Living with Mild Cognitive Impairment (MCI)

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PUBLIC PAGE
Dec 11, 2019

Revisiting gratitude

By Dr. Dona Locke, HABIT AZ Director, @DrDonaLocke
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The holidays are always a good background for discussing gratitude, which we've done before. I encourage you to look back at those posts in 2018 by HABIT team members Andrea Francone and Michelle Graff-Radford. Both provide helpful hints about how to start a gratitude practice. Today, however, I wanted to highlight some research on gratitude. The reason I find this research important is that (1) many of us (myself included) are not naturally "good" at gratitude practice and this research shows us it can be helpful for us to create an intentional daily gratitude practice and (2) one sample in this research was specifically a medical population facing significant challenges and the intervention was helpful for them as well.

So what if you are not naturally "grateful" (welcome to the club)

When I'm leading the wellness health-behavior change discussions of the HABIT program for patients diagnosed with Mild Cognitive Impairment here in Arizona, I often admit that I don't really have a temperament in which gratitude is natural perspective for me. I'm in awe of our team members and patients who naturally have a gratitude practice without even thinking about it. One patient once told me that her thoughts about potentially needing to stop driving and have her husband drive was, "That just means I get to spend that much more time with my husband!"  This is an example of the naturally grateful temperament I'm so envious of. I'm always able to find the frustrations in life and the things I wish were different. But so many things about life ARE frustrating and WILL NOT CHANGE.  So, I'm working on trying my own gratitude practice with these facts in mind and the research I'll review tells me it is worth my effort.

The research was published in 2003 by Dr. Robert Emmons and Dr. Michael McCullough, psychologists at University of California and University of Miami. The key question of their research is -does gratitude cause improvement in well-being or is it just that people with high well-being also frequently experience gratitude with no causal link between them? More simply, does intentional gratitude practice actually cause improvement in well-being? If this link is found then our efforts to intentionally build our own sense of emotional gratitude will then result in improved emotional well-being. If the link is not causal then it is more about natural temperament and paying more attention to the emotion of gratitude wouldn't improve well-being. The naturally joyful will remain more grateful and joyful (and us curmudgeons will just stay curmudgeons).

Study 1

The first experiment was completed with college students. They were randomly assigned to one of three assignments which involved:

  1. Thinking back over the last week and writing down up to 5 things in your life that you are grateful and thankful for (grateful condition).
  2. Thinking back over the last week and listing up to five hassles or irritants that occurred in your life (hassles condition).
  3. Thinking back over the last week and listing up to five events that had an impact on you in the last week (neutral condition).

The results showed that after 10 weeks of their assigned practice, those in the grateful condition rated their life more favorably overall and had higher optimism for the upcoming week than those in the hassles or neutral condition. They also reported fewer physical symptoms and exercised more than the other groups.

In addition, some students in the sample experienced a life challenge during the research and accepted some form of help for that challenge (such as accepting sympathy from someone, talking to someone about how they were feeling, or receiving concrete help or advice from someone). When they reported gratefulness in response to receiving that help (as opposed to feeling embarrassed, frustrated, or guilty) their overall emotional well-being was improved. This was true no matter what experimental condition they were assigned to.

Study 2

The second study was also with college students with similar gratitude and hassles conditions. This time, they completed their lists of things they were grateful for or hassles on a daily basis (rather than weekly). The third group in this study was a social comparison group instructed to think about ways in which they are better off than others or things they have that other's don't. This last condition was changed to give a more active comparison of a condition that, on the face of it, could be positive but not the same as gratitude.

The results showed that (1) the impact of the condition (gratitude or hassles) was stronger when completed on a daily basis than on a weekly basis and (2) gratitude practice again improved positive emotion.

Study 3

The third study is similar in terms of the experiment, but this time the participants in the study were patients from a neuromuscular disorder clinic. There are a number of neuromuscular disorders (NMDs) which impact the nerves and muscles in the body (see this link for more information). Even if you don't know what NMDs are specifically, it doesn't matter. The point is these are medical disorders that are chronic and often progressive and can involve significant physical disability for those who have them. In the context of this blog and Mayo Clinic Connect as a whole, this application to a significant medical population is such an important piece of this research. This group was randomly assigned to 21 days of reflection during which one group was assigned to reflect each day on things they were grateful for and complete measures of mood, well-being, and global outlook on life (gratitude group) or a group where they just complete measures of mood, well-being, and global outlook without any instruction about what to focus on about the day (control group).

The results showed that the gratitude assignment increased daily positive emotions AND reduced daily negative emotions. Those in the gratitude group were more satisfied with life as a whole, felt more optimistic about the coming week, felt more connected to others, and got more hours of sleep each night than those in the control group. Finally, in this study patients' significant others were asked for their perceptions and they also rated those in the gratitude condition as happier and more satisfied with life.

What's the take-away?

This research is important because it shows us that if we make an effort to establish a perspective that is more grateful, we are likely to improve our well-being, have fewer physical symptoms, take better care of ourselves better, and be more satisfied with life. This is obvious logic, but this research proves it. It also encourages us to accept help with gratitude when it is given--not only do we have the specific help but our gratefulness about it will help continue to improve our emotional well-being! These effects are occur even in patients struggling with very significant and chronic medical illnesses. Those patients with a gratitude practice slept better and were also noticed to be more happy and satisfied with life by their significant others as well. I really wish to emphasize this point because it is important not to ignore that medical illnesses of all types are stressful, may not be treatable, and may impact daily life. Mild Cognitive Impairment, our focus, is one such example. Gratitude is not about ignoring those facts--it is about recognizing that "every day may not be good, but there is something good in every day" and choosing that focus as much as possible.

With that, I hope you'll try to join me as I fight my own tendency to focus on my hassles and instead focus on those things I'm grateful for.

Best wishes to all of you for the holiday season from the (grateful) HABIT team!

Talk with others discussing what they are grateful for in the gratitude discussion in the  Mayo Clinic Connect Just Want to Talk group.

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