In a culture that values speed, technology and consumer cravings, you might think meaning would fade into the background. But people's desire for meaning remains strong. More than 90 percent of us say our lives are meaningful, according to a literature review by University of Virginia research associate Samantha J. Heintzelman, PhD, and University of Missouri social psychologist Laura A. King, PhD (American Psychologist, Vol. 69, No. 6, 2014). What's more, meaning in life appears to nurture us, with studies linking it to good health and health behaviors (Health Psychology Review, Vol. 11, No. 4, 2017), longevity, higher quality of life and lower rates of mental disorders, including depression and post-traumatic stress disorder.
To help clients explore and develop greater meaning in their lives and enjoy those benefits, psychologists use strategies from a variety of therapies, including logotherapy, meaning therapy, existential therapy and a combination of approaches. While more research is needed to show which interventions work best, such meaning-related work is helping people identify, prioritize and act on what matters most to them, says Clara Hill, PhD, a University of Maryland, College Park, psychology professor and author of "Meaning in Life: A Therapist's Guide" (APA, 2018).
"Almost every problem that's brought into therapy," she says, "is implicitly about the meaning of life."
According to a model developed by University of Connecticut researchers Login S. George, PhD, and Crystal L. Park, PhD (Review of General Psychology, Vol. 20, No. 3, 2016), most psychologists who study the topic agree that people believe their lives are meaningful when three aspects are in place:
- They feel that their lives make sense and have continuity.
- They are directed and motivated by meaningful goals.
- They believe their existence matters to others.
As for sources of meaning, they tend to fall into two main categories: meaningful relationships and meaningful occupation, whether that's a career, hobby or other creative pursuit. Many studies find that relationships rank No. 1, with studies showing that people feel the greatest sense of meaning when our needs for relatedness are met, when we feel we belong in the world and when we feel close to and supported by our families.
In addition to examining what constitutes meaning, researchers and practitioners are also exploring what Park calls "meaning-making": what we do when confronted by the need to re-evaluate our baseline sense of meaning due to an outside challenge, say a divorce or an illness. Park's research finds that people tend either to re-evaluate an event so that it better fits within their original beliefs and goals or to revise those beliefs and goals to accommodate the new information—a process that can take time and is not always successful, she notes.
Such periods of upheaval may spark an existential crisis that can blossom into important growth opportunities, says Paul T.P. Wong, PhD, a Toronto-based clinical psychologist and professor emeritus at Trent University in Ontario, Canada.
"Crises are a chance for people to give up dead wood—toxic habits or patterns—and explore who they truly are and what really matters in life," he says.
A variety of approaches
Wong is among the psychologists who have developed therapies that help clients foster more meaningful lives. Many of these interventions trace their origins to Viktor Frankl, the Austrian psychiatrist and author of "Man's Search for Meaning," first published in 1946, which chronicles his experiences in four Nazi concentration camps. After his release, Frankl went on to create logotherapy, which holds that humankind's main motivation is finding meaning in life, as opposed to striving mainly for pleasure or power, as other theorists emphasized.
Logotherapy posits that meaning is based on enduring values that emanate from three main sources: engaging in creative work or deeds of kindness; appreciating love, goodness, truth or beauty; and taking a courageous stance toward life's difficulties. In his work with clients, Frankl used techniques such as dereflection (helping clients focus less on themselves and more on higher-level goals such as helping others) and Socratic dialogue (asking open-ended questions to help people uncover meaning-related aspirations). If a client is passionate about saving the environment, for example, a therapist might help him or her explore concrete ways to realize that vision, such as participating in a river cleanup or starting a work-based recycling program.
Others have since refined Frankl's work. In 2010, Wong developed meaning therapy, which incorporates elements of cognitive-behavioral therapy (CBT), positive psychology and research findings on meaning. Using a model he calls PURE (purpose, understanding, responsible action and enjoyment/evaluation), Wong helps people balance positive and negative elements of life by helping them assume personal responsibility and encouraging them to pursue goals or activities that are greater than themselves. Studies have shown that his approach helps to reduce stress and depression and increase well-being (see "Clinical Perspectives on Meaning," Springer, 2016).
Meaning-centered psycho-therapy is another form of therapy derived from Frankl's work. Developed for advanced cancer patients by William S. Breitbart, MD, chair of psychiatry service at Memorial Sloan Kettering Cancer Center in New York, the intervention confronts patients' fears of mortality by helping them explore what they would consider to be a good or meaningful death. It also encourages patients to embrace more positive attitudes about their lives, illness and death; to consider how to courageously fulfill their responsibilities; and to connect with what makes them feel most alive. In addition, participants create "personal legacy projects" to address what is most meaningful to them, such as mending a broken relationship, volunteering or visiting a place they have always wanted to see.
In two randomized controlled trials, Breitbart and colleagues found that the treatment enhanced patients' sense of meaning, improved their quality of life and decreased their depression and hopelessness compared with controls (Journal of Clinical Oncology, Vol. 33, No. 7, 2015; Cancer, in press).
Still another vehicle for helping clients tap into meaning is existential therapy. Started by contemporaries of Sigmund Freud, including Otto Rank and Rollo May, it was updated in 1980 by Stanford University psychiatrist Irvin D. Yalom, MD. His model holds that life is inherently random and meaningless, so humans must create their own sense of meaning. The way to do that, Yalom asserts, is to engage more fully in life—with activities and people you're drawn to and that nurture you. From there, meaning arises naturally, he maintains. Therapists can help clients break down barriers to engagement by asking them what is preventing them from doing what they want, such as traveling more or taking an art class they've long been interested in. Existential therapies appear to benefit certain populations, particularly people with physical illnesses, research finds (Journal of Consulting and Clinical Psychology, Vol. 83, No. 1, 2015).
Finding meaning also plays a central role in acceptance and commitment therapy, or ACT, established in 1982 by psychologist Steven C. Hayes, PhD, of the University of Nevada, Reno. Like existential and meaning therapies, ACT seeks to help clients live full lives and face existential issues. It also helps them identify their values, choose behaviors in harmony with those values, and use mindfulness, awareness and acceptance strategies to meet life's difficulties. At least one meta-analysis concludes that ACT is effective in treating depression and anxiety, but there is insufficient evidence to deem it more effective than other treatments, such as CBT (Journal of Affective Disorders, Vol. 190, 2016).
Using meaning in practice
While some psychologists adhere to these specific modalities in their work with clients, others incorporate elements of these approaches while practicing more traditional therapy forms, including psychodynamic therapy and CBT. For instance, when cognitive-behavioral therapists use behavioral activation, they make sure to help their clients consider how they can incorporate their values into their actions, says Bruce Liese, PhD, a professor of family medicine and psychiatry at the University of Kansas who studies CBT approaches in treating addiction. CBT also emphasizes goal-setting, which involves articulating goals that are consonant with a meaningful life, he notes.
He and others provide these additional ideas to foster clients' quest for meaning:
Have a plan. As with any type of therapy, structure is key, says Liese. In developing case conceptualizations, he asks clients what is meaningful to them and uses that information to guide treatment.
In her work, Hill uses a three-part model that encourages clients to explore their meaning-related issues, gain insight into them and take action on them if they so choose. She also believes that therapists who do this work should be involved in this kind of inquiry themselves.
"By experiencing the depths and ambiguities of self-examination, therapists are more likely to be humble and compassionate and thus able to help and encourage clients in navigating their journey toward self-awareness," she says.
Foster a big-picture view. A big part of meaning therapy is helping clients learn to see the potential in difficult circumstances, develop resilient attitudes toward suffering, and contribute to others or to a larger cause. To this end, Wong uses a "double-vision" strategy to encourage his clients to aim high toward future ideals on the one hand while staying grounded in the present on the other. He uses strategies such as having clients keep daily journals to express gratitude for life's gifts, including challenges, and to track the sometimes bumpy journey toward making positive changes.
He also employs cognitive and behavioral techniques to help clients change their self-centered attitudes and habits. For someone who's an incessant complainer, for example, Wong might prescribe homework asking him or her to say something good about a person or circumstance every time he or she is tempted to grouse.
Tap the power of stories. Likewise, clinicians can use elements of life review and narrative therapy to help clients broaden their life views and assess where they've been and where they want to go, says Michael F. Steger, PhD, creator of the widely used Meaning in Life Questionnaire and director of the Center for Meaning and Purpose at Colorado State University. Blending meaning and narrative approaches "can facilitate how we really want our life story to be, how we want to write our stories," he says, and place challenges in a perspective of learning and growth.
Meanwhile, research by University of Kansas social psychologist Mark J. Landau, PhD, suggests that metaphors can be powerful tools for facilitating meaning. In fact, humans probably created metaphors based on cultural or physical experiences, such as journeys or wars, to make sense of abstract life events, says Landau, who along with Kathleen V. Vohs, PhD, and Roy F. Baumeister, PhD, edited a special issue on meaning in the Review of General Psychology (Vol. 22, No. 1, 2018).
"When we conceptualize our life in terms of these known areas, we're giving it meaning—a structure and a framework—that it didn't have before," he says.
A series of studies he conducted with Matthew Baldwin, PhD, and Trevor J. Swanson, PhD, shows that students who framed their lives as a journey reported more meaning in life than those who simply wrote about their lives in a straightforward, literal fashion (Self and Identity, Vol. 17, No. 2, 2017).
Respect individual differences. While close personal connections and purposeful work are universal sources of meaning, meaning in life also differs depending on such factors as a client's age, context, culture and religion, says Hill. Not surprisingly, the need to reformulate one's sense of meaning can bisect any of these areas: A young woman raised in a conservative religious household may face a crisis of meaning when she realizes her sexual orientation is different from the norms of her faith. Or a man from a collectivist culture may face an existential conflict when his life goals fail to square with those of his parents. Because of the complex, personal nature of meaning, therapists' best strategy is to help clients explore their own meaning issues and guide them in finding their own answers, Hill says.
"We have to listen to them to hear what they're thinking and where their beliefs come from, and to explore how that is working for them," she says.
Don't impose meaning. In a related vein, let the topic of meaning emerge organically, Hill advises. Only about 12 percent of clients enter therapy with an explicit request to work on meaning issues, according to a survey she conducted with 212 practicing psychotherapists (Counselling Psychology Quarterly, Vol. 30, No. 4, 2017). In another qualitative study she and colleagues conducted with 13 experienced psychotherapists (Psychotherapy Research, Vol. 27, No, 4, 2017), the therapists recommended approaching the topic with care. The best times to do so are when clients bring it up or during times of major life transitions or crises, they agreed. "The therapist's job is to figure out when it is beneficial to bring up the topic of meaning, and when it's not," says Hill.
Keep it off a pedestal. Finally, the University of Missouri's King is studying the notion that meaning is everywhere—in actions as simple as hanging out with one's family or walking the dog.
She and colleagues have also found that simply being in a good mood can inspire a greater sense of meaning and that intuition—not analysis—is linked to our ability to perceive a meaningful world.
King likes to share this research with older adults as well as their caretakers to let them know that everyday activities—tasks as simple as helping a person get dressed or taking a stroll together—can be as valuable as loftier or more ambitious goals.
"We tend to think of meaning as this most profound of human experiences," she says. "Yet all of these more ordinary things also foster our sense of meaning. And that, I think, is an incredibly huge relief."