IP LifeLine: Infectious Nature of Gratitude

IP Lifeline From Infection Control Today

Gratitude in Spring

For as long as I can remember, I have been energized and hopeful as winter ends and spring approaches. It’s an opportunity to take stock of the year and focus on my intentions, hopes, and dreams for the year to come. The fact that my birthday is right before Christmas likely contributes to this sense of cyclical endings and beginnings.

While this enthusiasm has been lifelong, cultivating true gratitude is a journey. Life experience is key to building the foundation for genuine appreciation. As we all reflect on winter 2024 and enter Spring 2025, what would happen if we considered gratitude a powerful agent of transformation? What if gratitude could spread through our offices, homes, and communities like a benevolent contagion?

Gratitude as an Infectious Agent

When we consider the morphology of infectious diseases, we look at their form, structure, and physical properties. In the case of gratitude, it does not have a prescriptive physical shape, but it can be described by how it manifests. Gratitude is a feeling of thankfulness and joy in response to a kindness received or a positive experience.¹ It can also be a state or a trait. State gratitude is a fleeting feeling of thankfulness towards someone, while trait gratitude is a more enduring tendency to experience such feelings.²

In simpler terms, the state of gratitude is an isolated infection that resolves in a relatively short duration.The trait of gratitude can be described as a chronic condition that makes the individual more susceptible to reinfection of gratitude again, and it may not be completely clear from the system.

How can you tell if your gratitude is a fleeting feeling or a personality trait? Fleeting, or localized, gratitude is short-lived, lasting from moments to a few days. It's usually triggered by specific positive events, like someone letting you merge in traffic when you're late or a meeting cancellation. This type of gratitude is context-dependent; you might feel it strongly in one situation but not another, even if both are positive. For example, the traffic merge might not elicit gratitude if you're not in a hurry.

Systemic gratitude, on the other hand, is a consistent experience. It's a general sense of thankfulness for the good things in life, regardless of specific events. You appreciate your colleagues, community, and even small gestures like a thoughtful email. This feeling persists even during challenges, allowing you to focus on the positive, appreciate what you have, and find meaning in all experiences. While some are naturally inclined towards systemic gratitude and others experience it more locally, it can be cultivated. It’s a skill we can develop.

Gratitude: A health care worker standing in a patient room with hands in the air.

(AI image credit: author)

The R^o of Gratitude:

The great thing about gratitude is that it is contagious. When we experience gratitude, we find ourselves in this highly contagious state. Some signs and symptoms you may experience include a full, toothy smile; sore cheeks from prolonged smiling; a new sparkle in your eye; a more optimistic outlook; increased generosity, patience, and a strong desire to connect to your personal and professional network. The desire to share this feeling and drive to interact with others makes the R^o for gratitude so high. For those with systemic gratitude, this reinforces their thankfulness for the positive and the value of life’s experiences.

For those who experience localized gratitude, this is where something magical can happen, a transition into systemic gratitude. This can occur following an experience of gratitude that is so profound that it impacts one’s perception of life. For example, gratitude for overcoming a serious or life-threatening illness, getting a job offer days after being laid off, or experiencing your community support after a tragic experience. The transition into systemic gratitude from these localized events can be subtle and intentional, such as keeping a gratitude journal or intentionally expressing gratitude to others. Systemic gratitude has many health benefits, including happiness, improved mood, reduced stress, and quality sleep.

A recent research paper explored the impact experiencing gratitude can have on mental health, strengthening relationships and making us more resilient in the face of challenges.³ The paper highlighted how gratitude can reduce anxiety and depression, increasing emotional stability and overall life satisfaction. Expressing gratitude to others can also make them feel appreciated and valued.² This can strengthen and reinforce social connectedness and bonding.³

The greater impact of gratitude, whether localized or systemic, is to increase the opportunities for others to experience gratitude and to experience higher levels of gratitude in both personal and professional environments.

Gratitude: Mode of Transmission

We traditionally categorize infectious agent transmission as airborne, droplet, or contact. Interestingly, gratitude can also be "transmitted," and it's a surprisingly sensory experience.We see acts of kindness, like a friend's thoughtful text or a stranger's generosity. We hear words of appreciation, a sincere "thank you" or "job well done."We smell a home-cooked meal or the subtle scent of bleach as we pass a patient’s room on enteric isolation. Or the taste of your favorite coffee brought to you by a co-worker or the fresh donuts your boss brought after an especially challenging week. Finally, the warmth of a hug from somebody you care about or a celebratory fist bump when we finish January without a CAUTI. Through each of these senses, we experience opportunities for gratitude each day. The trick is allowing ourselves to be aware of them and allowing them to enrich our experience of thankfulness by solidifying the positive connection with the source of our appreciation.

Living with Gratitude:

For the fortunate, there is a life full of gratitude and a deep desire to be thankful for all the goodness in their lives.Living with gratitude does not minimize the challenges or the tragedies in our lives. Gratitude is not about denying the reality that bad things aren’t happening or that pain doesn't exist. Rather, it's about consciously acknowledging the full spectrum of human experience, both positive and negative. When we are going through a difficult time, it can be easy to lean into the pain and focus only on what was lost.

Gratitude helps us to take a step back and see the larger picture and reminds us that even during suffering, there are still elements of life for which we can be grateful. Focusing on what we have rather than what we have lost or lack helps us be resilient in the face of adversity and reminds us of our internal strength and capacity to overcome. Finally, gratitude helps us find meaning and purpose in our suffering, allowing us to move through our grief and feel the full spectrum of emotions, both our sorrow and moments of appreciation.

In essence, living with gratitude helps us cultivate a balanced perspective, allowing us to acknowledge our challenges while being aware of the good. It’s about finding meaning and purpose in our experiences, whether they are positive or negative.

Living with gratitude means cultivating a mindset and way of life where appreciation and thankfulness are not just occasional feelings but a consistent and integrated part of how you experience the world. It's more than just saying "thank you"—it's a deep recognition of the good in your life, both big and small, and an active focus on the positive aspects of life.

References

1. American Psychological Association. Gratitude. Accessed February 5, 2025. https://dictionary.apa.org/gratitude
2. Tam KP. Gratitude to nature: Presenting a theory of its conceptualization, measurement, and effects on pro-environmental behavior. J Environ Psychol. 2022;79:101754.
3. Basit A, Ali R, Rahman S, Shah AA. Exploring how gratitude can strengthen interpersonal relationships, enhance mental well-being, foster emotional resilience, and promote greater social connectedness and cooperation. Rev Educ Adm Law. 2024;7(4):427-441.