When you’re experiencing severe chronic pain, it could be difficult to imagine feeling gratitude – especially during the process of grieving for the losses in your life caused by having persistent pain.
Gratitude is a topic that has attracted some research over recent years, and also more specifically in the field of chronic illness. Here’s what we know about gratitude and chronic pain.
Gratitude can be cultivated and changes the focus of your attention. Feeling gratitude causes long-lasting changes in brain activity. Gratitude is associated with quality of life, mood, mental and physical health, and positive social relationships, which can all affect experience of chronic pain.
This blog post will go into more detail about the influence of gratitude on chronic pain. I’ll also explain how gratitude affects your brain, offer ways to think about gratitude when you have chronic pain, and give some practical suggestions on how to deal with living with chronic pain using gratitude.
First of all, what exactly is gratitude? We all know what it means to feel grateful, but how do we actually define it?
Researchers in 2007 wrote about the therapeutic value of gratitude.
“A positive experience… from recognizing gifts or blessings and feeling thankful. Gratitude is also an attitude, a way of perceiving life, where individuals are attuned to the beneficial actions of others on their behalf.”
(Worthen et al., 2007)
Why should I be grateful for pain?
It’s really about changing your perspective, to view your life with chronic pain differently.
Pain hurts you. Persistent pain can change your life in so many ways. Grappling with changes while physically hurting can be really tough.
Isn’t it insulting to suggest people should be grateful for that?
I don’t mean it to be. The way I see it, gratitude is something you can cultivate, which will help you change your perspective on life. Changing the way that you view something can influence how you experience it.
I understand just how hard it can be to feel thankful, when the pain is severe and persistent. I also understand how pain affects mental health, and how hard it can be to do any of this under those circumstances.
It’s just about practicing trying out a different perspective.
When you change perspective on things, it changes the focus of your attention.
“Shifting attention from problems to blessings activates more effective problem-solving efforts. Gratitude is more likely to promote endurance and thriving in times of adversity.”
(Worthen et al., 2007)
You didn’t choose to live with chronic pain. Many aspects of experiencing pain seem as if there is no choice involved.
The experience of having persistent pain can leave you feeling as if you have no control. Many aspects of being a ‘pain patient’ are passive – on the one hand you have the pain controlling you, and on the other hand you have medical professionals treating your symptoms.
Being in the middle of that, can feel like a very passive experience at times, as if you have no control or choice about what is happening.
Indeed, much of the experience of chronic pain feels out of control, or as if you are grappling for some kind of control – control the pain itself, control over aspects of your treatment, control over the way that pain is affecting your whole life.
Gratitude is something that you can choose to have.
Our attitude is something we can make choices about. We can have some control over the situation in terms of how we think and feel about it
Making choices around things like how we respond emotionally to what is happening, gives us back a sense of control.
What does gratitude do to your brain?
These researchers in 2016 were interested in the neuroscience behind gratitude. They ran a lab study where they scanned the brains of people while they were doing an activity that evoked feelings of gratitude.
Several areas of the brain had greater levels of activity when greater gratitude.
Gratitude affected, “A number of regions in the frontal, parietal, and occipital lobes.”
(Kini, 2016)
They explain that the neural mechanisms associated with gratitude are different from things like empathy and altruism, although there is some overlap.
Gratitude uses brain mechanisms associated with math and calculations, and doing more than one activity at once.
The effects of feeling gratitude appear to be long-lasting.
“Even brief expressions of gratitude may have profound and lasting effects on neural activity.”
(Kini, 2016)
Does gratitude reduce pain?
There doesn’t seem to be any research results yet on the direct effect of gratitude on pain levels.
What we are learning though, is that gratitude is associated with well-being, quality of life and can have an effect on mood.
A 2010 review of the available research on gratitude points out that it is also related to mental health, positive social relationships and physical health, in particular stress and sleep. Improvements in these aspects can in turn affect how you experience chronic pain.
These researchers in 2012 measured mood and pain in the people who took part in the study at the beginning, and after 5-7 weeks of a gratitude intervention.
They found that the gratitude intervention improved levels of daily happiness and significantly reduced anger.
“This provides preliminary evidence that daily focusing on positive aspects of one’s emotional experience benefits those with chronic back pain.”
(Baxter, Johnson & Bean, 2012)
A study in 2017 looked at gratitude in people with fibromyalgia. They found that people with fibromyalgia had a lower quality of life and higher rates of depression and anxiety than people with good health, and gratitude was associated with a better quality of life.
“Our findings suggest that gratitude is a valuable positive psychological trait for quality of life in people with fibromyalgia. Interventions to improve gratitude in this patient population may also bring enhancement in quality of life.”
(Toussaint et al., 2017)
The researchers suggest that gratitude can help people develop resilience and positive coping styles, which can help people to adjust to chronic illnesses.
According to the 2010 review of gratitude research, gratitude is a quality that can be cultivated by using specific strategies and interventions, the positive effects of which can last over several months.
So, even although we don’t yet seem to know if there’s any direct relationship between gratitude and pain levels, we have seen that it can affect other things that are associated directly with pain intensity.
And knowing that the effects of practicing strategies that focus on gratitude can last for several months, it’s worth considering giving it a try.
How to deal with chronic pain emotionally, with gratitude
So, what are some practical ways to foster gratitude when you have chronic pain?
First of all, try not to be too concerned at the outset, if you don’t manage to feel particularly grateful all the time or generally.
I know you are likely to be dealing with a whole bunch of other challenges around chronic pain.
But we know from the research that even experiencing feelings of gratitude for a short period of time can provide benefits.
As you start to practice strategies, you’ll be helping to shift your perspective.
Based on the results of gratitude studies, these researchers in 2007 suggested some strategies to cultivate gratitude. Here are a few of the practical ways you could cultivate gratitude in your life with chronic pain.
1. List your blessings
Write down 3-5 things that you consider to be blessings. They can be in any area of your life.
It could help you to think of things if you focus on one area of your life at a time, for example your relationships with others, or other aspects of your health for example.
Blessings might be things that have improved for you, or lessons you have learned.
You might like to describe some details under each blessing that you list, which can help you to ‘bask’ in those blessings as you go through the exercise.
You can practice this strategy regularly, either daily or several times a week.
The more you do it, the easier it will become to think of even more blessings in your life.
2. Write a letter of gratitude to someone and then visit them
Is there someone in particular you feel particularly grateful towards?
It could be anyone who has been kind to you that you would like to thank. Choose someone you can meet with face-to-face this week, and call them to make a date to visit them.
Write them a letter of thanks, including concrete details of how they affected your life for the better. While you’re writing, include details like your thoughts and emotions at the time.
When you go to meet the person, let them know how you’re doing now and share the content of the letter with them.
After the visit, take some time to think about how you felt while writing the letter. Think about their reaction to your expression of gratitude, and how it affected you. Think about which other people you could show your gratitude to in the same way.
3. Appreciate your progress
We can often feel ‘stuck’ with our challenges, and if our emotions are negatively affected by pain, it can be hard to see our progress.
But it’s a worthwhile strategy, even if it feels tricky at first.
You could focus on progress in a specific area, like health, relationships or life-goals. The progress needn’t be a huge step, it could be something seemingly small, but meaningful to you.
Sometimes others are better able to notice your improvements, as progress can be easier to spot from the outside, looking in.
If you struggle to find examples of progress, it can be helpful to brainstorm with someone who knows you well, at least at first, until you get into the swing of it.
After a while, everyone can improve at noticing improvements! Once your mind begins to focus on them, you will find it easier to appreciate the ways that you’re progressing.
4. Appreciate ‘small’ things
Big events that you are grateful for might not come around too often – the type of things that easily stick in our minds as being life-changing.
Start to ‘tune in’ to the ‘small’ things during the day. We often take these things for granted, without really thinking too much about them.
Look out for anything that makes you feel satisfied, peaceful, content or happy. It could be finding a seashell, noticing the colors in nature, hearing birdsong, getting a good sleep, reading an interesting book, having a conversation with a friend, etc.
At the end of the day, remember those small things that happened. Think also about three things that didn’t happen that would have made you feel bad in some way. For example, you weren’t late for a meeting, you didn’t receive any bad news, or you didn’t hurt anyone’s feelings.
This can help you to be grateful that things are not worse, while continuing to appreciate things you might normally take for granted.
5. Regularly express thanks to others
Find different ways to express thanks to others in day-to-day life. This could be through notes of appreciation to those you are close to, or by finding different ways to say ‘thank you’ to the people you encounter.
Frequently expressing thanks in meaningful ways with different words will help you to consciously focus more on feelings of gratitude.
References
Baxter, H., Johnson, M., & Bean, D. (2012). Efficacy of a Character Strengths and Gratitude Intervention for People with Chronic Back Pain. The Australian Journal of Rehabilitation Counselling, 18(2), 135-147.
Kini, P., Wong, J., McInnis, S., Gabana, N., & Brown, J., W. (2016). The effects of gratitude expression on neural activity. NeuroImage, Volume 128, Pages 1-10.
Toussaint, L., Sirois, F., Hirsch, J. et al. Gratitude mediates quality of life differences between fibromyalgia patients and healthy controls. Qual Life Res 26, 2449–2457 (2017).
Wood, A. M., Froh, J. J., & Geraghty, A. W. (2010). Gratitude and well-being: a review and theoretical integration. Clin Psychol Rev, Nov;30(7):890-905.
Worthen, V. E., & Isakson, R. L. (2007). The Therapeutic Value of Experiencing and Expressing Gratitude. Issues in Religion and Psychotherapy: Vol. 31 : No. 1 , Article 5.