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Study shows how practicing gratitude can help train your brain and improve mental health over time

With the rise of man­aged health care, which empha­sizes cost-effi­cien­cy and brevi­ty, men­tal health pro­fes­sion­als have had to con­front this burn­ing ques­tion: How can they help clients derive the great­est pos­si­ble ben­e­fit from treat­ment in the short­est amount of time?

Recent evi­dence sug­gests that a promis­ing approach is to com­ple­ment psy­cho­log­i­cal coun­sel­ing with addi­tion­al activ­i­ties that are not too tax­ing for clients but yield high results. In our own research, we have zeroed in on one such activ­i­ty: the prac­tice of grat­i­tude. Indeed, many stud­ies over the past decade have found that peo­ple who con­scious­ly count their bless­ings tend to be hap­pi­er and less depressed.

We set out to address these ques­tions in a recent research study involv­ing near­ly 300 adults, most­ly col­lege stu­dents, who were seek­ing men­tal health coun­sel­ing at a uni­ver­si­ty. We recruit­ed these par­tic­i­pants just before they began their first ses­sion of coun­sel­ing, and, on aver­age, they report­ed clin­i­cal­ly low lev­els of men­tal health at the time. The major­i­ty of peo­ple seek­ing coun­sel­ing ser­vices at this uni­ver­si­ty in gen­er­al strug­gled with issues relat­ed to depres­sion and anxiety.The prob­lem is that most research stud­ies on grat­i­tude have been con­duct­ed with col­lege stu­dents or oth­er well-func­tion­ing peo­ple. Is grat­i­tude ben­e­fi­cial for peo­ple who strug­gle with men­tal health con­cerns? And, if so, how?

We ran­dom­ly assigned our study par­tic­i­pants into three groups. Although all three groups received coun­sel­ing ser­vices, the first group was also instruct­ed to write one let­ter of grat­i­tude to anoth­er per­son each week for three weeks, where­as the sec­ond group was asked to write about their deep­est thoughts and feel­ings about neg­a­tive expe­ri­ences. The third group did not do any writ­ing activ­i­ty.

What did we find? Com­pared with the par­tic­i­pants who wrote about neg­a­tive expe­ri­ences or only received coun­sel­ing, those who wrote grat­i­tude let­ters report­ed sig­nif­i­cant­ly bet­ter men­tal health four weeks and 12 weeks after their writ­ing exer­cise end­ed. This sug­gests that grat­i­tude writ­ing can be ben­e­fi­cial not just for healthy, well-adjust­ed indi­vid­u­als, but also for those who strug­gle with men­tal health con­cerns. In fact, it seems, prac­tic­ing grat­i­tude on top of receiv­ing psy­cho­log­i­cal coun­sel­ing car­ries greater ben­e­fits than coun­sel­ing alone, even when that grat­i­tude prac­tice is brief.

And that’s not all. When we dug deep­er into our results, we found indi­ca­tions of how grat­i­tude might actu­al­ly work on our minds and bod­ies. While not defin­i­tive, here are four insights from our research sug­gest­ing what might be behind gratitude’s psy­cho­log­i­cal ben­e­fits.

1. Gratitude unshackles us from toxic emotions

First, by ana­lyz­ing the words used by par­tic­i­pants in each of the two writ­ing groups, we were able to under­stand the mech­a­nisms behind the men­tal health ben­e­fits of grat­i­tude let­ter writ­ing. We com­pared the per­cent­age of pos­i­tive emo­tion words, neg­a­tive emo­tion words, and “we” words (first-per­son plur­al words) that par­tic­i­pants used in their writ­ing. Not sur­pris­ing­ly, those in the grat­i­tude writ­ing group used a high­er per­cent­age of pos­i­tive emo­tion words and “we” words, and a low­er pro­por­tion of neg­a­tive emo­tion words, than those in the oth­er writ­ing group.

How­ev­er, peo­ple who used more pos­i­tive emo­tion words and more “we” words in their grat­i­tude let­ters didn’t nec­es­sar­i­ly have bet­ter men­tal health lat­er. It was only when peo­ple used few­er neg­a­tive emo­tion words in their let­ters that they were sig­nif­i­cant­ly more like­ly to report bet­ter men­tal health. In fact, it was the lack of neg­a­tive emo­tion words—not the abun­dance of pos­i­tive words—that explained the men­tal health gap between the grat­i­tude writ­ing group and the oth­er writ­ing group.

Per­haps this sug­gests that grat­i­tude let­ter writ­ing pro­duces bet­ter men­tal health by shift­ing one’s atten­tion away from tox­ic emo­tions, such as resent­ment and envy. When you write about how grate­ful you are to oth­ers and how much oth­er peo­ple have blessed your life, it might become con­sid­er­ably hard­er for you to rumi­nate on your neg­a­tive expe­ri­ences.

2. Gratitude helps even if you don’t share it

We told par­tic­i­pants who were assigned to write grat­i­tude let­ters that they weren’t required to send their let­ters to their intend­ed recip­i­ent. In fact, only 23 per­cent of par­tic­i­pants who wrote grat­i­tude let­ters sent them. But those who didn’t send their let­ters enjoyed the ben­e­fits of expe­ri­enc­ing grat­i­tude nonethe­less. (Because the num­ber of peo­ple who sent their let­ters was so small, it was hard for us to deter­mine whether this group’s men­tal health was bet­ter than those who didn’t send their let­ter.)

This sug­gests that the men­tal health ben­e­fits of writ­ing grat­i­tude let­ters are not entire­ly depen­dent on actu­al­ly com­mu­ni­cat­ing that grat­i­tude to anoth­er per­son.

So if you’re think­ing of writ­ing a let­ter of grat­i­tude to some­one, but you’re unsure whether you want that per­son to read the let­ter, we encour­age you to write it any­way. You can decide lat­er whether to send it (and we think it’s often a good idea to do so). But the mere act of writ­ing the let­ter can help you appre­ci­ate the peo­ple in your life and shift your focus away from neg­a­tive feel­ings and thoughts.

3. Gratitude’s benefits take time

It’s impor­tant to note that the men­tal health ben­e­fits of grat­i­tude writ­ing in our study did not emerge imme­di­ate­ly, but grad­u­al­ly accrued over time. Although the dif­fer­ent groups in our study did not dif­fer in men­tal health lev­els one week after the end of the writ­ing activ­i­ties, indi­vid­u­als in the grat­i­tude group report­ed bet­ter men­tal health than the oth­ers four weeks after the writ­ing activ­i­ties, and this dif­fer­ence in men­tal health became even larg­er 12 weeks after the writ­ing activ­i­ties.

These results are encour­ag­ing because many oth­er stud­ies sug­gest that the men­tal health ben­e­fits of pos­i­tive activ­i­ties often decrease rather than increase over time after­ward. We don’t real­ly know why this pos­i­tive snow­ball effect occurred in our study. Per­haps the grat­i­tude let­ter writ­ers dis­cussed what they wrote in their let­ters with their coun­selors or with oth­ers. These con­ver­sa­tions may have rein­forced the psy­cho­log­i­cal ben­e­fits derived from the grat­i­tude writ­ing itself.

For now, the bot­tom line is this: If you par­tic­i­pate in a grat­i­tude writ­ing activ­i­ty, don’t be too sur­prised if you don’t feel dra­mat­i­cal­ly bet­ter imme­di­ate­ly after the writ­ing. Be patient and remem­ber that the ben­e­fits of grat­i­tude might take time to kick in.

4. Gratitude has lasting effects on the brain

About three months after the psy­chother­a­py ses­sions began, we took some of the peo­ple who wrote grat­i­tude let­ters and com­pared them with those who didn’t do any writ­ing. We want­ed to know if their brains were pro­cess­ing infor­ma­tion dif­fer­ent­ly.

We used an fMRI scan­ner to mea­sure brain activ­i­ty while peo­ple from each group did a “pay it for­ward” task. In that task, the indi­vid­u­als were reg­u­lar­ly giv­en a small amount of mon­ey by a nice per­son, called the “bene­fac­tor.” This bene­fac­tor only asked that they pass the mon­ey on to some­one if they felt grate­ful. Our par­tic­i­pants then decid­ed how much of the mon­ey, if any, to pass on to a wor­thy cause (and we did in fact donate that mon­ey to a local char­i­ty).

We want­ed to dis­tin­guish dona­tions moti­vat­ed by grat­i­tude from dona­tions dri­ven by oth­er moti­va­tions, like feel­ings of guilt or oblig­a­tion. So we asked the par­tic­i­pants to rate how grate­ful they felt toward the bene­fac­tor, and how much they want­ed to help each char­i­ta­ble cause, as well as how guilty they would feel if they didn’t help. We also gave them ques­tion­naires to mea­sure how grate­ful they are in their lives in gen­er­al.

We found that across the par­tic­i­pants, when peo­ple felt more grate­ful, their brain activ­i­ty was dis­tinct from brain activ­i­ty relat­ed to guilt and the desire to help a cause. More specif­i­cal­ly, we found that when peo­ple who are gen­er­al­ly more grate­ful gave more mon­ey to a cause, they showed greater neur­al sen­si­tiv­i­ty in the medi­al pre­frontal cor­tex, a brain area asso­ci­at­ed with learn­ing and deci­sion mak­ing. This sug­gests that peo­ple who are more grate­ful are also more atten­tive to how they express grat­i­tude.

Most inter­est­ing­ly, when we com­pared those who wrote the grat­i­tude let­ters with those who didn’t, the grat­i­tude let­ter writ­ers showed greater acti­va­tion in the medi­al pre­frontal cor­tex when they expe­ri­enced grat­i­tude in the fMRI scan­ner. This is strik­ing as this effect was found three months after the let­ter writ­ing began. This indi­cates that sim­ply express­ing grat­i­tude may have last­ing effects on the brain. While not con­clu­sive, this find­ing sug­gests that prac­tic­ing grat­i­tude may help train the brain to be more sen­si­tive to the expe­ri­ence of grat­i­tude down the line, and this could con­tribute to improved men­tal health over time.

Though these are just the first steps in what should be a longer research jour­ney, our research so far not only sug­gests that writ­ing grat­i­tude let­ters may be help­ful for peo­ple seek­ing coun­sel­ing ser­vices but also explains what’s behind gratitude’s psy­cho­log­i­cal ben­e­fits. At a time when many men­tal health pro­fes­sion­als are feel­ing crunched, we hope that this research can point them—and their clients—toward an effec­tive and ben­e­fi­cial tool.

Regard­less of whether you’re fac­ing seri­ous psy­cho­log­i­cal chal­lenges, if you have nev­er writ­ten a grat­i­tude let­ter before, we encour­age you to try it. Much of our time and ener­gy is spent pur­su­ing things we cur­rent­ly don’t have. Grat­i­tude revers­es our pri­or­i­ties to help us appre­ci­ate the peo­ple and things we do.

– Joel Wong, Ph.D., is an asso­ciate pro­fes­sor of coun­sel­ing psy­chol­o­gy at Indi­ana Uni­ver­si­ty, and Joshua Brown, Ph.D., is a pro­fes­sor of psy­cho­log­i­cal and brain sci­ences at Indi­ana Uni­ver­si­ty.  Based at UC-Berke­ley, Greater Good high­lights ground break­ing sci­en­tific research into the roots of com­pas­sion and altru­ism. Copy­right Greater Good.

The Study:

Does grat­i­tude writ­ing improve the men­tal health of psy­chother­a­py clients? Evi­dence from a ran­dom­ized con­trolled tri­al (Jour­nal of Psy­chother­a­py Research)

  • Abstract: Although the past decade has wit­nessed grow­ing research inter­est in pos­i­tive psy­cho­log­i­cal inter­ven­tions (PPIs), their poten­tial as adjunc­tive inter­ven­tions for psy­chother­a­py remains rel­a­tive­ly unex­plored. There­fore, this arti­cle expands the fron­tiers of PPI research by report­ing the first ran­dom­ized con­trolled tri­al to test a grat­i­tude writ­ing adjunc­tive inter­ven­tion for psy­chother­a­py clients. Par­tic­i­pants were 293 adults seek­ing uni­ver­si­ty-based psy­chother­a­py ser­vices. Par­tic­i­pants were ran­dom­ly assigned to one of three con­di­tions: (a) con­trol (psy­chother­a­py only), (b) a psy­chother­a­py plus expres­sive writ­ing, and © a psy­chother­a­py plus grat­i­tude writ­ing. Par­tic­i­pants in the grat­i­tude con­di­tion wrote let­ters express­ing grat­i­tude to oth­ers, where­as those in the expres­sive writ­ing con­di­tion wrote about their deep­est thoughts and feel­ings about stress­ful expe­ri­ences. About 4 weeks as well as 12 weeks after the con­clu­sion of the writ­ing inter­ven­tion, par­tic­i­pants in the grat­i­tude con­di­tion report­ed sig­nif­i­cant­ly bet­ter men­tal health than those in the expres­sive and con­trol con­di­tions, where­as those in the expres­sive and con­trol con­di­tions did not dif­fer sig­nif­i­cant­ly. More­over, low­er pro­por­tions of neg­a­tive emo­tion words in par­tic­i­pants’ writ­ing medi­at­ed the pos­i­tive effect of con­di­tion (grat­i­tude ver­sus expres­sive writ­ing) on men­tal health. These find­ings are dis­cussed in light of the use of grat­i­tude inter­ven­tions as adjunc­tive inter­ven­tions for psy­chother­a­py clients.

The Study in Context

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As seen in The New York Times, The Wall Street Journal, BBC News, CNN, Reuters,  SharpBrains is an independent market research firm tracking how brain science can improve our health and our lives.

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