10:07 AM

425 - Thanks-Giving Edition: Awe Walks, Embracing Gratitude, Daily Thanks-Giving

Take 3 – Practical Practice Pointers©

From the Literature

1) “Awe Walks” Can Improve Emotional Well-being in Older Adults

Aging into later life is often accompanied by social disconnection, anxiety, and sadness. Negative emotions are self-focused states with detrimental effects on aging and longevity. Awe is a positive emotion that people feel when they perceive they are in the presence of something bigger than themselves that they cannot immediately understand. Awe can be inspired by nature, art, music, collective action, or even the courage of others. The experience of awe has been shown to reduce self-focus, promote social connection, and foster prosocial actions by encouraging a “small self.”

A study published in 2020 by researchers at the UC San Francisco Memory and Aging Center (MAC) and the Global Brain Health Institute (GBHI) has shown that walking with an intention to experience awe can contribute to the experience of greater positive emotions in healthy older adults. Sixty participants took weekly 15-min outdoor walks for 8 weeks; participants were randomly assigned to an awe walk group or to a control walk group. Both groups were told to walk alone, maintain a light pace, and minimize usage of phones or other media. The awe-walk group was also asked to cultivate their sense of awe during the walk. They were told to tap into their childlike sense of wonder, to note the vastness of things, to notice the intricate details of things, and to seek out novel places to walk. The goal was to place the focus outside of themselves.

All participants were also instructed to take selfies before, during, and after each walk. Each day, they reported on their daily emotional experience outside of the walk context. They also completed pre- and postintervention measures of anxiety, depression, and life satisfaction.

The researchers found that compared with participants who took control walks, those who took awe walks experienced greater awe during their walks and over time exhibited an increasingly “small self” in their photographs (less of their self in the context of the overall picture). Participants also reported greater joy and prosocial positive emotions during their walks and displayed increasing smile intensity over the study.

Outside of the walk context, participants who took awe walks reported greater increases in daily prosocial positive emotions and greater decreases in daily distress over time. Postintervention anxiety, depression, and life satisfaction did not change from baseline in either group. The results suggest cultivating awe enhances positive emotions that foster social connection and diminishes negative emotions that hasten decline.

Mark’s Comments:

It was Sir John Lubbock, a British Statesman, who said, “What we see depends mainly on what we look for.” This simple study is a wonderful demonstration of this. I particularly appreciated the finding of the selfies to exhibit smaller “selves” over time in the awe walk group. I also loved the measurement of “smile intensity” by an independent, blinded group of smile raters. Perhaps over the next few weeks, consider trying some awe walks and see what you notice. And then see if someone comments on your increasingly “intense” smile. I think we’d all benefit from dialing up the smile intensity these days …

How could your life be even more awesome? The quiz at the 2nd reference below will help you find out.



From the “4th Aim” – Sustainability, Resilience, and Well-Being

2) Embracing Gratitude and Becoming Positively Contagious


The season of Thanksgiving always provides a wonderful backdrop for reflection on the place of gratitude in our lives. Studies show that the feeling of gratitude it is an important ingredient for overall well-being and will increase with regular practice (it’s a skill!). Below are some proven ways to become more grateful.

1. Take a Quiz. The gratitude quiz from Rick Hanson, PhD, provides a great way to reflect on your awareness of the things you’ve been given – from the kindness of friends to the gift of life itself. See the quiz link in the references. Note: This is not an endorsement of his programs, though I do find his work to be very helpful.

2. Use Visual Reminders. Because the two primary obstacles to gratitude are forgetfulness and a lack of mindful awareness (entropy!), visual reminders can serve as cues to trigger thoughts of gratitude. Often, the best visual reminders are other people.

3. Make a Vow to Practice Gratitude. Research shows that making an oath to perform a behavior increases the likelihood that the action will be executed. Therefore, write your own gratitude vow, which could be as simple as “I vow to count my blessings each day,” and post it somewhere where you will be regularly reminded. For even more impact, share your intention with friends, colleagues, and co-workers.

4. Watch your Language. Grateful people have a particular linguistic style that uses the language of gifts, blessings, good fortune, thanksgiving, and abundance. The focus is not self-centric, but rather on the inherently good things that others have done on your behalf and that are occurring in your life. Regularly expressing appreciation for the important people in your life is a wonderful and powerful way to practice this language.

5. Go Through the Motions. If you go through grateful motions, the emotion of gratitude should be triggered. Grateful motions include smiling, saying thank you, wishing others well, and writing letters of gratitude.

6. Keep a Gratitude Journal. Establish a daily practice, preferably in the evening, during which you remind yourself of the gifts, grace, benefits, and good things in your life. It can be done in less than 5 minutes. Recall moments of gratitude associated with ordinary events, your personal attributes, or valued people in your life, including your patients and those with whom you work. A “3 Blessings” exercise has specifically been shown to increase gratitude. See the 3rd Pointer for more details.

Mark’s Comments:

Consider choosing one or two of these and give them a try between now and January 1st. and become positively contagious. Why would you not!? Even better, invite a friend or even your PeerRxMed buddy/buddies to join in as well. Many people (including yourself) will be grateful you did.



From PeerRxMed ( www.PeerRxMed.org ) and Corey Martin, MD

3) Celebrate Thanks-Giving Every Day

“I don’t have to chase extraordinary moments to find happiness – it’s right in front of me if I’m paying attention and practicing gratitude”. -Brene Brown

When I ask people what they want more than anything in life, the top answers is always, “I just want to be happy”.

We spend our life chasing happiness and hoping someday we will finally figure it out. In reality, we are the architect of our own happiness. Studies show that only 10% of our happiness is contributed to the things (good or bad) that happen in our lives, 40% of our happiness is genetic and 50% of our happiness is how we process the things that happen to us. So, the good news is, much of our happiness is under our control. That bad news is, that if only 10% of our happiness is due to the people and things that happen around you, it’s pretty hard to blame others for our unhappiness…. (Darn…that would be so much easier.)

The tool I like the most to intentionally increase my happiness is called “Three Good Things”. It is simple, easy and only takes a couple minutes a day.

  • For 21 days before you go to sleep, reflect on three good things that happened to you during the day
  • Write them down in a journal (include the emotion/s you felt with these memories)
  • Reflect on why they happened
  • THAT’S IT, go to bed and let the magic happen.

Study after study has shown that doing this simple act for 3 weeks days prior to bed improves your happiness levels and decreases depression (by as much as taking a medicine like Zoloft) for at least 6 months.

Why does this work? We know that when we are sleeping, our brain continues to strengthen neural networks AND it strengthens those networks that were our focus within the 2 hours prior to sleep more than anything else. So, the idea with the Three Good Things is that if we focus on positive things in our life before we go to bed, our brain hardwires them during our sleep.

So, why not give it a try! As a warm-up, consider doing a round of 3 Good Things at the start of Thanksgiving Dinner with family and friends. Maybe you could even incorporate it as a bedtime routine with your kids, spouse, or partner. And after experiencing 3 weeks of the magic of increased happiness, at that point, why would you stop?!

Mark’s Comments:

My thanks to friend, colleague, and PeerRxMed buddy Corey Martin, MD, for his guest blog for this week. Corey is a family physician who is absolutely driven through his work to help improve the mental and physical health of our colleagues and care teams. As the founder of Innovations in Resilience (www.innovationsinresilience.com) and Bounce Travels (www.bouncetravels.com), one of the ways he does this is by facilitating wellbeing retreats across the US and throughout the world based on the work of Brené Brown, Parker Palmer, and the experience he has gained in working with thousands of colleagues.

I’ve incorporated gratitude in my journaling for many years, and the benefits continue to be substantial. Regularly sharing your “3 Good Things” from the day with a loved one (an instant answer to the “how was your day?” question) can also quickly transform the conversation. This doesn’t mean you don’t share your struggles and frustrations as well. It does, however, provide some important perspective! And it will likely be something you’ll look forward to sharing, even after a “long day.”

And remember, of course, that your daily “Thanks-Giving” is not about the food ….


  • Martin Seligman, PhD. The Three Good Things (also known as “The Three Blessings): Link


Mark and John

Carilion Clinic Department of Family and Community Medicine

Feel free to forward Take 3 to your colleagues. Glad to add them to the distribution list.

Email: mhgreenawald@carilionclinic.org