By Ericha Scott, Ph.D., LPCC917, ICAADC


It is easy to feel gratitude or thankfulness when life circumstances go our way. It is fun to celebrate- for example- a new job or a promotion, a new or rekindled romance, financial windfalls, graduations or retirement, and recognition for our natural talents or hard work.
It is much more difficult to feel gratitude when we are challenged with relational strife, grief and loss, trauma, abuse, addiction, poverty, and/or alienation.

I have learned about the power of gratitude by watching my clients.

I have worked with clients who were nearly destroyed by abuse, trauma, and sometimes even systematic and sophisticated torture- and yet, they found a moment or moments of gratitude.

They found these moments in the midst of a history of horror and the aftermath.
Observing that first moment – the dawning of thankfulness, is as wondrous as watching birth, and in fact; it is a birth of a spiritual life. Watching a client’s face as it shifts and changes with the new awareness that life is precious – is to bear witness to profound beauty.

Gratitude can be triggered by a small find in nature, a loving comment by a friend, a thoughtful gift, a break from suffering, an observation of selflessness in another, and/or the claiming of a talent. This form of gratitude is born from a small event of low monetary value more often than a new car or TV.

We can all learn from those who have been shattered by grief and their determination to recover. It might sound superficial but I have thought, “If they can do it, so can I”.

Survivors of trauma and addiction have taught me the true meaning of thankfulness and gratitude.

Scientific research supports my clinical observations regarding the positive impact of gratitude and thankfulness on physical and mental health. Although not all research is equal, many studies reveal a variety of significant benefits such as improved:

1. Relationships
2. Physical Health and Sleep
3. Mental Health and Happiness
4. Empathy for Others
5. Resilience from Trauma
6. Self-Esteem.

For many people, especially survivors of addiction and trauma, feelings of gratitude do not come naturally. Therefore, I encourage my clients to develop a daily practice of gratefulness, even if it feels fake at first. This practice is a disciplined approach versus an organic one. An example of a simple disciplined practice is one suggested by Salt Lake City therapist Debbie Reid, CSW. She suggests to, “write down two things each day for which I am thankful…..” She also suggests, “writing down five ways I can show gratitude to others during the day”.  Those in a 12-step program know that those with addiction who are newly sober are often asked by old timers to be grateful even if it’s just for, “a roof over my head, food on my plate, and shoes on my feet”. It seems as if gratitude magnifies abundance.

Along with the practice of list making as mentioned above, there are many ways to integrate gratitude into your life. You may decide to take mindfulness walks and notice the beauty of nature with appreciation. You may choose to dance, write poetry, make music or paint. You might ask a friend to share, even if only by text, thankful and grateful thoughts. You could interview your friends about what they appreciate and find meaningful about their lives. You may add thanksgiving to your time in prayer and meditation, and last but not least, you could be especially courageous and speak of your gratitude directly to and for the loved ones in your life such as family, friends and even colleagues.

These practices of gratitude, no matter how small, if practiced consistently gather depth and breadth over time.

It is important for counselors and therapists to note that even the simple exercise of writing a gratitude list can trigger protests from clients, as if one positive word or action invalidates decades of pain. Positive words and actions do not invalidate past suffering. Although, and this may seem ironic, it is true that positive words can trigger unexpressed grief or the pain of times when the client’s suffering was minimized or invalidated.

As a therapist, it is important to be very sensitive to this dynamic. It can be helpful to predict in advance, that for some people, affirmations of life can bring up unidentified grief and anger. This reaction should be described to the client as normative and a short, small, temporary step in the process of positive change.

One way to process the responses of gratitude list making is to have the client write down negative thoughts or rebuttals as they emerge. Very simply, list the gratitude items on the left of a column and the negative responses on the right. This list should be processed
with the therapist. This way, the list of negative responses can be evaluated for possible dysfunctional family myths or lies.

In my own healing process, one of the issues I have addressed with positive words and gratitude is my creative intelligence. The lie in my family of origin was that I was considered to be “retarded”, when in fact, I was gifted. This familial lie outlasted evidence to the contrary. For example, when I graduated with a Master’s degree and a GPA of 3.94 (out of 4.0), I had to make a conscious choice to honor my intelligence. It did not come naturally. The family messages carried weight long-term.

The practice of gratitude for my strengths even before I was able to see them clearly helped me take good care of myself and push beyond limited and sabotaging expectations.

There can be a dark side to the practice of gratitude, when the practice is not grounded in sobriety or reality. There is a risk of using gratitude to reinforce unhealthy behaviors. Most people who are chemically dependent, at some point, felt very grateful for the relief or high that their use provided. Yet, to dwell on that specific moment without noting the dangerousness of addiction can be destructive. This type of ungrounded positivity helps us deny or postpone our pain, which can seem like a good thing, but it keeps us stuck. The challenge is to write a gratitude list that is healthy, sustainable and realistic.

In addition, for those with a serious mental illness, especially
with delusions or grandiosity, a therapist’s assignment should be tailored to the specific needs of the client. It is important to be sure that grandiosity and delusions are not amplified or reinforced.

Many people include gratitude as part of their spiritual practice. It is also used by people who want to improve their mood, health, sleep, and relationships. Robert Fritz, a theorist who writes about creativity, offers a complimentary practice. He says that no goal is too big to create but that it is essential to be grounded in reality that is pertinent to your dream. He suggests, in a way that is not that different from Jung’s mandala polarities, to juxtapose the vision you want to create alongside of the reality of what you have. It is the “structural tension” between the two and how it engages your subconscious mind that helps energize and manifest what you want.

Gratitude gives people hope and the strength to endure. It is able to sustain and inspire us during times of despair. Simply said, gratitude is a very powerful healing tool. It is important to integrate the discipline and practice of gratitude into counseling sessions, 12-step work, and as part of a daily spiritual practice.

Gratitude bestows reverence, allowing us to encounter everyday epiphanies, those transcendent moments of awe that change forever how we experience life and the world.

~ John Milton

Dr. Ericha Scott – Licensed as E. Hitchcock Scott, Ph.D. has 32 years of professional experience working with those who have co-occurring addictions and complex trauma. She has published research in peer review journals and trade magazines. She has published on topics of addiction and trauma, research on self-mutilation by dissociative disordered individuals, and her theory of creative arts therapy. Her contribution to the book, Integrative Therapies for Addiction Treatment by Oxford University Press will be published in 2017. Dr. Scott is an artist, a Board Certified Registered Art Therapist (ATR-BC), a Registered Expressive Arts Therapist (REAT), and an Internationally Certified Advanced Addiction Counselor (ICAADC).