Calm
YOUR CAVEMAN
podcast
February 3, 2025
Gratitude Science: An Antidote to Anxiety's Grip
Listen or watch on your favorite platforms
In this episode, Dr. Twitchell discusses a powerful tool for managing anxiety in both the short and long term—gratitude. Sharing personal experiences of long COVID, Dr. Twitchell explains how a daily gratitude practice helped alleviate anxiety and improve overall well-being. Drawing from scientific research and personal anecdotes, the episode highlights the broad-ranging benefits of gratitude, including reduced inflammation, better sleep, and enhanced emotional resilience. Dr. Twitchell offers practical tips for starting a gratitude practice. The episode concludes with a listener-contributed story, a “Kindness Narrative,” that will aid all listeners in starting a painless weekly gratitude practice.
Hi, everybody. Thanks for joining me again today. I'm so glad to have you with me once again. We're going to be talking about a tool which is really powerful and really effective for anxiety in the short term and in the longterm. It can help you in those moments when you're having what feels like an anxiety crisis, when your anxiety is really high, and you just need to get a handle on it right now. But it also can help you in the longterm. It's something that if you can implement in your life on a regular basis, it can really reduce the amount of anxiety that you experience in general. So it has both short-term and long-term effects.
But first I want to tell you about how I became convinced to use this tool finally, because it was a hard sell for me. So as I explained before, in my introductory episode, for those of you who listened to that back in August, I talked about how in 2020 I got sick with COVID right at the beginning of the pandemic. And unlike most people, I did not recover quickly from it, but I ended up with long COVID, what's known as long COVID now, but at the time it was a new disease. And even though I went to see many doctors, both in the U.S and in Brazil, I live in Brazil, but I spent part of the pandemic in the U S, and I went to all kinds of doctors, but there simply wasn't enough known about this disease to be able to understand what was causing the numerous symptoms that I was experiencing.
So among the first symptoms that was most alarming was extreme lung pain and this incapacity to ever feel like I was getting enough air. Just a constant air hunger. And I soon after that had extreme inflammation in my lungs, one of my lungs partially collapsed and wouldn't open up, when inflate properly anymore. I also had extremely painful heart inflammation. Which made it so that I couldn't lie down horizontally without a lot of pain. Because heart inflammation feels worse when you're horizontal. And it also made it so that every breath that I took, my lungs would push on the contours of my heart, which was really sore and inflamed. And so it would hurt my heart every time I, I would take a breath. I had a lot of inflammation in my brain, which made me lose a great deal of my short-term memory. I had terrible problems in my digestion. And my autonomic nervous system began to malfunction in a lot of different ways. And I had a pretty much constant, debilitating, extreme fatigue so that it was really hard to get enough energy just to take a shower or to go up the stairs in my house. All of this was extremely alarming, but the worst part about it was that nobody really knew what was wrong with me. And nobody knew what to do about it. And so if doctors knew then what they know now about long COVID, they could have given me some medications that would have helped, but at the time, the solution wasn't clear. And night after night, I hardly could sleep. It's really difficult to sleep when you can't get enough air. And so I was perpetually sleep deprived on top of everything else. So month after month extended with my health, just getting worse and worse. And I felt a lot of things during this time, period. I felt principally a sense of panic and anxiety and anguish about the situation and my inability to solve the problems, the emergencies, the bodily emergencies that I was facing.
So after about six months of simply not getting better and in a lot of ways, getting worse still, I started to pay more attention to people on my online support group. I had a support group of people from all over the world who were suffering from long COVID like me, thank goodness, who could help me to understand what was going on. At least we could share what was happening to us, we at least understood that we were not the only ones going through this. And we also could share what our doctors had prescribed, what we had tried, what seemed to work, what didn't seem to work. And there was a lot of talk on there by a few wise people about the importance of engaging in daily gratitude. And how this practice of gratitude would influence the way that we could manage our symptoms and our ability to heal. Now gratitude is something that I personally had never practiced, it's something I had never really taken seriously. It's something that I had heard about all my life. Something that you should do, something that's nice to do. Kind of like smiling at a stranger. It's a nice thing to do, but it was something that I viewed as pretty cheesy. Something Pollyanna would do from the old movie Pollyanna, but kind of ridiculous, actually. So it was not something that I could at that point in my life, really take seriously. But after so many months had passed, and I was still sick. I realized that I had a couple of options. I was sick, no matter what, there didn't seem to be any fast solutions for me. So I could either be sick and anguished and anxious and panicked, and even a little bit angry about my situation, or I could be sick and try some of these methods that people were talking about of gratitude, and cultivating some kind of hope about recovery. And I began to notice after time, after some time, that being angry and anguished and panicked, actually made my physical symptoms unbearable. It made them unmanageable. It um, augmented the pain that I was feeling, whereas when I would try some of these gratitude exercises that people suggested, that this actually would give me a little bit of relief and it made my suffering a little bit more bearable. And it made me able to feel a little bit of pleasure amidst all of my suffering, and this made it easier for me to feel patient about the process. So I began to submit to this idea that gratitude might help me, even though initially I really didn't believe in it. And I actually felt kind of disdainful of it. But I didn't have a lot of choices as far as what was going to help me. And so I decided I ought to try this.
So I began writing a daily gratitude diary. I would take a notebook and I would write a paragraph about things that I was grateful that I had, and things that I was grateful that I didn't have. And for those of you watching on YouTube, I have five notebooks here that I filled out during this time that I was sick, during the three years that I had long COVID, in which I practiced these gratitude paragraphs, these daily gratitude paragraphs. And I'm going to share just a couple of the entries that I made, to help you to see what it was that I found to be grateful for even though I was going through a really difficult time. So the first entry I'm going to share is from November 6th of 2020. So this is more than six months of being sick. It's about eight months into my illness and this is what I wrote. I was grateful that I had some good feelings on some days this week, even though I had very little sleep. I wrote that I was grateful that I had been able to walk, to wash clothes, and to go upstairs in my house that day. I was grateful for medications that helped with my pulmonary irritation. That all of the machines in my house were working. I was grateful that I had been able to sleep a little, at least a little bit, the night before. And that my, my heartbeats were less irregular than they had been the month previous. I wrote that I was grateful that my sister, who had COVID at that time, I was grateful that she was still alive. I wrote that I was grateful for jokes on my support group, and for good friends. Now here's an entry a year later on November 21st of 2021. I wrote that I was grateful for beautiful days, grateful that I could have a family photo that night, for the things that I was learning, for progress that was happening. I wrote that I was happy that I could at least sleep a little last night, and that I was glad that even this little bit of sleep felt deep and was renewing for me. I wrote that I was happy that hot showers and hot baths were helping me with the nervous system problems that I was having. That I was grateful that my other sister had survived her heart surgery. And I wrote that I was grateful that my heart still knew how to beat. Now, a few months later in January, the 22nd of January of 2022, I wrote that I was grateful that my husband had been so, so good to me, so nice the previous day, that I had been able to sleep well, was grateful for the love and support of my sister. I was grateful that I was able to write a little bit, um, the previous day, even though I didn't feel good. I was working on my, my dissertation research. I was grateful that it was a little bit cold, cooler the night previous, because of the rain. January, of course, in Brazil, where I live, is hot, so I was grateful that things had cooled off a little bit. I wrote that I was grateful that I had been able to make a good soup the previous night, I was grateful for some positions in which I felt comfortable. I was grateful for all the people in the world that I love, and I was grateful that I had a little rest from pain and discomfort the previous night. So this is the type of thing that I was engaging in, that was able to help me shift my focus, and be able to cultivate a consciousness that there were beautiful things happening in my life, even in the middle of all of this difficulty and suffering. And I started to be able to have kind of a perspective shift where I was able to have more moments where I felt comfort, where I felt hope, where I felt patience because of this gratitude practice.
So since 2020, even after I recovered, in 2023, I have continued the habit of writing in the Gratitude Journal because of two reasons. Because I noticed how helpful it was in helping me to regulate in those moments when I felt extremely anxious, when I was having kind of an anxiety crisis. That writing in a gratitude journal could help me manually shift my perspective in a manner of, in a matter of minutes to be able to shift out of anxiety, or shift out of a threat response and toward a challenge response, toward a sense that I could handle the things that were going on around me. But, not only that, not only that it helped me to be able to regulate in moments of acute anxiety, but I found that it helped me to shift my mental defaults in a more permanent way toward a challenge mindset rather than a threat mindset. So just reviewing, we've talked a lot about this challenge versus threat response to stress. Threat is where we enter anxiety because that's where we feel that the demands that we're facing are too much for our resources. And, you know, On the contrary, if we can go into a challenge response, that's where our brain decides that we have resources to meet the demands. And that helps us to approach the stressor, to feel excitement about the challenge, and to rise to the occasion. It facilitates our cognitive performance. So a challenge response is really beneficial in a lot of situations. And what I found was that this habit of writing in the daily Gratitude Journal helped me to shift, to have more of a default toward challenge appraisals, so that I was actually able to avoid a lot of the default anxiety that I used to experience previous to this. And this is possible because, as I've referenced before, researchers have pointed out that when we can repeatedly practice a certain pattern of mental interpretation of the events, mental reappraisal of things, that we can create durable change in our brains. We can create, we can go from having a certain tool that we use occasionally to having it become a mindset that is kind of our default. It's the mental mindset and the default that our brains just reflexively select without us having to employ so much effort. So, in the beginning, When I started this gratitude practice, it took a lot of effort for me. It was difficult, it didn't feel natural. But over time it started to feel a lot easier and it started to feel pleasurable because I noticed I associated it with the shift that would happen both immediately and durably.
So as I mentioned, I was, at the same time that I was sick, I was working on my doctoral dissertation for three of the four and a half years that I was writing my dissertation, that I was working on my doctorate, I was sick. Of course, I wasn't able to do a whole lot during the time that I was really ill. I did more of it in the year and a half after I recovered. But I was still consistently researching and studying and trying to make little bits of progress while I was sick. And as I mentioned in that introductory episode, my research was on anxiety management, specifically in the area of music performance anxiety, but I chose this focus because I am a musician, but I chose it sort of as an excuse to be able to study anxiety management in general so that I could work on my own anxiety on a general level in my life, and not just my music performance anxiety. So I researched, A lot of strategies that are shown to help with generalized anxiety, not just with music performance anxiety. So there are many researchers that have been looking at the effects of gratitude on well being, both physical and mental. And one of the prominent researchers is Dr. Robert Emmons, who is a professor of psychology at UC Davis, who wrote a good book about gratitude, which I can link in the show notes. But he talked about how those who practice gratitude, who experienced gratitude on a regular basis, are able to cope more effectively with everyday stress and show increased resilience in the face of trauma induced stress. So he talks about how it's not just a form of positive thinking or happy ology, like this Pollyanna idea that I had, but it's an ability to recognize and acknowledge that goodness exists and even in the worst moments that life offers. So when you go back to that challenge and threat model, when we are exercising gratitude. We're basically exercising our capacity to search for evidence that we have some resources present for us right now to meet the demands that we're facing. And it also, we're practicing reframing the demands that we are facing as less threatening. So, it's a tool in which we are practicing shifting from a threat mindset to a challenge mindset, because it is a practice which bolsters our sense of our resources and diminishes the sense of the demands that we're facing, even when those demands are very difficult. So, it's this habit of paying attention to the resources that are present for us and looking for ways that the demands are not quite as scary as we thought.
Now let me talk for a second about the ways that research has shown that gratitude affects physical health. Um, it has been associated with reduced inflammatory response, which is maybe why I felt some relief when I would practice gratitude, that some of my inflammation in my body would actually physically reduce. It has been associated with better sleep quality. And emotionally it has been associated with, um, more positive emotions. Those who practice gratitude experience positive emotions more often, tend to have greater levels of satisfaction with life, more hope, and less depression, less anxiety, less envy. So it, doesn't this just describe that shift from threat to challenge? You know, even though it seems like a ridiculous practice, a cheesy practice, look how effective it is from shifting our brains from threat to challenge.
Those who keep gratitude journals have been shown to have reported feeling closer and more connected to other people, have been shown to be more likely to help other people, and have actually been seen by significant others as more helpful while they're practicing these gratitude interventions. They seem, to the significant others, the people practicing gratitude seem measurably happier and more pleasant to be around. So this may be why people who have higher levels of gratitude tend to have better relationships, are more likely to protect and preserve the relationships that they have, are more securely attached, and are less lonely.
So, to summarize, there is a lot of research, and I will link a lot of it in the show notes so that you can look at it one by one, these studies, study after study showing that gratitude is positively related to outcomes like life satisfaction, vitality, happiness, Self-esteem, optimism, hope, empathy, and so on, willingness to provide emotional and tangible support for other people and it is also shown to reduce anxiety, depression, envy, materialism, and loneliness. So what a battery of benefits from this simple practice. that we can engage in if we can just humble ourselves to the point where we can believe that this is actually a really powerful thing.
So, let me just tell you a little bit about how after practicing gratitude for three years, when I finally recovered from long COVID and I was able to perform again, let me just tell you a little bit about how that affected specifically my performance anxiety, after having practiced it for that long. So I'll start first by telling you briefly about the last concert that I performed before I got sick, which was in March, 2020, right before everything closed down because of the pandemic. I was performing with a local orchestra here in Brazil. They had invited me to solo with them only one month previous, so I only had one month to prepare for this concert. And it was new repertoire. It was extremely stress, stressful, both the preparation and the performance, such that I wasn't able to enjoy it at all because my performance, my performance anxiety levels were absolutely through the roof. It was thoroughly unpleasant, unpleasant, thoroughly painful, which is a real shame because it is a rare opportunity to get to solo with an orchestra, but I could not enjoy it because I was so overcome by performance anxiety. Fast forward now to my next performance, which was three years later in April, 2023. During that time that I was sick, I was unsure as to whether I would ever be able to perform again. Because when you're sick for that long, you start to wonder if maybe this is permanent. And it was really difficult for me to imagine ever having the stamina to prepare and perform a concert again. But when I finally was well enough to do that, and I was able to do it in April 2023, performing a concert with my quartet, it was an entirely 180 degrees shift from my previous performance, my last performance in March of 2020, as far as performance anxiety went. Whereas before I tended often to focus in my performances about how this performance might affect my reputation and my career, how it might affect the way people thought of me, the different opportunities that I might have in the future. I was focused on none of that this time. I was simply amazed and grateful that the systems in my body were robust and balanced and functioning well enough to allow me to be able to be active. And I even felt just awe and gratitude at all the processes at work in the audience members' bodies, that they were able to be present at the concert. So I just had this consciousness of how precious it all was from the ability to be able to practice consistently, to prepare for the concert, to be able to rehearse long hours with my group, and for the stamina for executing an entire program on stage. So my goals were totally different this time. I wasn't trying to be admired or trying to have my career bolstered by contacts from the audience. Instead I was just savoring the preciousness of this moment. And the beautiful opportunity to create. And as a result, in this concert, I had no performance anxiety. I didn't have any performance anxiety at all.
And I really credit this in part to my practice of looking for, on a daily basis, signs of resources that were around me. Signs of positive and beautiful things in my life. That I had trained my brain so long, over two and a half years, to look for these things on a daily basis, that it was, X, that it was easy for me to do that, even in a moment of being on stage and having that kind of stress. So, there's some both personal and scientific Um, evidence for you about what gratitude can do for all different types of anxiety, generalized anxiety, and performance anxiety.
So let's talk for a minute about how you can put it into practice because gratitude is something that has to be practice .Just because it's good for you doesn't mean that it's easy or natural for you. It certainly wasn't easy or natural for me. So you can start this practice as I did, writing daily in a gratitude journal, a paragraph, but there's also other ways to practice gratitude. You can write letters to people that have done kind things to you. You can even just have a weekly intervention. Studies have shown that even a weekly intervention of just a few minutes of registering Positive and beautiful things, a list of blessings instead of burdens from your week, can make a significant difference and give you many of these benefits that we have talked about, can cause a shift in your nervous system where your heart and your breathing and your blood pressure and your brain rhythms are synchronized and give many of these health benefits that we've talked about. It can help us to produce beneficial hormones. One study showed that after a month of practicing gratitude for 15 minutes a day that 30 individuals experienced a hundred percent increase in certain beneficial hormones and a 30 percent reduction in the stress hormone cortisol. So over and over again we see that this is a practice that has robust results.
This is worth engaging in even if we're suspicious of it, even if we feel like it's silly as we're practicing it. This makes a huge difference in our anxiety overall and in our our wellbeing, both mental and physical. So with this in mind, I want to help you to start a gratitude practice. Gratitude is, of course, more helpful the more you practice it. But even starting just small can make a big difference. And that's why I want to give you this little stepping stone to start with. We're going to do that by having what I call a kindness narrative at the end of each episode from now on, in which someone, one of our listeners, can offer a story about when someone was kind to them and share it with all of us. Now, there are studies that show that even listening to this type of story, when it's not your story, this can also provide many of these gratitude practice benefits. So it will benefit the person who is sharing the story, Who's expressing this, the appreciation, but it also benefits all of us who are listening to it.
So what will happen is we'll have a quick story, one to three minutes by a listener in which they share an experience of when someone was kind to them. If you want to send in a story, you don't need to use your name. If you don't want to introduce yourself, you can simply start telling your story. What's really important is the appreciation expressed for this act of kindness that will benefit both the person who shares it, and all of us who listen to it, because this will be part of our gratitude practice. So if you want to send in a story, you can do it by sending me an audio on instagram@calmyourcaveman.com, or you can send it to me by email, calm your caveman@gmail.com. But in any case, I'm going to start now with today's gratitude practice, kindness narrative. Just remember in those moments when you feel like this is cheesy and this feels strange, remember all of that battery of evidence that we have from all of the research that has been done about why this is important, and how much it helps you, and understanding how it shifts your brain out of threat to challenge, and that this is a really worthwhile practice and extremely accessible. It's something that we all can do. It's just a matter of taking a little bit of energy to do it. However, listening to this kindness narrative will take almost no energy on your part, and it will be a Uh, beginning to your weekly gratitude practice, which then you can expand according as you want to, into a daily practice to whatever type of gratitude practice benefits you most.
So if you want to look more into gratitude interventions and how these can be done, look at the articles that are referenced in the show notes and you can look at that in more depth. But I wanted to make sure that you understood how much this tool can help you and I wanted to try and convince you from my own story of doubt to belief about why this tool is important for you. Why it could make such a big difference in your life. Not only in helping you to managing anxiety in those moments when it's uncomfortable, but also in preventing anxiety from happening in the first place in a great measure in your life.
So that's what I wanted to share with you today. Thanks again for listening and we'll see you again next time.
Hello, my name is Samuel. And just a few months ago, I was living really close to a very impoverished community and this community had no roads, just a bunch of alleys, had no proper basic sanitation or electricity. And the houses were all made out of plywood and fiberglass tiles or whatever other materials people could find.
And the people who lived in this community were extremely hospitable. And even though it was a drug dealing hotspot. And it had a lot of criminal activity. I was always very welcome there and people that were very hospitable. And I never less left anyone's house there without having them feed me first.
And they'd always ask me if I had a place to sleep, they'd offer their house for me to sleep there. And they'd offer me food. They'd always, they would never let me leave without feeding me first. Even when some of those people didn't even have a fridge, but they would still feed me even when they had almost nothing.
And I learned so much from those people and I want to be hospitable like they were. And I'm very grateful for so many people around the world who care for their neighbor's wellbeing and who love their neighbor. And even when they have almost nothing they want their neighbor to, to be well off. And I'm very grateful for, for that.
And for the lessons those people taught me as well.
[00:00:00] - Introduction and Overview
[00:00:34] - Personal Journey with Long COVID
[00:04:19] - Discovering the Power of Gratitude
[00:07:19] - Gratitude Journal Entries
[00:10:58] - Scientific Benefits of Gratitude
[00:19:29] - Impact on Performance Anxiety
[00:23:35] - How to Start Your Own Gratitude Practice
[00:25:37] - Kindness Narrative and Conclusion