At the beginning of every New Year, many people express their gratitude for those who have positively impacted them in the past year. However, just like New Year’s resolutions, these emotions of gratitude quickly seem to fade. As January moves forward we tend to increasingly focus on the challenges that flu season and hospital crowding brings to our workplace. Instead of talking about what we are grateful for, we find ourselves engaging in conversations around workplace frustrations. While we must recognize that hospital overcrowding and a bed blocked Emergency Department increases workplace stress, I challenge you to consider incorporating gratitude into your daily practice for 2018.

What is practicing gratitude?

Webster’s dictionary defines gratitude as “a feeling of thankfulness and appreciation (1)”. To practice this, one simply engages in techniques that help to reflect upon what they appreciate and find valuable to create a general sense of thankfulness (2).


Why should I consider practicing gratitude?

Gratitude exercises CAN positively influence happiness. Several studies have demonstrated that there is a relationship between practicing gratitude and an improvement in overall sense of wellbeing. Seligman et al. conducted a study to evaluate the effect of five positive psychology exercises on the happiness of 544 participants (3). Study participants were assigned to one of the following groups:

  1. Placebo control exercise: participants had to write down early childhood memories each night.
  2. Gratitude visit: participants had to deliver a letter of gratitude in person to thank someone.
  3. Three good things: participants had to write down “three good things” in life that went well each day, and their causes.
  4. You at your best: participants had to write about a time when they were at their best and reflect on their personal strengths displayed in the story.
  5. Using signature strength in a new way: participants had to use their top strengths picked from a list of character strengths in a different way.

Study results showed that two exercises (using signature strengths in a new way, and “three good things“) increased happiness and decreased depressive symptoms for six months (3). Interestingly, participants were only asked to perform their assigned exercises for one week; however, when contacted in a follow up, many continued the “three good things” exercise on their own. Those who continued the exercise were found to be 5% happier at one month and 9% happier at six months, compared to their baseline happiness scores (3).

Studies have also investigated the impact of journaling gratitude on happiness in populations of adolescents and patients with neuromuscular disease. Study results have shown similar positive impacts of listing things for which patients are grateful (4,5). Participants who practiced gratitude generally were more optimistic and felt a greater sense of wellbeing (5). They also reported fewer physical complaints, better sleep and spent more time exercising (5). Furthermore, Froh et al. also found that participants with lower levels of positive feelings at baseline, compared to those with higher levels were more likely to experience gratitude from this intervention (6).


Why do gratitude exercises work?

Engaging in feelings of gratitude and thankfulness tends to foster positive emotions, which in turn, helps to contribute to an overall sense of wellbeing (2).However, engaging in practices that amplify feelings of gratitude can also help us to take care of ourselves by cultivating a sense of personal resilience (7). It is hypothesized that the positive emotions fostered by gratitude exercises can act as a personal bank of positivity and resilience that can be drawn on when we are challenged in the future (8). So, these exercises not only make one feel good now, but can actually increase the likelihood of functioning optimally and feeling happy in the future (5).

Don’t keep your gratitude for yourself

Remember how good it felt the last time someone acknowledged you at work? Employee recognition, appreciation and gratitude not only positively impacts the individual who is engaging in the exercises, but can have a positive effect in the workplace to improve performance and engagement of those around us. Sharing our gratitude for other’s hard work can create social cohesion, which in turn has been shown to improve productivity and joy in work (7). Financial rewards, parties and social gatherings alone are not sufficient to bring us joy in the workplace (9,10). Recognition and camaraderie between colleagues has been found to have a far greater impact on giving us a sense of meaning and support at work (7). When one is thanked for their efforts, they experience stronger feelings of social worth, which subsequently motivates them to engage in behaviours such as helping, sharing and teamwork that benefits others and the workplace as a whole (11).

Practically, how do I practice gratitude?

Although there is no ‘one right way’ to practice gratitude, according to some literature (2,7), it may be enhanced through many simple interventions. While these techniques are simple suggestions, it is important to pick one that is right for you (2).

Suggested psychological strategies that may enhance feelings of gratitude (5,12):

  • Journaling about things for which to be grateful
  • Thinking about someone for whom you feel gratitude
  • Writing/sending a letter
  • Meditating on gratitude
  • Undertaking the “count your blessings” exercise (write down three things for which you are grateful).
  • Practice saying “thank you” in a sincere and meaningful way
  • Writing thank you notes
  • If one is religious or spiritual, praying about gratitude


Using gratitude to cultivate personal happiness is an emerging technique to improve personal joy in life and work. Gratitude effectively stimulates optimistic emotions for individuals as well as positively impacting the sense of wellbeing for those around us. Expressing gratitude is simple and can contribute to creating a joyful workplace. So the next time you’re feeling frustrated by the challenges we are faced with in the workplace, why not consider trying a psychological strategy to enhance feelings of gratitude. What have you got to lose?



  1. Webster dictionary definition of gratitude [Internet]. [cited 2017 Jan 14]. Available from:
  2. Sansone RA, et al. Gratitude and Well Being: The Benefits of Appreciation. Psychiatry. 2010;7(11):18-22.
  3. Seligman, et al. Positive Psychology Progress: Empirical Validation of Interventions. American Psychology. 2005;60(5):410–21.
  4. Froh JJ, Sefick WJ, Emmons RA. Counting blessings in early adolescents : An experimental study of gratitude and subjective well-being ☆. 2008;46:213–33.
  5. Emmons RA, et al. Counting Blessings Versus Burdens : An Experimental Investigation of Gratitude and Subjective Well-Being in Daily Life. Journal of Personality and Social Psychology.2003;84(2):377–89.
  6. Froh JJ, et al. Who benefits the most from a gratitude intervention in children and adolescents ? Examining positive affect as a moderator. Journal of Positive Psychology. 2009;4(5):408–22.
  7. Perlo, et al. IHI Framework for Improving Joy in Work. IHI White Paper. Cambridge, Massachusetts: Instituate for Healthcare Improvement; 2017. (Available at
  8. Emmons & McCullough. Psychology of Gratitude (Series in Affective Science). Oxford University Press. 2004.
  9. Judge et al. The relationship between pay and job satisfaction : A meta-analysis of the literature. Journal of Vocational Behaviour. 2010;77(2):157–67.
  10. Herzberg F. One More Time:How Do You Motivate Employees? Harvard Business Review. January 2003.
  11. Grant, et al. A Little Thanks Goes a Long Way : Explaining Why Gratitude Expressions Motivate Prosocial Behavior. Journal of Personality and Social Psychology. 2010;98(6):946–55.
  12. Bono G & Mccullough ME. Positive Responses to Benefit and Harm: Bringing Forgiveness and Gratitude Into Cognitive Psychotherapy. Journal of Cognitive Psychotherapy. 2006;20(2): 147-58.


  • Samantha Calder-Sprackman

    Dr. Samantha Calder-Sprakman is a FRCPC Emergency Medicine Physician, with a fellowship in Quality Improvement, with an special interest in patient safety.

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  • Shahbaz Syed

    Dr. Shahbaz Syed is a FRCPC Emergency Physician at the University of Ottawa, he is also the assistant director of Digital Scholarship and Knowledge Dissemination, and Co-Editor in Chief of the EMOttawa Blog.

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