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Cultivating Gratitude while Living with Chronic Illness

Giving thanks promotes positive health outcomes.

Katie Willard Virant
Source: Katie Willard Virant

"Piglet noticed that even though he had a Very Small Heart, it could hold a rather large amount of Gratitude." ~A.A. Milne

I had the pleasure of spending a recent afternoon with a group of children who live with chronic illness. We talked about what we don’t like about having an illness. Shots, restrictive diets, and having to miss too much fun were right up there. As we commiserated, we also drew. Each of us had a large sheet of paper on which we drew outlines of ourselves. Think gingerbread people with distinguishing features like glasses, braces, and various hairstyles. We filled these body outlines with items that make us who we are. The children drew their hobbies of reading, playing video games, watching television, and playing sports. They drew their parents, their siblings, their friends and their pets. They drew their favorite toys, their favorite foods, and their favorite places. They drew their homes; they drew flowers; they drew sunshine. By the time we finished drawing, each of us had a representation of our body overflowing with the things that make us happy.

It occurs to me that our drawing group was counting our blessings. It also occurs to me that our blessings were many. We talked about hospital stays, surgeries and how needles really hurt; we also talked about the fun of soccer, the cuteness of cats, and the awesomeness of best friends. The things we love won’t cure our illnesses: There still will be medications with rotten side effects and symptoms that make us feel lousy. But they can make our illnesses easier to bear. Even on horrible days when pain is unrelenting and hope is dim, these “good things" we carry within us sustain us by reminding us that we are more than our suffering.

A recent research study found that gratitude predicted lower depression in chronic illness populations (Sirois & Wood, 2017). The study’s authors define gratitude as “a life orientation towards noticing the positive in life, including both thankfulness to others and a wider sense of appreciation for what one has (Sirois & Wood, 2017)." I’m struck that this definition in no way precludes the presence of anger and sorrow. To be thankful for what one possesses does not mean that one cannot simultaneously feel grief for what one has lost. Indeed, the group of children with whom I worked that afternoon interwove lamentation and delight in their descriptions of themselves. Gratitude did not remove mourning but rather placed it into a context that made it more bearable. The children saw themselves both as sick and well, honoring these contradictory parts of their experience.

As we ended our time together, the children and I talked about medication. We expanded the idea of medication to include, not just the pills prescribed to us by doctors, but also all of the “good things” in our lives that make us feel happy. I passed out blank prescription pads for the children to use, encouraging them to write themselves a prescription for their own emotional medicine. One eleven-year-old girl wrote a prescription for “Everybody in the World” to be refilled “Every Single Day.” She drew a nature scene of a pond surrounded by trees with a walking path winding through. The sun was shining in her picture, and she believed that everyone - chronically ill or not - would benefit from breathing in the fresh air and listening to the leaves rustle in the trees. Our group took in the scene she had depicted and smiled, heartened both by our memories of past walks in the woods and also by our anticipation of future outings. We were grateful for our past experiences of pleasure, grateful to be sharing these experiences with one another that afternoon, and grateful for the promise of days to come.

As we prepare for Thanksgiving, how can we play with cultivating gratitude, even as we struggle with illness? I began this month with this question on my mind, and I decided to use the alphabet as my guide for daily gratitude. The first day, I wrote down something for which I am grateful that begins with the letter A. The second day, I used the letter B as my prompt. At the end of 26 days, I will have 26 items on my list. If you prefer to do this activity with a group of people, you can sit in a circle and take turns running through the alphabet together as you name the things that make you happy. We carry within us sorrow, and we also carry within us joy. Let’s share both with one another as we embrace and express what it is to be human.


Sirois, F. & Wood, A.M. (2017). Gratitude uniquely predicts lower depression in chronic illness populations: A longitudinal study of Inflammatory Bowel Disease and Arthritis. Health Psychology, 36(2), 122-132.

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