Gratitude, Resolutions, and Cancer?

This is the season when many of us pause to give thanks and perhaps look toward the future for renewal. How can these themes be connected to the cancer experience?

Among psychologists, there has been increasing focus on studying gratitude’s role in well being, whether it is psychological, in terms of factors such as improved life satisfaction, reduced depressive symptoms, or increased positive emotion, or physical, in terms of such things as high quality sleep. Theorists have suggested that this relationship could be explained by feelings of gratefulness diverting attention away from the negative aspects of situations and relationships toward the positive aspects, which therefore improves mood.

Two recent studies have incorporated procedures intended to foster gratitude into interventions for cancer patients, with favorable results.

The first involved patients with cervical cancer who spent 4 weeks engaging in a gratitude and mindfulness intervention.¹ Participants were instructed to write down three things that they were grateful for and listen to a mindfulness-based program that guided them in directing their attention toward their breathing and bodily sensations in a nonjudgmental way. The intervention increased reappraisal (positively re-construing distressing emotional experiences) and levels of positive emotion, and reduced rumination (repetitively thinking about distressing things) and levels of negative emotion compared to a wait-list control condition. These findings are in line with theoretical work suggesting that gratitude broadens thinking, allowing people to think more flexibly and to cope better with stress.

In a second study,² researchers asked breast cancer patients to spend 10 minutes writing a letter to someone who had done something especially kind for them, expressing their gratitude on each of six weeks. The letters were considered strictly confidential by the research team and, although the participants could send the letter if they wished, they were free to write whatever they wanted without the intent to share it. This intervention was delivered online, which was considered a low-cost, portable, and scalable alternative to professionally-led, in person interventions. The researchers were specifically attempting to address fear of cancer recurrence and worry about death, common and disturbing issues for cancer patients. If fostering feelings of gratitude through writing were to accomplish this, what possible mechanism, one beyond just increasing positive mood, might explain the effect? The researchers believed, based on prior theoretical work, that death anxiety would be attenuated by pursuing culturally valued and personally meaningful goals. There was also evidence to suggest that engaging in activities to foster gratitude would promote a sense of meaning and the ability to envision future achievements. Accordingly, the study authors measured goal pursuit each week, along with feelings of gratitude, positive mood, fear of cancer recurrence, and worry about death. Those who engaged in the gratitude intervention (compared to those in a control group who simply listed activities that they had engaged in) experienced a decline in death worry over the course of the intervention and a 3-month follow up. Furthermore, this effect was mediated or explained by the extent to which they reported pursuing meaningful goals.

We are reaching the time of the year when the darkness retreats as the days begin to get longer. The winter solstice marks the end of autumn and the start of winter. At the solstice, the Sun appears to stand still; as seen from Earth it comes to a stop before reversing direction. We, similarly, may make the transition from looking backwards. Lit up with what we are grateful for we gain inspiration to look forward to what we can hope to achieve in the future.