I have never been a very touchy-feely person. I was trained as a biologist and chemist, then went to medical school where more science on top of science was aimed at me like a gushing firehose. I learned to put science and evidence first and to try in my practice of medicine to use only the therapeutic techniques that had some evidence base. That assured me that my patients would get well. This has always included solid therapies, medications, and procedures. Even though I love to write, I have never really thought of writing and expressions of gratitude as especially helpful when dealing with sadness, depression, or poor health in general.

Then I got an email a few weeks ago from the folks who make a journaling app that I do use to track my experiences, travel, food, and family time. It invited me to embark on a Thirty Days Of Gratitude challenge this month. The ask was to respond to a daily prompt that would allow you to ponder, consider, and explore people, things, actions, and events that had made you happy or fulfilled, and for which you felt gratitude. My non-touchy-feely clinical self would normally delete that kind of email right away, thinking that this kind of exercise was not my cup of tea. This time, though, maybe because of recent stresses, losses, and negative vibes in my world, I decided that I would go for it. After all, didn’t I have a tremendous number of things and people to be thankful for? Of course, I did.

The prompts over the last three weeks have included things like who I need to thank, what three things I appreciate in nature, and what I like about this time of year. I have written a little something each day, without fail, and on days that I get to this task later than sooner, I begin to fret that I will not meet my obligation to the challenge. In other words, the activity, the repetition, and the sheer act of writing down what I am thankful for has grown on me, to the point that I look forward to it every day. It has made me more attuned to the gratitude I feel every day for my wife, my life’s work, my friends, my hobbies, and my many blessings in all their many forms. It has done what it was advertised to do for me, but the clinician in me still asks the question, is it scientifically based? Is there evidence that this daily expression of gratitude really helps to increase your quality of life? I went hunting for evidence.

In the June 8, 2023, New York Times article “Gratitude Really is Good for You,” Christina Canon wrote of a study done two decades ago by Robert A. Emmons at UC Davis. This study found that gratitude might possibly improve psychological well-being, and it led to much more research in the area. This subsequent research has found that a grateful outlook and expressing gratitude may positively affect emotional health and the quality of interpersonal and romantic relationships. Gratitude is a positive emotion, it reflects the goodness in your life, and it also acknowledges that other people or a higher power, if you subscribe to that notion, may have some part in helping you feel positive and grateful. The source of many good things lies outside ourselves, and gratitude may be felt for that source, but the power of gratitude is multiplied manyfold by sharing it, wrote Canon in this article. Increased gratitude has been found to decrease depression, increase sleep quality, and may have physical effects such as lowering blood pressure.

How to express gratitude in a specific, measurable, and effective way? According to Joel Wong, a professor of counseling psychology at the Indiana University School of Education, long-term expression of gratitude in a habitual way is optimal. Daily journaling, as it turns out, is ideal! Who knew? To make your habitual gratitude even more powerful, link it to an existing routine, habit, or time of day. Make it as specific as you can, which deepens the gratitude you feel, says Wong. And that journaling habit that you’re going to try? Your iPad or laptop are fine tools, but the very act of writing things down slows your thinking just enough to help you ponder, better digest, and better express that gratitude you feel. Pen and paper are fine tools to this day. (I love my notebooks, and I always have several going at once for different purposes.)

Another August 14, 2021, article in Harvard Health, “Giving Thanks Can Make You Happier,” found Dr. Martin Seligman of the University of Pennsylvania echoing that even if there is no demonstrable cause and effect between gratitude and wellbeing, there is most assuredly a strong association. Whether in relationships between romantic partners, managers, workers, or others, expressed gratitude fosters good feelings, better communication and understanding, and even harder work. Another wonderful point that this Harvard article made was that gratitude focuses on what we have, not what we lack. I love this because in my clinical practice, it is so evident that we often let the negative and the stressful get to us, leading to our inability to see, experience, and feel gratitude for the many blessings we have, no matter how small.

If you are like me and you need a little push to start flexing that gratitude muscle (which gets stronger with use and practice), then here are a few things to try, from that same Harvard Health piece. Write a thank-you note. Keep a gratitude journal, with daily entries if you can. Write weekly about three blessings that you are thankful for. Be specific! Pray if you are so inclined. Meditate. (This is one that I want to take a stab at in 2024.)

Finally, dear readers, I want to take the time to express my profound gratitude to all of you who read my musings and who have taken the time to thank me for them over the years. They say you teach what you need to learn, and I learn something every time I sit down to write. Peace, blessings, and happiness to you and yours.

Greg Smith is a psychiatrist.