Service and Gratitude as Lifelong Practice

Posted on by helpingsoul

Why Giving Back to Others and Acknowledging What You Have Received Are Foundational to Sustained Growth — In Recovery and Beyond

A substantial revision of an earlier 2014 post on the twelfth step of Alcoholics Anonymous. The principles are sound. The framing has been broadened to address recovery and growth in their many forms.

The twelfth step of Alcoholics Anonymous, in its original wording, reads: Having had a spiritual awakening as the result of these Steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.

When I first wrote about this step in 2014, I was attending Adult Children of Alcoholics meetings as part of my own work. I was trying to understand my father, who has been in recovery for many decades, and trying to understand the legacy of growing up around his alcoholism. The twelve-step framework gave me one lens for thinking about the principles of sustained recovery — practical principles that have remained meaningful to me, even as my clinical work has expanded into other territories of healing.

What I have come to recognize, in the years since, is that the principles in this final step are not unique to recovery from alcohol. They name something true about how sustained growth actually works, for anyone doing meaningful inner work. The specific frame of AA is one expression of these principles. The principles themselves apply much more broadly. They apply to anyone in recovery from any addiction. They apply to anyone doing trauma recovery. They apply to anyone working through grief. They apply to anyone trying to live a more conscious life than they were trained to live.

This article is a broadening. The twelve-step community will recognize the source material. Anyone outside of that community can engage the same principles in their own context. Both readings are valid.

Recovery as continuing rather than completed

The original twelfth step recognizes that the work does not end when the immediate crisis is over. The recovering alcoholic who has stopped drinking has not finished. The work continues for the rest of their life. Maintaining the change is a daily practice rather than a destination.

The same is true for recovery from any meaningful pattern. The person who has done significant work on attachment trauma does not finish that work. The patterns may quiet. The reactivity may soften. New responses become available. And the underlying conditioning, formed across childhood, continues to surface periodically in ways that require continued attention. The work becomes a practice rather than an event.

This is honest. It is also, in some ways, freeing. The pressure to complete the work — to arrive at some final state of healing where the past no longer affects you — is a pressure that produces shame when the work continues to be needed years later. Recognizing that this is how sustained recovery actually works removes the pressure. You are not failing because the work continues. The work continues because that is what the work is.

Service as the natural extension of recovery

When someone has done significant work and arrived at greater stability, the question of what to do with what they have learned becomes meaningful. The original twelfth step answers this question directly: carry the message. Help others who are still in the early stages of the work you have completed.

In the AA context, this means becoming a sponsor, attending meetings to support newcomers, sharing your experience and strength and hope. The frame is specific. But the underlying principle is broader. The person who has done significant work has something genuine to offer others. The offering is part of what sustains the person’s own continued recovery.

This is not theoretical. There is research support for the observation that helping others produces durable benefits for the helper, sometimes more than the helped. The act of using your experience in service to someone else integrates the experience in a way that solitary processing does not. Telling your story to someone who needs to hear it makes the story more real, more integrated, more useful. The service is its own form of practice.

This applies regardless of the specific recovery context. The adult who has worked through their own attachment wounds becomes valuable to other adults doing similar work. The person who has navigated significant grief has something to offer others facing loss. The person who has come out the other side of any meaningful struggle carries knowledge that, shared appropriately, helps the people behind them on the path.

The service does not have to be formal. It can be the conversation with a friend who is struggling, where you share what you learned in your own version of that struggle. It can be the listening you offer when someone needs to be heard. It can be the patience you extend to someone earlier on a path you have walked. The service is whatever you do with what you have learned, in genuine response to what someone else needs.

Gratitude as the practice that sustains everything else

The other principle named in the twelfth step is gratitude. The recovering alcoholic, having received help, is asked to recognize what they have been given. This recognition produces a particular kind of stability. The person who can acknowledge what they have received does not have to carry the alone-against-the-world stance that often precedes addiction and other forms of struggle.

Gratitude, properly understood, is not a positive-thinking practice or a forced sunny disposition. It is the honest recognition of what is true. You are alive. Someone helped you. The conditions for your current state, whatever it is, include the contributions of many people, many circumstances, many fortunate alignments alongside the difficult ones. Acknowledging this is not optimism. It is accuracy.

There is also research on this. The work of Robert Emmons at UC Davis, who has been studying gratitude for several decades, has shown that consistent gratitude practice produces measurable changes in well-being, sleep, relational satisfaction, and physiological stress markers. Gratitude works in the body, not only in the mind. The system that regularly acknowledges what it has received functions better than the system that does not.

The practice does not require elaborate ritual. A short list at the end of the day. A specific acknowledgment to someone who helped you, given to them directly. A pause before a meal to recognize what is on the plate and who contributed to its arrival there. The simple acts, repeated, accumulate.

On the AA framework specifically

For readers who are themselves in AA or another twelve-step program, the original principles continue to apply. Sponsor someone if you are ready. Attend meetings consistently. Practice the steps as the lifelong path they are designed to be. The community offers something significant — the shared experience of others who have walked the same road, the regular practice of the meetings themselves, the structure that gives the principles their ongoing power.

For readers who are not in a twelve-step program but who are doing other forms of recovery or growth work, the same principles apply with appropriate translation. Find your equivalent of the meeting — the therapy group, the somatic class, the community of others doing similar work. Find your equivalent of the sponsor relationship — the mentor, the trusted friend further along the path, the therapist who has accompanied you. Find your equivalent of service — the role you can play in supporting others in their own work. The forms differ. The functions are the same.

I would also acknowledge, having written about this in other recent posts, that the language of the older twelve-step literature can sometimes feel harsh by current standards. The framing of alcoholism as disease, of the person in recovery as defective, of the surrendering of will to a higher power as the only path to sobriety — all of this works for many people and lands as shaming for others. Current trauma-informed understanding offers more compassionate framings of the same underlying work, recognizing the early conditions that often precede addiction and treating the addictive behavior as an intelligent if costly survival adaptation rather than as a disease to be cured.

Both framings can be held. Twelve-step community remains genuinely valuable for many people, even when the language sometimes lands hard. Trauma-informed framings offer additional language that some people find more accurate to their experience. The work itself, in both frames, is similar. The principles of service and gratitude apply to both.

Reflection questions

If you are doing recovery work in any form, the following questions may be useful for your own reflection.

Who has helped you in your work, and how have you acknowledged their contribution?

What have you learned that someone else might benefit from hearing?

Is there someone earlier on a path you have walked, with whom you could share what you know?

What does gratitude look like as a daily practice in your specific life?

How do you handle conflict differently now than you did before your recovery work began? What helped you develop the new capacity?

What is your relationship with the community that has supported your work, and how do you contribute to it?

When you imagine yourself five or ten years from now, what kind of presence do you want to be for others walking similar paths?

These questions are not a test. They are openings for reflection. The answers may come quickly or may take weeks to surface. Sit with them as feels right.

A closing thought

The principles in this final step, whether you encounter them in AA or in some other framework, are pointing at something true. The work of sustained growth is lifelong. The service to others is part of how the work sustains itself. The gratitude for what you have received is the foundation that keeps the rest of the practice from drifting into ego or fatigue.

Most of us were not taught these principles directly. We learned them through our own struggles, through the help of others who walked alongside us, through the slow accumulation of experience that comes from doing the work over years. Naming them clearly is part of what makes them transmissible — what allows them to be passed forward to the people who come after us on similar paths.

Whatever path you are walking, the principles apply. Continue the work. Help others where you can. Acknowledge what you have received. These three practices, held together, become the architecture of a life that does not need to escape from itself. The escape, eventually, becomes unnecessary. The life is the one you actually want to live.

Further reading: Alcoholics Anonymous and the broader twelve-step literature. Adult Children of Alcoholics. Robert Emmons, Thanks: How Practicing Gratitude Can Make You Happier. For the broader work on compassionate framings of recovery, see related posts on this blog including The Art of Detachment with Love.

April Wright, MA, LMFT is a Licensed Marriage and Family Therapist in California and Florida. She blogs about attachment, healing, and the courageous arts of becoming oneself at courageous-arts.com and sees clients at thecourageousself.com.

Happiness Is Not a Mood: What Thirteen Years of Reading the Research Has Changed in How I Understand Joy

Posted on by helpingsoul

A revisit of an old post on happiness — what I had right, what I had wrong, and what thirteen years of research has changed in how I understand joy.

In 2013, I wrote a blog post called Optimize Brain Function and Create Happiness. It was a list of twenty-five things — meditation, journaling, gratitude, exercise, kindness, supplements with specific dosages, positive thinking, eye contact, power posing, and so on. The post did well at the time. It captured what was current in the cultural conversation about happiness then. And reading it now, more than a decade later, I see that some of what I wrote has held up beautifully and some of it has not.

This post is a revisit. Not a replacement of the original — that one is still there if you want to look at it. A genuine rethinking of what I have come to understand about happiness in the years since I wrote it. The work I do as a Licensed Marriage and Family Therapist has changed me. So has the field. Some things that seemed straightforward in 2013 are more complicated than I knew. Some things I did not yet understand have become central to how I think about wellbeing.

Here is what has changed.

What I had right

Small changes still matter. That was the heart of the 2013 post and it remains true. Daily practices, repeated over time, produce more change than dramatic interventions. The brain and the body respond to consistency more than to intensity. A short daily meditation done for months produces results that a long retreat experience does not match. A gratitude practice of three things, written down most evenings, accumulates into a different relationship with one’s life over a year.

The basics still matter. Movement, sleep, hydration, time in nature, reduced exposure to chronic stress, regular meals — these are not glamorous interventions. They are the conditions under which the nervous system can function. Without them, no amount of mindset work will reach the underlying physiology that determines so much of what we call happiness.

Other people matter. The 2013 version of the post emphasized surrounding yourself with positive people, and that observation has been deepened rather than overturned by subsequent research. The single most consistent finding in happiness science over the past two decades is that the quality of your close relationships predicts your well-being more reliably than almost any other factor. Not the number of relationships. Not their visible success. The felt quality of being loved, seen, and known by the people closest to you.

What I had wrong

I framed happiness as a choice, full stop. “Happiness is a choice,” the original post said. It is not entirely wrong, but it is not entirely right either. Happiness involves choices, certainly — daily practices, attention to what fills you, willingness to engage in relationships that nourish you. And it is also significantly shaped by genetic factors, by current life circumstances, by physiological conditions that no amount of choosing can override, by trauma history, and by the social and economic conditions in which a person is trying to live.

Telling someone who is depressed that happiness is a choice often produces shame rather than help. The choice framing works for people whose baseline state is already pretty stable and who can benefit from small adjustments. For people whose baseline state has been compromised by depression, anxiety, chronic stress, unprocessed trauma, or serious medical conditions, the choice framing can be actively harmful. It implies that their suffering is, in some way, their own fault. It is not.

I included specific supplement dosages. I would not do that today. Blog posts are not the right place for supplement recommendations, both because the research has shifted on most of what I listed and because the legal and ethical standards around supplement advice have tightened appropriately. Anyone considering supplements should talk to their doctor or to a licensed nutritionist who can assess them as individuals rather than reading dosing recommendations from a blog post.

I listed twenty-five things. That was the format of 2013 blog writing, and lists still have their uses. But for a topic as layered as happiness, the list format can flatten what is actually a deeply nuanced subject. The list suggests that happiness is the sum of these twenty-five practices done consistently. It is not. Happiness is more relational, more physiological, more contextual, and sometimes simpler than a list of practices can capture.

What the field has learned since 2013

Sonja Lyubomirsky, who is one of the most influential happiness researchers working today and a Distinguished Professor at UC Riverside, has spent the past decade refining what she calls the architecture of sustainable happiness. Her work shows that happiness interventions do produce real change when sustained over time — but the change is more durable when the interventions are matched to the person doing them. Gratitude practices work better for some people than for others. Acts of kindness produce more benefit when they are varied rather than routinized. The how matters as much as the what.

Most recently, Lyubomirsky has published a book called How to Feel Loved, co-authored with Harry Reis of the University of Rochester. The book, released in early 2026, makes a striking argument grounded in decades of research. The single most reliable difference between happy and unhappy people is not money, success, or even health. It is whether they feel loved — felt loved, in their bodies, in ordinary moments, by the people closest to them. “To feel that the people in your life truly get you, value you, and love you,” Lyubomirsky and Reis write, “is what makes life worth living.”

This finding has changed how I think about happiness. It also resonates with the trauma and attachment work I do daily in my practice. The people who struggle most with happiness are very often people who, for reasons rooted in their earliest relationships, do not feel loved at a felt-sense level — regardless of how much love is actually present in their current lives. Their nervous systems were calibrated by early conditions to filter out the love that is being offered. The work of becoming happier, for these clients, is not a matter of adopting more positive practices. It is the work of slowly developing the capacity to feel love when it arrives.

Barbara Fredrickson, at the University of North Carolina, has shown through decades of research that positive emotions, even brief ones, produce measurable changes in cognition, social behavior, health, and resilience. Her broaden-and-build theory describes how moments of positive affect open the mind and build durable resources over time. More recent work from her Positive Emotions and Psychophysiology Lab has focused on what she calls positivity resonance — the felt sense of shared positive emotion between two people in conversation, in eye contact, in the simple moments of being together. These small shared moments are not decorative. They are the building blocks of the longer-term well-being that all the other practices try to produce.

What I would tell my 2013 self

Keep the small practices. They matter. Add to them the recognition that happiness is not primarily a matter of individual optimization but of relationship — to your own body, to the people in your life, to whatever you understand as larger than yourself.

Stop treating happiness as a target. Treat it as a byproduct of a life lived in close connection to the things and people that genuinely matter to you. The targeting itself, paradoxically, often gets in the way. People who aim directly at happiness frequently miss it. People who orient their lives toward meaningful work, close relationships, and genuine presence often find happiness arriving, more or less on its own, in the spaces those orientations create.

Be honest about what is not yours to fix. The chronic depression rooted in unprocessed trauma. The anxiety that has somatic components requiring medical care. The deep loneliness that small practices alone cannot reach. These conditions deserve respect, not optimization advice. The right response is often professional support — therapy, medical care, sometimes medication — rather than another daily practice.

And know that the small practices are still worth doing. The gratitude. The breath. The walk in the morning. The person you love. The work that means something to you. The thirteen years that have passed since the original post have only confirmed how much the small things matter — and how much they need to be set within the larger context of relationships, conditions, and the genuine work of becoming oneself.

Where to begin today

If you are reading this and looking for one practice to begin, here is what I would suggest. Once today, pause and notice one small thing you genuinely appreciate about someone in your life.

Not a polite thought. An actual felt sense of appreciation. Then, sometime today, tell them.

Briefly. Specifically. Without needing them to respond in any particular way.

This single practice, repeated regularly over months, produces more measurable change in wellbeing than almost any other single intervention I know. It builds the very thing that

Lyubomirsky and Reis identify as central — the felt sense of being loved, which arrives when we extend love in ways the other person can receive. Each act of specific appreciation is a small revision of the relational climate of your life. The climate, over time, is what we call happiness.

That is what I have come to understand. Happiness is not a mood. It is a relationship. With yourself. With others. With the conditions of your life. The work of building it is real, and the work is slower and more relational than the lists suggested. And it is genuinely worth doing.

Further reading: Sonja Lyubomirsky’s research is available at sonjalyubomirsky.com. Barbara Fredrickson’s Positive Emotions and Psychophysiology Lab at UNC is at peplab.web.unc.edu. For the clinical perspective on how nervous system regulation underlies the capacity to experience happiness, see my companion piece on thecourageousself.com.

April Wright, MA, LMFT is a Licensed Marriage and Family Therapist in California and Florida. She blogs about attachment, healing, and the courageous arts of becoming oneself at courageous-arts.com and sees clients at thecourageousself.com.

 

Open up and say ‘neigh’: Horses Help Teach Med Students

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Video: For America’s next generation of doctors, bedside manner can fall by the wayside in the first few years of medical school. But one doctor in Arizona is hoping to change that by offering a first-of-its-kind class using horses to instill compassion. NBC’s Dr. Nancy Snyderman reports.

For the next generation of doctors to develop a better bedside manner, it’s important to spend some time in a stable.

Neurosurgeon Dr. Allan Hamilton of the University of Arizona Medical Center, Tucson, is using his ranch for a first-of-its-kind class to help train first year medical students, bringing the humans in close contact with large flighty four-legged patients who can’t talk and who can be highly — and violently — reactive to doctors who aren’t attuned to their patients’ body language.

At his first “lecture,” Hamilton shows this year’s class how to safely approach a horse. He slowly walks up to one of his horses, running his hand over the animal’s body as he moves around it.

“I put my arm around him like this so the whole time, even when I go through his blind spot, he knows exactly where I am,” Hamilton tells the students and NBC chief medical editor Dr. Nancy Snyderman.

The slow, careful contact with the animal is not only for self-protection — the reaction of a startled horse can range from bolting away to spinning and kicking out at something it perceives as a threat — but also as comfort and reassurance.

The idea for the course began when Hamilton caught himself approaching a patient too abruptly and without the right amount of sensitivity.

“The whole thing started one day when I was in a hurry,” he said. “I was delayed getting to clinic and we just burst into this room because we were in such a hurry and this woman, she just screamed when we walked into the room because we came in so fast. I just remember thinking to myself, ‘boy I never would have done that if that was a horse.’”

The concept makes a lot of sense to Snyderman, a horsewoman herself. “As a physician I hear from medical school professors all the time who say that the students come in eager and passionate about helping others, and leave as cynical and harsh doctors,” she said.

Riley Hoyer, one of the first-year medical students who signed up for Hamilton’s innovative class, recognizes the skills he’s learning.

Right now, “I’m studying books instead of focusing on patient care and so this was just one class that I could do as an elective to try and better learn how to interact with animals and learn how to use my body language to interact with patients,” he told TODAY.

Because horses can’t talk, students need to learn to read their body language to set up a “conversation.” They need to have a rapport and develop trust before the horse will stand still to have its heart monitored with a stethoscope or to get an inoculation.

Snyderman watched as one of the other students connects with a horse. “And now he’s making eye contact with you because you approached him in a very sensitive way,” she said. “It’s a lot like [approaching] a patient.”

Hamilton believes that the program can build better doctors, helping them to overcome fear and improve confidence.

“Probably even more important is it saves doctors,” he said. “Our salvation is going to be to go back to what really makes us fulfilled, which is this essence of human-human interaction and the ability to take somebody in the most dire of circumstances and say,’grab my hand I know we’re going OK we’re in this together.’”

Hamilton’s class has been offered since 2001 and it’s gaining attention around the country. Stanford University and University of Medicine and Dentistry of New Jersey are now offering similar courses.

Hamilton didn’t get his horses with a plan to teach students a better bedside manner. “I moved out here specifically to do neurosurgery by day and horses by night,” he said with a chuckle.

Tenth Anniversary of the Iraq War: The Personal Impact – To the Point on KCRW

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Tenth Anniversary of the Iraq War: The Personal Impact – To the Point on KCRW.

Ten years ago tomorrow, the US invaded Iraq. The human cost to American veterans and their families – and the many Iraqis now desperate to leave a ruined country.

In 2003, Saddam Hussein was said to have “weapons of mass destruction.” There were hints he was tied to September 11. Eighty percent of Americans supported the US invasion. Ten years later, 58 percent say it was not worth years of unexpected combat, more than $2 trillion— and the deaths of 4500 Americans and 100,000 Iraqis. Marcos Soltero always wanted to be a Marine, and enlisted when he was 17 — two months after the Twin Towers collapsed in 2001. Linda Johnson watched both her husband and her youngest son go to war. Tomorrow, we’ll look at why the war is so widely perceived to have gone wrong. Today, we focus on the human consequences: veterans and families coping with injured brains and bodies. Was there ever a real welcome home?

Guests:
Steve Vogel: Washington Post, @steve_vogel
Elspeth Cameron Ritchie: former Army psychiatrist
Stacy Bare: Iraq War veteran
Matt Gallagher: Iraqi veteran, @MattGallagher83

Links:
Veterans Administration
2012 VA report on vets who die by suicide
Senate Veterans Affairs Committee hearing on timely access to high-quality care
Vogel on Army ordering reforms for mental health care treatment
Ritchie on the Army task force report on behavioral health
Sierra Club’s Mission Outdoors Program
Gallagher’s ‘Fire and Forget: Short Stories from the Long War’
Veterans Expeditions
Johnson’s ‘To Be a Friend Is Fatal: A Story from the Aftermath of America at War’
The List Project to Resettle Iraqi Allies

Emmanuel Jal: The Music of a War Child | TED Video.com

Posted on by helpingsoul