With Gratitude, Comes Peace

​As I look back on 2020, many emotions flood into my mind. I think it’s safe to say that we have all experienced just about every emotion on a fairly consistent basis since March. Fear, sadness, anger, frustration, grief, worry, anxiety and thank God, even joy became a daily emotion. With each passing day simulating that of a rollercoaster, it was hard to find joy until I began implementing a gratitude journal. Gratitude is an immensely powerful concept when discussing its ability to have a favorable impact on a person’s physical and emotional wellbeing which we all so desperately need after this whirlwind of a year.
 
At minimum, I have been writing two things I am grateful for along with an interesting thing that happened that day, this brief pause created a sense of calm and the emotional rollercoaster began to slow. At the end of the day, or sometimes even beginning the day my mind and body focused on the so many things I am grateful for. Some days, the gratitude would lie in sunshine or a hug from my son, more recently I was grateful for clean water! This daily exercise began reshaping my perspective and pointed out the all too evident fact that in today’s world many things are far beyond my control. As a type A individual, that is a hard pill to swallow but with gratitude journaling it became something I was willing to sit with.
 
A study done by Dr. Mills et al from University of San Diego Medicine provides us with an insight showing the effectiveness that gratitude has on the human body. Increased spirituality, decreased depression,  better sleep, less fatigue, more self-efficacy, higher Heart Rate Variability (HRV), and decreased bio-inflammatory markers are all seen when practicing gratitude.[4]  Interestingly, Heart Rate Variability could be a helpful measure that reflects heart wave activity and overall autonomic health, essentially showing that stressors causing more sympathetic nervous system activity.  Under the presence of stress, a patient’s HRV is seen to be low.  Conversely, when we are in a relaxed, calm state, our HRV is high with our   parasympathetic nervous system to be high functioning.  This is when the natural happy neurotransmitters, like dopamine and serotonin,  are being released into our blood stream. 
 
Exploring this idea of the autonomic nervous system and its relationship with positivity is one that I feel deserves a lot of attention, because ultimately, the virtue of gratitude can not exist without coming from a place of positive thought. [5,6]  It's important to note that we feel positive, increased levels of dopamine and serotonin are always present.[1] The studies on gratitude and positivity are game changers for me in practice as most of my patients like research behind my suggestions.  Quite honestly, I like it as well!   Our work as acupuncturists act on the autonomic nervous system as well, decreasing sympathetic nervous system activation (increasing parasympathetic nervous system activation) and may also affect the level of other neurotransmitters such as serotonin and dopamine in the limbic system. [2,3]
 
After weeks of personally implementing a gratitude journal, I shared the success with some of my patients and asked them to try as well. To somewhat of a surprise, chief complaints started improving. Why? As of late most patients come in with concern of stress, fatigue, anxiety, insomnia, or panic.  The mechanism of acupuncture is down regulating the sympathetic nervous system and the mechanism of this action is made stronger when including a gratitude journal. In my opinion, the ability of acupuncture to improve our patient’s mental wellbeing goes hand in hand with the effects of gratitude on the body.  Ultimately, I would love to see a study combining gratitude journaling with acupuncture.   
 
To our friends, patients, vendors, and colleagues alike we are so grateful for you. This year has been incredibly challenging with many dark moments, but with gratitude we can always remember the blue skies that lie beyond the clouds. I would implore all of us, each and everyday to find something to be grateful for. We are grateful for your endless support, and the abundance of opportunities to help our wonderful community of patients. May you find (or continue to find) gratitude in simple parts of life, may you find comfort and above all may you find peace in the new year!
 
 
Here are some tools we recommend:

The Five Minute Gratitude Journal 
https://www.intelligentchange.com/products/the-five-minute-journal

Heart Rate Variability Monitor 
https://store.heartmath.com/inner-balance-lightning/

References:
Dfarhud, D., Malmir, M., & Khanahmadi, M. (2014). Happiness & Health: The Biological Factors- Systematic Review Article. Iranian journal of public health, 43(11), 1468–1477.Retrieved from:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4449495/

Kim, H. G., Cheon, E. J., Bai, D. S., Lee, Y. H., & Koo, B. H. (2018). Stress and Heart Rate Variability: A Meta-Analysis and Review of the Literature. Psychiatry investigation, 15(3), 235–245. Retrieved from:  https://doi.org/10.30773/pi.2017.08.17

Kwokming James Cheng. (2014). Neurobiological Mechanisms of Acupuncture for Some Common Illnesses: A Clinician's Perspective. Journal of Acupuncture and Meridian Studies, 7 (3), 105-114. Retrieved from:
https://reader.elsevier.com/reader/sd/pii/S200529011300174X?token=6168D09E3B164E01C51B8EC5C6B4AB993F01C74860A044D1652F14E5A4902B29F1F19FEA1CCCCDB01A61C3A0704BED18

Mills, P. J., Redwine, L., Wilson, K., Pung, M. A., Chinh, K., Greenberg, B. H., Lunde, O., Maisel, A., Raisinghani, A., Wood, A., & Chopra, D. (2015). The Role of Gratitude in Spiritual Well-being in Asymptomatic Heart Failure Patients. Spirituality in clinical practice (Washington, D.C.), 2(1), 5–17. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4507265/

Sansone, R. A., & Sansone, L. A. (2010). Gratitude and well being: the benefits of appreciation. Psychiatry (Edgmont (Pa. : Township)), 7(11), 18–22.
Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3010965/
 
Wood, A. M., Froh, J. J., & Geraghty, A. W. (2010). Gratitude and well-being: a review and theoretical integration. Clinical psychology review, 30(7), 890–905. https://doi.org/10.1016/j.cpr.2010.03.005