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Clinical Orthopaedics and Related Research logoLink to Clinical Orthopaedics and Related Research
. 2021 Mar 11;479(5):901–903. doi: 10.1097/CORR.0000000000001711

Your Best Life: In Times of Crisis, Small Victories Matter

John D Kelly IV 1,
PMCID: PMC8052069  PMID: 33704101

The staggering number of illnesses and deaths around the world as a result of COVID-19 have researchers asking not whether the pandemic has damaged our collective psyches, but to what degree.

“The mental health and illness aspects of COVID-19 are among the most important side effects of this pandemic, which requires a national plan for prevention, diagnosis, and treatment,” Yamamoto et al. [12] write in their review article that characterizes the physical and mental toll taken by the pandemic.

We are all enduring, in some form, social isolation [5], economic anxiety, employment insecurity, or the everyday fear of contracting (or having a loved one contract) COVID-19. These burdens have led to an increase in anxiety and depression around the world [5].

I recognize that the topics I write about in this space will not put food on a single plate, add one cent to a bank account, or instantly heal the pain of losing a loved one. Three or four bullet points under a “Tomorrow, Try This” subhead at the bottom of my column will not tame COVID-19. But I believe that self-care approaches like practicing mindfulness [9] and showing gratitude [8], particularly in the time of COVID-19, can help one better manage the pressures of daily life and better negotiate the challenges ahead. Our disposition and our mood are the result of what thoughts occupy our minds. We all have the power to think about all that is good in our lives. By drawing attention to what we are grateful for, we will experience more energy and capacity to embrace whatever challenges await us.

That would be a small victory at a time when victories are hard to come by.

Why Gratitude Works

As I wrote in a previous column [8], showing gratitude fulfills two essentials for inner peace: it brings us into the present moment and directs our attention to all that is good. Giving and receiving gratitude can positively impact one’s mental and physical health—enhanced sleep [6], decreased inflammation [10], and increased levels of “feel good” neurotransmitters [13] are just some of the byproducts of a thankful disposition. We can learn to rewire our brains and become more resilient by practicing gratitude and, to use the term coined by author Martin Seligman, “learned optimism” will manifest [11]. If we can learn to give and accept gratitude then, in the words of writer Johann Wolfgang von Goethe, “the universe conspires to assist you.”

I understand how practicing “learned optimism” in the midst of a deadly pandemic sounds out of touch. (Yes, I have seen the news lately.) I understand that it seems like the universe is actually conspiring against us. (von Goethe didn’t go through 2020.) I understand because I’ve lived with those negative emotions inside of me, too. But when we hit lows in life, we can either remain in darkness or choose to grow.

As I reflect on my own experiences, there have been occasions that in the moment felt tragic, but over time, proved instead to be treasures. My interest in wellness and stress management was the result of a rock bottom time in my life that included a frivolous lawsuit, health concerns, and the loss of my father. The nadir of my emotional life prompted me to revisit the fundamentals of wellness. I reconnected to God as I knew Him, learned to control my thinking, and prioritized relationships and self-care. Engaging in an 8-week mindfulness course and regular sessions with a cognitive behavioral therapist finally gave me some measure of mastery over my thoughts, which had become steeped in negativity for years.

I now look back at that time and remain grateful for the lessons learned and the motivation to help others. My sense of empathy and compassion have appreciably increased over the years only because I have suffered in my life. Now, armed with tools such as mindfulness and gratitude, I can embrace every misfortune as an opportunity for learning and growth. I can now ask myself: where is the gift in this moment? Another small victory.

Ways to Practice Gratitude

Practicing gratitude is merely directing attention to all which is positive in one’s life. Research by UC Davis psychologist Robert Emmons PhD [3] shows that simply keeping a gratitude journal—regularly writing brief reflections on moments for which we’re thankful—can increase well-being and life satisfaction. One study led by Dr. Emmons on journaling [4] found that those who kept gratitude journals increased regular exercise, experienced fewer physical symptoms, generally felt better about their lives, and were essentially more optimistic about upcoming events compared with their negatively focused counterparts.

Expressing gratitude to another has been shown to fortify relationships [2]. So why not start with the ones closest to you? To begin a gratitude practice, obtain a journal and begin writing daily on three aspects of your life for which you are thankful for [7].

A recent journal entry of mine looked something like this:

“Three Good Things” Entry—January 2, 2021

I can still jog at my age and enjoyed a great run yesterday.

I have the opportunity to assist those in need of orthopaedic care.

Our twin daughters, Mary and Ann Marie, have found wonderful soulmates (Chris and Dan).

A direct written expression of gratitude appears to be especially powerful in eliciting positive emotions. You could write a gratitude letter [1] to someone you’ve never properly thanked. Thanking a mentor who substantially helped or guided you in your career may yield a lasting effect on your gratefulness quotient. This practice may be especially effective if it is directed to someone whom you haven’t connected with for a long period of time.

My Latest Letter—January 2, 2021

Today, I wrote a detailed email to my brother Mike who is presently ill and thanked him for being a role model of strength, toughness, and faith.

Another gratitude practice is to take one positive experience from the prior day and spending just two minutes writing down every detail about that event. As you recall this experience, your brain will consider how truly meaningful the event was and magnify the effect it has on your neural circuitry [1]. This practice will sensitize our brains to recognize more the gifts we are bestowed on a daily basis.

My Latest “Experience”—January 17, 2021

Last evening, my wife and I enjoyed a light show in an outdoor garden. I recognized the meaning of having a trusted and loyal soulmate who stood by me through thick and thin. I was grateful that we both enjoyed good health and could share our love for nature.

Dr. Emmons suggests that focusing our gratitude on the people in our lives for whom we’re thankful, instead of circumstances or possessions, will enhance the benefits we experience and emphasize the small victories in our day.

Tomorrow, Try This

  • Spend a few minutes quieting your mind with deep breathing, stretches, or any other mindfulness practices that suit you.

  • Write about three things you were grateful for. They may be small, and the written entries short, but if they brought you joy, write about them.

  • Once a week, pick someone who has positively impacted you and thank them via letter or email.

  • Recall yesterday’s positive experience and take a few minutes to write down the details from that small victory.

Footnotes

A note from the Editor-in-Chief: I am pleased to present the next installment of “Your Best Life,” a quarterly column written by John D. Kelly IV MD. Dr. Kelly is a Professor of Clinical Orthopaedic Surgery at the University of Pennsylvania. His column explores the many ways that busy professionals—surgeons and scientists—might find peace, happiness, and balance both at work and in their personal lives. We welcome reader feedback on all of our columns and articles; please send your comments to eic@clinorthop.org.

The author certifies that neither he, nor any members of his immediate family, has funding or commercial associations (consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article.

All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research® editors and board members are on file with the publication and can be viewed on request.

The opinions expressed are those of the writers, and do not reflect the opinion or policy of Clinical Orthopaedics and Related Research® or The Association of Bone and Joint Surgeons®.

References

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