I am writing this on the heels of Thanksgiving and Black Friday in hopes of finding Americans in a more thankful and grateful frame of mind.

Now, of course, the challenge is how to keep that up because when we are feeling down it unfortunately doesn’t bring out the best in us.

“Why are Americans so unhappy?” is a question several Indians asked me on my recent trip to Mumbai, Bangalore and Delhi. I felt embarrassed by it in light of seeing the still-incredible amounts of poverty in India and yet seeing how happy people seemed compared to Americans.

I responded, “Americans may be unhappy because of all the financial insecurity since the awful financial problems began in late 2008.”

One of my hosts said, “With all due respect Dr. Mark, they were unhappy long before that. And add to that, they rarely seem calm or content. Most of our country has very little, but we still seem much happier and more content than your country. What is that about?”

I didn’t have an answer, but one came to me on my 27-hour journey back to Los Angeles. Many Americans seem to be addicted to more, sooner. That can lead to feeling that at any given time, no matter what they have, they always want more. And no matter how quickly they get it, they always want it sooner.

If you think that is too simplistic, how many Americans do you know that are happy, or even okay with having less, later?

It seems that India has been so used to having less for ever that they are able to appreciate having anything more than that. They also seem more patient, perhaps because they know that becoming impatient doesn’t help the process.

What is something that you and I as Americans can do to become a little happier even as we wait and hope for our financial situation to stabilize?

A few thoughts and situations come to my mind and I hope you will add in your comments suggestions that you can offer.

First, start every day thinking of 10 people you’re thankful and grateful for. It may be people who stood up for you against other people, stood by you during a crisis or stood up to you to prevent you from doing something stupid (think of all the sponsors in 12-Step Programs who came and took you to a meeting before you fell off the wagon). It may be people who saw good in you and potential in you that you couldn’t see or people who believed in you when you didn’t. On Thanksgiving, I received a wonderful email from the co-author of my next book which will be about the power of positive influence, Dr. John Ullmen. He wrote to say that he has recently gotten into the habit of each day thinking of 10 people he felt thankful to and told me that for several weeks I have always been on the list.

Talk about positive influence. That email from John influenced me to not only feel gratitude towards him for his comment and for doing the lion’s share of the details in writing that book (which we think you will all enjoy when it is published in fall 2012), it influenced me to write this blog entry.

Second, I think how much happiness is directly related to our perspective on the world and others and ourselves. One of the best examples I can remember about a perspective I try to keep is the day 20 years ago when two women in their late 70s came to see me separately on the same day. Both had arthritis.

The first was a rather vain woman whose fingers were moderately swollen. She had one too many plastic surgery procedures, was dressed to the nines and bemoaned how unsightly her swollen fingers looked and how she would now have to get her jewelry re-sized. It’s not up to me to judge my patients and I did my best to empathize with her and help her deal with her upset about her condition.

A few hours later a woman who was about the same age came in and was hunched over with severe arthritis, walking slowly with a cane. She reminded me a little of the witch in Snow White. But what stood out about her from the first woman and from the witch in the Disney classic was the radiant smile on her face. She not only seemed happy, she seemed glowing. The contrast between her and the prior woman was astounding.

It caused me to say to and ask her, “Excuse me, you look in a fair amount of pain and are walking with such difficulty. I need to know. Why such a beautiful smile?”

She looked at me with that smile radiating even more and said, “I was just thinking how great this cane is going to look when I am in a wheelchair in a few years.”

Talk about perspective, if all of us could look at our present through the eyes of our future and see our present glasses as well more than half full, perhaps that could put a smile on our faces that we could hold onto.

Finally, there was the story of Mr. Cohen. It was 4:30 in the afternoon and I had just finished doing an EKG on him. Unlike everyone else living at the Jewish Home for the Aged in Jamaica Plain, Massachusetts, Mr. Cohen was spry and totally alert for his 87 years. As a third- year medical student with much living (and learning) ahead of me, I couldn’t understand why he was staying in this place, which well appointed as it was still remained a last holding unit for people who were waiting to die.

I asked Mr. Cohen why he lived in such a depressing place when he was clearly doing so well. He looked at me with a patient, knowing look and explained: “Two floors below us is my wife, Emma. Three years ago, she developed Alzheimer’s disease and then had a stroke on top of that. On the very best of days, which don’t occur that often, I think she might recognize me. At all other times, she’s lost.”

He went on to tell me to me that Emma and he had fled the Russian revolution together, and that more than a few occasions she had saved his life. The couple made their way to America, started a tailoring business and raised a wonderful family. “I tell my family not to visit as much as they’d like,” he said, “because I want them to make sure they enjoy their families now and because their mom and I are doing fine.”

Each day, he would wake up, go downstairs to his wife’s room, bathe her, replace the diaper she now needed, put her into a sun dress, braid her hair, have breakfast with her and then read his newspapers and books as he sat beside her.

I didn’t get it. Why was he doing this with a woman who couldn’t even recognize him? “This poor man must be eaten up with guilt,” I thought.

I suggested, presumptuously, that Mr. Cohen’s guilt would not help his wife. The old man looked at me with an annoyed expression on his face and shook his head at my stupidity.

“Each day I get to go downstairs and give my wife dignity. That’s what she would do for me and want to do for me. You don’t understand, do you? This is where I want to be. Maybe someday you will understand.”

It’s been nearly 40 years ago since my visit with Mr. Cohen and I think I do finally understand. Instead of guilt, he felt joy in the presence of someone he had loved and been loved by for 60 years.

What are some suggestions from you or stories you can share for becoming more happy?

The key to doing that is to develop what in psychology is referred to as “object constancy.”  Object constancy is the ability to maintain an emotional connection in the face of disappointment, hurt and frustration and even anger.  It is something the parents of baby boomers and their parents had because every day life for them contained obstacles, setbacks and situations they had little control over.  And if they let such things knock and keep them down they would have not been able to function, so they didn’t allow that to happen.

But baby boomers and their millennial children have lived under the illusion that life should not have disappointment, hurt, frustration and that when those things happen there is something wrong.

It’s never too late to develop object constancy if you choose to do so.  The way to do that is to face disappointment, hurt and frustration head on, take the hit (even if you have to say to yourself that you hate it when such things happen), but not hit back at others angrily or at yourself with self-contempt.  If you do that, pretty soon it will dissipate.

What is the benefit of that? First it will become easier with time.  Second you and the world will begin to see you as classier and possessing one of the rarest and most admirable qualities you can have.  And that is what we refer to as “poise.”

Me: What? You have a hospital names after you. You’ve created an industry and thousands of jobs.

Patient: I have all the admiration, love and respect that money can buy and that’s all it’s worth. I’m not really close to anyone… not my wife, not my ex’s, not my children from three marriages and not my friends. I always played it close to the chest and never let anyone in and now I’m paying the price. Maybe, just maybe, I out-smarted myself.

Getting to know people like the patient above can teach you a lot about life and what a good life means. Granted there are many people unlike my patient above who are able to feel fulfilled by great accomplishments that benefited others even if it was at the cost of feeling close to anyone. However there are many who like my patient feel a sense of emptiness even after a life of great accomplishment.

Something that I have noticed in a number of those in the second category suffer from what I call the “Syndrome of Disavowed Yearning.”

They often come from parents where their dad was too busy with his job or career and their mother lacked warmth. Often these were not bad parents. The dad was often worried about earning a living and so was focused more on his boss or his customers and clients than his family. The mom often came from a mother who also lacked warmth (it was often a condition passed on for generations).

In the ideal situation, a child feels most solid from the inside out when there is warmth (usually from a mom) to comfort them when they are hurt or afraid or just plain lonely and “you can do it” guidance, support and coaching (usually from a dad) that can lead to confidence and courage.

If these are missing, that child’s personality discovers that instead of feeling the pain from the lack of warmth and enthusiastic support, it hurts less if you disavow needing either.

In the people who become high achievers, they sublimate what would have been an aching yearning into accomplishing things. If you’re like them, even if that doesn’t fill you up from the inside out, the conditional grin of approval for what you do instead of the love and celebration for who you are can certainly distract you from the yearning. However, as great a way as that is to cope, down deep something at your core feels false. And after many years of accomplishments, those grins of conditional love and approval wear thin and you can feel empty.

In contrast to the patient and condition above, I remember an entirely different man I will call Mr. Cohen.

It was 4:30 in the afternoon and I had just finished doing an EKG on Mr. Cohen. Unlike everyone else living at the Jewish Home for the Aged in Jamaica Plain, Massachusetts, Mr. Cohen was spry and totally alert for his 87 years. As a third- year medical student with much living (and learning) ahead of me, I couldn’t understand why he was staying in this place, which well appointed as it was still remained a last holding unit for people who were waiting to die.

I asked Mr. Cohen why he lived in this morgue when he was clearly doing so well. He looked at me with a patient, knowing look and explained: “Two floors below us is my wife, Emma. Three years ago, she developed Alzheimer’s disease and then had a stroke on top of that. On the very best of days, which don’t occur that often, I think she might recognize me. At all other times, she’s lost.”

He went on to tell me to me that Emma and he had fled the Russian revolution together, and that more than a few occasions she had saved his life. The couple made their way to America, started a tailoring business and raised a wonderful family. “I tell my family not to visit as much as they’d like,” he said, “because I want them to make sure they enjoy their families now and because their mom and I are doing fine.”

Each day, he would wake up, go downstairs to his wife’s room, bathe her, replace the diaper she now needed, put her into a sun dress, braid her hair, have breakfast with her and then read his newspapers and books as he sat beside her.

I didn’t get it. Why was he doing this with a woman who couldn’t even recognize him? “This poor man must be eaten up with guilt,” I thought.

I suggested, presumptuously, that Mr. Cohen’s guilt would not help his wife. The old man looked at me with an amused sparkle in his eyes and shook his head at my stupidity.

“You really don’t understand, do you? This is where I want to be. Maybe someday you will understand.”

It’s been thirty five years since my visit with Mr. Cohen and I think I do finally understand. Instead of guilt, he felt joy in the presence of someone he had loved and been loved by for sixty years.

It is difficult to change from a human doing to a human being, but as I observed first hand from people who died having it all, but who felt as if they had nothing and others who had very little, but felt they had it all, it’s probably something worth the effort.

One of my close friends, attorney Harry Glazer was telling me recently how when his kids are happy he’s happy and when they’re not, he’s not.  My wife’s version of this is: “You’re only as happy as your most unhappy child.”  I agree with both of them.

Harry told me that he knows that there is at least one thing that makes his kids smile each day, but he often doesn’t hear about that because they mainly call him or text him about a problem or to ask for something.

He thought about this and responded to this situation by each day sending out a text to each of his young adult children, age 19 and 22, asking them: “What made you smile today?”  And he meant anything such as seeing their refrigerator had their favorite food, getting a great parking with money in the meter, noticing one of the many inane things that show up on their facebook page, a hot shower after being out in the cold.

At first his children thought he was just being a nerd or goofy, but he persisted.  He has also taken to sending them a quote for the day to think about that might relate to something they are going through. Over time this has made a difference in his relationships with them.  He thinks that exchange helps put an additional smile on their faces as well as his own because a) it forces them to pause and remember something happy each day; b) by sending their answer to their dad, they know they are making him happy which underneath all their daily problems, they enjoy doing.

Another friend of mine, Marshall Bitkower, a  Los Angeles based attorney, has started a blog entitled, MYBLOGMITZVAH, where he invites people to share not what made them smile, but what they did to put a smile on someone else’s face.

I hope you’ll visit his page and share what you did today to make someone else smile.  The world could certainly use it.

I hope this post puts a smile on your face as imagining you reading it has put one on mine.