a critical impact on gratitude unless you change the script and focus on other perceptions.
So in the setting of "self-care" of case managers, let us delve into the science. First, the symptoms of the grateful person versus the stressed person with headaches, sleeplessness, compassion fatigue, and digestive issues can be likened to the sympathetic nervous system (the fight or flight response) versus the parasympathetic nervous system (the part of the nervous system that allows our body to "rest and digest"). And science is beginning to show this.
It seems that, in general, people are more cognitively aware of their "headwinds" (or barriers they face) than "tailwinds" (benefits they receive). By paying more attention to our tailwinds, studies have shown that they can accentuate feelings of happiness, optimism, and positive emotion (Pratt, 2022).
Perhaps not as stringent as double-blind studies, research has been done to emphasize how gratitude (or lack of gratitude) can affect our nervous systems. Some research used adults seeking counseling services at a university and put them into two groups: the control group and the group who practiced gratitude interventions such as journaling and writing letters to recipients of the grateful.
According to Dr. Emiliana Simon-Thomas, Science Director at the Greater Good Science Center, the parasympathetic nervous system can help you conserve energy by slowing the heart rate, stimulating digestion, and contributing to overall relaxation. This soothing of the nervous system may be one mechanism by which gratitude works to calm the body. A study of heart failure patients who were randomly assigned to either an 8-week gratitude-journaling group or a treatment-as-usual group found that patients in the gratitude group showed more parasympathetic heart rate variability, which is a sign of better heart health (Pratt, 2022). With the significant numbers of heart failure patients, this may be added to their "plan" for a better life.
A neuroscientist named Glenn Fox (Fox, 2019) took a different approach. Using the USC Shoah Foundation Institute for Visual History, which houses the world's largest repository of videotaped Holocaust survivor testimonies, he began by watching hundreds of hours of survivor testimony to find stories in which the survivor received help of some kind from another person. They turned them into short scenarios that were shared with the participants. Each scenario was rephrased into the second person (e.g., "You are on a wintertime death march and a fellow prisoner gives you a warm coat") and presented to the study's participants. They asked them to imagine themselves in the scenario and feel, as much as possible, how they would feel if they were in the same situation. Although the participants reflected on the stories, they measured their brain activity using modern brain imaging techniques (in the form of functional magnetic resonance imaging, or fMRI). An example of a story was:
Imagine you are on the run from a Nazi manhunt and are taken under the protection of a stranger. This stranger spends the winter providing you with food and shelter-even traveling to other towns to relay messages to your family members-yet has no hope or expectation of repayment from you. While your loved ones are systematically ensnared by the Nazi machine, this stranger keeps you alive and nourishes your faith in humanity, offering proof that in the midst of widespread horror, many individuals still act with unfettered compassion and dignity.
When you think about this stranger, what they risked, what you received-how would you feel?
The results revealed that when participants reported those grateful feelings, their brains showed activity in a set of regions located in the medial prefrontal cortex, an area in the frontal lobes of the brain where the two hemispheres meet. This area of the brain is associated with understanding other people's perspectives, empathy, and feelings of relief. This is also an area of the brain that is massively connected to the systems in the body and the brain that regulate emotion and support the process of stress relief.
There is so much more to understand, but both techniques certainly showed that our emotional state is linked to the health body, mind, and nervous system. With all the trauma induced in today's world, this may be an important indicator (or lack) of health. According to Fox, better understanding of the physiology of gratitude can help pinpoint strategies for harnessing its health benefits and help people understand the importance of fostering this powerful emotion. The goal of his research has been to lay the groundwork for understanding what happens in the brain when we feel grateful-and a picture of the grateful brain is now starting to emerge (Fox, 2019).
Gratitude helps people realize that they wouldn't be where they are without the help of others. Sure, our clients/patients are often grateful for all we do, but frankly, I am grateful for all the case managers who have made me what I am-and for the tough job we do every day to help others. Thank you.
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