Giving and receiving gratitude

“Gratitude is both a response to moral behavior and a motivator of moral behavior” (McCullough et al 2001:250).

Last week a student walked up to me near campus and with a beaming expression keenly told me how much she had appreciated our discussions in the recent focus group. She mentioned sharing her learning and experience with others. She feels more connected with different aspects of her learning. A video recording of our conversation could have captured this special moment where I felt drawn in by the student’s warmth and gratitude.  

I question why, as health educators we tend to give more space and time for criticism than appreciation? The health system is governed by regulatory practices focused on accountability to indicate measures of quality. Similarly, the education system is driven by assessment processes to maintain requisite standards. It becomes apparent that expressions of care and kindness are often missing, perhaps oppressed by power and regulation within the hierarchy of medicine. There seems scope for more time to be spent on gratitude, an emotion that is incorporated in the growing movement of positive psychology and mindfulness.

In Obstetrics many students have commented on the joy they felt as recipients of gratitude. For instance even after a traumatic delivery when the student was left with a feeling of helplessness, there was a sense of worth when thanked by the new mother. A small act of kindness has a large impact. I continue to question why this is notable rather than naturally forthcoming.

While reading students' reflective commentaries over the past 4 years, it has struck me how much they value gestures of gratitude. These have been demonstrated in different ways such as a baby named after the student or simply a thank you for being present at a vital time. In recognizing the value of gratitude, our department now sends out complimentary notes to individual nurses in the birthing facilities who students identify as being special educators and role models.

Zournazi (2002) relates gratitude to ethical and political responsibilities suggesting that “it is through our everyday experiences and choices that gratitude manifests in its subtle as well as substantive forms” (2013:287). In a similar vein, Braidotti (2013) writes about affirmative ethics and Barad (2007) about the need to interrogate our intra-actions in a positive manner looking in on the finer details and connections rather than critique.

Recent studies using stories of kindness and compassion from personal narratives related to the Holocaust have indicated the neurological changes that are triggered through acts of gratitude (Fox et al 2015). Shariatmadari (2015), editor of The Guardian, refers to this study in his column where he questions the under-valuing of gratitude, suggesting that it could be the most important social emotion and ought to get more attention. Wood, Froh and Geraghty (2010) point out how under-researched gratitude is, yet it could become “a key element for sparking positive changes in individuals, families, and organizations” (Bono et al 2003:272).

Using Baradian concepts, perhaps gratitude can be described as an appreciation of the entanglement of our intra-actions when our in/separate roles coalesce; an apparent apartness that is made visible by the coming-together through choice rather than obligation (Barad 2007). In Obstetrics, the act of birthing can become a moment of superposition creating a lasting memory which impacts on the being and becoming mother/doctor. If we delve deeper into the relationships ”to feel what lurks in the interstices” (Stengers in Zournazi 2002:145) there can be a sense of hope and appreciation of the value gained from the togetherness of mother, infant, helper and the materialities in the intra-actions that transpire.

McCullough et al. (2001:250) put forward three reasons for giving more attention to gratitude.

1. It is used less than other positive emotions
2. It is experienced and expressed in a large variety of ways both in local and global contexts due to cultural differences
3. It relates to “a good outcome as a result of the actions of another person” (2001:250)

In developing a socially just pedagogy, it seems that gratitude can become an important component to create a culture of appreciation that can complement hope for change.

The image above was drawn on the iPad using Adobe Ideas App. It highlights how we can breathe gratitude through our actions and intra-actions.

Barad, K. 2007. Meeting the universe halfway: Quantum physics and the entanglement of matter and meaning. Durham, NC: Duke University Press.

Bono, G., Emmons, R. A. & McCullough, M. E. 2004. Gratitude in Practice and the Practice of Gratitude. In (Eds.) P. A. Linley & S. Joseph. Positive Psychology in Practice. John WIley & Sons, New Jersey. 464-481.

Fox, G.R., Kaplan, J., Damasio, H. & Damasio A. 2015. Neural correlates of gratitude. Frontiers in Psychology. Retrieved  http://journal.frontiersin.org/article/10.3389/fpsyg.2015.01491/full

McCullough, M. E., Kilpatrick, S. D., Emmons, R. A. & Larson, B. 2001. Is Gratitude a Moral Affect? Psychological Bulletin. 127:2:249-266.

Shariatmadari, D. 2015. Could gratitude be the most important emotion of all? The Guardian. 30th October.

Wood, A. M., Froh, J. J. & Geraghty, A. W. A. 2010. Gratitude and well-being: A review and theoretical integration. Clinical Psychology Review. doi:10.1016/j.cpr.2010.03.005.

Zournazi, M. 2003. Hope: New philosophies for change. New York. Routledge.

Zournazi, M. 2013. Critical Hopes – gratitude and the magic of encounter. In (Eds). V. Bozalek, R. Carolissen, B. Liebowitz & M. Boler. Discerning Critical Hope. Routledge.