The Role of Gratitude in Mental Health

By Jennifer Voorhaar, LCSW-C

As we enter a very busy holiday season, we know that there will be “hustle, bustle” while we are busy and hectic. We will certainly try to enjoy the fun and festivities, but we can sometimes lose sight of the blessings around us. Whether this is due to grief, sadness, depression, anxiety, or the stress of the expectations, we can work to shift our focus to a mindset of gratitude for improvements in our overall well being.

Some even deal with the effects of Seasonal Affective Disorder (the mental health related impacts of less sunshine and less time outside) and may need professional counseling. Regardless of the source of the low mood and high anxiety, research tell us that a daily practice of gratitude can impact wellbeing. Is being grateful and saying “thank you” all if takes to improve our overall mental health? No. However, it certainly can help.

According to the Merriam Webster Dictionary, the word gratitude is derived from the Latin word, gratus which means grace and grateful. The word grateful means “appreciative of benefits received” or “affording pleasure or contentment.”

To show gratitude, we express thankful appreciation for what we have and what we have received whether it is a tangible item (food, shelter, gifts, etc.) or intangible (support, phone calls, time with friends, etc.). When we show our gratitude for something we often acknowledge what is outside of ourselves therefore connecting us with others. The others could be a person, a collective community, nature or a higher power.

We know that being grateful and expressing gratitude involves a positive shift in mindset which directly correlates to greater happiness and overall wellbeing. When we acknowledge the good in our lives, we can feel and express positive emotions, enjoy positive experiences, having improved health, better manage difficult circumstances and have strong connections with others. The way that we express gratitude is different for all of us. For some it may involve looking back to positive memories of our past and being grateful for the events of our childhood. For others it might be looking at our current life and not taking our blessings for granted. While others it may be hopeful and optimistic about the future. Regardless of which way we look at gratitude, we know that there will be improved quality of life merely by being grateful. Reading a blog or hearing a friend tell you to be grateful may not be enough for some to embrace the concept of gratitude.

For some, research and data help to solidify ideas. Often in the mental health field, our work is driven by research so it is only fitting to share a bit of research with you to better enlighten the concept. I often share with clients the importance and research-based ideas of gratitude journaling and one study by Dr. Robert A. Emmons of the University of California, Davis and Dr. Michael E. McCullough of the University of Miami further supports this idea. These two researchers are leaders in the study of gratitude. In one study they asked participants to write down a few sentences each week and were given a particular topic to write about.

The first group was asked to write down what happened to them that they were grateful for each week. Another group was asked to write down the things that irritated or displeased them every day. The final group was asked to written down events that had affected them (with no emphasis on them being positive or negative). The study showed that after a 10-week period of time, the first group who wrote about gratitude were more optimistic and felt better about their lives. Surprisingly, they also exercised more and had fewer visits to physicians than those who focused on sources of aggravation.

It is hard for these kinds of studies to show cause and effect. But we can at least see a connection between gratitude and our overall wellbeing. Other studies at the impact of being grateful has on relationships. One such study showed that couples who took time to express gratitude to their partner left more positive toward the other person but also felt more comfortable expressing concerns in the relationship.

Additional studies show that managers who express gratitude and say thank you to their employees will impact productivity and motivation to work harder. Unfortunately, there have been studies to show no impact on well being based on a practice of gratitude journaling or being grateful toward others. However, with emotional maturity and a mindful pursuit of gratitude, one may experience an overall improvement in wellbeing.

So at this point you might be wondering, “what do I need to do in order to show gratitude?” We can begin by appreciating what we have instead of reaching for the new shiny object hoping for increases happiness. We can enjoy what we have and find satisfaction in what we do have rather than unsatisfied about what we don’t have. We can focus, change our focus at times, on what we have rather than

what we lack. And, we can acknowledge the improvement in our mental health as we shift and change our practice to one focused on gratitude.

As few ways to do this include:

1. Writing thank you notes – express, in writing, your appreciation for what someone did and the impact on your life. I know I love receiving fun mail so drop a note, a card, or a letter in the mail. And, maybe occasionally you send yourself a note because after all we can be appreciative for the way we care for ourselves as well as the way others care for us.

2. Send an email or text – we may not have access to someone’s mailing address so in that instance, maybe you send a text, an email or social media message. Be sure to include what you’re thankful for and how this act improved your life.

3. Think about someone and have a mindset of gratitude – there may be people who we appreciate and have no way of contacting them. Maybe it is the kind person in the grocery store who helped lift a heavy item and we said thank you in the moment but wish we could do more. Thinking about that person and being mindful of your appreciation can impact your overall mindset and create a positive environment in your own mind.

4. Gratitude journal – every day write down the things you are grateful, the gifts received, the acts of service you appreciate and overall the things that happen during your day of which you are grateful.

5. Count your wins – whether you call them blessings, wins or accomplishments, write about them, big or small consider what went well, what improved, etc.

6. Pray – cultivate your faith and use prayer to show and acknowledge your appreciation for your blessings

7. Meditate – be intentionally mindful about what you are grateful, focus on the tangible items or the emotional feelings to bring to light the pleasant experience gratitude brings

Sometimes in the midst of life we lose sight of all that we truly do have to be thankful for. So, this holiday season, I invite you to consider each day just a few things to be thankful for. It doesn’t have to be huge and it doesn’t have to be magnificent. Today I am grateful for the patience and understand of my team as I

procrastinate on writing this blog. I am grateful for the warm coffee I sipped while I started my morning. And, I am grateful for fall weather, falling leaves and chilly weather. Maybe in January I’ll wish for warmer days and sunnier skies but for today, I’ll take the autumn breeze.

Prioritizing Your Needs Over Other's Wants- Boundary Setting

By Jessica Roberson, LMSW

Sometimes we set boundaries and people choose not to respect them. Other times we stay quiet and allow resentment to build as people violate boundaries we never told them about. Boundary setting is an important skill to learn, and one that can improve our relationships, our mental well-being, our self-esteem, and our overall quality of life.

Setting healthy boundaries involves self-awareness: what are we comfortable with, what are our expectations for ourselves and of others, what are our non-negotiables, and do we have the assertiveness and communication skills to express all of the above? First, you must understand what your needs are. When you say “yes” to others, make sure that it’s not saying “no” to yourself.

Boundary setting requires the ability to assert your needs and priorities as the highest form of self-care; protecting your own mental health. Be clear and straightforward if someone does not understand the extent of your boundaries. This will leave no room for them to assume you are okay with them breaking them down. Allow yourself grace and accept the discomfort that can come with expressing your needs to others - guilt, shame, remorse, or worry how others will react. The discomfort is common amongst individuals with poor boundary setting, people pleasers and those who are codependent – which is a commonly learned behavior when there is a history of childhood trauma.

Show of hands. Where are my people pleasers at? I need you to hear this:

Setting boundaries is not rude, it's necessary.

Setting boundaries does not mean you don't care, it means you are trying to care for yourself.

Setting boundaries is not your way of declaring your needs over others, it's your way of protecting your mental health.

Your personal space and who you allow to be near to it or touch it is an obvious personal boundary.

Setting healthy boundaries is self-care and requires assertiveness, which is a skill you can learn from working with your therapist.

If it’s so important, why isn’t everyone setting healthy boundaries?

The term "narcissist" has been thrown out a lot lately, but it's hard to distinguish whether we have a bunch of people who lack empathy for others in this world, or a bunch of people pleasers that weren't taught boundary setting at a young age. My guess is both.

Setting healthy boundaries is a skill most adults and teens are lacking.

I hear things from my clients like:

"I don't want to be rude"

"I have to attend, it's a family function"

"I don't want to hurt other people's feelings"

"It's fine, I'll just push through it"

Boundary setting can be used in all aspects of our lives. Healthy boundaries in relationships both intimate, with friends, with family as well as with employers and coworkers is important to our overall well-being and life satisfaction.

In therapy, you will learn through boundary setting that you are able to clarify the expectations you have for yourself and the expectations you have of others. Make your expectations clear rather than assuming people will figure them out. Even if this person is around you every day and you believe they should pick up on what you're feeling. Ultimately, no one wants to assume the worst about you, so you have to express your thoughts and needs to them.

You will learn that declining anything you don't want to do or are too tired/too stressed to do is a boundary. How many times have you thought to yourself, "I really don't feel like going"? Then don't go! The people who love you will understand, some won't understand and give you grief about it, but no one should be guilting you into any event or situation that will cause you discomfort or jeopardize your mental health. Stand your ground.

We all need support but it’s important to understand and set emotional boundaries too. How emotionally available you are to others is a choice. You must take care of yourself first before you can take care of others. If you are not in a good place emotionally and mentally it is your responsibility to put your needs first before you can be emotionally available for others. Don't take on other’s baggage if you are already carrying enough of your own stuff.

Sometimes no matter how clear the boundaries, people fall back into old patterns. Reaffirm the boundaries with them until it sticks. If you have been doing things a certain way and have finally worked up the courage to set boundaries, don't be surprised if it takes people a little time to adjust. This can often happen in our closest relationships - family, friends, significant others. Don't let this be an opportunity for you to back down on your boundaries - set them and continue to clearly restate them as needed.

If you find yourself constantly restating boundaries it can lead to resentment. If you find that people are continuing to violate them, decide to restate them and walk away from those individuals or employers as needed.

Boundaries aren't just meant to be used in our relationships. Setting boundaries at work with coworkers and employers are just as important to our mental health. Have you ever heard the phrase “don’t kill yourself for a job that would replace you in 2 weeks if you dropped dead”? It’s harsh but there is some truth behind it. Boundaries at work look like taking your lunch breaks, taking your sick days, working in a supportive environment that helps you to succeed at your job, not taking on additional work that you are not being compensated for – stop saying “yes” to everything. To establish a healthy working environment, it is important for you to communicate your limits and your needs with your employer and colleagues.

And last but not least, set healthy boundaries with yourself too. That to do list can wait! Allow yourself the grace of being late for something, for having a messy house, for rest. Set realistic expectations for yourself and be patient with yourself. Take things one day at a time. We all have our own timeline - just keep doing what you can, care for yourself and allow everything to work out as it does. It may not be how you planned it, but everything does work itself out eventually.

5 Years of Serving our SOMD Community

As I sat down to write a blog to include in our September edition of our Hope and Healing newsletter, which is dedicated to the celebration of our 5th anniversary, I realized something. We are gearing up for a big 5th anniversary, but we’ve neglected to celebrate along the way. And, well, that is just sad. I’m not going to start at the beginning because you learn all about it by watching, listening, or reading via one of these options.

But what I am going to do is take you on a little journey….5, 4, 3, 2, 1….blast off!

5 years ago, we started as a one woman show in a one office suite in a small local business building. Five years ago, I had an idea, explored, and with the support of those around me, I started the journey. Maybe you’ll consider listening to The Wing Space Podcast Episode #1 to hear a bit more about the idea of “start, keep going and don’t stop.” Hope and Healing started five years ago as a resource for our community in need of trauma therapists. You’d often find me walking around Leonardtown Square and The Wharf during my Walk and Talk sessions. My idea of holistic mental health care was born.

4 years ago, we had grown from 1 to 4 in our little office suite, and you’d often hear us using the phrase “office tetris” because we had to be creative about who could use the office at any given time. We continued to Walk and Talk with our clients while also adding Psychological Evaluations to our box of tools. (Be sure to subscribe to our podcast to catch an upcoming episode about the benefits of walking). We spent the end of 2019 preparing for a major expansion not knowing that a global pandemic was just around the corner.

3 years ago, we grew from 4 to 6 and added an administrative assistant to our team. We started 2020 in a new office suite with 3 offices, tripling our space. We partnered with wellness collaborators for specialized grief counseling and massage therapy. The Wellness Center model was blooming until March of 2020 came along. On March 17, 2020, we all went home and for the most part everyone stayed at home providing our newest service, telehealth, to our ever-growing caseload of clients. We navigated the pandemic as a team doing all we could to provide support to one another and our clients while being available to our clients for their ever-growing needs. We continued to focus on holistic wellness and it was in 2020 that I also obtained a Faith Based Group Fitness Certification. I was determined to bring yoga and fitness into our model along with the talk therapy, walk and talk therapy, and massage services.

2 years ago, we added 5 more to our team including our first intern, a social media specialist and 3 more therapists. What we learned through 2020 and into 2021 was that the stigma around mental health treatment was going away. I still haven’t figured out if it is because so many people were feeling the isolation and stress of the pandemic, or if telehealth allowed people to engage in therapy without having to walk into a building. Whatever it may have been, our team was busy and we were truly blessed to serve the community of St. Mary’s County. The blessing continued in 2021 as we expanded into Calvert County mirroring our start in St. Mary’s in a one office suite in another provider’s building. By the end of 2021, we were ready for another expansion in Leonardtown as the Wellness Center model came to be.

2 years ago, our biggest expansion to date occurred as 2021 came to an end and 2022 kicked off with the snow storm of all snow storms. Our “grand opening” was delayed due to snow, ice, downed trees, and power outages… but, we persisted. We held our first open house in January and began offering wellness workshops, fitness, yoga and aromatherapy services. Our team went from 10 and 2 wellness collaborators to a team of 12 and 4 wellness collaborators. Our intern became an employee, another intern joined us, and we were filling the halls of our new, much larger location. By the end of 2022, the blessing of Hope and Healing was felt by all. With each employee, intern or wellness collaborator who joined our team, my commitment to them grew stronger. I wanted everyone who worked within the walls of Hope and Healing to love WHERE they worked, WHO they worked with ,and WHAT they did. It is a never-ending journey, but one I am committed to.

1 year ago, as 2023 began, our team was still growing and to date we are a team of 16 with 6 wellness collaborators and a full line up of services. We have mirrored another expansion in Calvert County moving from a shared office to our own suite with 2 offices. As we turn into September and round the corner to our 5th year, I cannot help but look back at the past 5 years with admiration, appreciation, respect, gratitude, and love.

1. I admire the clients who gather the strength to make the first call and step into their first session.

2. I appreciate the staff and wellness collaborators on our team for their tireless commitment to serve our community.

3. I respect the hard work our staff and our clients do each and every day.

4. I am grateful for the staff, clients and community who have trusted me and our team at Hope and Healing to walk with them along their journey of healing and wellness.

5. I love where I work. I love who I work with. I love what I do.

I’ve also been confused by birthdays and anniversaries because we aren’t on year 5 but rather, we’re starting year 6. So, while we are celebrating our 5th anniversary, we are being mindful of what is to come in our 6th year. For us in the mental health field, mindfulness comes from attention to and intentionality in the use of our senses. When our clients are in need of grounding, we tell them to find 5 things they can see, 4 things they can hear, 3 things they can touch, 2 things they can taste and 1 thing they can smell.

So, this 6th year, you will…

See:

1. New staff

2. New programs and services

3. Sales and specials

4. Our new Calvert Office in full swing

5. More of Leonardtown in Walk and Talk therapy promos and services

Hear:

1. A new podcast

2. From our new staff in their meet the therapist interviews

3. From our wellness providers as guests in the podcast to share about their aspect of holistic wellness

4. More about holistic wellness, it’s benefits and how to engage in wellness for your overall well being

Touch:

1. When engaged in new massage and yoga (YoMassage) classes

2. Explore mind body connections to feel the feelings and connect with your thoughts in a healthy way for healing

3. New retail and swag items

Taste:

1. Brenda Jean’s cookies in our lobby

2. The joys of Hershey Kisses, DumDum pops, Smarties and LifeSaver mints.

Smell:

1. Aromatherapy products

In celebration of our anniversary, I close out in true appreciation for you and your support of the us in service to our Southern Maryland community.