Gratitude Made Me Groan Too.

Here’s Why I Practice It Anyway (And how you can too)

It’s Thanksgiving week, which means you’re about to be flooded with gratitude content.
🙏🏽 Lists of what to be thankful for
🙏🏽 Gratitude journals
🙏🏽 Hashtags about counting your blessings.

And if you’re groaning right now, I see you.

Gratitude is made out to be something wishy-washy, or forced, something that sounds like toxic positivity dressed up in a nicer outfit. But you can’t just thank yourself out of grief or poverty or illness or challenge. When people imply you can, it feels offensive. And honestly? It is.

But that’s not what gratitude actually is. The real magic (And science) of gratitude is one of the most powerful medicines I know. And I almost missed it completely.

The Pivotal Moment

I talk about this in my TEDx talk below and my book, Joy Is My Justice. (ahem, on quite a Black Friday sale right now)

On a bright sunny September day, my husband and I received news that transformed our lives forever. Our second son, Zubin, almost 3 years old at the time, was diagnosed with Duchenne muscular dystrophy, a devastating, progressive neuromuscular disease that causes muscle weakness, wasting, and then death. Like an ALS in kids is how I describe it.

There is no cure. And as a physician, I knew all too well what lay ahead.

After the diagnosis, I was desperate for a way out of my anguish. I tried prayer, but that didn’t sustain me. I tried reading every self-help book I could find.

None of it was working.

So I called one of my most trusted mentors, Debbie—a brilliant integrative psychotherapist who had taught me foundational work I do with all my patients.

Her answer? To find gratitude in this situation. She explained, Not gratitude for the good things in your life. Gratitude for your son’s illness.

And even though it made me angry, I was desperate. So I gave in.

I went to Zubin’s bed every night after he fell asleep and said the words: Thank you for this illness.

I wasn’t feeling very thankful. So I tried other phrases as well.

Thank you for this life.

Thank you for this path that we’ll walk together.

Countless nights. Through even more countless tears.

And slowly, something shifted. (I explain this shift more in my book but I was in essence, softening to the reality of my life instead of fighting it.)

Gratitude had created a buffer, a safe space in which I could take a breath with my pain instead of fighting against it.

What Gratitude Actually Is

Here’s what I learned: Gratitude is not what we’ve been sold.

Gratitude is NOT:

• Bright-siding your pain

• Pretending everything is fine

• Being grateful you don’t have it worse (”at least you...”)

• A platitude on a coffee mug

Gratitude IS such a simple magical thing. It’s…

Turning back toward your life when everything in you wants to turn away.

When something is painful, our instinct is to escape. To numb. To resist. To look away. Gratitude is the practice of looking AT your life, not away from it. Not to pretend it’s different, but to see it in a bigger way.

When I said “thank you for this illness,” I wasn’t saying I was glad Zubin was sick. I was saying: This is my life. I’m here. I’m not running from it.

Gratitude fundamentally shifts how you relate to your pain. It doesn’t remove or fix it. But it changes your relationship to it.

And for those of you left brained people out there like me, I use an equation in my TEDx talk and book, S=P X R, to explain how this shift works. It’s truly amazing when you see it in simple math! Gratitude doesn’t remove the pain. It removes the resistance that multiplies our suffering.

The Neuroscience: Why This Matters

Let’s talk about what’s actually happening in your brain and body when you practice gratitude:

Gratitude Works Like an Antidepressant

Neuroscientists from UCLA and the University of Montreal have shown that gratitude increases levels of dopamine and serotonin, the same neurochemicals that antidepressants target. When you practice gratitude, you’re literally producing the chemicals that make you feel happier and more connected.

And here’s the magic: The more you practice, the more your brain looks for things to feel good about. It’s a positive feedback loop. I think of it as exercising your gratitude muscle, the more you use it, the stronger it gets, and the easier it becomes to find things to be grateful for. I literally never cease to be astonished at how it can shift a patient after a 30 day practice.

Remember you are primed evolutionarily to look for danger and fear. You have to train yourself to look for beauty and good. And no, it doesn’t mean you bright side the world. The world frankly terrifies me on a daily basis. But the beauty that lies in it, despite the terror, is what keeps me going.

Gratitude Signals Safety to Your Brain

A study from USC’s Brain and Creativity Institute used functional MRI imaging to show what happens when we feel gratitude. It stimulates parts of the prefrontal cortex that modulate stress and pain, the same parts that light up when we’re with someone we love.

Gratitude sends a signal of safety to your brain during a painful experience. Not that the pain is gone, but that you are safe enough to be with it.

I love this one the most because to me it feels like authentic gratitude practice that does not dismiss the hard is like a good friend or lover holding your hand.

Gratitude Calms Your Fear Center

Research shows that gratitude practice can decrease the resting state activity of your amygdala, the fear center of your brain. It makes you less hypervigilant. It creates a renewed sense of safety in the present moment.

Gratitude Is Anti-Inflammatory

Studies show that gratitude practice strengthens your immune system. People who keep a simple gratitude journal feel better, sleep deeper, and get sick less often. The science even shows that people with heart failure do better just by noting a few things they’re grateful for daily.

Let me say that again: Gratitude makes your heart work better.

This isn’t woo-woo. It’s biochemistry.

What Gratitude Gives You Back

This is the really critical part so if you’ve been skimming, stop right here.

Here’s what I’ve learned, personally, from 27 years of practicing medicine, and most importantly as a human who has reclaimed beauty and power in her life, despite tragedy.

1. Gratitude Gives You Back Your Power

When the world takes your power away, through illness, loss, injustice, trauma, gratitude helps you reclaim it.

When you practice gratitude, you’re making a choice. You’re choosing to look at your life. You’re choosing to find something, even if it’s something tiny, worth being here for. You’re choosing to say “I’m still here.”

That is power. Not power over your circumstances, but power within them.

Gratitude helps you reclaim your power in your body when the world has taken it away. It is that magical. Trust me. (And no, gratitude isn’t the ONLY thing that has helped me do this. That’s why I wrote a whole book about what did! But it’s been a critical piece.)

2. Gratitude Gives You Back Connection (to others AND the world)

Here’s the hard part. The part that feels shameful and scary to say out loud.

Before I practiced gratitude for Zubin’s illness, all I wanted to do was push him away. Because all he represented to me was pain. And none of us want pain.

Mothers aren’t supposed to feel that way. Saying thank you opened me to my son’s life, not as I had hoped and dreamed it would be, but as it is. Gratitude reconnected me to him when every instinct was telling me to run.

Gratitude, even more importantly, reconnects me back to that terrifying daily world, when I want to escape it. It keeps me present. (And by the way, on the days that you need to escape the world and distract yourselves from the terror, that’s ok too! It’s just that if we only escape, we lose a part of ourselves in the process.)

3. Gratitude Gives You Back Your Humanity

There are many days that I am crying through exhaustion and grief and fear of what lies ahead. I’m no superhero. I’m only human, like you.

And even in those moments, I am able to acknowledge that I’m grateful I can still feel this much sadness. Because that means I haven’t lost yet. If you’ve been around a while, you’ve heard me say that the capacity to feel joy, pain, all of it, IS what it means to be human. When I can feel all of this, it means I still have my humanity. That I’m not numb.

This feels so hard. And I’m so grateful that I’m here feeling all of it.

Gratitude helps me reclaim the whole continuum of my human experience, the grief AND the joy, the pain AND the beauty, the exhaustion AND the love.

****What I NEVER Do With Gratitude****

I want to be clear about what gratitude is not, in my practice: (I don’t know how to highlight this even more, notice all of my stars! 😂)

I never force gratitude. I only practice it when I mean it. I don’t force it or “should” it. The practice is powerful precisely because it’s genuine. (You may wonder if the time my mentor told me to do it qualifies as forced. I would say no because I agreed to it. It was definitely not feeling truthful at first but this was my chance to immerse in and learn the practice so that might be one exception.)

I never tell someone in acute crisis to be grateful. Timing matters. When someone is in the thick of shock, grief, or trauma, I don’t say “be grateful.” The right timing reveals itself when you’re first present to someone’s pain.

I never use gratitude to bypass pain. When people say “at least you should be grateful you have two other healthy children,” I want to lash out. Because what they’re doing is not seeing my pain. Gratitude requires that we SEE the pain first, not skip over it.

I never imply that pain happened “for a reason.” I am never going to say it’s good that my son is suffering. That everything happens for a reason. That’s not what gratitude is. Gratitude is saying: I’m grateful for who I am through this. I’m grateful for my capacity to feel it all, as hard as “the all” is.

I’m grateful to still recognize the indestructible good in a world that feels so hard.

Simple Ways to Practice

If you want to try this, here’s what I prescribe to my patients: (we can also dive even deeper into this in our monthly workshop tomorrow and I have a whole chapter on this science and practice in my book)

A Daily Practice

For one month, find ONE thing to be grateful for each day. It can never be the same thing twice. Write it down or say it out loud to someone.

That’s it.

But here’s what my patients discover: It’s not what they write that shifts things. It’s that they start asking the question throughout the day: Could THIS be something I’m grateful for tonight?

As one patient told me: “It wasn’t that I was looking FOR things, but instead I was looking AT things in a different way.”

That, to me, is a revolution. The same life looks different.

A Gratitude Jar (*a particularly good tool for T’giving*)

In my family, we have often used a gratitude jar—a container with small pieces of paper next to it-nothing fancy, that’s it. Throughout the year, whenever someone feels moved, they write down a gratitude, fold the paper, and place it in the jar. I’ve taught this to my resident physicians and they use it in the hospital team room.

You can do this before Thanksgiving dinner as well. Place it on the table and let everyone know they can write down anything they are grateful for, small to large, while you’re cooking or milling around before dinner. Then at dinner, you can pull notes out and read them together. I love when people pull out each other’s notes because it’s a beautiful way to feel the neurotransmitter surge, both from hearing yours and reading another. It’s a reminder of the good we may have passed by or forgotten.

If you use it through the year, you can read it on a weekend night or at a set time. Sometimes we would read gratitudes from months ago that we’d completely forgotten—small moments that would have disappeared if we hadn’t captured them.

It’s one of my favorite traditions. And it’s simple to start. For old times sake, here’s pictures of our family gratitude jar (still on my kitchen island) with a couple of my all time fav notes from when the kids were young!)

Don't miss these sweet notes!

Writing Gratitude Letters

This one is particularly powerful in the scientific literature, particularly if you write a letter to someone and then read it to them in person or on the phone, for example. It feels so uncomfortable to think of reading it. (And I will be the first to admit that EVERY time I’ve done this, I have tried to talk myself out of it beforehand.) But it’s pure magic, every time.

The Harder Practice (When You’re Ready)

When you’re ready, and only when you’re ready, you can try saying thank you to your pain.

Not thank you that it happened.

Thank you for what you’re becoming through this.

Thank you for your capacity to feel it.

Thankfulness for you being here, in your life, instead of running from it.

This is advanced practice. Build your gratitude muscle with the simpler practices first.

The Bottom Line

Gratitude doesn’t solve everything. It doesn’t cure disease. It doesn’t undo loss. It doesn’t fix injustice.

But it does something profound: It puts you back in your body, in your life, facing forward instead of running away.

When you practice gratitude, you lower your resistance to pain, which decreases your suffering. You signal safety to your brain, even in painful circumstances. You produce neurochemicals that improve mood, sleep, and immune function. You reclaim your power when the world has taken it away. You reconnect to your life and the people in it. You remember your own humanity.

I’m not superhuman or special. I’m just a mom who was desperate to feel that this life was worth living again. Gratitude didn’t fix my son’s diagnosis. But it cracked me open to a life I could bear, and eventually, a life I could truthfully call beautiful.

Every time we say thank you to our pain, we remove our resistance. And that space can be filled with something else.

Sometimes, even joy.

And A Note for the Thanksgiving Holiday ❤️

If gratitude feels hard this week—if you’re grieving, struggling, exhausted, or just not feeling it, you don’t have to perform thankfulness for anyone.

But if you’re open to it, try one thing. Something small. Something that feels true.

Not because you should. But because you deserve to reclaim even a small piece of your power back.

As always, I’d love to hear from you. What’s your relationship with gratitude? Does it feel forced or real? And I would love to feel a waterfall of gratitude in the comments so we can have that dopamine surge:) What’s one thing, even something small, that you’re grateful for today? Share with us if you’re able. And paid subscribers, don’t forget about our office hours tomorrow, Nov 22nd at 10 AM PST/ 12 PM CST/ 1 PM EST. You’ll be getting a very short email with that link right after this one. (If I attach it to this one, it makes me limit comments to only paid subscribers as well, so please forgive the double email today!) If you think someone you care about needs to read this, go ahead and share it with them with a short note of why you’re grateful for them!

If you’re new here, welcome! I’m a board-certified physician with 27+ years in the trenches of medicine and life, and I’m passionate about helping midlife women connect the dots between hormonal, metabolic, and mental health. Real medicine. No toxic positivity or 47-step morning routines over here.