Gratitude: Resilience and Healing for Clinicians During a COVID-19 Pandemic

Contributor: Linda Roszak Burton
To learn more about Linda, click here.

 

“Gratitude is a vaccine, an antitoxin, and an antiseptic.”
~ John Henry Jowett

No one is immune to trauma, grief, pain and human suffering brought on by COVID-19, especially physicians, nurses, and other clinicians. The pandemic has ushered in higher levels of stress, anxiety, depression and post-traumatic stress disorder (PTSD) for physicians and nurses who were already experiencing epidemic levels of burnout. The practice of gratitude can serve as a balm to emotional distress as well as a protective bulwark against the potential long-term repercussions of the range of feelings triggered by COVID-19 for those infected by the novel coronavirus and those caring for patients who have been described as among the sickest clinicians have ever seen.

What is gratitude exactly?

The Latin root of the word gratitude is gratus or gratia — thankful, by favor. It’s considered a state of mind, a spontaneous feeling, a strength of the heart. And, as the great Roman philosopher Cicero once said, “Gratitude is not only the greatest of virtues but the parent of all others.”

What does the research tell us?


There is an extensive body of research which documents the many potential benefits of gratitude:

Consider the role gratitude has played in other traumatic events.

  • A 2018 study in the International Journal of Social Psychiatry of New Orleans police officers following Hurricane Katrina indicated that positive factors such as gratitude and social support led to fewer depressive symptoms and helped mitigate post-traumatic stress disorder symptoms.
  • Another study in the Journal of Personality and Social Psychology found gratitude was a major contributor to resilience after the 9/11 terrorist attacks, holding depressive symptoms “at bay and fueling post-crisis growth.”
  • A study in the Journal of Positive Psychology of Israeli adolescents exposed to missile attacks found gratitude, more than other positive emotions, was linked to a greater appreciation of life and may serve as a protective factor against PTSD symptoms.
  • Additionally, a study of healthcare workers during a 2014 MERS-CoV outbreak found special recognition by hospital administration was one of the top five staff satisfiers. This, along with a positive attitude in the workplace, would enhance healthcare workers’ experience during future MERS-CoV outbreaks.

Consistent with positive psychology--the scientific study of strengths that enable individuals and institutions to thrive--gratitude is defined as a strength. Positive psychology, complementary to traditional psychology, is not the absence of pain and suffering. Likewise, practicing gratitude to help process the difficult experiences associated with COVID-19 is not to deny negative events ever happened.

An article in Mayo Clinic Proceedings recommends promoting physician well-being and self-care by including resilience training and positive psychology exercises. It also suggests the same strategies be used for nurses and other healthcare professionals. During the course of our work with healthcare executives and their teams, we have found positive psychology coaching and gratitude interventions and practices (exercises) lead to greater job satisfaction and statistically significant improvements in engagement and meaningfulness in their work.

 An Urgency for Resilience

“Life doesn’t get easier or more forgiving; we get stronger and more resilient.”
Steve Maraboli

There is an urgency to build a reserve of resilience (a personal ability) to rebound and recover from the ongoing uncertainty, negativity, and grief associated with the pandemic. Resilience is generally defined as a commitment to finding purpose in negative events, the ability to adapt in the face of trauma and adversity, and to bounce back when inevitable setbacks occur. Just as being fearless is not the absence of fear, being resilient is not the absence of trauma and adversity. Rather, it’s the ability to work through them and ultimately achieve personal growth.

Resiliency experts categorize resilience in four ways:

  1. Emotional resilience – the ability for an individual to manage stressors and emotions in a healthy, positive way;
  2. Psychological resilience – sometimes referred to as mental fortitude; the ability to cope and adapt to uncertainty, challenges, and adversity;
  3. Physical resilience – the body’s ability to adapt and recover from illness, accidents, or other physical demands;
  4. Community resilience – a community’s ability to recover from adverse situations, e.g., violence, natural disasters, pandemics, and other significant hardships.

One gratitude practice to support resilience in these categories is to “remember the bad.” It’s a way to reframe and contrast the negative experiences you are currently going through. During this time of crisis, you and those closest to you often have the most to gain by having a grateful perspective on life.

Being grateful is a choice. When people are suffering and the devastating events of COVID-19 occur, a grateful attitude and perspective are hard to achieve. Practicing gratitude heightens awareness of the people and resources that helped us push through past difficult life experiences.

Multiple studies indicate practicing gratitude creates greater resilience, leading to such positive outcomes as:

  • Greater mental and emotional well-being;
  • Greater resilience to trauma;
  • Lower rates of post-traumatic stress disorder (PTSD) and an increased sense of purpose;
  • Lower levels of depression and

The Healing Benefits of Gratitude

If you concentrate on finding whatever is good in every situation, you will discover that your life will suddenly be filled with gratitude, a feeling that nurtures the soul.”
~ Harold S. Kushner

The most recognized definition of gratitude is the affirmation of goodness and the recognition of goodness outside yourself. Practicing gratitude includes reflecting, expressing, and receiving, and is linked to effective coping skills for managing chronic or acute stress. While experts consider some stress to be a motivating force, life’s many challenges due to the pandemic can quickly push the needle into the too much stress zone. Gratitude leads to a protective response in the body. Expressing gratitude blocks the release of the stress hormone, cortisol. Studies have shown gratitude stimulates the release of oxytocin, a neurochemical that prevents the release of cortisol.

Reflecting and expressing gratitude activates your parasympathetic nervous system (calming part of the nervous system). In doing so, you’re able to achieve many positive health benefits. According to research, having a sustained gratitude practice improves overall health and well-being, including:

  • Fosters higher levels of positive emotions;
  • Supports greater life satisfaction, vitality, and optimism;
  • Enables more hours of sleep;
  • Fosters better self-care;
  • Strengthens the immune system and lowers blood pressure.

Your gratitude practice can start small by thinking about one thing that brought you comfort or peace during the day. One researcher coined the term “two-minute miracle.” Taking just two minutes to write about good events in your life may be enough to begin to gain a greater appreciation of your life, your positive relationships, and your personal strengths.

Another simple but significant reflective technique is to find a quiet moment to reflect on someone or something that brought you comfort or peace. Take a quiet moment to close your eyes, take a deep breath, and reflect. In your reflection, identify a positive emotion you felt in the last 24 hours and why you’re grateful.

Practicing gratitude gives you the power to energize, to heal, to bring hope, and to help you cope with these harsh and challenging times.


Contact Linda at: 
lburton@img-4.com  
lburton@drwcoaching.com