Sumiko at 62: Ageing means loss. So what is there to be grateful for – and how?

Experts weigh in on what gratitude really is, whether it can improve our well-being, and how we can learn to practise it.

The science of gratitude, in its current form, is about 25 years old and relatively young, but there is already a substantial body of research. ST ILLUSTRATION: MANNY FRANCISCO

So in the end, the treatment didn’t work and my pomeranian, Princess, died.

She had a relapse of a life-threatening autoimmune condition. I had known the prognosis wasn’t good, but some part of me had remained hopeful. For the four weeks after she first went to the vet, my emotions swung from worry to happiness (when her blood count improved), fear to hope.

The weekend before she died, I decided to put those feelings aside and focus on gratitude.

Be grateful, I told myself again and again. Be grateful that you still have time together. Be grateful she is still eating and drinking. Be grateful you can still cradle her and feel the warmth of her body. Be grateful you can still stroke her long, silky hair. Be grateful she came into your life at all.

So I tried.

But gratitude couldn’t save her. It couldn’t lengthen her life.

I was at a business lunch when she died. My helper messaged me on WhatsApp to say that Princess had been sleeping on her cushion in the living room when she began to struggle a little, then slipped away.

I was heartbroken and angry, and she left a big hole in our lives. I tried to remind myself of the 2½ years we had shared – all the things I should be grateful for – but I drew a blank. It felt almost offensive to be grateful for anything, now that she was gone.

Gratitude has always been a difficult emotion for me to express. It is not because I take the good things in my life for granted. I am grateful for them. But I have always carried a superstition that acknowledging happiness too openly might tempt fate to take it away.

Yet I know gratitude is supposed to be good for us and I ought to cultivate it. I want to be a more positive person. I don’t want to grow old and become someone who just complains and can no longer see the good things around her.

But how does one develop gratitude at this age?

Ageing means loss. We lose our parents, our siblings and our friends. We lose our health, our looks, our career. The future becomes shorter than the past.

What, exactly, are we supposed to be grateful for, and how? 

What is gratitude?

Gratitude is actually quite a demanding emotion, relative to other emotions, says Lee Li Neng, a senior lecturer in the Department of Psychology at the National University of Singapore’s faculty of arts and social sciences.

To feel gratitude, he explains, you have to recognise three things: first, that something good has happened; second, that it came from somewhere outside yourself; and third, that you did not entirely earn it.

“That last one is where most people struggle with because gratitude essentially requires admitting dependence, and plenty of us would rather not,” he says.

Psychologists use the word “gratitude” to describe several different things, Lee says.

There is gratitude as a feeling, or what psychologists call a “state”, such as the small temporary warmth you feel when a colleague helps you out. Then there is gratitude as a disposition, or “trait”: tendency to keep noticing such acts. Both of these have a clear benefactor to be grateful towards.

There is also a looser, everyday meaning: Simply being thankful for a good night’s sleep or living in a safe country. In these moments, there may be no specific benefactor to thank. Some psychologists argue it is this broader orientation to life that really predicts well-being, Lee says.

The science of gratitude, in its current form, is about 25 years old and relatively young, but there is already a substantial body of research.

One of the more interesting ideas is that gratitude evolved primarily as a form of “relationship machinery”, says Lee. It helps us identify people who are worth investing in and strengthens our bonds with them.

If so, the popular image of gratitude as something we practise privately – sitting quietly in a room writing down three things you are thankful for in a journal – might be missing the point, he adds. “It’s better understood as primarily a social emotion.”

Does gratitude have health benefits?

Yes, to some degree, says Lee. But there are two separate bodies of evidence, and they don’t clearly agree.

A study published in 2024 followed nearly 50,000 older American nurses with an average age of 79. The most grateful third had about a 9 per cent lower risk of dying over the four-year follow-up period, and a 15 per cent lower risk of dying from cardiovascular disease, even after taking into account their health, lifestyle and social participation.

But the study was observational, Lee says. “The obvious problem is that people who are healthy, comfortable and well-loved have rather more to be grateful for.” In other words, it could be that better health leads to greater gratitude, rather than gratitude leading to better health. 

When researchers look at experiments, where causation can actually be tested, the picture is less dramatic.

A 2020 review of 19 randomised trials found that the physical health effects of gratitude were mixed. The one reasonably consistent finding was better subjective sleep. A 2021 meta-analysis of 27 trials found a small effect on depression and anxiety.

“So there is a reliable small lift in mood, a plausible improvement in sleep, and a longevity link that is real but where we can’t tell the direction of effect,” says Lee.

Psychologist Charis Lee from the Department of Psychology at the Singapore General Hospital (SGH) says gratitude may shift our attention away from threats and towards the resources and support we have; help us cope better with stress; strengthen relationships when we express appreciation to others; and help us find meaning in positive experiences.

It may also activate brain regions involved in emotional regulation, social connection and reward. “Taken together, these findings suggest that though gratitude is not a substitute for psychological and medical treatment, it is a protective factor that enhances overall well-being,” she says.

Are some people more open to gratitude?

Culture seems to matter more than we might expect.

NUS psychology lecturer Lee says a study published in May examined six different gratitude exercises across 34 countries, involving about 10,600 participants. Gratitude exercises include writing and sending a thank-you message and making a gratitude list.

The positive effects of doing these exercises varied considerably depending on where people lived. They were large in Mexico, for example, but very small in Norway and China. Singapore was not included in the study.

Another finding was that gratitude practices appeared to produce weaker gains in culturally “tight” societies – places with strong social norms and less tolerance for stepping outside them.

Why do some people seem more naturally grateful than others?

NUS’ Lee sees three possible reasons. The first is temperament. “Grateful people tend to be warmer, more outgoing and less anxious, and these traits are somewhat heritable,” he says.

The second is a habit of thinking. Gratitude requires us to make a particular attribution: That something good came from outside ourselves and was meant for us. This can be trained, he says.

The third layer is personal history.

“Gratitude comes easier to people who were actually treated well,” he says. For someone whose early life taught them that kindness is uncertain or comes with strings attached, being told to “notice what others have given you” can be far more difficult than it is for someone raised with consistent warmth.

Angie Chew, chief executive officer and mindfulness principal of mental health charity Brahm Centre, echoes this. She believes the family has an impact on one’s approach to gratitude.

“When parents express appreciation instead of complaining, the child will likely treat what she has with appreciation instead of with a sense of entitlement,” she says.

SGH psychologist Lee adds an important qualification: People who are chronically stressed, depressed, anxious or traumatised may focus more on threat, loss or inadequacy, making it harder to appreciate what they have. 

She cautions against judging a person’s internal emotional state from their external behaviour. “Someone who doesn’t express gratitude may still feel it deeply,” she says. “Conversely, someone who frequently says ‘I’m grateful’ may not necessarily experience greater gratitude internally.”

Source: The Straits Times © SPH Media Limited. Permission required for reproduction.