Finding Joy When the World Feels Hard: A Conversation with Dr. Tanmeet Sethi

"The practice of joy is reclaiming how to be safe in a moment, even when the world is not safe."

Physician, author, and global trauma worker Dr. Tanmeet Sethi has spent decades sitting with suffering—in disaster zones, in exam rooms, and in her own home after her son was diagnosed with Duchenne muscular dystrophy, which progressively destroys muscle tissue and is fatal. She talks about receiving that diagnosis, while nine months pregnant with her third child, in her New York Times article, “Why It’s Best to Imagine the Worst.” That convergence of personal pain with her years as a doctor is what led Dr. Sethi to a realization that became the foundation of her book, Joy is My Justice, that happiness and joy are not the same thing. Dr. Sethi explains,

"Happiness is cognitive and binary and evaluative...it's either or. It's like you either get this or you don't. Joy, on the other hand, really was related to the same wells of meaning and love and connection that were part of my pain. And when I understood that, denying my meaning, love, my connection, my pain also meant I would deny my joy."

For Dr. Sethi, this wasn't just a personal revelation, it reframed everything about how she understood healing. Joy, she came to believe, is not a destination you arrive at when things get better. It is a human right available even in the midst of suffering, and claiming it is itself an act of resistance.

"Joy was actually a protest...a protest to whatever suffering it is you have in this world and also a protest to the world and its ways of inducing fear and heightening our nervous system constantly."

This idea takes on particular urgency right now. With so many people feeling overwhelmed by violent attacks on our neighbors and the daily news cycle, Dr. Sethi points to what's happening in our nervous systems. When we're stuck in fear and desperation, we're operating from our amygdala, our brain's fear center, and it becomes neurologically impossible to think clearly, act boldly, or fight for change. She argues that systems of power and oppression depend on exactly this.

"The point of maintaining power is to hijack our capacity to feel human. The less we feel human, the more we are subjugated to the power above us...every time we stay and sustain that place of fear and helplessness, the systems we're talking about gain more power and we lose it."

This is also where Dr. Sethi draws a sharp distinction between self-care and what she calls self-nourishment. The wellness industry, she says, has normalized the conversation around mental health, but it has also turned inward care into a consumer product that can become a form of bypass, a way of numbing out rather than showing up.

"Systems of inequity are not made okay by a vacation or a spa day. They're made okay by real systemic change and yet we are human beings who have to live in those systems...Self-care is actually quite easy. Self-nourishment is much harder."

So what does self-nourishment actually look like? Dr. Sethi offers three steps and explains that the first two are the ones people resist most. The first is simply to acknowledge how hard things are — not to perform strength or say "I'm fine" when you're not. The second is to accept that joy is your human right, that it belongs right next to the pain, not after it. The third, savoring joy when you find it, becomes easier once you believe you deserve it.

At the core of practicing joy, Dr. Sethi says, is learning to find safety and belonging, even when the world feels like it's constantly pulling both away. She describes belonging as reconnecting to the world in whatever way opens your heart. The world shuts our hearts down daily, she explains, making us feel disconnected and unseen. The practice of joy is the work of reclaiming that connection.

"The practice of joy is about saying to yourself, this is hard, I acknowledge it. That makes your nervous system safe...most often we're either on vigilance, not safe, or disconnected, not belonging. That's where we are right now in this world. It's a nervous system hijack every day, all day. And joy, the practice of joy, is reclaiming how to be safe in a moment, even when the world is not safe."

One of the tools Dr. Sethi returns to again and again is gratitude, but not the kind the wellness industry sells. For her, gratitude is not about positivity or pretending things are okay. It is about widening your lens when grief has narrowed it to a pinpoint. She experienced this firsthand at the airport before her son's Make-A-Wish trip, surrounded by cheerful banners and well-meaning strangers, feeling utterly unseen in her sorrow. Rather than let her heart close, she made a deliberate choice.

"I'm going to find things to be grateful for, even though I'm crying and that doesn't mean bypassing and denying the crying. It means widening the lens to see more than I see right now, because all I see right now is the sorrow."

She illustrates this with a moment from that same trip. Standing at the airport, her daughter quietly put an arm around her without saying a word.

"I felt like, oh, I'm so grateful. My daughter has that much compassion that she can just know to put her arm around me...we could choose to make that part of our lens, or we could choose not to, and it's a matter of what we choose."

Dr. Sethi is currently relaunching Joy is My Justice as a grassroots movement to get the book to the audience she believes it deserves, especially now. You can follow her on Substack and Instagram @tanmeetsethimd for updates on the relaunch and her ongoing writing about joy, gratitude, and grief. You can pick up a copy of Joy is My Justice at Bookshop or wherever books are sold.