Do gratitude practices work for everyone?

I have been thinking about gratitude journals. Something about them has always made me slightly uncomfortable, and not because I have anything against gratitude; quite the opposite. I am grateful for many things in my life, and gratitude practices have been researched, with some evidence that they improve wellbeing. Writing down three things we are grateful for seems harmless enough.

Still, I resist the idea, and I think it has something to do with the point at which gratitude changes from something we feel into something we should practise.

I am interested in the word should. It comes up a lot in therapy. People tell me they should be coping better, worrying less, being more organised. Neurodivergent clients often arrive with a long history of these expectations: I should be able to manage this because other people do; I shouldn't find the noise so difficult; I shouldn't need so much time alone. Perhaps I should be more grateful belongs on that list too.

The problem with happiness

My training is in existential therapy, an approach more concerned with understanding difficult experiences than removing them. I have always been drawn to the idea that the harder aspects of human existence are not necessarily problems to be solved. Anxiety, sadness, uncertainty and isolation are not pleasant, but neither are they abnormalities. They are part of being human, and I am not convinced that a good life is one in which we become especially successful at avoiding them.

This sits awkwardly with our current preoccupation with wellbeing. There is an ever-growing number of things we can do to become better at being well: meditate, journal, exercise, sleep properly, spend time in nature, write down three things we are grateful for every evening. I do several of these myself, which makes my scepticism inconvenient, but I wonder what happens when wellbeing becomes another task we have to perform well.

The research is interesting here. A 2025 meta-analysis pooled 145 papers involving almost 25,000 people across 28 countries. Gratitude interventions were associated with improved wellbeing, but the effect was small and varied considerably between countries; the UK was among those where no significant effect was found.

A small effect is not a reason to dismiss something. I am more interested in what happens to research once it reaches popular culture, where 'this may help' can quite easily become 'this is what you should do'.

What are we trying to change?

This becomes more complicated when I think about neurodivergence. Many autistic and ADHD people have spent years adjusting themselves to environments that don't work well for them. If a classroom is unbearably noisy but everybody else seems fine, perhaps I am too sensitive. If I cannot organise myself in the same way as my colleagues, perhaps I am lazy. Repeated often enough, these messages make it difficult to tell the difference between: 'this is difficult for me' and 'I shouldn't find this difficult'.

I see versions of this confusion in therapy. Somebody might tell me they have a good job, like their colleagues and find the work interesting, yet come home completely exhausted with nothing left for anything else. Their appreciation of the job is real, but so is their exhaustion.

There is plenty we could explore therapeutically: anxiety, perfectionism, boundaries, or masking (the effort of suppressing your natural responses in order to appear like everyone else). Mindfulness might help, and perhaps gratitude might too. But I would also want to understand what actually happens during that working day.

Is there constant noise? How many interruptions? How much social interaction is required? Is there somewhere quiet to go? How much effort is being spent appearing fine?

At some point, I think we have to ask what exactly we are helping the person to cope with.

Gestalt therapy, another influence on how I work, places considerable importance on the relationship between a person and their environment: we cannot understand somebody separately from the conditions they live in. That has been useful to me in thinking about neurodivergence, because otherwise therapy can easily become one more place where the individual is asked to adapt.

Of course, we cannot redesign the world around ourselves, and there will always be circumstances we have no power to change. Finding a different relationship with those circumstances matters, which is where I find myself returning to Viktor Frankl, the psychiatrist who wrote about finding meaning in conditions he could not alter. His argument that we retain some freedom in how we respond has always felt both powerful and slightly uncomfortable to me. I value the agency in it, while wondering how easily an idea about freedom can become another expectation placed on somebody already struggling.

If I cannot change a situation, discovering how I want to meet it may give me some agency. I would, however, like to know first whether the situation really cannot be changed.

Gratitude and attention

Perhaps this is why I don't actually want to argue against gratitude journals. At its simplest, gratitude asks us to pay attention, and much of life passes without us noticing: the first warm evening of spring, somebody remembering how we take our coffee, the relief when somebody cancels plans we never wanted to attend.

Phenomenology, which in simple terms means staying close to an experience before rushing to explain it, has strongly influenced the way I work. What is happening, what do I notice, what is this like for me? What matters is that we don't already know what we are supposed to find.

This is where my difficulty with the gratitude journal becomes clearer. If I sit down at the end of the day with the instruction to find three things I am grateful for, I have already decided which part of my experience to look for. I might remember how much I enjoyed my coffee in the garden. I might also notice that I felt tense whenever a particular person spoke to me, or that the lights in the supermarket left me irritable for an hour afterwards. I don't think we need to decide in advance which of those is the psychologically healthier observation.

There is some early research here. A UK study of 47 autistic adults found that gratitude, hope and honesty were associated with greater life satisfaction. It is interesting, although an association does not tell us that practising gratitude would make an autistic person happier, and the researchers describe their work as preliminary.

It makes me wonder whether we need to resist the temptation to turn everything associated with wellbeing into something people ought to practise.

So, am I grateful?

Of course I am. But gratitude is one part of my experience, alongside irritation, tiredness, excitement, envy and relief, and I don't think the aim should be to identify the more acceptable experiences and give those more room.

This feels important for neurodivergent people, who may have spent years being told which of their responses are reasonable and which are excessive. Therapy, as I understand it, can offer a chance to become interested in an experience before deciding whether it needs correcting.

So perhaps this is where I have arrived. I don't want to reject gratitude, and I don't want to turn it into a therapeutic intervention either. I would rather think of it as one of the things we find when we pay attention to our lives, alongside discomfort, relief and the parts of experience that are harder to categorise.

So at the end of the day, I am less interested in asking what I am grateful for, and more interested in asking: what did I notice?

What helps one person may not help another. If something in your own life is difficult to make sense of, talking it through with a qualified counsellor or psychotherapist can be a good place to start.

Sources

Choi, H., Cha, Y., McCullough, M. E., Coles, N. A., & Oishi, S. (2025). A meta-analysis of the effectiveness of gratitude interventions on well-being across cultures. PNAS, 122(28).