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Trial of Gratitude

I often wonder and think about how I can connect my scientific, professional life to my spiritual, personal life.

As a drug information pharmacist, I’ve spent many years formally reviewing clinical trials published in medical journals about new medications. I would determine how these new medications compare to existing therapies and then develop guidelines for their use.

The gold standard for a clinical trial design is a randomized, controlled trial. The study participants need to be randomized to either the treatment or placebo group. The treatment group is the group that takes the medication. The control group is the group that takes a placebo or another similar drug. Participants must be randomized so that both groups would be the same. If you don’t randomize, you might end up with a group that is older or sicker and then your results could be inaccurate.

I often watch a YouTube channel called MedCram. The tagline of this YouTube channel is “medical lectures explained clearly.” I regularly watched this channel early in the pandemic to learn about the COVID-19 illness, vaccines, and treatments. A few months ago, right before Thanksgiving, they had a video called, “The Science of Thankfulness Clearly Explained.”

In this episode, the YouTuber described a clinical study titled: Does gratitude writing improve the mental health of psychotherapy clients? Evidence from a randomized controlled trial. I was quite excited to learn that it was a randomized control trial on gratitude.

In this study, the three groups were:

  1. Psychotherapy only (control group)

  2. Psychotherapy plus expressive writing about stressful experiences

  3. Psychotherapy plus gratitude writing

Participants in the expressive writing condition wrote about their deepest thoughts and feelings about stressful experiences and participants in the gratitude group wrote a letter expressing gratitude to a person they had not properly thanked. The researcher’s definition of gratitude was “acknowledging the value of a benefit in one’s life or that one has received something of value from another person.” They measured the participants’ mental health status using a survey called the General Mental Health Index at the initial visit, at three weeks, four weeks, and at 12 weeks.

After four weeks and 12 weeks, the patients that were in the gratitude writing group had a significantly higher General Mental Health score compared to the other two groups.

The authors of the study had four conclusions:

  1. Gratitude unshackles us from toxic emotions. The gratitude writing group used more positive words. The group that wrote about stressful experiences had lower mental health scores, and therefore, don’t ruminate on negative experiences.

  2. Gratitude helps even if you don’t share it. Only 23% of the gratitude writing group sent their letters, yet they saw the same benefit.

  3. Gratitude benefits take time. Benefits were seen at week four and 12, so even if you don’t notice anything in the first couple of weeks, you need to stick with it and see the benefits over time.

  4. Gratitude has lasting effects on the brain. In a follow-up study, the gratitude writing group had greater activity in the medial prefrontal cortex, which is a part of the brain where learning and executive function occur.

I once heard a minister say that Namo Amida Butsu means to experience gratitude beyond words. In the randomized controlled trial, people wrote letters to express their gratitude. I think you can have the same effect by just saying or thinking Namo Amida Butsu. Especially, if you know that Namo Amida Butsu expresses gratitude beyond words. As I wrote this article, I tried to think of examples of what I’m grateful for. I think most of us will think of family and friends as things we are grateful for, but as I thought more deeply, my list got longer and longer. Soon my list started to become complex and abstract and unexplainable. To me, this is what is meant by gratitude beyond words. Our Shin Buddhist practice gives us a simple tool to express that gratitude by just saying Namo Amida Butsu.

As I looked back at the study conclusion, I connected my scientific, professional thoughts with my personal, spiritual thoughts to make the following conclusion:

  1. Namo Amida Butsu unshackles us from toxic emotions.

  2. Namo Amida Butsu helps even if you don’t share it.

  3. Namo Amida Butsu benefits take time.

  4. Namo Amida Butsu has lasting effects on the brain.



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