Several studies demonstrate that people who are grateful for things in their lives experience high levels of well-being. These studies cut across socioeconomic status. It is easy to lose sight of the things that make a person grateful, secondary to life’s struggles and disappointments. Persistent pain is one of the most difficult of those struggles. Making a list of one’s gratitudes is an excellent way to start remembering the good things that have happened. In the brain this sets off pleasure circuitry. Pleasure reverberates between cell clusters deep in the brain to large networks in the thinking brain. Just as pain causes pain and calm leads to more calm, pleasure generates more pleasure. Starting with a gratitude list can be a helpful way to get back on track and build pathways in the brain that reinforce pleasure.