When tackling mental health issues, taking a multifaceted approach to treatment typically yields the best results. Providing complementary adjuncts to traditional psychological counselling – such as guided gratitude practices – can help patients benefit more substantially from therapy in a shorter amount of time. Today, with the demand for acute mental health care increasingly rapidly, using this multimodal approach to make therapy as time and cost-efficient as possible has never been more vital.
What the Research Says About Gratitude and Mental Health
The beneficial effects of gratitude are well-documented in the general population. Studies have linked gratitude to numerous improvements in quality of life, including better sleep quality, more robust social connections, a reduced incidence of depression, and an enhanced ability to cope with stress. Until recently, however, research on gratitude focused primarily on individuals who already possessed a high level of mental functioning. We knew relatively little about the effects of gratitude on those with mental health concerns.
Though research in this area is still in its infancy, experts are beginning to shed light on how gratitude exercises could improve the lives of people struggling with mental illness. First, and perhaps most importantly, we know that being grateful cannot reduce depression or anxiety symptoms in the absence of conventional treatment. However, a small study conducted at the University of California in Berkeley suggests that combining gratefulness exercises with therapy is more effective than counselling alone. In this study, researchers examined 300 college-age adults seeking mental health counselling for depression and anxiety. (Most participants had clinically poor mental health at the beginning of the study period.) Participants were divided into three groups: One group was assigned the task of writing a gratitude letter every week, while another had to document their negative thoughts and experiences. A third group did not complete any writing assignments. At the end of the 12-week study period, the students who wrote regular gratitude letters reported more pronounced mental health improvements than those who documented their grievances and those who only attended counselling. These results suggest that gratitude confers advantages to the mentally ill that echo those observed in the mentally healthy population, as long as patients also receive psychological treatment.
How Does Gratitude Change the Way We Think – And Feel?
Gratitude changes the way we view life and approach problems, allowing us to identify beneficial opportunities and suppress limiting beliefs. This paradigm shift invites more enriching experiences into our lives, which gradually teaches the brain to expect positive – rather than negative – outcomes. Specifically, gratitude alters the brain by initiating the four transformative processes outlined below:
1. Gratitude releases us from toxic feelings and beliefs.
Unsurprisingly, researchers in the UC Berkeley study found that participants in the gratitude letter writing group expressed more positive feelings than those who documented their negative experiences. However, using a greater number of positive words didn’t necessarily guarantee an improvement in mental health. Instead, researchers discovered that only those participants who used fewer negative words (not just more positive expressions) in their letters experienced a reduction in depression and anxiety symptoms.
These results suggest that gratitude exercises improve our mood and outlook on life by shifting our attention away from toxic feelings and beliefs. Not only a gratitude is an excellent coping mechanism, but, over time, expressing gratitude trains the brain to focus on how the experiences and people in our lives benefit us. This change in perspective makes it easier to counterbalance negative emotions, like resentment and envy, and leaves less time for pessimistic rumination.
2. Gratitude provides a way for people to independently improve their mental health.
Another interesting finding of the UC Berkeley study is that gratitude retains its transformative power even when it’s practiced in solitude. Though only 23% of participants shared their gratitude letters with a recipient, most people in the gratitude letter writing group enjoyed similar mental health benefits. This means that gratitude is an effective intervention even for isolated individuals and those whose anxiety prevents them from sharing vulnerable feelings with others. It also makes gratitude a highly accessible mental health tool, as patients can practice it in various settings; e.g., one can write a gratitude journal while riding the bus, during breaks at work, etc.
3. Gratitude changes the way the brain processes information.
MRI scans show that actions motivated by gratitude activate different brain regions than actions motivated by negative emotions, like guilt or obligation. In one experiment, researchers gave participants a small amount of money and asked them to “pay it forward” to a cause of their choice the next time they felt grateful. Researchers then asked participants to rate how grateful they felt after being given the money and how grateful they feel towards their life in general. Participants were also asked to describe any negative feelings they had during the experiment; e.g., how guilty they would feel if they didn’t donate any money to a cause. Researchers found that participants with the highest level of gratitude (and the lowest level of guilt and obligation) had distinct brain activity not seen in other study subjects. Specifically, the learning and decision-making areas of the brain (the medial prefrontal cortex) demonstrated greater sensitivity. Similar brain imaging results were found among the group of UC Berkeley study participants who wrote gratitude letters.
Though these results are difficult to interpret, they imply that being grateful rewires the brain to be more receptive to positive experiences. Grateful people may also be more attentive when expressing gratitude and more capable of finding constructive solutions for problems. Most strikingly, researchers found that these brain alterations did not reverse upon completion of the study. Increased activity in the medial prefrontal cortex could still be seen three months after participants started writing gratitude letters. This suggests that gratitude exercises confer long-term benefits that continue to enrich patients’ lives after therapy has ceased.
Like other mental health interventions, gratitude exercises don’t yield results overnight. To achieve lasting improvements in mood and outlook, individuals with mental health concerns should commit to a guided gratitude practice for at least 12 weeks. When implemented alongside traditional counselling, however, gratitude is a worthwhile tool in the fight for better mental health. Nearly everyone, from the severely mentally ill to those coping with normal life stress, can benefit from counting their blessings.