Turning Distress into Joy, Part IV:  Gratitude


Tears were streaming down his mother’s face.  Just minutes earlier, he had unleashed a flurry of harsh statements and cursed at her as she stood their silently.  For months, John Foppe’s parents had tried to provide various options, and even personal encounters with others similar to him, to teach him how to do the basics.  Like dressing himself.  Or eating without assistance.  Or using the restroom on his own.  But over and over, John had refused to open himself to these possibilities, and was resigned to a life largely dependent on others.  His parents struggled with what to do next.  But, the night before, they had spoken with his brothers, and told them that they were no longer to help him unless told otherwise.  They had decided it was time that John started learning how to do these things on his own.  In a moment John later described as one of the most important in his life, his mother walked out of the room to leave him to put his clothes on.  He failed.  But, lying naked on the floor all alone, he suddenly “accepted that the miracle I had so desperately wanted wasn’t going to happen…I also came to the point at which I realized that my anger at God had brought me no relief, only further pain” (p. 46).

John Foppes had been born with no arms, among a number of other serious congenital abnormalities.  Doctors questioned whether he would survive at all.  In his deeply motivating book, “What’s Your Excuse?  Making the Most Out of What You Have,” John describes his life of growing up with no arms into one of full independence, and his feelings of stigmatization and isolation even in the midst of support from others.  In the depths of his struggle, John also notes evident gratitude in what most perceived as a very unfair situation.  He expresses his appreciation for moments of tough love, and for many people that were willing to help.  He speaks with graciousness for opportunities to take on new challenges, to experience natural surroundings, to know others more deeply.  But most of all, he illustrates how growing up with no arms offered him an unusual chance to discover a unique perspective, a unique calling that ultimately helped him overcome many fears and obstacles, not just the ones presented by his missing appendages.  What may sound really strange to some people is that John Foppes became thankful that he had no arms, even though much of life would have been easier with them.

Before we can really discuss what authentic gratitude is, though, it seems we address what gratitude is not.  Gratitude is not false positivity or the denial of negative emotions.  Gratitude is not condoning atrocities and maltreatment by others, even if an outcome might be good.  As was noted by Christina Enevoldsen in her blog,false gratitude can lead to negative outcomes that span generations.Being thankful also does not mean being tragically idealistic, or blind to obvious realities.  True gratitude does not encourage settling, or an erosion of high standards, even if struggles highlight meaningful moments and progress that may remain hidden to untrained eyes.

The word gratitude itself is derived from both the Latin word gratus, meaning pleasing, and grātitūdin- (stem of grātitūdō), indicating thankfulness.  It speaks to not only an act of graciousness, but also positive feelings originating from this deed.  Studies (Park, Peterson, and Seligman, 2005) have noted that it is endorsed as a universal character strength across countless cultures and creeds.  Research has also indicated that gratitude can have a number of significant, long-lasting positive effects on an individual (Emmons, 2013; Emmons, 2007).  In addition to physiological improvements, such as decreased blood pressure and improved immune function, gratitude has been consistently shown to improve social-emotional outcomes in the area of anxiety, depression, and substance use.  As a specific therapeutic technique, gratitude can be effective for multiple issues.  In one particular study, a gratitude intervention was compared to four other positive-based strategies to determine whether each would increase levels of happiness and reduce depressive symptoms (Seligman et al., 2005).  Participants were simply asked to write and deliver a letter to someone that they had never properly thanked.  Results indicated that in comparison to other experimental strategies (e.g., focused on using/identifying strengths, recognizing good things in life), the “gratitude visit” group showed far and away the biggest increase in happiness and decrease in depressive symptoms on the immediate post-test.  Evidence suggests, however, that repeated acts of gratitude are most likely to be associated with long-term benefits.  As I noted in a previous article, In Search of a Hundred Miles of Gratitude, it appears that the direct experience of gratitude, even fleeting, is incompatible with misery and distress. In giving thanks, we recognize a gain, no matter how small;  at least for a moment, we let go of our sense of loss.

For those who have experienced significant trauma, gratitude interventions are gaining increasing recognition as effective means for progress.  Studies (e.g., Kashdan, Uswatte, and Jillian, 2006; Vernon, Dillon, and Steiner, 2009) have consistently found that PTSD levels are negatively correlated with post-trauma gratitude, independent of trauma severity, chronicity, and time elapsed since the traumatic event.  Gratitude not only provides intrapersonal benefits for the gracious person.  It also provides interpersonal connections for those who have been traumatized to maintain and expand their network of support.  As unfortunately happens, people suffering with significant psychological distress can “wear down” others through repeated solicitation of assistance and comfort.  Acts of gratitude provide a unique opportunity to repair these strained bonds.

In really understanding the essence of gratitude, it is important to recognize that gratitude extends much beyond a pleasing act of graciousness.  As eloquently described in the article, “Gratitude as a Psychotherapeutic Intervention” written by Robert Emmons and Robin Stern, gratitude is composed of two key components.  One, there is an assertion of “goodness” that exists in a person’s life.  But beyond this, there is a clear understanding that at least some of this goodness lies outside the individual.  For many, gratitude is not just a worldly transaction, but elemental of a transcendent link.  It exemplifies a sense that we are all part of a mysterious, interconnected, interdependent network.  As Emmons and Stern noted:

“True gratefulness rejoices in the other. Its ultimate goal is to reflect back the goodness that one has received by creatively seeking opportunities for giving. The motivation for doing so resides in the grateful appreciation that one has lived by the grace of others. In this sense, the spirituality of gratitude is opposed to a self-serving belief that one deserves or is entitled to the blessings that he or she enjoys.” (p. 847)

Some may question whether gratitude can be taught as a lifetime practice, or simply that it is acquired intrinsically or experientially in different ways.  KIPP, the Knowledge Is Power Program, is a national network of free, open-enrollment, college-preparatory public charter schools with a track record of preparing students in underserved communities for success in college and in life. There are currently 162 KIPP schools in 20 states and the District of Columbia serving more than 58,000 students. More than 88 percent of their students are from low-income families and eligible for the federal free or reduced-price meals program, and 95 percent are African American or Latino.  Many students have experienced (and continue to experience) significant trauma and discord in their families and neighborhoods.  Nationally, more than 93 percent of KIPP middle school students have graduated high school, and more than 82 percent of KIPP alumni have gone on to college. The program is largely founded on character building, which focuses on seven very predictive, highly researched traits:  zest, grit, self-control, optimism, social intelligence, curiosity, and gratitude.  What these educators found, as well as many others, is that traits such as gratitude can be taught, even to those who seem to have many reasons to not be thankful.   Qualities such as gratitude not only foster personal responsibility and achievement, but also teach youth that much of their success depends on the well-being of a larger team.

On Father’s Day 2010, our family set off on a morning bike ride.  What started out as a fun day turned into horror when our daughter plunged off a precipice after losing control on a local trail.  A rock crushed through her forehead just under the helmet.  When she stood up, we realized that a hole had opened into the inner covering of her brain.  I thought I might be saying goodbye.  But as I detailed in my book, many extraordinary things happened on her way to being blessed with an emergency craniotomy in the wee hours of the following day—her 4th birthday.  This morning, I walked by her room as she slept soundly after another frenetic day at the Schroeder household.  The seven titanic plates and the scars remain, although somewhat faded over the years.  I am reminded that she could easily have not been with us.  Yet I know we would have been asked to carry on, even joyously, without her.  Years removed from that Father’s Day morning, I am not grateful for the experience nor do I hope to ever encounter a similar one again.  But I am tremendously thankful for the insight and the gratitude it has provided.

* * * * *


Emmons, R.A., & Stern, R. (2013).  Gratitude as a psychotherapeutic intervention.  Journal of Clinical Psychology:  In Session, 69, 846–855.

Emmons, R. A. (2013). Gratitude works! A twenty-one day program for creating emotional prosperity. San Francisco, CA: Jossey-Bass.

Emmons, R. A. (2007). Thanks! How the new science of gratitude can make you happier. New York, NY:  Houghton-Mifflin.

Kashdan, T.B., Uswatte, G., & Julian, T. (2006). Gratitude and hedonic and eudaimonic wellbeing in Vietnam war veterans. Behaviour Research and Therapy, 44, 177_199.

Park, N., Peterson, C., & Seligman, M. E. P. (2005). Character strengths in forty nations and fifty states. Unpublished manuscript, University of Rhode Island.

Seligman, M. E. P., Steen, T. A., Park, N., & Peterson, C. (2005). Positive psychology progress: Empirical validation of interventions. American Psychologist, 60, 410–421.

Vernon, L.L., Dillon, J.M., & Steiner, A.R.W. (2009).  Proactive coping, gratitude, and posttraumatic stress disorder in college women.  Anxiety, Stress, and Coping, 22, 117-127.



  1. Hi James,

    Given the topic of the article it seems appropriate to say thankyou lol.

    Looking back over the series I have realised how each one has triggered some deep spiritual searching in me. This has been a healing tool that just doesn’t come in the form of a pill. Not a lot of dollars in that, but I get the feeling your not measuring wealth by your bank balance.

    I agree that gratitude can be learned, but must also be maintained. Constant reminders is what works best for me. So thank you for reminding me of the reasons I have to be thankful.

    Kind regards

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    • Few things are better than an authentic thank you, given and received. You are right about the bank account – I hope by the time I pass on there is nothing left in it except for what I have given meaningfully to others. And as you indirectly noted, there is a tremendous link between psychology and spirituality that few people seem to acknowledge, or recognize.

      Thanks for filling up my bank account the only way it matters. Hope the rest of your week is good.

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      • Talking about bank accounts and feelings of gratitude reminds me of an old book classic by George Eliot “Silas Marner: The Weaver of Raveloe “. It may seem overly moralistic for this day and age but there are some simple truths in there.

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  2. Ok, I’m sorry to be somewhat cynical but this is one concept I don’t particularly agree with. This is not directed specifically at you but at “gratitude and mental health” in general. So many times I have heard motivational speakers or self-help books go on about how you just need some gratitude. I know that you are making a good case for it and your argument is not a simplistic one (as I have seen one speaker tell a room of young people that happy people are grateful and so if you’re not happy you just need to be more grateful) but there’s something that just doesn’t sit right with me about this whole topic.

    I think that for me personally, when it is implied that a person is suffering because they are not grateful, or that they can feel better if they show more gratitude, it sounds like victim blaming. It’s like being told off “You’re not grateful enough. Look at all these wonderful helpful people and all the good things in your life. You’re being a bit selfish by not recognizing all these things.”

    It’s like one more thing you have failed at. I wish I could express myself a little bit better about this subject but I can’t seem to find the words at the moment.

    I agree with being grateful for beautiful and joyful things in the world (such as nature, being alive etc.). For me, people who have been through trauma often feel helpless and out of control, they have low-self esteem (I think sometimes due to not have been able to control the traumatic event). I think the first and most important thing is to find your inner strength again. It is always there but we need to reconnect with it after trauma. The first thing is to feel good about yourself again, self-acceptance.

    Gratitude is focusing on things outside yourself, not on your inner self and sometimes feels like putting yourself down “I’m so grateful these people are putting up with a crummy person like me.” which makes things even worse.

    As I said I haven’t been able to articulate my thoughts exactly so I apologize if anything came across as too negative. If gratitude makes you feel good and gives you strength then that’s awesome.

    Personally, when I hear the oversimplified message (and as I said, this article was not oversimplified) of gratitude=happiness I cringe because basically what it sounds like is you’re selfish and that’s why you’re unhappy when nothing could be further from the truth. For people with trauma from abusive relationships (family, friends, work etc.) it is often the message they have been getting “You are a selfish, bad person.” And hearing that message is painful. Being told you just need to be grateful feels just as painful: Right now you are ungrateful, which really means, selfish or self-absorbed.

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    • Also I just wanted to add that there are different types of gratitude. It is beautiful how you feel grateful for your daughter after the horrible accident. I think it’s natural and automatic to feel grateful when things could have gone horribly wrong but didn’t, we don’t even have to try to feel gratitude, it just comes. I’m talking about that forced gratitude where you have to look for things to be grateful for.

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    • I’m glad that someone else said this – and very nicely!

      Practising gratitude goes along with forgiveness and “getting out of yourself”/helping others as one of those injunctions that can be very hurtful to someone experiencing emotional trauma, for the reasons that fluffybunny outlines. None of them is inherently wrong; to the contrary, genuine forgiveness is liberating, and gratitude is something that I try to practise in my own life. It does seem to me, however, that people experiencing distress are too often called upon to exhibit saintly virtues in a world that is far from saintly.

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      • Sally! Your last sentence summed up exactly what I was trying to say in a paragraph! Lol! Thanks 🙂 I too find it appalling that traumatized people who need self-care and support the most are often made to feel even more terrible and selfish by basically being given the message that they are selfish for not taking care of their abusers’ feelings by not forgiving or by not thinking of others (being grateful). Its like “this person/people abused you but you need to forgive them so they don’t feel so bad. Don’t be so selfish and forgive them so they can get on with their lives.”

        I read somewhere one definition of forgiveness that I like and that was that forgiveness is basically when you heal from the trauma and no longer let the abuse have a negative impact on hour life. I like it because it has nothing to do with condoning the actions of the abuser… which I something a lot of forgiveness pop psychology implies. I’m shocked at how often victims are asked to “see things from the abusers point of view”. Its like the whole exercise is about finding an excuse to to let the abuser off the hook. In perfect world when two people hurt each other they would be able to come together and discuss what happened with each clearly expressing what they think and feel about what happened. If you think about that’s why therapy is for, to discuss what happened and let all your emotions out in a safe way. Imagine if we could just do that as people. Everyone gets hurt at some point, the trouble is that often we have to suppress the experience but what if we could openly talk about it without fear and the people who caused the hurt listened emphatically? Maybe we wouldn’t need forgiveness as such because we could all come to mutual understandings… I have a lot of thoughts on all this in my mind at the moment…

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      • Hi Sally,

        Thanks also for sharing your thoughts about this and others matter. What you expressed is why many people shy away from these topics, as they arouse such strong emotions and unintended hurt. I know they are often not received well, and yet I feel like there is so much that is important to still discuss and communicate that can be helpful to people. But, I realize that when it comes from another person, especially someone who has a career as mine, it can be felt as blaming or condoning wrongdoings. But, as I made very clear in my posts on forgiveness and gratitude, none of this excuses wrongdoings done or minimizes hurt that people feel. As I mentioned in my comment below to fluffbunny, I just try to do my best in discussing opportunities that we all have, and I certainly know and respect that each person will make their own decision. But it is certainly a lonely place to write at times, and I do hope that people know who read my material that my intentions are to just do the best by others that I can.

        Thanks again for your thoughts and time.

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    • Thank you so much for weighing on what is a difficult topic. I actually thought you articulated your concerns and difficulty with gratitude well, and i hope that you know I really tried my best to be sensitive to the concerns you voiced. The last thing that was intended with this or previous posts was to blame victims – in fact, my humble hope is that these articles and others would empower people to recognize the great opportunities that we all possess to reduce distress and increase happiness in our daily lives.

      But, I recognize that when I write in this area, of which focuses on self-improvement (as much for myself as for anyone), I do thing that we are all faced with possible decisions that could improve our well-being that do not sit well with us for different reasons. But, in the end, if the research is actually true, and areas like gratitude, helping others, forgiveness, etc… actually increase the odds that our distress is reduced and our psychological well-being is improved, we are faced with a decision. Do we forego these possible avenues of growth due to our inherent, and very understandable uneasiness, or do we work through this uneasiness for the possibilities that lie in store? Again, this is a question that I continue to ask myself this on a regular basis, but it is one that I think we are all asked to consider when it comes to topics like these. But I know that each person considers this from their own experience, especially those that can be very difficult.

      Thanks again for your thoughts – I really appreciate from your thoughts.

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    • I kind of agree. It’s the same thing (or even more) with forgiveness. I mean, sure these are positive feelings but I find it questionable to “teach” people to feel a certain way, especially when they have experienced trauma or other major life difficulties which you have not. Also nothing (well a few things but only a few) makes me more angry than the “see how bad these people have it – you’re so lucky, you should be grateful for what you have”. It’s my life and my pain and only I can judge it even if “objectively” you may think kids in Africa have it worse. It’s a very arrogant way of minimising other people’s problems and there’s nothing empowering about it.

      I think that all these great “techniques” are not techniques – they should be genuine feelings coming from ones perception and life experience, not something that a therapist tells you you should feel.
      Also I don’t find all these talks by people who have been through hell and came out OK or people who live with severe disabilities so much optimistic and empowering as some. Sure, they will put on a smiley face and be grateful and maybe that is how they feel at least sometimes but on the other hand – what should they do? They probably have felt pretty bad for periods of time as well and those who didn’t make it are not there to give speeches. For me it’s just another “kids in Africa have it worse” argument. I’m pretty sure that all the people who get so worked up about the motivational speeches would not want to change places with the grateful guys nonetheless and for good reasons. I just hate this whole positive thinking propaganda – in many ways life sucks and then you die and it’s a personal thing how people deal or not with this reality and find meaning but please, don’t try to force your vision of it down my depressed and pessimistic throat.

      Btw, while I’m already ranting, one more thing which drives me crazy about psychiatry & co is their claims that people who are suicidal or depressed have problems of thinking or perception. Because thinking that life has no meaning and being unhappy about it is somehow objectively untrue. In fact this is an entirely subjective perception and your optimism is no more delusional and distant from reality than my pessimism. Arrogance of people who think they know better is astounding and they dare to label this medical.

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      • Hi B,

        As always, I appreciate your willingness to continue reading and weighing in with great thoughtfulness despite your frustration with much of what I have said. I actually agree with much of what you said, most importantly that everyone ultimately must choose the direction they want to go. I certainly don’t feel I am forcing my vision down yours or anyone else’s throat, and just as you have a right to retain a pessimistic perspective, I have a right to retain an optimistic, or what I believe is a reasonable perspective. In fact, I would say that pessimistic perspectives are available daily on MIA, and often I stick out like a sore (and probably poorly read) thumb.

        But as the title of my personal column professes, I am always “just thinking” , much of which is thought focused on how I can better my life, but more importantly that of my kids and others close to me. Daily, I do have many people coming to me in search of greater happiness/contentment and less distress. And although you may tire of what you describe as “positive thinking propaganda”, I actually think practices such as gratitude and forgiveness are anything but propaganda, but actually ____ (however they are categorized) that are available to everyone free of charge and without serious side effects. And although we would like if the feeling of gratitude (or other practices) simply emerged, it is clear that it often doesn’t happen until we repeatedly put these practices in place, sometimes through regular teaching (especially with kids). If I and others don’t speak about these viable, potential life-changing practices, then the airwaves and the internet will be even more filled with discussions of psychotropic medications, of which I know you are not in favor of.

        As far as the kids in Africa argument (or in my case, the kids in Haiti as my father spends time there at least yearly), I actually think in many ways, they have it better than we do as the joy they exude despite deplorable conditions is remarkable. And a large part of the reason seems due to their deep sense of gratitude.

        Thanks again for taking the time to comment. You will probably be glad I only have one part left. Hope you might be willing to still check it out.

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  3. I think gratitude should come with reciprocity. Having things given to you may make your life easier but it makes one dependent and feeling forced to be grateful to others. Having something to give back, if not to the very person who has helped you, but to anyone is the most empowering thing.
    Owning to people, even the most loving, can be a burden which can only be lifted and transformed into a positive relationship by the act of giving back.

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