Resilience and Loss: The Correlation of Grief and Gratitude

International Journal of Applied Positive Psychology https://doi.org/10.1007/s41042-023-00126-1 RESEARCH PAPER Resilience and Loss: The Correlation of Grief and Gratitude John Elfers1,2 · Patty Hlava1 · Farrah Sharpe1 · Sonia Arreguin1 · Dawn Celeste McGregor1 Accepted: 8 September 2023 © The Author(s), under exclusive licence to Springer Nature Switzerland AG 2023 Abstract The present study investigated the relationship between cultivating gratitude and coping with grief. The primary research question guiding this study was: What is the correlation between resilience in grief, transcendent gratitude, and nondual awareness? Five measures were administered to collect data for this study: Grief and Meaning Reconstruction Inventory, Adult Attitude to Grief Scale, Gratitude Questionnaire 6, Transpersonal Gratitude Scale and Nondual Awareness Dimensional Assessment. A diverse demographic pool of survey respondents (n = 619) was recruited to determine what correlations might emerge from the data. Bivariate correlational analysis revealed strong correlations among total scores and specific subscales of grief, gratitude, and nondual awareness. Subscale correlations suggested positive correlations among transcendence, valuing a relationship, resilience, and personal growth; and negative correlations with efforts to control the overwhelming emotions associated with grief. Nondual awareness showed moderate correlations with resilience and personal growth, pointing to the centrality of whole-person transcendence in the association of gratitude with flourishing after profound loss. A regression model demonstrated that gratitude and nondual awareness predicted resilience in coping with grief. Conclusions include the potential value of pre-loss cultivation gratitude to enhancing competence in coping with grief. Keywords Grief · Gratitude · Transcendence · Resilience · Posttraumatic Growth 1 Resilience and Loss: The Correlation Between Grief and Gratitude It may seem odd to bring together the constructs of grief and gratitude since they are often treated as distinct. Beyond sharing the same two first letters of their name, what do they have in common? Preliminary research has begun to point to a possible * John Elfers John.Elfers@sofia.edu 1 Sofia University, Palo Alto, CA, USA 2 Arroyo Grande, CA, USA 13 Vol.:(0123456789) International Journal of Applied Positive Psychology salutary relationship between coping through profound grief following the loss of a loved one and the supportive role of gratitude in enhanced flourishing through grief. This study investigated this relationship by correlating five measures of grief and gratitude in a large sample. There is a growing acknowledgment that profound loss is a shock to all levels of human functioning – physical, cognitive, emotional, relational, and spiritual (Hatala, 2011). It may be tempting to think of grief as an emotion, and clearly it is a state primarily dominated by affect. However, it is more appropriate to characterize grief as an emotion experience that touches every dimension of life. It shows up in the body, overwhelms cognition, impacts relationships, and potentially fractures the spirit. Weller’s (2015) model highlights the phenomenon that a significant loss can open the floodgates to all of the unacknowledged and unprocessed grief from a lifetime as though a dam had been opened. The enormity of loss may leave the person initially paralyzed, in shock, or overcome. Sadness and grief are often used interchangeably, but sadness is generally of shorter duration. Sadness is a categorical emotion and rather distinct. Grief is not a primary emotion; its profile is better understood as a unique pattern of complex emotions involving sadness fear, anger, shame, etc., some of which are hybrid (BenZe’ev, 2022; Cholbi, 2022). The emotions of grief are often felt intensely in the body to the point of physical pain. In addition to the affective component, grief is attentional in that it can dominate (even hijack) attention and consciousness (Cholbi, 2022). The cognitive dimension of grief receives less attention but may be the more salient for the process of healing through grief (Ben-Ze’ev, 2022). The cognitive features of grief are evident in obsessive replay of events of the relationship, rumination on wishful fantasies of other outcomes, and intense self-blame for the cause of death or inadequacies in the relationship. The cognitive elements actively participate in grief and can steer the process in many directions and even prolong grief beyond its normal progression (Cholbi, 2022; Ben-Ze’ev, 2022). Cognitive rumination and rehearsals may either further the process of grieving and coping or complicate grief by keeping it mired in unhelpful thought patterns. When attention is dominated and cognition overwhelmed, previously learned coping patterns may be unavailable and new ways of addressing the loss must be created. The Diagnostic and Statistical Manual of Mental Disorders ­(5th Ed; DSM-5; American Psychiatric Association, 2013) includes a diagnosis for what is called Prolonged Grief Disorder (PGD). The symptoms of PGD include a persistent and intense preoccupation with the deceased, with additional symptoms of avoidance of reminders, intense emotional pain, feelings of emptiness, and difficulty engaging with life. Prigerson et al. (2021) demonstrated that the Prolonged Grief-13 Scale could distinguish among prolonged grief, major depressive disorder and generalized anxiety disorder, confirming that grief is a unipolar construct and not a combination of mood disorders. Russ et al. (2022) found that complicated grief was correlated with attachment anxiety and somewhat with attachment avoidance. Those with attachment issues may be more vulnerable to complicated grief. PGD may also be related to the circumstances of the death, the developmental stage of the bereaved, coping style, and concurrent stressors (Clarke, 2021). Estimates for the number of 13 International Journal of Applied Positive Psychology bereaved who develop complicated grief range from 10–20% (Shear, 2010). The COVID-19 pandemic witnessed a rise in the incidence of complicated grief (Clarke, 2021). Thinking of grief in terms of stages has captured the popular imagination but stage-based models seem to defy empirical validation. Perhaps the most well-known and oft-cited model of the stages of grief is from Elisabeth Kübler-Ross’s (1970) book On Death and Dying. The stages of denial, anger, bargaining, depression, and acceptance describe some of the psychological processes and defenses involving both cognition and affect that a person might go through on the road to working through grief. A major criticism of stage models is that the stages are rarely sequential and some stages may not apply to everyone (Clarke, 2021). Koster (2022) suggested that the dynamics of grief involve an “altered mode of being” (p. 84) that isolates the griever from the world and understands it as a selfprotective affective state. There is danger in a failure to reconnect with the world (Shear, 2010). While often thought of as primarily personal, grief is also communal and the expression of grief influenced by culture, religious messages, and patterns that dictate acceptable expressions of grief (Garg, 2023a; Popovich, 2013). While grief is a normal and expected human experience, can culture and religion prescribe just how “normal” is normal grief? Though it is important not to pathologize the process, this leaves open the question of how to intervene or support someone in moving through grief in a way that leads beyond mere coping. Messages such as get over it, move on, let go, adapt, manage, work through it, may not be helpful (Clarke, 2021). There is increasing evidence that the process of grief can be an opportunity to enhance resilience and healthy adaptation (Hurst & Kannangara, 2022; Neimeyer et al., 2018; Shear, 2010). Resilience is understood as a pattern of growth and positive coping following a major stressor or adversity, such as losing a loved one (Hatala, 2011). Resilience research has sought to identify the somatic and psychosocial variables that inform or predict the development of growth-oriented coping. To this list, Hatala (2011) adds spirituality as an important feature in developing resilience. Hurst & Kannangara, 2022) point to mounting evidence that posttraumatic growth can result from grief. This study explores the possible influence that developing gratitude may have on developing resilience and posttraumatic growth through coping with grief. 2 Gratitude Gratitude describes the complex taxonomy of emotions and appraisals that arise in response to receiving some benefit. This traditional understanding of gratitude emerges from the functional role of reciprocity and altruism in the dynamics of all human social relationships (Bonnie et al., 2004; Buck, 2004; Komter, 2010). In a social context gratitude is characterized as having three core elements: a beneficiary, a benefactor, and a benefit; that is a giver, a receiver, and something of value that is offered (Roberts, 2004). A cognitive appraisal is essential to gratitude. The beneficiary of a gift must first determine the intention and level of sacrifice on the benefactor’s part, and the gift’s 13 International Journal of Applied Positive Psychology perceived value (Algoe et al., 2008; McCullough & Tsang, 2004). This appraisal, in turn, influences the intensity of the affective response to receiving a gift. Sensations related to the felt experience are varied and generally are associated with feelings of comfort, security, warm sensations in the chest, appreciation, admiration, joy, love, and being blessed (Hlava & Elfers, 2014). Gratitude has been described as a positive emotion, complex emotion, an empathic emotion (Fredrickson, 2004), and a self-transcendent emotion (Stellar et al., 2017). Gratitude has been studied as a transient emotional state, and a dispositional trait characteristic of a grateful personality (McCullough et al., 2002). The exchange of benefits has a prominent role to play in interpersonal relationships. The subjective experience of gratitude is associated with the softening of self-other boundaries and a deepening of relationships. Both reciprocity and the associated feelings of gratitude have been shown to be instrumental in relationship building (Algoe et al., 2008) and relationship maintenance (Hlava, 2010; Kubacka et al., 2011). Awareness and expression of gratitude have been correlated with measures of wellbeing (Lambert et al., 2010; Watkins et al., 2009). Gratitude has also been studied as a self-transcendent emotion experience because of its role in attenuating self-other boundaries. When the benefit that triggers gratitude in response to an undeserved gift or connection with nature, gratitude is associated with feelings of profound transcendence (Elfers & Hlava, 2016; Steindl-Rast, 2004). When the appraisal of benefit eclipses relational gifts to encompass appreciation for life, nature, or a higher power, the grateful response can rise to the level of a peak experience of oneness or nonduality (Garg, 2023b; Steindl-Rast, 2004). For this reason, gratitude has found a home as a spiritual practice or discipline in all major religions (Emmons, 2008). Emmons characterized gratitude as having a worldly, relational value as well as transcendent value. “Gratitude’s other nature is ethereal, spiritual, and transcendent” (2008, p. 122). Because of its intimate association with profound transcendent experiences, gratitude has been characterized as a self-transcendent emotion along with awe, admiration, and compassion. As with gratitude, transcendent emotions involve cognitive appraisals that shift attention toward others and attenuate the self-other boundaries that characterize individual ego identity, resulting in enhanced spirituality (Cappellen, 2013; Stellar et al., 2017). Gratitude has been shown to be correlated with experiences that involve unity consciousness or nonduality (Elfers & Hlava, 2016; Prem, 2020). 3 Gratitude and Grief Research is beginning to point to a relationship between resilience in coping with grief and the cultivation of gratitude (Beckley, 2022; Popovich, 2014). The bridge between these two very human experiences has been slow in coming, likely due to the fact that one results from an overwhelm of cognition and an abundance of negative emotion, while the other moves towards transcendence and an abundance of positive emotion. Yet both share features in common. Both involve all levels of human functioning: physical, cognitive, emotional, relational, and spiritual. Both 13 International Journal of Applied Positive Psychology involve cognitive appraisals, with grief involving an appraisal of loss and gratitude an appraisal of abundance and blessing. Each involves a separation from ego identity, with grief triggering partial isolation from others in processing emotions and profound gratitude moving toward prosocial behaviors and transcendence of identity. Beckley (2022) found that the wellbeing fostered by gratitude helped to mediate prolonged grief when coping with the loss of a loved one. In a cross-cultural study, Popovich (2014) found that spiritual traditions in an African and Asian sample fostered the cultivation of gratitude, which then mediated perceptions of loss. 4 Present Study The present study sought to investigate the relationship between cultivating gratitude and coping with grief in a large sample. The primary research question guiding this study was: What is the correlation between resilience in grief and transcendent gratitude? The secondary research question was: What is the correlation among resilience in grief, gratitude, and non-dual awareness? Five measures of grief, gratitude, and nondual awareness were administered to collect data for this study. Hypothesis 1: The researchers predicted that the two measures of gratitude would correlate with the total score on the Grief Meaning and Reconstruction Inventory and the five subscales since the overall focus of this assessment is on resilience in coping with grief. The prediction for the Adult Attitude to Grief was that measures of gratitude would correlate positively with the Resilience subscale and show a neutral or negative correlation with the Controlled and Overwhelm subscales that highlight continued efforts to control grief and feelings of overwhelming emotion. These scales were chosen because they measure a more generalized response to grief in relation to the loss of loved one. Hypothesis 2: The relationship of gratitude and grief to non-dual awareness was more exploratory, with researchers predicting that there would be some modest correlations among nondual awareness, gratitude, and resilience in coping with grief. 5 Method 5.1 Participants and Procedure The researchers administered these five psychometric assessments of grief and gratitude using Survey Monkey, a secure online platform, to 619 participants drawn from the US. Participants were recruited from personal contacts, group listservs, social media groups, and professional organizations. An a priori power analysis was conducted. Assuming a desired power of 0.80 and an expected R ­2 of 0.26, a regression model with 12 predictors (independent variables plus control variables) determined a minimum sample size of 61 for a significance level of 5%. This study recruited a diverse demographic pool of survey respondents 13 International Journal of Applied Positive Psychology to determine what correlations might generalize to a wide population. A bivariate correlational analysis was then conducted using SPSS to explore the relationship among total scores, subscales, and survey participant demographics. All data were kept secure and anonymous, and no personally identifying information was taken from survey participants. Of the 619 participants interviewed for the study, 65.8% (n = 407) identified as women, 31.3% (n = 194) as men, 1.6% (n = 10) as transgender, and 0.8% (n = 5) as non-binary. Ages ranged from 18–24 (11.6%, n = 72), 25–40 (32.1%, n = 199), 41–55 (33.3%, n = 206), 55–70 (18.3%, n = 113), and > 70 (4.7%, n = 29). The sample identified as American Indian (2.7%, n = 17), Asian/Pacific Islander (13.2%, n = 82), Black (11.5%, n = 71), Hispanic (16.8%, n = 104), and White (61.2%, n = 379). See Table 1 for a comparison of survey participant demographics. 6 Description of Measures 6.1 The Grief and Meaning Reconstruction Inventory The Grief and Meaning Reconstruction Inventory (GMRI; Gillies et al., 2014) is a 29-item measure of sense-making, value and identity reconstruction during bereavement. It utilized a 5-point Likert scale. Reliability was high, and Cronbach’s alpha for the full scale at 0.84 and the inventory showed strong convergence. The GMRI showed strong discriminant validity in the form of negative correlations with negative emotions associated with bereavement and psychological distress, and convergent validity through positive correlations with personal growth. Respondents are asked to consider one person whom they have lost that produced a measure of grief. The inventory produces 5 subscales: continuing bonds (e.g., I cherish the memories of my loved one), personal growth (e.g., Since this loss, I’m a stronger person), sense of peace (e.g., This death brought my loved one peace.), emptiness and meaninglessness (e.g., I do not see any good that has come from this loss-Reverse scored), and valuing life (e.g., I value and appreciate life more). Table 1  Survey participant demographics Age Ethnicity N = 619 Freq % 18–24 72 11.6% Am. Indian Gender Freq % 17 2.7% Man Freq % 194 31.3% 25–40 199 32.1% Asian/PI 82 13.2% Nonbinary 5 0.8% 41–55 206 33.3% Black 71 11.5% Woman 407 65.8% 55–70 113 18.3% Hispanic 104 16.8% Trans 10 1.6% > 70 29 4.7% White 379 61.2% N/A 3 0.5% 13 International Journal of Applied Positive Psychology 6.1.1 The Adult Attitude to Grief Scale The Adult Attitude to Grief Scale (AAG; Sim et al., 2013) is a 9-item measure that measures vulnerability in grief covering a range of possible grief responses. The reliability coefficient was acceptable at 0.7. Construct validity in the AAG was supported by correlations with measures of anxiety and depression for two of the subscales and a significant difference in scores for clients with Prolonged Grief Disorder for the third subscale. The scale utilized a 5-point Likert scale from “strongly agree” to “strongly disagree.” It produces three subscales: overwhelmed (e.g., I feel that I will always carry the pain of grief with me), controlled (e.g., For me, it is important to keep my grief under control), and resilient (e.g., I feel very aware of my inner strength when faced with grief). 6.2 The GQ6 The Gratitude Questionnaire 6 (GQ6; McCullough et al., 2002) is a 6-item measure of a grateful disposition. Internal consistency reliability of the measure was Cronbach’s alpha = 0.82. The one-factor solution for the GQ6 was validated using structural equation modeling with measures of life satisfaction, optimism, hope, and vitality. The scale utilizes a 7-point Likert scale ranging from “strongly agree” to “strongly disagree” and produces a single scale of gratitude (e.g., I have so much in life to be thankful for). 6.3 The Transpersonal Gratitude Scale The Transpersonal Gratitude Scale (TGS, Hlava et al., 2014) is a 16-item measure of an approach to gratitude that emphasizes transcendence. The scale contributes a transpersonal and spiritual dimension to the construct of gratitude. Internal consistency was high for both the subscales and the overall scales, with a reliability coefficient of Cronbrach’s alpha at 0.88 (Hlava et al., 2014). The TGS showed good convergent validity by positively correlating with measures of reciprocity, empathy, and spiritual transcendence. It showed good discriminant validity, revealing negative correlations with negative reciprocity. The measures yielded 4 subscales: expression (e.g., I tell my friends that I am grateful for them), value (e.g., Gratitude helps me to feel open with others), transcendence (e.g., I feel grateful for just being alive), and spirituality (e.g., I am grateful to a divine being for everything in my life). The measure utilizes a 6-point Likert scale. The original 4-factor structure of the TGS was recently validated in a sample of 524 from India (Garg, 2023a). 6.4 The Nondual Awareness Dimensional Assessment The Nondual Awareness Dimensional Assessment (NADA; Hanley et al., 2018) is a 13-item measure of nondual awareness. The composite reliability coefficient 13 International Journal of Applied Positive Psychology for the scale was 0.93. The NADA showed adequate construct validity through positive correlations with dispositional mindfulness, self-transcendence, decentering, and bliss. Additionally, individuals with a mindfulness practice showed higher scores on nondual awareness. The scale utilizes a 5-point Likert scale ranging from “never” to “very often.” It produces two dimensions that load onto a single factor: self-transcendence (e.g., I have had an experience in which the boundaries of myself dissolved), and positive affectivity (e.g., I have experienced an all-embracing love). 7 Data Analysis Statistics for survey data were analyzed using SPSS version 28.0. Tests of skewness and kurtosis showed that responses to all measures were within the ± 1.5 range, indicating normal distribution. The one exception was kurtosis for the Total AAG score, which is understandable given that two subscales indicate an ongoing struggle with grief and one subscale indicates resilience in coping with grief. This slight departure from normality is not an issue since ANOVA is robust to violations of normality (Pallant, 2010). 8 Results Tables 2 shows the results of an analysis of variance (ANOVA) among the various demographic groups for the GMRI, AAG, and GQ6. Table 3 shows the ANOVA for the TGS and NADA. The results showed variation in scale scores among the demographic categories. In order to identify specific subgroups within the demographic categories, posthoc tests were conducted in the form of pairwise tests of equality of means. The Tables show the mean score for each demographic subgroup and the significance level of the difference. Under gender, non-binary and transgender participants were combined (n = 15) given the low numbers for each category. Most notable in the results was that women scored higher than men on both measures of gratitude, a difference noted in other studies (Elfers & Hlava, 2016). Age showed that resilience with grief as measured by the GMRI increased with age, which is understandable given enhanced life experience. Gratitude scores were highest in the 24–55 age group and among those identifying as Black and Hispanic. 9 Correlations A bivariate correlational analysis was applied to the total results of the five assessments and the subscales of the GMRI, AAG, and TGS. As seen in Tables 4 and 5, scores for the five scales showed significant positive correlations (2-tailed at < 0.01) that varied from weak to strong. Overall, the correlations were generally in the direction anticipated by the two hypotheses. The total score for the GMRI correlated strongly with the total scores 13 103.333a 105.211a Woman 106.428a Non-Bin/Trans 106.345ab > 70 Man 105.648b 25–40 106.965b 99.639a 18–24 55–70 106.655b White 106.291b 105.084b Hispanic 41–55 105.034b Black 104.233b API 0920 4.948 6.250 F 0.399 0.000 0.000 p 0.003 0.031 0.042 η2 30.332b 30.667ab 32.119a 29.448a 30.619a 31.112a 31.146a 30.556a 30.612a 31.530a 31.362a 32.041a 30.800a Tot AAG​ 10.29 1.191 1.943 F 0.000 0.314 0.102 p 0033 0.008 0.013 η2 34.926b 31.600ab 31.907a 36.138bc 35.858c 34.607c 32.889b 30.125a 34.560bc 34.265b 33.155ab 30.726a 31.667ab Tot GQ6 16.93 12.74 6.423 F 0.000 0.000 0.000 p 0.05 0.08 0.04 η2 AmInd American Indian, API Asian Pacific Islander, Non-Bin/Trans non-binary and transgender, GMRI gratitude meaning and reconstruction inventory, AAG​adult attitude to grief, GQ6 gratitude questionnaire 6 Tests are adjusted for all pairwise comparisons within a row of each innermost subtable using the Bonferroni correction Values in the same column and subtable not sharing the same subscript are significantly different at p < 0.05 in the two-sided test of equality for column means. Cells with no subscript are not included in the test. Tests assume equal variances Gender Age Race 91.600a AmInd Tot GMRI Table 2  Analysis of variance among demographic categories for grief and gratitude International Journal of Applied Positive Psychology 13 International Journal of Applied Positive Psychology Table 3  Analysis of variance among demographic categories for grief and nonduality Total TGS Race Age F p η2 Total NADA F AmInd 72.667 ace API 71.685ab 39.068a Black 78.431ce 5.831 0.000 0.0392 39.172a Hispanic 79.482 cd 38.060a White 73.853be 36.678a 18–24 67.083a 34.431a 25–40 74.256b 41–55 76.631b 8.413 0.000 0.0519 38.864b 55–70 76.230b 34.912a > 70 73.241ab 33.621ab Man 72.139a Gender Non-Bin/Trans 65.133a Woman η2 p 37.000a 1.128 0.342 0.0078 38.518ab 4.732 0.001 0.0299 37.366a 11.111 0.000 0.035 76.165b 38.933a 0.193 0.825 0.0006 37.130a Values in the same column and subtable not sharing the same subscript are significantly different at p < 0.05 in the two-sided test of equality for column means. Cells with no subscript are not included in the test. Tests are adjusted for all pairwise comparisons within a row of each innermost subtable using the Bonferroni correction. AmInd American Indian, API Asian Pacific Islander, Non-bin/Trans nonbinary and transgender, TGS transpersonal gratitude scale, NADA nondual awareness dimensional assessment Table 4  Pearson’s r correlations among measures of the survey data GMRI Tot GM Bonds GM Pers GM Peace GM Empt GM Valuing GQ6 0.497** 0.361** 0.239** 0.07 0.423** 0.393** TGS Tot 0.582** 0.500* 0.521** 0.166** 0.063 0.584** TGS Exp 0.416** 0.339** 0.322** 0.074 0.165** 0.384** TGS Value 0.587** 0.447** 0.560** 0.187** 0.058 0.599** TGS Trans 0.552** 0.418** 0.499** 0.190** 0.064 0.576** TGS Spirit 0.401** 0.417** 0.363** 0.108** -0.021 0.402** NADA Tot 0.309** 0.195** 0.434** 0.188** -0.143 0.318** N = 619. GMRI (Grief Meaning and Reconstruction Inventory), GQ6 (Gratitude Questionnaire 6) TGS (Transpersonal Gratitude Scale), NADA (Nondual Awareness Dimensional Assessment) **p < 0.01. two tailed for two measures of gratitude, the strongest correlation being with the TGS. The AAG total scores showed moderate correlations with TGS total score but not with the GQ6. Exploring further, the TGS subscales of value and transcendence showed the strongest correlations. These data highlight the possible value of transcendence in fostering resilience. The controlled and overwhelmed subscales of the AAG showed a slight to no correlation with gratitude, with the exception of a moderate correlation with the GQ6. Given that these subscales indicate a significant loss of positive affect and reflect someone who continues to feel overwhelmed by grief, an 13 International Journal of Applied Positive Psychology Table 5  Pearson’s r correlations among measures of the survey data AAG Tot AAG Cont AAG Res AAG Overw GQ6 TGS NADA GQ6 0.098* −0.114 0.366** 0.351** TGS Tot 0.242** 0.119** 0.418** −0.014 0.607** 0.607** 0.047 0.405** TGS Exp 0.059 0.048 0.297** −0.087 0.615** 0.205** TGS Value 0.305** 0.158** 0.504** −0.008 0.565** 0.396** TGS Trans 0.265** 0.144** 0.415** 0.006 0.605** 0.393** TGS Spirit 0.174** 0.114** 0.231** 0.018 0.332** NADA Tot 0.315** 0.148** 0.342** 0.146** 0.047 0.327** 0.405** N = 619. AAG​(Adult Attitude to Grief Scale), GQ6 (Gratitude Questionnaire 6) TGS (Transpersonal Gratitude Scale), NADA (Nondual Awareness Dimensional Assessment) **p < .01. two tailed absence of meaning for the loss, and the need to control feelings, this absence of correlation was predicted. The disparity between the correlations of the two subscales of controlled and overwhelmed and the moderate to strong correlations with the TGS subscales of value and transcendence with the resilience subscale also highlight the relationship of transcendence to resilience in coping with grief. Two subscales of the GMRI revealed exceptionally strong correlations with two subscales of the TGS. These were the personal growth and valuing subscales of the GMRI. These subscales reflect the sentiments of since this loss I am stronger and more reflective, and I value family and life more, which indicated personal growth in the face of loss. These correlated with the value and transcendence subscales of the TGS. The sentiments in these correlations reflect gratitude as helping me feel more open, loving, and address obstacles in my relationships, and I am grateful for the opportunities I have had and for just being alive. These statements reflect an appraisal of grief that is focused on a shift in the loss of relationship and what is no longer there, toward an appraisal of benefits, abundance, and the gifts of life and relationships. Since gratitude is, by definition, focused on appreciation and generally involves emotion with a strong positive valence, it presents a clear shift from grief, which involves significant loss and generally involves emotion with strong negative valence. The TGS correlations were stronger than the GQ6, which measures the more quotidian gratitude implicit in everyday life and does not purport to measure the transcendent dimension of gratitude central to the TGS. Nondual awareness is defined as “a state of consciousness that rests in the background of all conscious experiencing—a background field of awareness that is unified, immutable, and empty of mental content, yet retains a quality of cognizant bliss” (Hanley et al., 2018, p. 1–2). It reflects a state of metacognition in which the boundaries between self and other dissolve into a state of oneness. Respondents to the NADA have acknowledged feelings of awe and wonder, a boundary-dissolving state of oneness with life and a merging with others. Nondual awareness, then, finds itself situated squarely within the realm of transcendence and at its extreme is an anomalous state of consciousness associated with mystical states. Hanley et al. (2018) point out that nondual awareness often goes unrecognized since it is obscured 13 International Journal of Applied Positive Psychology by thoughts and emotions that dominate attention. Findings from this study showed that the enhanced nonduality correlated moderately with the personal growth and valuing subscales of the GMRI, the valuing and transcendence subscales of the TGS and the resilience subscale of the AAG. These subscales reinforce the correlations between grief and gratitude, pointing to the strong diminishment of self-other boundaries in the process of healing from grief and the potential palliative value of transcendent gratitude. These data suggest a convergence among specific subscales of five of the measures of grief, gratitude and nondual awareness that highlight the role of resilience, adaptive coping, valuing, personal growth and transcendence. 10 Regression Model A regression model was employed to measure the effects of the GQ6, TGS, and NADA on the GMRI. The AAG was not used since two of its three subscales measure continued coping with grief rather than resilience. Table 6 shows the model coefficients controlling for the effect of Age, Race, and Gender. ‘Age 18–24’, ‘Female or other’ and ‘White’ were used as reference categories and are omitted from the table. Total scores on the GQ6 had a positive effect on GMRI (β = 0.287, p < 0.001). The TGS total scores also had a significant positive effect on GMRI (β = 0.370, p < 0.001). The same result was observed for NADA (β = 0.143, p < 0.001). When the scores of these three measures increase, a significant increase is also expected on total GMRI scores. Being male had a positive effect on GMRI (β = 0.148, p < 0.001), Being American Indian had a negative effect on GMRI (compared to being White) Table 6  Regression model ­coefficientsa Model 1 Unstandardized Coefficients Standardized Coefficients t Sig B Std. Error Beta (Constant) 53.736 2.643 TotalGQ6 0.551 0.081 0.287 20.329 0.000 6.814 TotalTGS 0.351 0.043 0.000 0.370 8.260 TotNADA 0.152 0.000 0.037 0.143 4.074 Age 25–40 0.000 1.196 1.296 0.046 0.923 0.356 Age 41–55 0.300 1.323 0.012 0.227 0.821 Age 56–70 0.553 1.461 0.018 0.379 0.705 Age 70 + 1.172 2.096 0.020 0.559 0.576 Gender—Male 3.874 0.826 0.148 4.691 0.000 AmInd -9.487 2.300 -0.127 -4.124 0.000 AsianPI 0.481 1.163 0.013 0.414 0.679 Black -1.273 1.205 -0.033 -1.056 0.291 Hispanic -1.614 1.042 -0.050 -1.549 0.122 a Dependent Variable, TOTAL GMRI total scores of the grief meaning and reconstruction inventory, GQ6 gratitude questionnaire 6, TGS transpersonal gratitude scale, NADA nondual awareness dimensional assessment, AmInd American Indian, AsianPI Asian Pacific Islander 13 International Journal of Applied Positive Psychology (β = -0.127, p < 0.001). Violations of the assumptions of normality, linearity and homoscedasticity of residuals (errors) were examined for the regression model. No substantial violations of normality were detected. The model showed good fit (F = 39.245, p < 0.001, ­R2 = 0.426). There was no multicollinearity in the model since Variance Inflation Factors for all variables were below 10.000. 11 Discussion This study explored the relationship between enhanced gratitude and resilience in coping with grief. The findings point to some of the ways in which healing from grief and enhanced gratitude may be mutually supportive. Both grief and gratitude involve a measure of separation from the everyday egoic identity. Grief involves an overwhelming of attention that partially isolates the griever from others. Gratitude involves the attenuation of self-other boundaries as the benefits associated with gratitude become more relational and transcendent (Hlava & Elfers, 2014). Nondual awareness also involves a softening of self-other boundaries and is, by definition, a transcendent experience. Transcendence implies the engagement of cognitive structures that facilitate meaning (Stellar et al., 2017). The cognitive appraisals associated with gratitude are centered on benefits and may contribute to the shift in meaning that is necessary to transform an assessment of loss to one in which the benefits and value of the relationship are salient. Thus, it may be the transcendent nature of transpersonal gratitude and nondual awareness that support the process of coping with grief. Grief can initiate a deep reflection on mortality and a personal life review that may need a broader vantage point to create meaning. In a review of eight studies, Lambert et al. (2011) found that gratitude was “related to fewer depressive symptoms, with positive reframing and positive emotion serving as mechanisms that account for this relationship” (p. 615). The effect of gratitude on reducing symptoms of depression was supported in a follow-up study Alkozei et al. (2019). Given that gratitude emerges from perceived benefits from outside the self and from others, it is a highly relational experience. Thus, one of its gifts is the enhancement of relationships. The relational benefits of gratitude have been repeatedly correlated with subjective wellbeing (Seligman, 2011; Wood et al., 2010), prosocial behavior (Stellar et al., 2017; Wood et al., 2010) and relationship maintenance (Emmons, 2008; Hlava, 2010; Lambert et al., 2010). Wood et al. (2007) found that “gratitude correlated positively with seeking both emotional and instrumental social support, positive reinterpretation and growth, active coping, and planning” (p. 1076). In a meta-analysis of 38 studies of gratitude interventions, Dickens (2017) revealed that participating in gratitude interventions can yield positive benefits in overall wellbeing and a reduction in symptoms of depression. The fact that gratitude can be cultivated as a deliberate practice means that it is possible to enhance the functional benefits of gratitude. Gratitude is frequently paired with self-compassion, awe, and admiration under the category of self-transcendent emotions, that “are fundamentally organized by the concern to enhance the welfare of others and as a result they promote prosocial behavior” (Stellar et al., 2017, p. 2). As a self-transcendent emotion, gratitude is 13 International Journal of Applied Positive Psychology associated with more positive emotions that convey increased wellbeing (Fredrickson, 2013; Seligman, 2011) and may help to balance the profound sense of loss inherent to the experience of grief. The subscale correlations among the measures of grief and gratitude showed that participants reported a shift in perspective, leading to the increased value placed on family, friendships, and social support, heightening responsibility, and a tendency to explore new knowledge and learning opportunities. Gratitude would seem to function as a bridge between the challenging emotions of grief and the prosocial orientation of self-transcendence. The preoccupation with self, associated with the initial phases of grief may be attenuated in the boundary dissolving state of transcendence shown in the increases of gratitude and nonduality. This reflects not only the relationship with self but also the relationship with the object of grief. 11.1 Resilience and Posttraumatic Growth Two constructs that best describe this shift are resilience and posttraumatic growth. Resilience can be understood as “a pattern of positive adaptation following significant stress, adversity, or risk, and is often examined when looking to see why some individuals fall victim to despair while others seem to thrive” (Hatala, 2011, p. 27). The construct of posttraumatic growth challenges the assumption that more adversity is automatically associated with functional impairment and poorer mental health outcomes. For some, adversity can be a catalyst for advancing from mere coping to a more optimal state and enhanced flourishing. In the development of the Posttraumatic Growth Inventory, Tedeschi and Calhoun (1996, 2004) included the significant loss of a loved one as a primary catalyst for trauma. Several theorists have highlighted important distinctions between resilience and posttraumatic growth (Elam & Taku, 2022; Luo et al., 2022; Oginska-Bulik & Kobylarczyk, 2016). Resilience is more of an ongoing adaptation, whereas PTG seems to be a more radical transformation of cognitive appraisal. Luo et al. (2022) found evidence that pre-trauma experience with adversity predicted more PTG. Elam and Taku (2022) found that PTG was associated with higher empathy and emotion recognition than resilience, pointing to the potential role of trauma in the development of empathy. Albert (2017) also detected significant transformational growth after healing from a mental health crisis. Posttraumatic growth has been associated with enhanced wellbeing and spirituality (Galea, 2014). Seery (2011) found that a history of moderate adversity predicted better outcomes than a history of high adversity or no adversity. These studies suggest that posttraumatic growth may be a more useful explanatory construct than resilience for understanding the impact of gratitude on coping and healing through grief. See Fig. 1 for a visual depiction of the potential role of gratitude on traumatic loss. The regression study already described demonstrated that gratitude predicts enhanced processing and integration of grief after loss. Given that gratitude practices may enhance wellbeing and decrease symptoms of depression (Dickens, 2017), a pre-loss emphasis on developing transpersonal gratitude could help to build 13 International Journal of Applied Positive Psychology Fig. 1  Potential relationship among gratitude, resiliency, and future PTG resilience in a way that builds the cognitive, emotional, and spiritual competencies that facilitate the process of working through grief. 11.2 Summary Recent research raises questions about whether pre-loss experience in managing adversity may prepare someone for working through grief. Is there an internal readiness that predicts the potential for a transformative outcome to profound loss? Is managing adversity a competence that can be learned and developed over time? In other words, if someone’s initial experience of adversity comes through a profound loss, are they challenged with building skills to address adversity even as they struggle with making sense of it? Finally, this raises the question of whether the deliberate development of gratitude can facilitate enhanced strength after adversity. The strength of the correlations found in this study and the effects of gratitude and nonduality on grief in the regression model, point to the potential palliative impact of gratitude on adversity overall. This is a question worth pursuing as it intimates that preparing for loss in advance may predict more skillful and adaptive outcomes. Does pain make us stronger, more open, and more beautiful? Findings from this study suggest that practicing gratitude affects attitude, meaning, and positive emotion and may generate resilience and personal growth through the grief process. 11.3 Limitations and Future Directions A note of caution is in order as we must be careful not to assume causality between transcendent gratitude and resilience in processing grief. Such conclusions are too premature. The exact mechanisms of action by which gratitude may have a salutary influence on processing grief also remain unclear. More predictive models may be able to hone in further on the direction of this relationship and mechanisms of 13 International Journal of Applied Positive Psychology action. Another clear limitation was that this was a point-in-time study inviting participant reflection on past experience with grief and gratitude. It did not examine their relationship prospectively nor longitudinally. Studies employing a gratitude intervention with those experiencing loss would allow for longitudinal studies. While the study recruited a diverse sample within the US, generalizability to cultures beyond those borders has yet to be tested. A recent study by Garg (2023b) validated the factor structure of the TGS and showed a positive relationship with spiritual wellbeing in a sample in India. However, the relationship between gratitude and grief has yet to be explored. Another limitation is that the broad sweep of findings across a large sample did not allow for a more nuanced exploration of participants lived experience of processing grief while resourcing gratitude. The impact of gratitude on grief would likely be influenced by the closeness and length of the relationship, as well as the number of years that have passed. Such a studies would likely deepen our understanding of the potentially meaningful dynamics between grief and gratitude. 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