From a distance, Emma is the picture of good fortune. Her nails are flawlessly manicured, her makeup expertly applied. She somehow maintains a neat ponytail, despite the windy weather outside, and her perfectly tailored silk blouse and pants are accented with tasteful, elegant jewelry.
Yet from where I’m seated, in a chair directly across from her, I can see that Emma’s eyes are full of tears, and her perfectly manicured nails are digging into her palms. I’m Emma’s psychologist, and I know she’s been struggling.
Emma is telling me about a post she saw on Instagram, from a woman she follows with a name like @BlissedOutZenMama. Apparently @BlissedOutZenMama exhorted her followers to cultivate gratitude at this time of year, noting the importance of publicly taking stock of all they are #grateful for (those amazing kids!) and remembering how very lucky they are.
Emma suffers from anxiety and occasional depression, which tends to worsen at this time of year. She says that she knows she should be grateful for her children, especially because she endured several grueling rounds of IVF to get them. She knows, too, that she should be thankful for her privileged life. That she continues to struggle, despite all of these things, fills Emma with shame. I spend the session validating her continued feelings of sadness and anxiety and urging her to show herself compassion.
At this time of year, I hear a lot of stories like Emma’s. During Thanksgiving season we are barraged with social media posts insisting that we spend some time each day thinking about and publicly declaring what we’re #grateful for (or listing all the reasons why we are #blessed). We’re told that gratitude will help us put things into perspective and appreciate what we have, thereby helping us feel happier and healthier.
I have some trouble with the deliberate cultivation of gratitude. Don’t get me wrong: I absolutely see the value in waking up each morning and taking stock of the good things in our lives. But I also know that the gratitude mandate can be oppressive for people like Emma, who have much to be grateful for and yet still struggle.
I work in an affluent New York City suburb and specialize in treating maternal anxiety and stress. Like Emma, many of the women I see appear to have everything to be thankful for—a comfortable lifestyle, an extensive support system, children. And yet they come to me because they are suffering. They often have a hard time with the pressure to feel grateful, because despite “having it all,” they are in pain. When they continue to feel sad or anxious, despite their many advantages, they feel guilty—who are they to be miserable, they think, if they are so #blessed? This guilt is then layered on top of the depression or anxiety they already feel.
Further complicating the gratitude picture is the fact that we can be grateful for some things in our lives but not others. Consider the huge disconnect many of us feel between our own personal lives and what has been happening in our wider world, exemplified recently by the issue of family separation at the US borders. Many parents I know both personally and professionally simultaneously felt gratitude for their own kids and horror for the refugee children who were taken away from their parents. Our gratitude for our own kids does not wash away the grief and helplessness we feel about these other children. And nor should it—it’s our grief and helplessness that motivated many of us to donate time and money to the cause.
I often encourage patients to make space for the good and the bad—the things they’re grateful for, and the things they wish would change. In fact, this idea is a key tenet of Dialectical Behavior Therapy, recently in the news as the therapeutic modality favored by Selena Gomez (another example of someone who has everything to be thankful for, yet continues to suffer). We cannot expect that if we amass a large number of things to be grateful for, they will mentally overrule the things we’re not so happy about. Anyone who has had the experience of living through mental or physical illness, or losing a loved one, or enduring a trauma knows that no amount of money, success, or support is enough to shield you from pain.
While we should certainly try to be grateful, we must also be compassionate towards ourselves and acknowledge the things that aren’t going well for us. Because it’s this compassion that will open our eyes and hopefully inspire us to take action, to help ourselves (and our country). Again, I’m thinking here of the parents who heard about family separation and worked to stop it. I’m thinking too of Emma and my other patients, who recognize that they are having difficulty and take action by engaging in psychotherapy.
If I were @BlissedOutZenMama, I’d urge my followers to cultivate compassion along with gratitude. Be #grateful, yes, but also be #compassionate towards yourself if you are suffering, for whatever reason. And be compassionate towards others who may be suffering as well. It is this compassion that will help us change things for the better, both in our own lives and in the wider world.