Gratitude and Gratefulness

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Gratitude and Gratefulness

THC Editorial Team June 15, 2021
Titian Ramsay Peale, Spray of Flowers and Ferns, date unknown, National Gallery of Art (article on gratitude)
Spray of Flowers and Ferns, Titian Ramsay Peale, date unknown, Courtesy National Gallery of Art, Washington


What Is Gratitude?

Many different understandings of gratitude exist, as do definitions of the concept. We often think of gratitude as the appreciation we show to another individual or individuals for something beneficial we receive from them, either tangible or not. However, gratitude can go beyond relationships with others and be defined as an appreciation for the positive elements in one’s life and even in the world. In a more spiritual context, being grateful can be described as feeling the presence of the Divine in our lives.1 Various factors can influence a person’s experience of gratitude, but two essential components are an affirmation of goodness in one’s life and the awareness that this goodness can lie in external sources outside of the self.2 These components allow for gratitude to solidify and strengthen relationships and allow for the transformational healing power of gratitude.

The healing power of gratitude is rooted in its ability to promote positive reframing, which changes how we perceive situations and what we pay attention to in our daily lives.3 Taking a step back to objectively notice all the good in one’s life can significantly improve an individual’s state of mind. By altering how we view things to see what is positive, we can shift our attention away from the things that elicit negative emotions. Gratitude also promotes an increased sense of abundance, increasing the happiness and contentment we feel in our lives. Regularly noticing and appreciating the good around us promotes thankfulness and positivity, which profoundly impacts our mental well-being.

How to Practice Gratitude

Anyone can practice gratitude at any time; no specific materials or therapists are needed.4 To practice gratitude, many people try to cultivate heightened positivity toward others, increased sensitivity to good experiences in everyday life, and more vital understandings of positive emotions as they occur. Examples of gratitude practices include the following:

  • keeping a gratitude journal and writing down things you are grateful for on a daily or weekly basis
  • practicing the Three Good Things (TGT) exercise, where you write down three things that went well throughout your day before going to sleep
  • expressing gratitude to others verbally and through action
  • noticing and appreciating the beauty in your surroundings
  • engaging in regular acts of kindness
  • spending quality time with those you care about
  • volunteering and giving back to your community
  • seeing the good even during tough times
  • focusing on what you have rather than what you lack
  • praying
  • meditating

Benefits of Being Grateful

According to research studies evaluating the effectiveness of gratitude interventions, the following are potential benefits of gratitude:

  • higher levels of joy, enthusiasm, love, happiness, and optimism
  • decreased feelings of envy, resentment, greed, and bitterness
  • increased resilience during trauma-induced stress2
  • improved positive affect (mood)4
  • improved subjective well-being4
  • physical health benefits, including reduced diastolic blood pressure,5 improved cardiovascular biomarkers,6 and improved blood sugar control7
  • improved satisfaction with life4
  • improved quality of life
  • decreased depressive symptoms4
  • decreased anxiety8
  • reduced lifetime risk of depression, anxiety, and substance abuse disorders2
  • lower levels of psychopathology9
  • improved coping mechanisms10

The Power of Gratitude

Extensive research on the efficacy of gratitude interventions has yet to be conducted, but several studies have demonstrated promising results.

  • In 2007, Wood and colleagues studied the effect of gratitude on well-being during a significant life transition. One hundred fifty-six first-year undergraduate students completed two questionnaires measuring appreciation, one during the first few weeks of the semester and another 3 months later at the end of the semester. The questionnaire asked participants to indicate how frequently and strongly they experienced gratitude by reporting how much they agreed with various statements, such as “I feel thankful for what I have received in life.” Gratitude was shown to lead to lower levels of stress and depression and higher levels of perceived social support.11
  • In 2011, Rash, Matsuba, and Prkachin researched a 4-week gratitude contemplation intervention using 56 participants. Twice a week, participants in the experimental group had to think about what they were particularly grateful for and maintain those feelings of gratitude in their lives. After the intervention, participants in the gratitude condition experienced increased self-esteem, improved self-concept, and improved life satisfaction compared to the control group.12
  • In 2012, Lambert, Fincham, and Stillman conducted eight studies to determine what factors played significant roles in mediating the association between gratitude and decreased depressive symptoms. The first mediator they identified was positive reframing, which is the ability or tendency to change one’s view of situations from negative or neutral to positive, eliciting a grateful state.3 The second mediator was positive emotion; being grateful promotes positive affect, and being in a positive state reduces depressive feelings.3
  • In a 2017 series of meta-analyses, Dickens found that gratitude interventions elicited positive outcomes in many different areas. However, the strengths of these improvements varied. Overall, people tended to experience varying benefits related to levels of happiness, life satisfaction, well-being, grateful mood and disposition, and positive affect. The results also indicated that gratitude interventions also decrease depressive symptoms.4
  • In 2018, Wong and colleagues conducted the first randomized controlled trial in which a gratitude intervention was compared to expressive writing, an evidence-based therapeutic intervention. Two hundred ninety-three adults were randomly assigned to one of three conditions: psychotherapy alone, psychotherapy and expressive writing, and psychotherapy and gratitude writing. Gratitude writing consisted of writing letters of gratitude to others, whereas expressive writing involved writing about deep thoughts and feelings about stressful experiences.13 At 4 and 12 weeks after the intervention, individuals who took part in gratitude writing combined with psychotherapy reported better mental health than the participants assigned to expressive writing combined with psychotherapy or the control group (psychotherapy alone).13 A significant finding from this study was that benefits from the gratitude intervention were maintained over time and accrued over time. This implies that gratitude writing is a low-cost intervention that individuals can utilize and benefit from long term.
  • In 2020, Bohlmeijer et al. studied the impact of a 6-week gratitude intervention on 217 adults. The intervention consisted of various gratitude exercises, such as writing in a gratitude diary, psychoeducation on gratitude, and answering questions that triggered reflection about cultivating gratitude.14 Other participants were assigned to a self-kindness intervention or no intervention. Those in the gratitude intervention group displayed improved mental well-being compared to the self-kindness intervention group and control group. This improvement was maintained up to 6 months after the study. These findings indicate that an appreciative and grateful perspective on life can become a lasting resource for living a joyful and meaningful life.14


  1. Romero, L. E. (2017, November 22). Gratitude: The ultimate spiritual practice. Forbes.
  2. Emmons, R. A., & Stern, R. (2013). Gratitude as a psychotherapeutic intervention. Journal of Clinical Psychology, 69(8), 846–855.
  3. Lambert, N. M., Fincham, F. D., & Stillman, T. F. (2012). Gratitude and depressive symptoms: The role of positive reframing and positive emotion. Cognition & Emotion, 26(4), 615–633.
  4. Dickens, L. R. (2017). Using gratitude to promote positive change: A series of meta-analyses investigating the effectiveness of gratitude interventions. Basic and Applied Social Psychology, 39(4), 193–208.
  5. Jackowska, M., Brown, J., Ronaldson, A., & Steptoe, A. (2016). The impact of a brief gratitude intervention on subjective well-being, biology and sleep. Journal of Health Psychology, 21(10), 2207–2217.
  6. Cousin, L., Redwine, L., Bricker, C., Kip, K., & Buck, H. (2020). Effect of gratitude on cardiovascular health outcomes: A state-of-the-science review. Journal of Positive Psychology. Advance online publication.
  7. Krause, N., Emmons, R. A., Ironson, G., & Hill, P. C. (2017). General feelings of gratitude, gratitude to God, and hemoglobin A1c: Exploring variations by gender. Journal of Positive Psychology, 12(6), 639–650.
  8. Cregg, D. R., & Cheavens, J. (2020). Gratitude interventions: Effective self-help? A meta-analysis of the impact on symptoms of depression and anxiety. Journal of Happiness Studies, 22, 413–445.
  9. Jans-Beken, L., Lataster, J., Peels, D., Lechner, L., & Jacobs, N. (2018). Gratitude, psychopathology and subjective well-being: Results from a 7.5-month prospective general population study. Journal of Happiness Studies: An Interdisciplinary Forum on Subjective Well-Being, 19(6), 1673–1689.
  10. Emmons, R. A., & McCullough, M. E. (2003). Counting blessings versus burdens: An experimental investigation of gratitude and subjective well-being in daily life. Journal of Personality and Social Psychology, 84(2), 377–389.
  11. Wood, A., Maltby, J., Gillett, R., Linley, P., & Joseph, S. (2008). The role of gratitude in the development of social support, stress, and depression: Two longitudinal studies. Journal of Research in Personality, 42, 854–871.
  12. Rash, J. A., Matsuba, M. K., & Prkachin, K. M. (2011). Gratitude and well‐being: Who benefits the most from a gratitude intervention? Applied Psychology: Health and Well-Being, 3(3), 350–369.
  13. Wong, Y. J., Owen, J., Gabana, N. T., Brown, J. W., McInnis, S., Toth, P., & Gilman, L. (2018). Does gratitude writing improve the mental health of psychotherapy clients? Evidence from a randomized controlled trial. Psychotherapy Research: Journal of the Society for Psychotherapy Research, 28(2), 192–202.
  14. Bohlmeijer, E., Kraiss, J., Watkins, P., & Schotanus-Dijkstra, M. (2020). Promoting gratitude as a resource for sustainable mental health: Results of a 3-armed randomized controlled trial up to 6 months follow-up. Journal of Happiness Studies, 22, 1011–1032.

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