In my last article, Why Gratitude Is A Superpower, I highlighted the power of gratitude through a story about a thank you note that my daughter Maya left me one morning. The note was simple, and very effective. The image of that note and her coffee cup, and the warmth it generated, will stay with me until the lights go out.

The idea of gratitude sounds great. Being grateful sounds like a good thing. But exactly how do you do being grateful? Being a surgeon and having a strong inclination towards wanting to know exactly how to do things, I have studied the various ways to practice gratitude as part of a paper I wrote called The Resilience Bank Account: Skills for Optimal Performance.

I have boiled down the practice of gratitude down into 4 distinct methods. The first two are solo practices. Their purpose is to invoke a sense of gratitude for one’s place in the universe or for the good things one has or is experiencing in life.

1. Reflection. Here the focus is on Awe, which is defined as a reverential respect mixed with fear or wonder. The beauty of this practice is that it can be done anytime, anywhere, and on demand. I practice this form of gratitude when I am walking my dogs in silence, when I can look up at the sky and the stars or sun rise and nature and take in the staggering fact that this whole deal is actually happening and I am lucky enough to be a part of it for a few brief moments. I also feel Awe and gratitude when I consider the fact that my brain is made up of 100 billion cells (same number of stars in the Milky Way Galaxy) that have 100 trillion connections between them (same number of stars in the largest known galaxy) and in those precious moments when I feel close to someone I love. I like to soak it up.

2. Write in a gratitude journal, daily. Here I like to use The Five Minute Journal because it has a lovely and simple structure and nice quotes. By writing three things from the previous day that I am grateful for I prime my emotional and mental pump for the day. It works.

The next two practices are other directed and are aimed at the expression of gratitude to someone who has positively impacted you in small or large ways.

1. Saying thank you. Yes, just saying thank you. But not like a parrot saying polly wanna cracker. Intention is the key here. You must actually feel appreciative and the tone, body language, and your eyes have to match the words to convey real appreciation. A thank you can also be turned into a value bomb for another person by getting specific about what you are thanking them for. Specificity is the killer app of gratitude to another human being. Examples: 1) “Honey, thanks so much for starting my car and scraping the snow off it. It was so nice to get in a warm car when I went into work.” 2) “Thanks so much for stopping at the hardware store, you saved me a trip!” This particular gratitude practice is the antidote to taking people and what they do for granted. It also is contagious, and it creates a culture of respect and valuing others.

2. Writing a gratitude note, email, or letter. This is a high impact action, for both the recipient of the note and for the writer. Have you ever gotten a note of gratitude from someone? Feels great, right? Have you ever written a gratitude note to someone? Feels great, right? Two points for this practice. If you write a note, do it with a total spirit of generosity without any expectations of acknowledgement. This is critical. The second is to be specific about what you are grateful for, with lots of detail about what the person did that meant so much to you. It is handy to keep a pack of small cards near by to write and mail notes. As an example I recommend watching this video made by Josh Coyne.

Gratitude, in any form, takes you out of the weeds of your life and puts rays of sunshine on the things that matter. And that sunshine is essential, because what you focus on grows.