August 19, 2016 Neuroscience, Podcast 2 Comments

Episode 142

Growing up, how many times did your mom tell you to be grateful for what you have?  Well, turns out she was on the right track (although you can’t make people feel grateful).

This ain’t no hippy-dippy stuff either.  This is cold, hard neuroscience showing concrete physical and cognitive benefits from being grateful for things big and small on a regular basis.

Dr. Glenn R . Fox, Research Fellow at USC’s Brain and Creativity Institute, started out wondering:  What are the universal traits of good living?  That question led him down the path to the new science of gratitude.

What is Gratitude Anyways?

Gratitude is the emotion we experience when we receive something that came from some level of effort from the donor and that fulfills some need for the recipient.

So, gratitude is made of two separate ingredients:

  1. Effort from the donor.
  2. Fulfilling a need of the recipient.
The research has, so far, focused on small, tangible favors.  But you might feel grateful for the sun on your back or the wind in your hair, without thinking that the sun or wind is exerting any particular effort for your benefit.

Let’s distinguish gratitude from appreciation.  You can appreciate the effort your preschooler put into making breakfast, but since it’s probably inedible, you won’t feel very grateful.

And it’s not the same thing as happiness.  It requires the humility to understand that we depend on other people to regularly provide things we need.

Neither is it indebtedness.  True gratitude does not come from the feeling that you have to repay the other person right away.

How Does Gratitude Benefit Us?

The tangible benefits of gratitude are pretty well established and reach all areas of our lives:  physical, cognitive, and interpersonal.

Grateful people have better interpersonal relationships.  They recover faster from heart surgery and trauma.  They have less inflammation.  They have reduced physical pain.  They can live up to 10 years longer (yes you read that right — 10 years!).

On the cognitive side of things, being grateful improves sleep quality and duration, and we all know how darn important sleep is for a healthy brain, right?  (If you don’t, go listen to Episode 36 right now).

Grateful people also have fewer PTSD symptoms than less grateful people who experienced the same trauma.  It seems that being grateful can build up a cognitive reserve, protecting the brain against future trauma.

How Can You Practice Gratitude?

The good news is that it’s easy to reap the benefits of gratitude.  It’s a trainable skill, so the more you practice, the better you get, and the larger the benefits.

You don’t have to wait to win the lottery to feel grateful.  Small doses of regular gratitude probably do more to change your brain than occasional huge doses because you’re constantly strengthening the neural connections of gratitude.

You do need to have some social awareness, though.  You need to have the emotional maturity to recognize and understand that other people are helping you.

Here are Dr. Fox’s recommendations for practicing gratitude:

  • Write thank you notes and give them to people who are not expecting them.
  • Keep a weekly gratitude journal.  Weekly journals are actually more effective and beneficial than daily ones.
  • Try to focus on things you’re grateful for, and let go of small, daily hassles.
  • Notice small things people have done to give you a better life, like running water, a working car, or a good cup of coffee.
  • Take a moment in transition times, like while waiting for the coffee to brew, to be grateful for 30 seconds.

And check out Dr. Fox’s latest research on the Neural Correlates of Gratitude for more of the science behind gratitude.

Episode Highlights

0:22Dr. Glenn R. Fox on Gratitude
1:21This Week in Neuroscience: Obesity associated with increased brain age from midlife
3:55The audience interaction section
6:08Intro to Dr. Fox
6:52The nature of “the good life”
8:02The definition of gratitude
9:07Religion and gratitude
11:55Cognitive and physiological benefits of gratitude
14:43Is there a limit to gratitude’s usefulness?
18:15Gratitude versus appreciation
22:25How gratitude develops in people
26:13Gratitude and cynicism
28:01The effect of gratitude on sleep
30:12How to practice gratitude
33:05Mindfulness and gratitude
34:03Gratitude under the influence
35:19What Dr. Fox wants to see next in gratitude research
39:41Ruthless Listener-Retention Gimmick: The first human head transplant

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Episode Transcript hideshow

— This Week in Neuroscience --

Jesse: So, the average age of humans on Planet Earth is getting older, and the average weight of humans on Planet Earth is getting heavier, and not surprisingly, scientists have been curious to find out how these two interact.  In a recent study released in the Neurobiology of Aging, researchers say, and in fact they highlight their article with the title, "Obesity Associated With Increased Brain Age from Midlife."  So as we know, our brains tend not to work quite as well as we age.  In fact, we see brain shrinkage and also a lessening of what we call fluid intelligence. 

The long and the short of this study, this was 527 individuals, this was a study conducted at Cambridge, people aged between 20 and 87 years with body mass indexes between 18, that would be a very lean person, to obesity, which is a body mass index of 30 or beyond.  One of the holes on the research actually cited by the scientists were that, in this study, there were some levels of obesity where the people were literally too large to fit in the scanner, so they couldn’t get data beyond a certain point, certain levels of obesity.  However, what they found was certainly indicative, that being that the brain shrinkage associated with aging seems to be accelerated in obese individuals, and at middle age, around 40-years-old, is an area of particular vulnerability, apparently.  Prior to this age, the differences between leaner and heavier individuals are not so pronounced, and as people age the difference becomes less extreme.  But during midlife, it can be as much as a 10-year difference as far as the expected volume of the brain and what they actually see in people with heavier vs.  lighter BMIs.  The physical changes that they saw were characterized by a reduction of white matter, as well as a reduction of cortical surface area.  And finally, they did cognitive testing also on the subjects within the study, finding that general cognition was pretty well predicted by the brain’s size.  So the accelerated shrinkage of the brain was also accelerating this downtrend in cognitive capacity. 

Now, the scientists pointed out this is a correlative study.  Their data do not indicate that obesity is causing brain shrinkage.  It could possibly be that shrinking brains are causing people to become obese.  One suspected mechanism of action, if it is obesity that’s causing a reduction in brain size, are compounds called proinflammatory cytokines, which are produced by adipose tissue.  Adipose tissue is basically the scientific term for fat in the body.  The presence of those cytokines has been tied in other studies to changes in white matter within the brain, which could be part of a damage cycle associated with normal aging.  Long story short, the 40-year-old obese person probably has a brain that’s more similar to a 50-year-old with a healthier body weight.  So, assume what you want about the causative arrow, but it’s probably a safe bet, based on the weight of all the science out there, to avoid obesity and play it safe. 

— Main Interview --

Jesse: Dr. Glenn R. Fox is both an advocate and a practitioner of gratitude.  He has got papers to his credit with names like "How Does the Effort Spent to Hold a Door Affect Verbal Thanks and Reciprocal Help?"  "Interpersonal Liking Modulates Motor-Related Neural Regions," and the paper that brought him to my attention was one called, "The Neural Correlates of Gratitude."  This is something I was curious about.  Gratitude, it sounds like one of these nice ideas.  In a way, it’s almost intuitively obvious that it’s good to feel and express gratitude; it feels nice, it’s not a bad emotion.  But is this just hippy-dippy nonsense or are there real benefits to be had, and if there are real benefits to be had, is there a right and a wrong way, or at least better and worse ways to feel and express gratitude?  That is what we are diving into in the following conversation.  So let’s hear now from Dr. Glenn R. Fox. 


Dr. Fox: I’ve always been interested in what is the nature of the good life.  I’ve always wanted to know something about what are the universal traits of good living.  Growing up, I was really interested in religion and philosophy, and in high school and college I did a lot of reading on those topics.  I started to kind of look for universal themes, and as I got further along in college, I became more and more interested in the details underneath everything that we can do to live a good life.  Gratitude, as it happens, is broadly found in all these works as something emphasized by religion and philosophy, and then also when I began to study science… So, psychology studies started happening in about 2002 that were showing that gratitude can have some really good benefits to health and well-being.  I saw the connection between this emerging science of gratitude and the historical emphasis placed on it by these philosophers, and I thought, "Oh, well there must be something more to it," so I started reading more and more, and what I actually found was that almost nothing was known at the time about how gratitude actually accomplishes these things.  There wasn’t a lot of information about what really makes us grateful, and there was nothing on what happens in our brain when we experience gratitude. 

Jesse: Sometimes when we’re talking about scientific terminology, the definition that scientists are talking about is not necessarily in line with sort of the common, everyday speech definition.  Is there anything like that going on with gratitude?  Is the gratitude that you’re researching the same gratitude we commonly talk about? 

Dr. Fox: The earliest research on gratitude says that gratitude is the emotion we experience when we receive something that comes from some level of effort from a donor and fulfills some sort of need for a recipient.  So, it has kind of this two-ingredient recipe for making gratitude, where you can recognize that someone went out of their way to provide something to you that was costly by some dimension—it could be money or it could be physical energy, it could be the unexpectedness of the gift.  Any of that sort of stuff we kind of chalk under this wide umbrella of effort, how much effort it took to provide something.  And then on the flip side, you have the state of the recipient perceiving the gift, the need state of that person receiving the gift determines a lot about how grateful they’ll be.  If I just had lunch and you provide me with another meal, I’ll probably be less grateful than if I haven’t eaten for a day or two. 

Jesse: Okay, so I’m just going to lob a hand grenade right at the outset here: the first of those two criteria, the idea that there needs to be the perception that effort has been applied for whatever it is that we’re grateful for, does that give sort of an advantage in gratefulness for religious people because they’re able to more easily ascribe effort to invisible forces as effort-bearers that other people might think is just happenstance? 

Dr. Fox: Well, I don’t know about the research on that.  I think philosophically it’s possible.  I think one of the things with something like gratitude is that it sounds great to say that gratitude has all these important health benefits, but actually studying it scientifically gets really difficult.  It’s kind of a moving target.  You have people who aren’t grateful when we expect them to be, you have people who maybe are grateful and we don’t expect them to be, and everything in between.  So this definition of it is sort of restricting this complicated space of gratitude down to just those situations that involve gift-giving between two people.  So, what I did when I started my thesis was really focus on narrowing the multidimensional space down to a couple parameters that maybe couldn’t explain everything but we could kind of wrap our head around a little bit in terms of confining it to a giver, a gift, and a recipient.  So yeah, I don’t know, I think given that religion is so heavily emphatic on increasing gratitude in people, I think it’s possible that people get better at practicing it.  I tend to think gratitude is something of a habit that we can build over time, and if you’re involved in a church or a community group of some sort that emphasizes that, it probably helps prime you to feel grateful and also to attribute it also to any sort of broad force that you can to generate gratitude. 

Jesse: Right, I can feel grateful for the sun on my back without thinking that the sun is putting a lot of effort into it. 

Dr. Fox: Right, absolutely.  Yeah, so there’s kind of a broad range, and that’s something that I really wanted to think about when I studied gratitude.  Gratitude can also be this sort of transformative experience of the sun on the shoulders, deep breath and grateful to be alive sort of thing.  That’s something I think is only just beginning to be studied.  Most of the studies on gratitude are really focused on actually a very narrow range of small favors, looking at, "Sally helped you with your homework" sort of thing, as opposed to the width of someone holding a door for you, which we actually did study, all the way up to the broad thing of how to be grateful for the sun and the universe.  And so, I’m still a little bit more tended toward the door-holding and the small gift thing, but I hope people can expand the studies to whatever it is that can help us understand the benefits of gratitude. 

Jesse: But some of your studies have also dealt with much more macro-level gratitude, like somebody hiding from the Nazi secret police and things like that. 

Dr. Fox: Right, I tried to push the envelope a little bit past the daily small favors thing.  By including stories of survivors of the Holocaust, we’re able to look at gratitude for the bigger gifts, gifts that are potentially life-saving, and look at the type of gratitude that we can feel for those type of gifts as well. 

Jesse: Speaking on behalf of all the strict rationalists out there and the people that are thinking, "Gratitude sounds nice, but these guys just sound like a couple of hippies talking about a bunch of hippy stuff," could you take 30 seconds to just kind of run down what we know about the cognitive, the physical, the physiological benefits of gratitude that we’ve seen from different studies? 

Dr. Fox: Oh, absolutely.  The benefits of gratitude are pretty well-established.  People who are higher on gratitude just tend to have better day-to-day lives.  They show better interpersonal relationships, they show literally faster recovery from heart trauma and heart surgery; they recover faster from trauma; they have lower inflammatory cytokines. 

There’s a longitudinal study that showed that people who practice positive emotions, like gratitude, can live as long as 10 years longer than those who do not.  This is actually a very interesting study, and it’s a neuroscience study, they were looking at brain development longitudinally in a set of nuns.  So basically it follows the same cohort over time and examines changes in their physiology, changes in their personality, in their life, over a long period of time.  So, this study began with a group of nuns at a convent, I think they were in Wisconsin, I think they might still be following them, but it’s a really long-term study, it’s like 20-30 years, where they’re checking in on these individuals over time and looking at just how their lives play out.  What’s neat is that when people are enrolled in these studies, they give them a whole battery of tests, and one of these was, in the nun study, to write a little bit in a journal about their lives and about why they wanted to become a nun.  This was something like, the people were pretty young when they filled out this journal, and then they were able to look at the sentiment within those journals and correlate it to their life outcomes.  In these journals, it was found that people who remarked on positive emotion and were prosocially motivated toward the path that they chose, these are the people that tended to live, on average, 10 years longer than the people who did not have as positive a journal entry. 

Jesse: Wow.  Yeah, that is not chump change. 

Dr. Fox: No, a decade.  And what’s interesting in that study is that it wasn’t that the people who didn’t write positive things—they didn’t write negative things, they just kind of were empty of positive things.  So it’s kind of a neutral vs.  positive effect.  I don’t know what the other effect would be, if you have negative people or whatever, but those folks would probably be less likely to sign up for a nun convent anyway…

Jesse: That’s a good point. 

Dr. Fox: …I’m guessing.  And we do see something, this is not published, so we’re not going to take it very seriously, but in my data we were starting to run some of these gratitude interventions to look at people keeping track of their daily hassles compared to the things that make them grateful on a daily basis, and we definitely see their journal entries over time trend toward the very negative things, people who focus on the daily hassles, showing some effects that we find are a little bit more troubling. 

Jesse: So you don’t recommend keeping a "people to kill" list? 

Dr. Fox: No.  I just think, let go of the daily hassles as much as you can.  That’s one of the things we see, and there’s other studies showing that gratitude compared to hassles, if you have a choice, and I think we do to some extent, keep track of gratitude instead. 

Jesse: Oftentimes in the things that we talk about on this show, there’s sort of an inverted U-curve of performance, where getting a little bit of something might improve a person’s performance, but after a while, too much of a good thing and it starts decrementing again.  Is there a top of the U-curve for gratitude?  Does it suddenly become too much of a good thing at some point? 

Dr. Fox: I’m really interested in plotting that curve, of the limits of gratitude’s usefulness and benefit.  One of the interesting things we find, if you’ll allow me to kind of dive into a detailed result here.  In my thesis, what we did when we began the study is we actually just had paper and pencil responses to the gifts that people received.  So, we had people rate these gifts according to how much effort they thought the gift took, how much they needed it, and how grateful they felt for it.  And they went through a wide range of gifts, and the gifts varied by nature, as I alluded to earlier, things like lunch on an ordinary day, all the way to gifts that were life-saving.  We also asked our participants to fill out 4-5 personality questionnaires before the experiment began.  One of these questionnaires is something called the Interpersonal Reactivity Index, which is fancy psychology speak for an empathy questionnaire.  Part of empathy is the ability to understand perspective-taking, and this questionnaire measures how likely we are to take someone else’s point of view when we consider a situation. 

I had hypothesized that people who are much more prone to take perspective would also see more effort overall in the gifts, that someone who’s really attuned to what it takes to provide something would be more apt to see more effort overall in a gift.  If I understand what it took for you to do something and I’m more likely to see your point of view, I will attribute more energy on your part.  What we actually found is something way more interesting and way more surprising, that people who are very high on this perspective-taking scale actually showed much more differentiation in the level of effort that they perceived in the gifts.  In other words, people who were more apt to take perspective didn’t see more effort overall, but they tended to see the more fine-tuned details in the effort itself. 

Jesse: Can you give me a tangible example of that idea? 

Dr. Fox: So, we receive gifts all the time and it’s always the case that we don’t really know what effort took into it.  Think about your average Seinfeld episode that involves the re-gifting thing, right?  So if you imagine that a re-gift came, you might feel like, "Oh, this is a pretty useful gift," but it didn’t take much effort on their part to deliver it, or you could see it as being a lot of effort or a little effort or anything, right?  So these people who are more apt to take other people’s perspective would actually more accurately attribute what it took to provide it.  So, they might be actually less grateful overall if they’re really attuned to re-gifting.  But what they’re doing is that they’re seeing the situation in greater resolution.  They have more "HD vision" for gift-giving, I would say. 

And so, this is my assumption, that they’re more accurate in what they think of in terms of what it took to provide something.  So, this is an interesting kind of wrinkle in what we expected to find.  It wasn’t just the case that seeing more effort is better.  If we assume that being high on this perspective-taking scale is beneficial, then we would also expect that seeing whatever these people do is probably something we should learn from.  So when these people come back with the data that says they don’t see more effort overall, they don’t attribute higher degrees of energy spent to give a gift, instead they tend to see it in greater detail, I think that tells us something about gifts and how we should look at our overall relationships to the things other people do to benefit us. 

Jesse: Before we started this interview, I was almost interchangeably thinking about gratitude and appreciation, but your example just really called out what a big gulf there can be between those two.  Let’s say that a nine-year-old kid made me a gift.  I mean, chances are, they’re a nine-year-old kid, they’re not necessarily going to have the same skill as somebody that’s been practicing their skill for another 20-30 years.  But I could see that, wow, as a nine-year-old this was probably a whole lot of work, even though the end result might not be as good.  Let’s say the nine-year-old baked a birthday cake and it wasn’t the greatest cake in the world.  I would probably feel more gratitude for the nine-year-old’s cake, knowing the effort that went into it.  But I would probably appreciate a well-made cake that was made by an expert cake-maker that didn’t really put much effort into it a lot more.  So, take those two ideas and go back to sort of the science and the studies.  Do we see differences in the end results for people, whether they’re feeling gratitude as you’re studying it, vs.  appreciation, which would deal more with the value of what was received rather than the effort of what went into what was received? 

Dr. Fox: I’m not sure if my data are able to differentiate maybe something like appreciation and gratitude.  I would say that, in those examples of the nine-year-old cake vs.  the expert cake, you’re also going to delve into something about individual differences and how people relate to things.  A lot of people are much more utilitarian and they would say, "Well, thanks kid, but I appreciate this expert cake." 

Jesse: I guess I outed myself. 

Dr. Fox: Yeah, and other people might be more moved by the effort that the kid spent to do it.  One of the ways that we wanted to study gratitude, actually, is manipulating effort and need independently and seeing all the different emotions and feelings that people can have around them.  And in our study, we didn’t try to differentiate feelings that were very close to each other, like appreciation and gratitude.  I’m not sure if there’s an academic definition that would split those things apart.  But one of the things that we did see that was really interesting is when we asked people to tell us how they felt after the gifts—and we had gifts that were actually very similar to the kid and the cake gift, we’d have things like people going out of their way to provide you with a gift that you could not use in some way but was still quite effortful.  And then people would often report, for those types of gifts, feeling that they recognized the effort but it didn’t fulfill a lot of need, and their gratitude was tinged with something else, like guilt or bitterness.  There were all kinds of complex emotions sprinkled in with gratitude, and this tells us a lot about the complicated feeling space that we can have in response to receiving a gift. 

Gratitude itself is not necessarily also a synonym for happiness.  Oftentimes when we receive a gift that we need very much, that’s often met with a bit of pain.  When we really receive a gift that bails us out of a tough situation, there’s often some conflict because you’re at the mercy of the world and somebody’s reaching their hand down to lift you up, and that act by itself can inspire some conflict for a lot of people.  Here’s an interesting example.  This isn’t work I’ve done, but I’ve read a lot of studies about organ donors and organ recipients.  If you think about this high effort/high need gift-giving, a kidney is probably going to be just about the highest thing you can have.  And what’s interesting is when you read these reports, for one thing, people who receive organs report overwhelming gratitude toward the people that have helped them, even if the donor is living or passed or whatever.  But in the cases where the donor is living, the people often report immense guilt for receiving the gift, the organ itself.  The donors themselves feel just pure joy for it.  So, the conflict, you would think that the person who’s giving their kidney would feel more conflicted about what’s happening than the person who’s receiving it, but that’s not the case.  And then once you put yourself in the shoes of the people, you can kind of feel, "Oh yeah, that actually is more appropriate."  You’d probably feel more conflicted about it if you were receiving it, because you know what it would take to give it. 

So it’s an interesting space, this gratitude, and one of the things that I think I’d like to impart to listeners is just that gratitude isn’t a synonym for happiness, it’s part of the humility to understand that we need things and that people regularly provide help for us, and learning to recognize those instances is extremely powerful.  And that’s really where gratitude starts to have its virtuous cycle.  We begin to see the things that people give us and it inspires us to give in turn, and that’s not just about being happy or being pleasurable about getting a nice thing, it’s about the way that receiving a gift inspires us to help others. 

Jesse: Yeah, I thought that was one of the interesting things in some of your papers, was pointing out how gratitude is sort of more of a mature emotion because it requires a theory of mind and recognizing that it’s an outside entity that’s performing something for you.  It’s like a newborn baby doesn’t have the capacity to be grateful because it doesn’t even distinguish itself from the rest of the world. 

Dr. Fox: Yeah, and that’s another open, interesting question, is how gratitude develops in people.  You actually see some interesting hallmarks of gratitude pretty early on, but I think it does require a certain social awareness, and I think that’s part of how we develop as people, to recognize the things that other people do to help us.  It is definitely a mature emotion; it definitely takes maturity to understand that other people are helping you all the time.  One of the funnier things as a gratitude researcher: The first thing so many people say to me is, "How can I make my kids grateful?"  It happens all the time.  So I have this tagline that, according to everybody, gratitude is the most important emotion for other people to have toward us.  I say, "Well, it’s best if you don’t try to make people grateful.  You just give and see, and let them respond how they like." 

Jesse: You need to write a book called Gratitude For Your Snot-Nosed Kid.  It would be an instant best-seller. 

Dr. Fox: It’s funny, one of my good friends and colleague, his name is Giacomo Bono, he’s a professor at Cal State, Dominguez Hills.  He just wrote a book called Making Grateful Kids, and it’s full of research on gratitude and development, and all the work that he’s done with gratitude and schoolchildren has shown that these gratitude interventions can reduce bullying and increase cooperation, and some really wonderful stuff.  Even grade school, middle school kids can show tremendous benefit from gratitude interventions. 

Jesse: It seems like it really is probably a very trainable skill if we call attention to it. 

Dr. Fox: I absolutely think so.  It’s actually been shown through a number of intervention studies, gratitude is something that, when we practice, we get better at it, and we can better experience its benefits.  Kind of the original intervention study done by Bob Emmons in the early 2000s was a very simple paper and pencil test of having people write down the things that they’re grateful for, then they tracked how things changed and how people felt about the world, and they saw, of course, reduced physical symptoms, reduced symptoms of physical pain, they improved their sleep and they just had a generally better, more positive outlook on life.  But what’s so amazing about this study—this is kind of an anecdote, this isn’t part of the published finding, but something that Dr. Emmons talks about—is that months after the experiment ended, his participants would write to him and say, "Hey, I’ve kept going with my intervention.  I’ve made such a habit out of keeping a gratitude journal, I’ve just kept it up."  Now, what’s funny is when you do research day-to-day, just getting your participant to finish an hour-long experiment is something of an accomplishment.  The idea that they’d keep doing it for months on end is mind-boggling. 

Jesse: Yeah, taking your homework during the summer and continuing to do it when the school year has ended. 

Dr. Fox: Yeah, it gets its hooks into you.  So I think it’s definitely a trainable skill, you don’t have to start as a grateful person.  And I also think part of letting the pressure off of people to try to feel grateful as they can all the time… That actually could be almost harmful if you’re always trying to be as grateful as possible all the time.  I think when you practice gratitude and you use these techniques, simple things like gratitude journals and writing thank-you notes, they kind of put you at ease in the space of being grateful on your own terms and learning to develop and recognize it without forcing yourself.  I think that’s an important part of it, because one of the things we see is that people who are high on these scales tend to show some more differentiation in how grateful they are, so they’re not necessarily about the effort and the perspective-taking scale.  These people that have these natural virtuous traits don’t necessarily push themselves all the time, they just try to see it as it is and try to be probably more cognizant overall.  And I think for most of us, when we really think about it, the appropriate level of gratitude is probably more than we feel at any given time.  But it doesn’t mean that you need to fall over in gratitude when someone holds a door for you. 

Jesse: What does somebody do if they find themselves of a cynical bent, where when they receive something, their natural suspicion is that somebody is just doing something nice so that they’ll receive something nice later, that they tend to look at things more transactionally and have a hard time accepting as a gift? 

Dr. Fox: I think there is some research out there showing that gratitude and cynicism kind of have an antagonistic relationship.  I’ll go kind of outside of what I know from research and just kind of give my opinion on this.  I think one of the things you have to train yourself to do if you want to be a more grateful person is give people the benefit of the doubt and also kind of accept that you don’t know what’s on someone’s mind when they give you something.  There’s this relationship between gratitude and indebtedness, and some studies are actually able to show that the feelings of gratitude are actually pretty independent of indebtedness, that true gratitude doesn’t come with this hallmark of, "I’ve got to repay this thing right away."  So, people who are hoping to develop a sense of gratitude, I think it’s partly—and we all have this trap, of accepting gifts graciously and just feeling grateful in the moment and savoring that positive emotion without pinching yourself to go back and repay right away. 

I think it’s something that is very practicable, and I think if you want to kind of reason yourself into it, one of the ways—and this is my opinion—is just that you have to accept that you don’t know what’s on someone’s mind when they give you a gift, so it’s up to you to decide how you want to respond to it.  And if it’s a good gift, enjoy it.  If it’s a gift that you can use in your day-to-day life, just say thanks and appreciate it.  Let their reaction be what it is.  If you have to repay, if you know that this gift was given in a manipulative way, well, that’s up to you to repay or not, but it’s about how you feel about the gift itself independent of the expectations that can go with this very complex space of gift-giving.  But I think it takes practice.  I don’t know if that made any sense. 

Jesse: A few minutes ago you mentioned the benefits of gratitude to a person’s sleep, and sleep is something that we talk about a lot on this show because of all the neurological and cognitive benefits that are sort of spillovers from getting good sleep.  Are there any distinctly cognitive benefits for a person upgrading their own gratitude levels? 

Dr. Fox: Cognitive benefits of gratitude… So, Alex Wood, Bob Emmons, and Giacomo Bono, and a few others have really laid the groundwork.  So, Alex Wood did a study and it showed exactly how gratitude influences sleep; they were able to actually track people’s gratitude and kind of correlate with features of the sleep correlated with how grateful people were.  So, we kind of have an idea of the mechanism underneath it.  I’m trying to think about if gratitude is correlated with better memory or… To the extent that you can differentiate something "cognitive" from something emotional, these things are really one and the same.  They’re all just part of our general and universal human cognitive architecture. 

Jesse: We probably don’t yet have like a gratitude unit, like newton or a pound or something like that.  But if somebody were to choose between small doses of gratitude frequently applied, and occasional, big, whopping boatloads of gratitude for a few isolated things, is there a better or worse way, or do we know? 

Dr. Fox: We don’t know.  My opinion is definitely that small doses of regular gratitude will be more beneficial overall, because it builds a habit in your mind for how to think about the things you receive.  Waiting for the big wedding present or kidney or something, for your chance to be grateful is shortchanging yourself of all the wonderful things that people do that are much more unrecognized in the meantime.  Part of one of the things that gratitude can do is increase your resilience to trauma.  In war veterans with PTSD, people higher on the trait gratitude actually show reduced symptoms of PTSD.  Even if they have the same diagnosis, people who are more grateful tend to be able to handle the situation a little bit better.  One of the things that gratitude can do is sort of build up something of a reserve by practicing it on a day-to-day basis.  Thankfully, I would like to believe that most days are fine.  Most days, our lives are pretty good.  But we’ll run into the bad day or the bad month or the bad year, and it’s those times that our practice being grateful on a day-to-day basis will really kick in and can help you recover more quickly from the trauma that we can have. 

Jesse: Can you talk some about how to put these ideas into practice?  I think the idea of doing a gratitude journal is a pretty well-popularized idea.  But what are some of the other approaches that a person could use if journaling isn’t their thing? 

Dr. Fox: Research says that it looks like the most effective way to feel the benefit of gratitude is to write thank-you notes and deliver them to someone who’s probably not expecting it.  Part of gratitude is the rewarding effect of giving a gift back to someone, or to recognize their effort, and that’s part of what creates that social bond between people.  So in terms of the research, in terms of the biggest effect size, it’s writing a thank-you note and delivering it.  And then below that is your gratitude journal, and then there’s even some evidence to say that, if you do have a gratitude journal, it should probably be done weekly, not necessarily daily.  There’s something about the weekly ritual of having a weekly gratitude journal.  It looks like it’s more effective than keeping one on a daily basis.  This is something that we’ve seen in a couple of studies, that the interval by which you fill out the journal can actually matter.  Yeah, so that’s an interesting thing.  There’s something about that weekly ritual that I think might be important.  I know some of the research has said that there is something behind that thing, about if you do it before a busy work week, you might be able to buttress yourself up against some of the challenges you can face in an ordinary work week. 

Jesse: So you would think, timing-wise, the best would be towards the end of a work week, or maybe the beginning, like Sunday night before Monday kicks off the next day? 

Dr. Fox: Yeah, I would think so.  These are the sort of questions that I don’t think are out there in the research yet.  So, tune yourself on this.  Chart it, make it a habit, and see what happens over the span of a couple of months and try it.  Be your own best subject, as I like to say. 

Jesse: Needless to say, this is something that you eat, sleep, and breathe.  What are your own personal gratitude practices? 

Dr. Fox: You know, I really try to spend as much time doing something of a gratitude mindfulness on maybe a morning-by-morning basis.  As I’m kind of waking up and enjoying coffee and looking out the window and getting ready for the day, just try to take even 30 seconds noticing something that people have done to create a better life for me.  Even things that aren’t necessarily personal.  There are some ways to generate gratitude that are a little funny, where you can look at, say, the coffee beans that I use every morning to make a little bit of coffee, and think about what it took to actually put those coffee beans in my coffee machine, and see that it actually took a really wide sphere of people to create the situation where I can have this cup of coffee in the morning.  That kind of expanding, thinking about all the things that have to go together to make our lives possible, is available for just about anything, from a glass of water to turning that key in your car and having your car start, or whatever.  The opportunities to practice gratitude are really broad, and for me, I just try to take moments, especially in those transition times, where I park my car after a long day, put it in park and just sit there for a few seconds and try to think, "Oh wow, the grass looks green, it looks like somebody put some effort into that," or whatever.  So I kind of try to nibble at it throughout my day.  And there’s always more opportunities that I probably miss. 

Jesse: It sounds like there’s a lot of potential crossover here with meditation and mindfulness.  I know specifically there’s a kind of meditation called Loving-Kindness Meditation, where you’re kind of spilling out all the positive vibes that you possibly can.  Is that a fruitful line of questioning? 

Dr. Fox: I think that the mindfulness research shows a lot of promise.  Unfortunately, there’s some mindfulness research that I don’t think is properly controlled at this point.  But overall, you’ll see that there are some really good benefits, and there are some cases where—I think there’s a study that actually pitted a gratitude mindfulness vs.  present mindfulness, like a breath-counting thing.  That sort of mindfulness actually showed to be incredibly beneficial and actually matched some of the benefits of gratitude.  So even just taking a moment to be aware of your surroundings can have a lot of benefits for recognizing that your day went okay, or whatever.  There aren’t a lot of studies that actually use gratitude as a mindfulness technique and actually measure it over time, so that’s research that I hope can come out in the next couple of years and show us whether or not it’s useful. 

Jesse: I’m wondering about chemical means of influencing gratitude.  Like, you can only think of the example of somebody that gets really drunk and is just like, "Aw, I love you, man!" Is that person actually exhibiting more gratitude than they normally would, or is it just that alcohol is allowing them to express something they wouldn’t otherwise express but might still be feeling?  Or do we even know? 

Dr. Fox: I don’t think it’s known.  I mean, it probably says something about the type of person.  Complete conjecture here, but there’s probably some relief of inhibition toward connecting with people that can happen when we’re under the influence.  I mean, I don’t think it’s the right way to do…

Jesse: Not sustainable. 

Dr. Fox: No, but it’s an interesting question just in terms of the pure neuroscience of it, in terms of the circuitry of how do the GABA circuits actually influence the release of inhibition, influence our desire to connect with others.  That’s a very interesting question.  A really interesting study came out I think last year that showed that there were differences in the oxytocin-expressing gene in people more prone to express gratitude. 

Jesse: Oh, that’s fascinating, yeah. 

Dr. Fox: Yeah, so it follows a story that gratitude is an inherently social emotion, that people more prone to express gratitude, there may be some sort of genetic disposition acted out through this oxytocin social system.  So there’s some connection between brain chemistry and gratitude, but there’s no studies manipulating it or looking at changes over time that I know of. 

Jesse: If you could wave a magic wand with funding or research time or whatever it is, and see the perfect study that you’d like to see done next, what would you like to see done, either performed by you or somebody else? 

Dr. Fox: Oh, man.  Okay, let’s see if I can write a grant application in 30 seconds.  No, I mean, we did this study on gratitude in the brain, and it was the first direct report of the neural correlates of gratitude.  That study was published last October.  Since then, another study came out that was really well-done, also looking at gratitude in the brain, and it looked at how people dealing with depression, how an intervention designed to boost gratitude changes how their brains actually process gratitude.  It actually showed that people who are dealing with depression, when they practice gratitude, it actually changes how their brain constructs the feeling of gratitude.  So, that study was really good and that’s another longitudinal or pre/post-test study that looked at the effects of it.  I’d like to see more of the space of gratitude explored a little bit better in terms of the wider variety of gratitude that we can have for things.  I’d really like to see gratitude in terms of real-time social interaction, like maybe we can do Christmas in the brain scanner or something, where we can really look at how people are interacting in real time and how gratitude unfolds at a more fine-tuned timescale.  I think that those intricate social mechanics in the brain are the most fascinating thing, so I’m prone to want research that takes what I did and look at how it unfolds in real time and how it unfolds at a more personal level of gratitude than we were able to elicit. 

Jesse: I wonder if we might have sort of a problem in the future of gratitude, in that as technology and general human wealth increases, everything is getting easier.  It’s like if I have my 3D printer and I can whip up a nice new iPhone just by pressing "print," and you know that I can do that, it makes it hard to think that a lot of effort went into anything that I might provide for a person.  Is that a fundamental problem in the future of gratitude?  Dr. Fox: Well, hey, don’t forget about those engineers, they worked incredibly hard to figure out the principles of molten plastic.  There’s a funny bit by Louis C.K., I think he was on The Tonight Show or something, and he was saying that everything is amazing and nobody’s happy. 

Jesse: This is his airplane riff, yeah. 

Dr. Fox: Yeah, I think this is right along the same lines of what you’re saying.  I have a general hypothesis that it’s not such a bad time to be alive.  There’s always problems, always things that we need to work on, but we are fortunate enough to live in a time when you can almost print an iPhone.  We also have the ability to worry about anything at any time, too.  So, as much as our capacity for having things delivered to us with a lot of convenience, I’m sure that will grow, but also our anxiety around other things.  So, the chances to use the benefits of gratitude I don’t think are going to go away.  I think it’s just going to be a constant practice to build those habits.  So, I’m hopeful for it.  I think the more I can print my own iPhone, the better, and I’ll do my best to be grateful when it happens. 


Jesse: So, thank you so very much to Dr. Fox.  Or, should I say we’re very, very grateful for Dr. Fox’s having taken the time to have that conversation with us?  Because having the conversation, it actually was probably pretty fun, it didn’t take that long, but if we think back to all the years of research and work and toil and self-education that Dr. Fox had to put himself through in order to be able to have that conversation, that is a lot of effort that he’s put out for which we can be duly grateful.  I liked that approach that he had, of sort of telescoping back and looking at all the input sources to even the trivial good things in our life.  It certainly does give a large wellspring of things for which one could express gratitude. 

I think that a lot of us—maybe not a lot of us, but at least I’m channeling my own feelings on this one—are a bit conflicted with some of the happy emotions when you hear good things about them.  Because you don’t want to necessarily go around as a full Pollyanna all the time, expressing that everything is sunshine and lollypops and moonbeams, largely, I think, because we have the intuition that if you’re super, super satisfied with everything, then it kind of removes the impetus to make things better, and not wanting might lead to not striving.  I think that intuition that effort itself has some sort of inherent value or nobility or whatever, that’s a pretty strong bias that a lot of us hold.  It makes me wonder if there’s a minimum effective dose of gratitude, some way of striking that balance between appreciating what we have but still maintaining our hunger and our motivation to make change in the world.  Lots of interesting ideas here, a little bit of a departure from our standard fair.  We’ll get back to something more neurochemical next week.  But right now, to go out with a bang, we will switch to maybe the world’s elective surgery, coming up next in the Ruthless Listener-Retention Gimmick. 


— Ruthless Listener-Retention Gimmick --

Jesse: So, a couple of months ago we talked about the work of Xiaoping Ren, of Harbin Medical University in China, who has gained some fame and notoriety within the medical community for having successfully transplanted a monkey’s head from one monkey to another, the full-on combination of Mary Shelley’s Frankenstein and the guillotine from the French Revolution, moving an animal’s head from one animal’s body to another.  He was able to pull that off with a monkey and he has been talking, in recent months, about trying to do it with a human being next.  He believes the technology there, and we did, I think it was a This Week in Neuroscience, 8 or 10 episodes ago about his efforts. 

Now it sounds as if there’s something of a race going on within the medical head-severing-and-reattaching community.  There is an Italian neurosurgeon, named Sergio Canavero, who says he’s planning to perform the world’s first ever human head transplant in December 2017.  He will put the head of a terminally-ill wheelchair-bound Russian, named Valery Spiridonov, onto an entirely new body.  The body probably, not surprisingly, has not been selected yet, but it will be a brain-dead but otherwise healthy individual.  Spiridonov has Werdnig-Hoffmann Disease, a rare and incurable spinal muscular atrophy.  So, although this surgery has never been performed yet and there’s obviously huge dangers, he doesn’t have the option of sitting by and doing nothing.  And he and the doctor, Canavero, are currently in the midst of raising $18 million to pay for the procedure, which they’ve given the acronym HEAVEN, grabbing the letters for that acronym from Head Anastomosis Venture.  The way that this will work, the details, if you’re curious, which I’m sure you are, is that Spiridonov’s head will be cooled down to a chilly -15 degrees celsius, at which point both his head and the head of the body donor would be severed, then reattached, and after a slow and careful reheating, Spiridonov would be kept intentionally in a coma state for about a month allow for healing before they would attempt to reawaken him in the new body. 

Spiridonov himself is a computer scientist and sounds like he’s taking a very engineering-type approach to this.  He says, "I’m not rushing to go under the surgeon’s knife.  I’m not shouting, ‘Come here and save me now!’ Yes, I do have a disease which often leads to death, but my first role in this project is not that of a patient.  First of all, I am a scientist, I am an engineer, and I am keen to persuade medical professionals that such an operation is necessary.  I’m not going crazy here and rushing to cut my head off, believe me."  Which sounds like a pretty sober and even-handed way to look at this.  Somewhat more controversially, Dr. Canavero says, "With the possibility of this sort of surgery, we are one step closer to extending life indefinitely, because when I will be able to give a new body to an 80-year-old, they can live for another 40 years." 

Written by Hannah Sabih
Hannah believes there's nothing 8 hours of sleep and some kale can't cure (yes, she's from California). She's an avid runner, reader, and traveler, who brings you the latest and greatest in neuroscience via our social media channels.
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