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Kansha shite · Be grateful
What Three Thank-You Letters Did to the Brain
People starting therapy for anxiety or depression wrote one gratitude letter a week for three weeks. Three months later, their brains were responding to gratitude differently from those who had not.
Kansha shite, be grateful, is the third of the five precepts. It sits at the heart of Reiki self-practice.
The study
A small practice, then a long wait, then a scanner
The participants were not volunteers recruited for a gratitude study. They were people who happened to be beginning counselling for anxiety or depression at a university clinic, which makes them unusual in this field. Most gratitude research is done on people who are already doing well.
Some were asked to write a letter of thanks to another person each week for three weeks, alongside their therapy. Others simply had therapy. Then, around three months later, a subset of each group lay in an fMRI scanner and played a game designed to measure gratitude as it happened.
- Design
- Randomised trial, with fMRI in a subset
- Participants
- 43 scanned, all beginning psychotherapy
- Comparison
- Therapy without any writing task
- Measured
- Brain activity while feeling and expressing gratitude
What they found
Three results
Gratitude has its own address
When people felt more grateful, activity rose in the medial prefrontal cortex, a region involved in weighing value and making decisions. This pattern was largely separate from the regions used for empathy and for reading other people’s minds. Gratitude, in the brain, is not simply a form of fellow-feeling.
The letter-writers responded more strongly
Three months after their last letter, the writing group showed greater sensitivity to gratitude in that same region than the therapy-only group. The practice had ended. The difference in how their brains handled gratitude had not.
They also felt more grateful
Alongside the scan, the letter-writers reported higher gratitude in daily life than those who had not written. In the larger trial these participants came from, the gratitude group also reported better mental health at follow-up than those given expressive writing or therapy alone.
Three letters is not much. That a difference could still be found three months later is the reason this small study is so often cited.
Read this part too
Limitations
The authors describe the brain-scan part of this work as cross-sectional, and that word is doing a lot of work.
- No scan before the writing. Brains were only imaged at the three-month point. So this is a difference between two groups at one moment, not a measured change within anyone.
- Forty-three people is small for brain imaging. fMRI studies of this size are known to produce results that do not always repeat.
- The control group wrote nothing. Without a comparison writing task, the study cannot say whether it was gratitude specifically or simply the act of reflective writing.
- Everyone was starting therapy. These were people with anxiety or depression, and therapy itself was changing them across the same three months.
- Gratitude was measured as giving money. That is one expression of it, chosen because it can be counted. It may not capture the quieter kinds.
- The scanned group was self-selected. Only some of the trial’s participants agreed to be scanned, and those willing may differ from those who were not.
- A brain difference is not an experience. The scan shows a region responding differently. It cannot say what that felt like from the inside.
The research
Kini, P., Wong, J., McInnis, S., Gabana, N., & Brown, J. W. (2016). The effects of gratitude expression on neural activity. NeuroImage, 128, 1–10.
The larger trial: Wong, Y. J., Owen, J., Gabana, N. T., Brown, J. W., McInnis, S., Toth, P., & Gilman, L. (2018). Does gratitude writing improve the mental health of psychotherapy clients? Evidence from a randomized controlled trial. Psychotherapy Research, 28(2), 192–202. Read it here →
This is research into gratitude, not into Reiki, Reiki treatments or Reiki training. It is included here because gratitude is one of the five precepts.
For today only, be grateful.
It may go on shaping how you respond long after today has passed.
