the hands of an elderly man
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The healing power of gratitude

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A middle-aged man came to see me during the recession in 2008. Hector (not his real name) was crying in my Kaiser office and depressed because of his near financial ruin.

Fortunately, he was not suicidal. He still had a job doing auto repair work but had lost his home due to foreclosure. I prescribed an antidepressant and made an appointment for him to see a psychologist within a week.

As I explored with him what emotional and spiritual resources he had available, I discovered that prayer was an integral part of his life. With his permission, I said a prayer for him at the conclusion of his visit, a practice that I have integrated into my patient care since the early 2000s.

When Hector came to see me a few months later for an unrelated problem, he appeared rejuvenated. I was stunned to learn that he failed to keep his psychotherapy appointment and that he had taken only one dose of the antidepressant. He explained that the prayer I’d said helped him shift his focus from all he’d lost to what he was fortunate to have in his life. In other words, he found gratitude.

My reaction to Hector and others like him who report benefits from prayer or, in this case, finding gratitude: “That’s great, but please don’t stop your medicine!”

How can gratitude help emotionally? According to Harvard Medical School, “Gratitude helps people connect to something larger than themselves as individuals — whether to other people, nature or a higher power. In positive psychology research, gratitude helps people feel more positive emotions, relish good experiences, improve their health, deal with adversity, and build strong relationships.”

The following are two noteworthy studies that demonstrate the beneficial effect of gratitude. In a placebo-controlled study, Martin Seligman and his associates from the University of Pennsylvania found that a simple exercise asking people to list three things that went well each day resulted in greater happiness and decreased depressive symptoms compared to controls.

A 2003 study published in the Journal of Personality and Social Psychology demonstrated significant benefits of practicing gratitude. Subjects who were asked to keep a weekly gratitude journal were compared to those whose journals focused on hassles or neutral life events. Those who kept the gratitude journals exercised more regularly, reported less pain, felt better about their lives as a whole, reported more sleep and better sleep quality and were more optimistic compared to those in the other groups.

How can one cultivate gratitude? One way is to pray. There are many blessings of gratitude in Judaism. If one is unsure which blessing to say, there is always the Shehechiyanu: “Thank you God for keeping me alive, sustaining me and letting me reach this moment in time.”

Since I became aware of the life-changing effect of gratitude, I have asked many patients what they are grateful for. Recently I saw a patient at Samaritan House Clinic who was grieving the loss of his son, who was killed in a car crash caused by a drunk driver several years earlier. He was clearly depressed, but he declined psychotherapy or antidepressants.

When I asked him to share something he was grateful for, his face suddenly became animated. He told me about his young granddaughter who, after coming home from school, would sing delightful songs she had learned. I told him that the memory of his son will always be with him but that utilizing gratitude could help mitigate his loss. He understood my point and said it was going to be hard to change his thinking. I plan to see him in a few months to see if he has made any progress.

It is not unusual for patients to tell me how grateful they are for their family and friends. Another common response to my “what are you grateful for” question from my Samaritan House clinic patients is how thankful they are to be alive.

Here are ways that can cultivate gratitude: Write a letter or email to someone who had an impact on your life, keep a gratitude journal, count your blessings each week and meditate, focusing on what you’re grateful for.

Take a moment to think of something you feel fortunate about that occurred recently, or think about someone for whom you are grateful. And if you haven’t done so already, let that person know.

Dr. Jerry Saliman

Jerry Saliman, MD, retired from Kaiser South San Francisco after a 30-year career and is now a volunteer internist at Samaritan House Medical Clinic in San Mateo.