Is it possible to become a more positive, hopeful person?
Yes. Research shows that by deliberately focusing on good things in your life, you can become happier.
Embracing optimism and your role in making the world a better place is an especially valuable tool as the COVID-19 pandemic has made life extremely challenging for many people, including essential workers, those who have lost jobs, parents with young children and older adults who must isolate themselves to stay healthy.
A simple tool called ‘Three Good Things’
Dr. Annie Moore helps her patients boost their positive attitudes and resiliency while reducing harmful self-criticism through a daily exercise called “Three Good Things.”
It’s a simple exercise that can take just a couple of minutes each evening before bed. Highlighting Three Good Things each day can yield long-lasting health benefits.
Moore is an internal medicine doctor at CU Denver Internal Medicine Group near Denver’s Cherry Creek neighborhood. She is also a Professor of Clinical Practice at the University of Colorado School of Medicine and did a fellowship in integrative medicine at the University of Arizona. Integrative medicine doctors are trained to focus on the whole person and partner with patients to help them adopt lifestyle changes that can make them healthier.
“We look at root causes for health problems, in addition to giving patients a diagnosis and treatment plan. We hope to understand why a patient gets an illness, especially a chronic illness in the first place,” Moore said.
Researchers in positive psychology tested ‘Three Good Things’ and it worked
Moore first learned about the Three Good Things tool when she worked at Duke University Medical Center. Experts there encourage health care workers to use Three Good Things to prevent burnout.
Happiness researcher, Dr. Martin Seligman, pioneered and tested the Three Good Things tool. He and his team at the University of Pennsylvania Positive Psychology Center did randomized controlled trials to measure the effectiveness of simple interventions that might make people happier. They published their findings in 2005 in American Psychologist.
In their experiment, the researchers randomly assigned participants to try one of six interventions including a control group that simply wrote in journals about their childhood. One group did the Three Good Things exercise each evening for one week. Then, researchers measured how all the study participants did over time. One month after the study subjects wrote down their Three Good Things each evening for a week, participants “were happier and less depressed than they had been at baseline, and they stayed happier and less depressed at the three-month and six-month follow-ups,” the researchers found. Click here to see a video in which Seligman describes how Three Good Things works.
Harsh self-criticism harms health
Moore started using Three Good Things herself at Duke and brought the practice with her when she came to Colorado in 2015. In addition to benefiting personally, she likes using Three Good Things with patients who are especially hard on themselves.
“It’s extraordinarily common that we hear a loud inner critic among our patients,” Moore said. “Through what they say, they imply, ‘I’m not good enough. I’m not meeting my own expectations.’”
And, says Moore, that negativity “impedes progress” toward improving health.
“The more you feel like a failure, the more you’re going to fail. The goal of Three Good Things is to build back confidence and increase motivation to help people feel more empowered to take positive actions in their lives,” Moore said.
How does Three Good Things work?
So, how exactly does a person use the Three Good Things tool?
The concept is easy and individuals can personalize how they use Three Good Things. The researchers who first tested Three Good Things required study participants to write down three things each evening. By doing the exercise toward the end of the day and before bed, they felt that participants would sleep better.
Moore doesn’t always write hers down, but when she has in the past, she has enjoyed going back to read previous lists.
Also, in order to count a deed as one of your Three Good Things, you need to embrace your role as the director of your life.
“The core aspect of this is that it’s something we made happen or were actively involved in,” Moore said.
So, if the sunrise was beautiful, you can enjoy that, but can’t list that as one of your Three Good Things since you didn’t play a role in bringing on a new day or turning the sky pink and orange.
Not a gratitude journal; Three Good Things requires intention and action
Moore said some people misunderstand Three Good Things as a gratitude journal or a way to appreciate blessings. Certainly, it’s great to be thankful, but Three Good Things is different.
“This requires more intention,” Moore said.
To be effective, you must recall actions you took such as: carving out time for exercise, calling a friend, picking up groceries for a neighbor or skipping an unhealthy habit like smoking a cigarette.
“The role we have in creating positive choices is a critical aspect of this,” Moore said. “The empowerment and resiliency benefits come from recognizing our role in how we think and act.”
Some people only do the exercise for one week and that’s OK. But for others, it becomes a cherished daily practice.
“We see positive outcomes,” Moore said. “The idea is that once you notice the positive things you do, you’ll choose to do more and you will see more positive things others do as well. This requires action on a person’s part, to see the positive, which is critical to resilience.”
What if I’m feeling hopeless because of the pandemic?
Moore said it is absolutely normal for people to feel depressed and anxious now. The pandemic has upended everyone’s lives. In particular, she sees older patients suffering if they are extroverts and don’t feel safe socializing. Working parents with young children are another hard-hit demographic.
For anyone who feels they have severe depression, by all means, call your doctor or seek immediate help elsewhere. Anyone who is having suicidal thoughts can get help 24/7 through the National Suicide Prevention Lifeline at 800-273-8255.
For most people, it’s normal to feel somewhat depressed amid the COVID-19 upheaval. Using Three Good Things won’t erase sorrows, Moore said. Rather, it’s a practice that can help people cope better.
“Especially now, there’s so much negativity. We don’t use Three Good Things to dismiss all of our challenges,” Moore said.
“We can say, ‘This is terrible and tragic.’ And, at the same time, at the end of each day, we can also say, ‘There were Three Good Things in which I participated to make my work and the world better.’”
Who can benefit from Three Good Things?
Moore sees some patients who are coping with difficult, genetic health challenges. They sometimes feel hopeless.
“They might say, ‘I have high cholesterol. No matter what, I’m going to have a heart attack and diabetes. I’m going to die young.’”
Moore tells them that while acknowledging they inherited a tough genetic deck of hands, they can also improve their health and their lives.
“They can start to feel more empowered to minimize the genetic impact, understanding the majority of health outcomes are lifestyle-based. A lot of people are defeatist these days. There is a balance between owning health challenges and maximizing our health choices to live the best life we can,” Moore said.
She also sees patients who have avoided going to a doctor for years because they are embarrassed about their weight or they are dealing with addictions to alcohol or drugs.
Or, an older patient might be struggling with balance. A patient of any age who has had a tough surgery might be depressed about a difficult recovery.
For people in these circumstances, one good thing to celebrate can be as simple as getting out of bed.
And, we can all do good things to fight social isolation.
“You can write a note to a friend or arrange an outdoor lunch. Taking the initiative to have some social contact is great,” Moore said. “The list of ideas for good things is endless.”
The concept of positive psychology doesn’t mean that you will go around feeling positive all the time.
“But, in the middle of a pandemic, some people find they are living in one ongoing negative emotional state. It can be great to balance the sadness with positive thinking,” Moore said.
How long do you have to do Three Good Things?
In the original clinical trial, study volunteers did the Three Good Things for seven nights in a row. Some continued voluntarily. Even if the participants stopped after a week, the benefits continued. Noticing good things seems to stick with us and improve our attitudes over the long term.
Do you have to do Three Good Things every day?
Yes. In order to do the activity correctly, you are supposed to do it every day for at least 7 days in a row.
Can you pick the same Three Good Things every day?
No. You need to pick new good things each day.
Do you have to do Three Good Things before bed?
Most advocates for Three Good Things say it’s best to do the exercise before bed. Focusing on good things clears your head and drives stress away, thus helping people sleep better. But Moore isn’t a purist. If a patient is a morning person and will be more dedicated to focusing on Three Good Things in the morning, then that can work too, she said.
What kind of results have doctors seen?
Seligman’s clinical trial showed that doing Three Good Things resulted in greater happiness as measured six months later. Some medical experts say that using Three Good Things can be as effective as using anti-depressants.
Moore has seen excellent results among her patients, whether they have naturally sunny dispositions or tend to see the world pessimistically.
“Everyone can see the world in a more positive way. Hope and confidence overlap,” Moore said.
“You can do this on your own. You can do it with your family. It’s not going to make bad things go away. But, it does help you cope better with them.”