Is gratitude medicinal?
Establishing a foundation from which lifestyle change can occur is paramount to the process of change itself.
Context Comes First
Admittedly, writing about this topic feels a bit silly. The question itself is odd – as if a doctor would write out a prescription for “gratitude” with an expectation that it would be filled. Yet, I feel this question can be used to investigate the ever-changing relationship between medical intervention and lifestyle change. Let me explain…
For many diseases, “lifestyle change” (a.k.a. behavior change, making better choices, etc) is a first-line treatment. However, as you may or may not know, change is INCREDIBLY difficult. It’s hard. This difficulty is worsened by a lack of lifestyle change breakthroughs over the last few decades, whereas multiple pharmaceutical breakthroughs have occurred in the same period. Thus, pharmaceutical interventions are emphasized over lifestyle changes.
To give a real-world example, the American Academy of Pediatrics just issued new guidelines regarding childhood obesity and included, for the first time, medications and surgery as treatment. Lifestyle change is still included in the strategy, as evidenced by nutrition and exercise therapy. However, these things have been a mainstay of treatment since obesity’s recognition as a diagnosis. The decision to include medication and surgery for obese kids represents a quasi-retreat from behavior change as treatment. We are losing the obesity epidemic and, instead of bolstering the values underpinning lifestyle changes, we lean on impressive new drugs.
Continuing with obesity in general… this is NOT to say that obesity is a simple disease process comprised solely of a person’s poor dietary choices. On the contrary, there exist many factors influencing the development of obesity. This is also NOT to say that these new medical treatments shouldn’t be used or aren’t effective; generally speaking, they are effective and should be used when appropriate. However, their use comes with its own set of risks, and their efficacy does not dismiss the fact that they work best in concert with lifestyle changes, not in place of them. Choices matter… and if a person continues to make the same ones that led them to obesity while taking a newly-prescribed medication, then the deployment of that medication reinforces those choices.
Example - If you have a goal of eating fewer Cheetos, then that goal is disincentivized by medication that’s effective no matter how many Cheetos you eat.
Instead of promoting better choices, ever-improving medical interventions inevitably enable poorer ones. We are trending, as a society, to a place where medical intervention makes choices and behavior change obsolete.
You may argue whether this is good or bad - that discussion is not the focus of this article. What I’m merely pointing out is that it’s within this context that my question sheds its silliness. If the goal is to promote effective lifestyle change, then we must first promote a foundation from which that change can occur. Enter - gratitude.
Gratitude and Medicine
To investigate the medicinal properties of gratitude, we must first briefly define the words “gratitude” and “medicinal.”
Gratitude is the state of being grateful; thankful. To give an example - instead of focusing on what you don’t have and harboring resentment, you focus on the things you do have and generate thankfulness.
Medicinal is used to describe a compound having properties that are curative (able to heal disease) or palliative (able to alleviate symptoms of disease). We’ll examine gratitude’s medicinal properties with two basic conditions: (1) medicinal things can be prescribed, and (2) medicinal things have curative and/or palliative properties.
Condition 1 - Can gratitude be prescribed?
Yes.
An example of a prescription could be a simple daily reflection - about a person in your life, a quality about yourself, a challenge you are facing, etc - for which you are grateful. This could be through journaling, from speaking it aloud, or just by simply thinking about it.
Condition 2 - Does gratitude exhibit curative or palliative properties?
Yes.
In proposing how gratitude works, we can support this answer. It goes something like this:
Your values influence your choices and actions.
If you choose to be grateful, you will act in ways that exhibit gratefulness.
Grateful acts spread goodwill.
Spreading goodwill improves your well-being.
Improved well-being is associated with improved health.
The Value of Footholds during Change
This then begs the question - how can you measure gratitude’s positive impact? Or, put differently - how do you know this to be true?
Research into gratitude’s effects is surprisingly thorough. Gratitude has been shown to improve people’s social life, as well as emotional and physical well-being, among others. There is a multitude of scientific literature that exists in support of gratitude and its beneficial effects.
However, scientific research is not the standard by which gratitude is justified as “good.” Instead, this research describes the objective principle that is “gratitude is good.” In other words, we know that gratitude is good because gratitude is objectively good. We know it in our bones. There exists no external standard from which to justify gratitude because gratitude is the standard.
This is what makes gratitude and its sibling values - courage, strength, kindness, etc. - paramount to behavior change. The goodness of these values is objectively true and will always be objectively true. It’s this objectivity that makes gratitude a rock-solid foundation from which to change behavior.
Returning to our earlier example, instead of saying, "I want to eat fewer Cheetos because I probably should and it’ll be good for me and yadda yadda yadda… " You say, "A grateful person cherishes their health; Cheetos are unhealthy; since I am a grateful person, I will eat fewer Cheetos." You don’t move the standard to your desire; you move yourself to the standard you hold dear—in this case, the standard of gratitude.
At this point, you may offer a rebuttal: "Why should I hold myself to a higher standard?" Or you may offer something like, "I reach my goals and change my behavior because I want to; I find no issue with my motivation being nothing more than "because I should."
To that, I offer this in response: medicine is far from an exact science. Change, by definition, is uncertain. You may be able to function adequately if you do things simply because you want to or feel obligated to do them. However, when you find yourself in a storm, whether it's a category 5 hurricane or a gentle but constant rain, it's at these times that you must rely on your values, because the future is uncertain. Gratitude is a foothold of certainty and security in the midst of swirling uncertainty. The same is true for other objective values. You look to your values and find solace because you know, without a doubt, that they are true. The certainty gained will allow you to navigate the storm of change clearly and consistently, compared to navigating without it.
Put simply, to build a long-lasting house of positive change, you must first have an abiding foundation on which to build. Gratitude and other objective values are the foundation.
What are the components of your foundation? What goals do you have for the new year? What are you grateful for? I’d love to know in the comments!
— Ty
____
As always thank you for reading Building Docs. If you’ve yet to subscribe please consider it to support my work. Like, comment, and share this post to promote my work and mission!
Tyler,
Your post is so refreshing and reassuring to hear from an amazing young man embarking into the medical profession. While in the past, I always believed that the Medical profession, our public health agencies (FDA, CDC, NIH, AMA...etc) operated in the best interest of society. Unfortunately, I no longer believe that. Their actions, lies and coverups over the past 3 years have knocked the legs of "belief" that I ever had in them. IMHO, they operate solely from a basis of Greed, Power & Control. Hopefully, you will be able to help restore some of the faith that which has been lost :-)
I have copied some of your comments - and then responded with my thoughts. I sense your heart and compassion in your words...and therefore, wanted to offer you the same heart-filled feedback to you.
=============================================================
"Thus, pharmaceutical interventions are emphasized over lifestyle changes."
The primary reason that pharmaceutical interventions are emphasized over lifestyle changes are not
necessarily because lifestyle changes are hard - it’s because Big Pharma makes Big Money from
pushing their newly developed, "still-under-patent" drugs. It's the most profitable path of least resistance
and effort on their part.
=======================================
"We are losing the obesity epidemic and, instead of bolstering the values underpinning lifestyle changes, we lean on impressive new drugs:"
Again, Big Pharma cannot make money on bolstering values, or on re-purposed, off-label drugs that have already been developed. These repurposed drugs are no longer under patent and therefore, are no longer promoted as viable treatments. Additionally, whenever I discovered that Big Pharma
provides a HUGE PERCENTAGE of the operating budget of the FDA, that was a eureka moment for me.
Check out this article in Forbes: https://www.forbes.com/sites/johnlamattina/2018/06/28/the-biopharmaceutical-industry-provides-75-of-the-fdas-drug-review-budget-is-this-a-problem/?sh=2ea3ac8b49ec
I no longer believe that the FDA is acting in the best interest of humanity’s health. Instead, it fast-
tracks and approves “new” drugs developed by Big Pharma in a “quid-pro-quo” understanding. At the
very least…a monumental conflict of interest between the FDA and an outside industry that it is supposed to regulate.
===================================================================
"Instead of promoting better choices, ever-improving medical interventions inevitably enable poorer ones. We are trending, as a society, to a place where medical intervention makes choices and behavior change obsolete."
This is 100%, absolutely correct!
==========================================
"There exists no external standard from which to justify gratitude because gratitude is the standard. This is what makes gratitude and its sibling values - courage, strength, kindness, etc. - paramount to behavior change. The goodness of these values is objectively true and will always be objectively true. It’s this objectivity that makes gratitude a rock-solid foundation from which to change behavior."
Your comments here Tyler are so closely yoked to the Bible’s “fruits of the Holy Spirit” .
See Galations: 5: 22-23
They are not only “objectively true”, they are “spiritually true”. And (in disagreement
with you), I believe there IS an external standard in which to justify gratitude. Gratitude, happiness and
Joy is lasting and based in more than simply an emotional reaction to our circumstances: it is an active
choice of attitude. As followers of Christ, we rejoice, because in him, we have redemption. Psalm:71:23
================================================================================
"However, when you find yourself in a storm, whether it's a category 5 hurricane or a gentle but constant rain, it's at these times that you must rely on your values, because the future is uncertain. Gratitude is a foothold of certainty and security in the midst of swirling uncertainty."
I would only suggest here that instead of relying on our own “human” values, which are inherently
flawed, we should rely on God’s values which are righteous, true and steadfast. Also, on the fact that
Christ died for our sins and therefore, our future is indeed secured and certain for those that accept,
believe and follow him. He has redeemed us with his blood and prepared a place to spend eternity with
him. John 3:16-17
===============================================================
"Put simply, to build a long-lasting house of positive change, you must first have an abiding foundation on which to build. Gratitude and other objective values are the foundation."
Totally agree “you must have an abiding foundation on which to build”. That foundation is best found
in Christ - the solid rock …"all other ground is sinking sand”. When we pattern our lives after Christ,
the Holy Spirit that lives within us enables us to exhibit the “Fruits of the Spirit”...which are: love, joy,
peace, patience, kindness, generosity, faithfulness, gentleness, self-control...all of which enable us to
live a life of Gratitude :-) Love your heart Tyler...and love you!
My hope is built on nothing less
Than Jesus’ blood and righteousness;
I dare not trust the sweetest frame,
but wholly lean on Jesus’ name.
When darkness veils his lovely face,
I rest on His unchanging grace;
In every high and stormy gale,
My anchor holds within the veil.
His oath, his covenant, his blood
Support me in the whelming flood;
When all around my soul gives way,
He then is all my hope and stay.
When he shall come with trumpet sound,
O may I then in Him be found,
Dressed in His righteousness alone,
Faultless to stand before the throne
On Christ the Solid Rock I Stand
All other ground is sinking sand
All other ground is sinking sand.
I just had to comment again...after reading your blog earlier today, I saw the latest guidelines about childhood obesity from the American Academy of Pediatrics being discussed on an evening news talk program - specifically with respect to surgery on children. The panel found surgery alarming and discussed incorporating more health and movement in children's lives, at home and in school. Reportedly, some schools don't even offer physical education anymore.
Less and less movement, too many sugary drinks, too much time spent on devices and gaming....or walking in the fresh air, drinking more water, cutting back on cheetohs as you say...choices really do matter. This was thought provoking.