Three Challenging Questions about Living Gratefully from Yale School of Medicine

More than twenty years ago, I regularly spoke to medical students about end-of-life care and spirituality. The case I made then, which I still hold true, is that death teaches us to take nothing for granted and helps us to reprioritize. Today, thanks to living gratefully, I also know that when we understand our life to be a gift, we also experience a richer and more complete life. 

I was recently invited to return to my old stomping grounds at the Yale Program for Medicine, Spirituality, and Religion to deliver the closing talk of the semester. During the Q&A portion, Yale medical residents and folks from the National Institute of Health asked me several important questions about living gratefully:

• Living gratefully sounds like a means to an end. What’s the end?
• Does living gratefully matter without a religious grounding or perspective?
• How is living gratefully not self-gratification without God?

As you can see, these were not softball questions. Each of these questions are a talk unto themselves, and I think each answer is what distinguishes living gratefully from gratitude. As a way of being that is a trait rather than an attitude, living gratefully offers transformation and, Br. David and I would argue, transcendence. 

Before you read on, I want to invite you to pause, especially if you are a regular practitioner, and reflect on your own answers to these questions. Your answers and lived experience may be far more fruitful than my responses.

Living gratefully sounds like a means to an end. What’s the end?

Relationality. Living gratefully shakes us out of the stagnant and restrictive beliefs we have about ourselves and the world around us by waking us up to new realities in life, which provide us with new and always changing perspectives. This arousal gives us meaning because, in our awakening, we cannot become selfish or engrossed by an individualistic mindset when we have a relational worldview. When the relational aspects of life are revealed to us we are unable to ignore our dependence on each other or the fact that we exist within a network of cooperative relationships that sustain life. I am not a doctor. I cannot heal my ailments. And you likely are not a farmer harvesting the food for your dinner tonight. We need each other. 

At this juncture in the human story, I think it is perfectly clear that our relationality is the only way we can go forward and continue evolving and surviving. Once we recognize our interdependence and no longer take our responsibility to each other for granted, we can’t unsee it. It seems that one of life’s greatest truths is our responsibility to each other. Living gratefully is a means to help us understand this more fully. So, if that’s the means then what’s the end? Well, that has everything to do with continually strengthening our social bonds and being superb stewards of finite resources for future generations. I believe the ethical and policy frameworks that a grateful perspective can generate are revolutionary for these sick and singular times. 

Does living gratefully matter without a religious grounding or perspective?

I think the answer to this question is personal. We were founded by a Roman Catholic monk whose scholarship is rooted in interfaith dialogue. His brilliance is his ability to recognize themes across religion. So, our perspective on living gratefully is spiritual, but also quite specific.

Spirituality means “life breath” or “what makes you come alive.” Throughout life, in all of its iterations, we need to answer the question of what makes us come alive — that includes when we are dying, when we are grieving, when we are elated, and when we are lost in uncertainty. If your religious perspective makes you come alive then living gratefully very much matters to your religious practice. If, like many Americans, the religious tradition you were born into does not make you come alive and you have left, then perhaps a religious grounding is not important here.

I can’t help but think about the importance of relationality here, too. In many religions, a core component of the tradition is about being in relationship with the divine, holy, sacred, Ultimate Reality, etc. Religion, whether through a Sangha or church community, is relational. So, perhaps, those with a religious grounding may understand relationality more easily than those who have never experienced it.

While this next point was not part of my answer at the time, I want to lift up the words of Pope Leo XIV and his stunning encyclical: MAGNIFICA HUMANITAS. Paragraph 118 states, “Everything that appears as a ‘limit’ — incapacity, illness, old age, suffering, vulnerability — tends to be seen primarily as a defect to be corrected, rather than as a reality through which our humanity matures and opens itself to relationship.”

Our life — our very humanity — opens us to relationship through vulnerability and imperfection. The sacred texts across traditions tell us about the human situation and how our ancestors struggled to be in relation. Many offer paths for addressing these struggles. Living gratefully is a path grounded in these truths. 

How is living gratefully not self-gratification without God?

This is a wonderful question, but perhaps not for the reason you think. The wellness industrial complex and its many conveyors of self-help trends have turned outrageous profits by promoting self-gratification. I have plenty of bookshelves lined with proof that I am among its victims. We are all seeking meaning and purpose in life. This universal human need makes us vulnerable to those who may innocently or quite intentionally exploit this essence of our humanity. Rather than teaching us how to be in relationship with each other — through things like grace, forgiveness, compassion, and kindness — we hear about how to hold people accountable, purity tests, culture trends rather than human truths, and fads that distract us from the fragility of our humanity. So much of what we hear contributes to the suffering of ourselves and others. We can easily become self-gratified in our self-righteousness. 

So, does God help us mute self-gratification? I cannot answer that. If I asked ten of you to define God, I would get ten different answers. This is an area where Islam is brilliant. It teaches that God (Allah) is infinite with no single name or attribute that can fully capture the divine essence. For example, Islam has 99 names for God to describe a distinct attribute. 

Some names for God in Islam are “The Giver or Life,” “The Most Merciful,” “The Sensitive, the Most Gentle, the Subtle One.” In my Christian tradition, “Prince of Peace,” “Love,” and “Universal Christ” are among my favorites. I honestly do not know if self-gratification is mitigated by God given how I’ve seen many so-called holy religious people behave. But I do feel confident saying that when we recognize we are recipients of ineffable gifts in life — including life itself — and when we arise to the responsibilities bestowed upon us by life like caring for each other, well, being self-gratified becomes a very difficult perspective to upkeep. And thank God for that!

Photo by Saffu

Joe Primo, Grateful Living

Joe Primo is the CEO of Grateful Living. He is a passionate speaker and community-builder whose accomplishments made him a leading voice on resilience and adversity. Gratefulness for life, he believes, is foundational to discovering meaning and the only response that is big enough and appropriate for the plot twists, delights, surprises, and devastation we encounter along the way. A student of our founder since his studies at Yale Divinity School, Joe is committed to advancing our global movement and making the transformational practice of grateful living both accessible to all and integral to communities and places of belonging. His TED talk, “Grief is Good,” reframed the grief paradigm as a responsive resource. He is the author of “What Do We Tell the Children? Talking to Kids About Death and Dying” and numerous articles.

See more content by Joe Primo, Grateful Living →