The Power of Gratitude for Pain Management

It may seem impractical—or even unrealistic—to be thankful when you are in pain, especially when pain is such a huge part of your life. However, studies show that practicing gratitude can have a profound and sustained effect. In fact, it is during the difficult times in our lives that a positive outlook becomes essential.

What does research say about gratitude and pain?

Studies in the field of positive psychology show that experiencing gratitude can both directly and indirectly affect pain. Some of the benefits associated with gratitude include:

Improved quality of sleep

Up to 72 percent of individuals with chronic pain suffer from sleep disorders and clinical insomnia. Research shows that people with high levels of gratitude report better sleep, which leads to an overall decrease in depression, and anxiety as well as a marked improvement in pain;

Gratitude alleviates pain

Gratitude decreases sensitivity to pain while improving pain tolerance. People who are more grateful in their lives feel pain in fewer places, with a much lower intensity; and

Increased positive emotions and self-esteem

Most of the secondary effects of chronic pain result from the anxiety and depression brought on by the burden of the pain. Research indicates that the overall positive outlook on life that comes from gratitude is associated with better self-esteem.

Ananda Mahony, a naturopath and nutritionist in Australia, elaborates on the positive effects of gratitude: “Gratitude can play an important role in the management of pain, and it does so in numerous ways. Gratitude relates to improved psychological well-being and adjustment to the current state, including illness acceptance and actively seeking out positive benefits.” She adds, “Gratitude also strengthens the relationships we have with others, promoting connection and satisfaction. People in pain who have more social support and feel less isolated tend to develop less pain-related disability and show fewer pain-related behaviors, such as excessive resting, and less medication use.”

The power of the conscious and subconscious mind

The mind is divided into two components: the conscious and the subconscious. The conscious mind is the active thinker, the part of our mind of which we are aware. The subconscious mind is the silent doer, the part that controls our actions without our knowledge. Psychologist Chandni Srinivasan, who works with people suffering from chronic illnesses, explains the concept: “The subconscious mind records certain parts of your experiences that impact you, and stores them away as memories, which later influence your thoughts and actions. Your subconscious mind is always on—even when you’re asleep. This awareness is why family members and health-care professionals speak to patients who are in a coma—although they are unconscious, their subconscious mind can hear everything around them.”

Significant interaction occurs between the conscious and subconscious mind. It is now understood that positive experiences stem from a positive subconscious mind. Harnessing this effect requires reprogramming the brain.
Have you ever noticed how everything seems to go wrong some days, while on other days, everything you touch is a success? This phenomenon occurs because thoughts build up in your subconscious mind, attracting incidents that generate more of the same kind of thoughts—this applies to both positive and negative thoughts. Positive emotions have an upward spiraling effect, which means that when you genuinely feel happy and sustain that emotion, it leads to an overall improvement in your well-being.

Studies show that the easiest way to reprogram your brain is through gratitude. This is because unlike other emotions, which are based on what happens next, gratitude involves being thankful for what you already have; it is based on your current reality. You can use gratitude to draw what you want into your life.

Many experts believe you should set your mind to believe that you are in abundance. For example, if you want a promotion at work, you must visualize it and believe it; this may start with you saying, “I already have a promotion!” When your subconscious mind retorts with, “No, you don’t!” you should focus on saying, “I love my job, I am grateful for the roof over my head and for three meals a day.” Your subconscious mind will have no choice but to support the belief that you are in abundance. Furthermore, as you build more of these grateful thoughts, your subconscious mind acts to create an outward experience that will invoke more of this gratitude in you.

When you are in pain, it is the only thing on your mind. It is unrealistic to start thinking, “I have no pain.” However, focusing on being thankful for a caring family or a steady income, for example, generates thoughts of being in abundance. With time, you will build enough thoughts of gratitude to fuel positive experiences in your life, including better sleep, a reduction in pain and improved self-esteem.

Srinivasan explains, “Every time you thank the universe, there is a rebound effect on you. Gratitude is essential in the healing process; it is one of the most powerful tools.”

How to get started

Start small and work your way up, focusing on being regular and consistent with your gratitude. Here are a few ways to include gratitude in your life.

1. Maintain a gratitude journal

Make a detailed list of the things over the past week for which you are thankful. Research shows that people who kept a gratitude journal for as little as three months could express gratitude readily and found more things for which to be thankful. Your gratitude may be for simple things, such as a nice cup of coffee, or they can be larger, such as being thankful for a loved one.

Lauren Zalewski, founder of, shares her experience: “Over the past 17 years that I’ve been sick, I’ve tried every medication, every supplement, every treatment, every doctor; and most of them have left me with very disappointing results. When I started incorporating a gratitude practice of writing down things that don’t hurt or don’t give me trouble, I was able to see things from a completely different perspective. It took practice, but now that perspective is a knee-jerk reaction.”

2. Start a gratitude jar

Keep a jar filled with notes or photos of moments and people you are grateful for. Pick one out occasionally to get an instant boost of gratitude.

3. Write a letter of gratitude

Choose a person who has been helpful or kind to you, and write a letter thanking them. Describe what they did that made you feel grateful and how it impacted your life. Don’t worry about making the letter completely perfect; the idea is to express yourself freely. You can choose to keep the letter or deliver it to the person in any way you like.

4. Three good things

Each night, before going to sleep, write down three things that occurred during the day for which you are grateful, taking time to reflect on each one. Focus on how these events made you feel and why you appreciate them so much.

5. Remember the bad

This may seem counterproductive, but studies show that remembering some of the difficult times from our past helps us appreciate how far we have come. Take some time to reflect on how you tackled your problems, and be thankful for your personal growth.

6. Share gratitude

Share the experience of gratitude with your friends and family by taking the time to express what you are grateful for at the dinner table or during a get-together. Encourage your loved ones to do the same.

Zalewski offers another method of finding gratitude in pain: “I tell people to think back to a time when their pain was at its lowest. Most of the time, they can think of a time when the pain was even more excruciating than it is at that given moment. Even a quick five-minute meditation or breathing exercise can be an enormous help. I like to share a few guided meditations I’ve found on YouTube. Usually, when you’re in pain, you’re all tensed up. Doing breathing exercises helps to take care of some of that.”

According to Mahony, “Research shows that gratitude can be learned and increased. At first, gratitude exercises may not always manifest as a feeling of gratitude but, like a muscle, feelings of gratitude will come more easily with practice. Try to sustain a practice of gratitude even though you might feel anything but grateful. Try different gratitude activities and see what works for you. Even just experiencing the smallest flutter of gratitude is enough to build on. Incorporate the most gratitude-inducing activity into your daily routine to help build and sustain feelings of gratitude. If in doubt, set yourself a three-week challenge to perform a specific gratitude activity every day and see how you feel at the end. The consistency of practice is the key to longer-term benefits that go beyond momentary feelings of gratitude.”

Tools to help sustain gratitude

It may be hard to feel real gratitude when you are in pain, even with regular gratitude exercises. Fortunately, you don’t have to do it alone—multiple forms of help exist that can keep you motivated and strengthen your practice.

1. Support groups

Sharing your experiences and listening to those of others who are practicing gratitude can give you a psychological boost and get you more involved. Attitude of Gratitude with Chronic Pain is a Facebook support group created by Zalewski that brings people with chronic pain together so they can share their thoughts and experiences. “Staying connected with others is very important for our emotional well-being and recovery from chronic pain/illness,” says Zalewski. “Groups like Attitude of Gratitude with Chronic Pain, where you can speak to others who know what it’s like, take away your thinking of being unique and that nobody understands.”

2. Chronic Pain Anonymous (CPA) meetings

CPA is a fellowship of people struggling to cope with pain. They have come together in acceptance of their struggle and to start looking at the solution rather than the problem. You can take part in face-to-face, phone and online meetings, making it highly accessible to your needs and preferences.

3. Follow the work of experts

Listen to recordings and read articles and books by professionals who have dedicated their lives to the science of gratitude. Louise Hay, motivational author, has written 17 books on positive psychology and produced multiple affirmations (audio and video) that are available through her website.

4. Use online resources and tools

There are plenty of free tools online that you can use as a framework for your gratitude practice. You will find some downloadable worksheets at Therapist Aid, which you can use to explore various forms of gratitude, including relationship gratitude and self-gratitude.

Mahony says, “I set out to practice a month of gratitude. The things I thought about were small and big, such as how much I love walking my dog in the local forest reserve, or the rain in Brisbane after a long period of dry weather. Some days it was hard, and I had to work at feeling grateful—those days were the biggest teachers. Keeping up practice on those days made it easier on the days I had lots to feel grateful for. After a month, I noticed myself feeling gratitude without the need to prompt myself. It started to become second nature. However, I found that not practicing also became a habit, so since then, I write in my gratitude journal two to three times a week, and this keeps me ‘topped up.’”

What are you waiting for?

Start today by including a simple gratitude activity into your daily routine. Be grateful for the opportunity to try this self-management tool and see what benefits you reap.

Want to learn more about coping with chronic pain? Read “Your Self-Management Toolbox,” “Improving Quality of Life With Chronic Pain,” and “ACT for Chronic Pain.”

Nicola Davies, PhD, is a health psychologist. She last wrote for Pain-Free Living about coping when pain and mental illness collide.

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