Practicing gratitude is a great way to put life in perspective and remember what’s really important. It increases happiness and can improve health outcomes too. According to Robert Emmons and the Greater Good Science Center, gratitude is twofold (1):
An affirmation that there are good things in the world, things from which we’ve benefited, and
A recognition of where that goodness comes from—the people and things in our life that have conspired to give it to us (pp.5-6)
This definition may sound overly positive, and it CAN be if there’s no acknowledgement of the negative things that happen as well. I think this definition hopes to shine light on the goodness that can exist even in times of despair. It’s easy to feel and show gratitude when everything is going well. It’s a lot harder to remember how difficult situations can still result in something good. The more we practice the skill, the easier it gets. The second part of the definition also reminds us of our connection to the world around us.
Expressing gratitude towards those who have helped us also brings connection and positive emotion in others. Some of my most memorable experiences are ones in which a patient or trainee has expressed gratitude to me for my part in their care or education. These are the patients that kept me in practice when I was exhausted and feeling unheard and unseen; not specifically because of the words “thank you,” but more because of the impact that I made in their life. They cared enough to acknowledge my part in it all. It’s the same with trainees. I remember inviting a resident to get lunch before she joined me in clinic when she was running late, and I had already started seeing patients that afternoon. She expressed gratitude for my encouragement to take a few minutes for herself so that she would be ready to see patients and be able to learn. These moments provide information to me about what I’m doing right and how I can make a difference.
Another way to not only feel gratitude but also pay it forward and show someone else the gratitude that you feel for them is by writing a gratitude letter. The research on gratitude letters is mixed when it comes to cultural differences and who to share your gratitude letter with. Cultures that are more individualistic and value independence and autonomy are more likely to benefit from this exercise than cultures that are more collectivist and value obedience and relatedness. The latter may have more expectations that can decrease the relative utility of writing a gratitude letter to a family member or close friend. (1, 2). It’s still a useful gratitude practice even if you don’t share the letter. When you share the letter with the right people, it can be even more impactful.
I have been meaning to write a gratitude letter to one of my mentors for years now. When I went through my own experience of burnout and was trying to get back on my feet, he was there for me. He’s been a presence in my life since medical school and continues to be a dear friend today. Here’s an example of my gratitude letter to him below:
We have known each other for so long now—close to 20 years—and I realized that I have never truly and thoughtfully thanked you for everything that you have done to support me in my career and as a friend. When I was in medical school at CWRU and you were the family medicine residency director at UH, you encouraged me to go into family medicine because you saw my potential and also coached me for my residency interviews. After I decided to go to a different program, you congratulated me in my match and supported my choice to leave Cleveland because you knew that I would get excellent training in “that state up North.” Thank you for hooding* me at graduation and sending me on my way with so many words of encouragement and support.
It was wonderful to start my sports medicine fellowship in Cleveland and find out that you were the graduate medical education director and would also be involved by leading osteopathic manipulation and leadership workshops. I celebrated another graduation with you as I officially completed my medical training and was off to my first job as an attending.
As the years passed and I became disillusioned and came home to take some time off and reflect on my next career move, you were still there. You were on my “board of directors” as a mentor and friend who bolstered me up and reminded me of how much I have to contribute to this world and specifically in the healthcare space. You did not show any disappointment that I did not follow the primary care path. You have been one of my biggest cheerleaders and have eagerly served as a reference and couldn’t wait to tell prospective employers how lucky they would be to have me. You told me that I matter and that my life and work experiences have helped shape me into a person who can succeed anywhere.
I don’t think I realized how much I needed to hear those words from someone that I respected so much. You cut through all the doubts and feelings of imposter syndrome and showed me how much you truly care about me as a human being. You have my sincerest gratitude and appreciation for being you. I don’t know how different my life would have been if I had never met you, but I know that it couldn’t have been any better.
Thank you so much, Michael!
Click here (https://ggia.berkeley.edu/practice/gratitude_letter) for more information on how to write your own gratitude letter.
*Hooding is a ceremonial experience of receiving the master’s or doctoral level hood around the time of graduation. It is placed on the graduate by a faculty member. We were able to request who could hood us and I asked Michael.
Smith, J. A., Newman, K. M., Marsh, J., & Keltner, D. (Eds.). (2020). The Gratitude Project How the Science of Thankfulness Can Rewire Our Brains for Resilience, Optimism, and the Greater Good. New Harbinger Publications.
https://ggia.berkeley.edu/practice/gratitude_letter Accessed on 10/23/2023