He who has a why to live for, can deal with almost any how. — Nietzsche
In our dynamic time of political, economic, societal, and ecological crises, the ways how we live our lives are continuously questioned. More than ever, we need to focus on what motivates us and offers structural stability. As meaning-centered professionals, we have an opportunity—and some would say: “a responsibility”—to use our expertise to help individuals and communities to refocus on our why. Meaning seems to offer resilience, perspective, and practical tools for a more humane future. But how can we share our expertise?
Submitted by Joel Vos, PhD, Department of Psychology, University of Roehampton, London for the Positive Living Newsletter (January 2017). Read the rest of the newsletter here.
About the author | Psychologist and philosopher; Reader (Associate Professor) in Counselling Psychology; Deputy Director of the Centre for Research in Social and psychological Transformation (CREST); Chair of the “International Meaning Conference: Joining forces in practice and research” June 30-July 2, 2017 in London, UK. Contact: Joel.Vos@roehampton.ac.uk
Knowing How to Do It
A large body of literature has validated the clinical and aetiological foundations of meaning-centered therapies and practices (Vos, 2016a; Vos, Cooper, Correia, & Craig, 2015). For example, a quick examination of empirical studies suggests a common understanding of meaning as a unique psychological experience, consisting of multiple components: motivation (e.g., goals and purpose), self-worth, values, understanding, commitment, and self-regulation (e.g., setting and adjusting goals). Other research shows how meaning is also intrinsically related to existential themes, such as coping with existential anxiety, life’s limits, and responsibility (e.g., Vos, 2014). More specifically, individuals experience many different types of meaning, as a review of 107 studies shows how over 45,000 individuals in 50 countries have described material-hedonic, self-oriented, social, higher, and existential-philosophical types of meaning (Vos, 2016a, 2017a). Individuals seem to ask meaning-centered questions particularly when they are at crossroads in their life, such as when they are confronted with a physical disease, the loss of a loved one, and possibly also the loss of hope for our societal future (Vos, 2016b). By definition, recovery from mental health issues means “learning to live a meaningful and satisfying life despite everything” (Andresen, Oades, & Caputi, 2000).
Thus, meaning seems validated as a clinically and aetiologically important and coherent phenomenon. But how can meaning-centered practitioners help individuals? What should they do in their consultation room? What should they tell managers and politicians? What works and what does not work? Possibly there are as many different ways of working with meaning as that there are human beings: Nothing seems so unique as how individuals experience meaning. At the same time, nothing seems so universal as wanting to experience meaning. Supporting clients in their quest for meaning is possibly the most common factor to all psychological therapies (Vos, 2016a).
Certain meaning-centered practices seem beneficial for a larger group of individuals than other practices. A systematic literature review identified 60 empirical studies in which meaning-centered therapists followed a semi-standardised treatment manual or a predefined collection of therapeutic skills and exercises (Vos, 2016a). We identified 37 skills which most of these practitioners used, such as assessment, meaning-specific, relational, existential and phenomenological-experiential skills. The most effective were practices which did not include religious-spiritual formulations, but were structured; explicitly stimulated clients to set and experiment with achievable goals in daily life; used mindfulness exercises; explicitly discussed one type of meaning per session; discussed many different types of meanings in total over all sessions; addressed self-worth; discussed existential limitations in life; mentioned the coherence of time; and focused on creating a positive therapeutic relationship (Vos & Vitali, 2017).
In line with this review, meaning-centered practitioners should discuss what their different approaches have in common and teach these common skills to new practitioners, for instance via conferences and handbooks (e.g. Vos, 2017b). To achieve this common perspective, it could be helpful to develop a joint statement what we regard as the most essential and beneficial skills, based on our best practices and evidence-based research.
Worldwide, many different people work with meaning. Unfortunately, too often we seem to focus on where we differ and not where we overlap. This seems unjustified, as the experience of meaning is so unique to different individuals, that we need as many different perspectives as possible. Therefore, it seems timely to build bridges between different communities working with meaning, for instance between researchers and practitioners; psychologists, theologians, philosophers and politicians; mental and physical health carers; healthcare providers and business/HR consultants; positive and existential psychologists; researchers using different methods such as constructivist, phenomenological, and clinical studies. These bridges can be built on our epistemological understanding of meaning as a unique subjective experience which can be addressed with a large plurality of methods. More specifically, it seems of utmost importance to build bridges between different cultures. For instance, there seems to be relatively little conversation between the large schools of meaning-centered therapists in Continental Europe and USA/Canada. In my experience, the INPM is a home with many different rooms where different communities can meet. A home where differences are valued and where we support each other, each in our unique way.
Evaluating the Evidence Base
In our evidence-based era, it seems of utmost importance to use rigorous methods to evaluate our practices. It is important to use a plurality of evaluations, given our epistemological and methodological differences. We also need a place to meet, converse, and draw joint conclusions. Because we share the common aim to communicate the usefulness of meaning-centered practices to our clients and policymakers in healthcare. We could create a joint statement on the state of the art of our field. Such a statement could describe the aforementioned empirical evidence for the clinical and aetiological foundations, beneficial therapeutic skills, general effectiveness, and applications in different populations. As many clients and policymakers focus on quantitative research nowadays, an important contribution could be provided by quantitative researchers. For example, our meta-analysis of 60 meaning-centered trials in 4,000 participants in 20 countries shows that meaning-centered therapies have overall large effects on the quality-of-life and psychological-stress of clients, on short and long term, and compared with alternative treatments (Vos & Vitali, 2017).
Thus, meaning-centered practices seem to be bona fide practices with similarly strong empirical foundations such as cognitive behavioural therapy. However, meaning-centered practices are less widely practiced and applied in healthcare. We can—and possibly “must”—aim for more. We can do this by meeting each other at conferences, sharing our expertise with each other and new practitioners. We can develop a joint statement on the state of the art in our field, and use this strategically in our communication with clients and policymakers. As a step into this direction, we are organising an International Meaning Conference in London (UK) from June 30-July 2, 2017, with the title “Joining Forces in Practice and Research”; this will include speakers from different fields and continents, workshops, lectures and the creation of a joint statement (www.roehampton.ac.uk/CREST/). Hopefully, this will be one of many ways to share why we live, so that we can deal with the many challenges to how we live our lives.
- Andresen, R., Oades, L. G., & Caputi, P. (2011). Psychological recovery: Beyond mental illness. New York, NY: Wiley.
- Vos, J. (2014). Meaning and existential givens in the lives of cancer clients: A philosophical perspective on psycho-oncology. Palliative & supportive care, 12(9), 1-16.
- Vos, J. (2016a). Working with meaning in life in mental health care: A systematic literature review and meta-analyses of practices and effectiveness. In P. Russo-Netzer, P., S. E. Schulenberg, & A. Batthyány (Eds.), Clinical perspectives on meaning: Positive and existential psychotherapy (pp. 59-87). New York, NY: Springer.
- Vos, J. (2016b). Working with meaning in life in chronic or life-threatening illness: A review of its relevance, and the effectiveness of meaning-centred therapies. In P. Russo-Netzer, P., S. E. Schulenberg, & A. Batthyány (Eds.), Clinical perspectives on meaning: Positive and existential psychotherapy (pp. 171-200). New York, NY: Springer.
- Vos, J., Cooper, M., Correia, E., & Craig, M. (2015). Existential therapies: A review of their scientific foundations and efficacy. Existential Analysis: Journal of the Society for Existential Analysis, 26(1).
- Vos, J. (2017a). The many faces of meaning in life: A systematic literature review on different types of meaning and their use in meaning-centered therapies. (Under review).
- Vos, J. (2017b). Meaning in life: An evidence-based handbook for practitioners. Basingstoke, UK: Palgrave MacMillan. (To be published).
- Vos, J. & Vitali, D. (2017). The effects of psychological meaning-centered therapies on quality-of-life and psychological-stress: A meta-analysis. (Under review).