My presentation is to offer an alternative approach to mental health. My relativity theory of sustainable wellbeing posits that under conditions of high degree of suffering, our existential wellbeing is relative to our decision to activate the spiritual dimension of seeking ultimate meaning. According to Viktor Frankl (1978), ultimate meaning entails both the quest for self-transcendence and faith in God or the supernatural realm.

We are facing an unprecedented mental health crisis which cannot be resolved by the medical model or the health sector alone. We need to rethink mental health not in terms of health versus illness but in terms of the quality of life or total wellness. This broader holistic framework calls for total mobilization; all sectors in society need to be involved in promoting mental health, such as the workplace, school, family, religious institutions, and a new cultural narrative of behavioral economics (Wong, Ho, et al, 2022).

This new cultural narrative identifies two main barriers towards full engagement of our spiritual dimension. Firstly, secularism (Ertit, 2018; Sotillos, 2022): Religious beliefs have survived as a robust survival mechanism (Austin, 1980; Ken, 2019) but the increase in secularization may contribute to decline in religious beliefs and practices such as prayer and religious coping (Pargament, 1997; Smith, 2018), which are especially important for cancer care (Vallurupalli et al., 2012) and palliative care (Richardson, 2014).

Secondly, the dominant paradigm of seeking pleasure and avoiding pain (e.g., Freud’s Pleasure Principle, Neal Miller’s model of approach-avoidance conflict): This paradigm certainly works well for survival at the subhuman animal level, but this prevailing negative attitude towards any kind of suffering or discomfort is a hindrance to human adaptation in a digital world (Wong, Cowden et al., 2022). We now have a coddled generation (Lukianoff & Haidt, 2018) which may not be prepared to face the inevitable reality of suffering.

In order to overcome these two obstacles to seeking ultimate meaning, we need to recognize suffering as the missing link to wellbeing (Fowers et al., 2017; Soper, 2020; Wong, 2022). Suffering, like gravity, is inescapable. All our attempts to be happy are doomed to fall short when we fail to learn how to cope with stress and suffering effectively (Wong, 1993).

We also need to recognize that suffering is a trigger to meaning (Frank, 1946/1985; Wong & Weiner, 1981) and meaning is the most effective antidote to suffering (Wong, 2015). Under conditions of high degree of suffering, such as cancer or trauma, nothing short of ultimate meaning is needed for survival and healing (Wong, 2021; Wong & Laird, in press). My presentation focuses on how to experience existential wellbeing in palliative care (Wong & Yu, 2021) through meaningful living and meaningful suffering by activating one’s spiritual dimension.

(This keynote was presented with Tim T. F. Yu)


  1. Austin, W. H. (1980), Are religious beliefs “enabling mechanisms for survival”? Zygon: Journal of Religion & Science, 15, 193-201. https://doi.org/10.1111/j.1467-9744.1980.tb00385.x
  2. Ertit, V. (2018). Secularization: The decline of the supernatural realm. Religions, 9(4), 92. https://doi.org/10.3390/rel9040092
  3. Fowers, B. J., Richardson, F. C., & Slife, B. D. (2017). Frailty, suffering, and vice: Flourishing in the face of human limitations. American Psychological Association.
  4. Frankl, V. E. (1978). The unheard cry for meaning: Psychotherapy and humanism. Touchstone.
  5. Frankl, V. E. (1985). Man’s search for meaning. Washington Square Press. (First published in 1946)
  6. Ken, B. (2019). Religion as the ultimate human evolutionary survival strategy. In L. E. Grinin & A. V. Korotayev (Eds.), Evolution: Evolutionary trends, aspects, and patterns (pp. 145-166). Uchitel Publishing House.
  7. Lukianoff, G., & Haidt, J. (2018). The coddling of the American mind: How good intentions and bad ideas are setting up a generation for failure. Penguin Press.
  8. Pargament, K. I. (1997). The psychology of religion and coping: Theory, research, practice. Guilford Press.
  9. Richardson, P. (2014). Spirituality, religion, and palliative care. Annals of Palliative Medicine, 3(3). https://apm.amegroups.com/article/view/4175
  10. Smith, J. (2018, December 26). Prayer as a coping skill. Church and Mental Health. https://churchandmentalhealth.com/prayer-as-a-coping-skill
  11. Soper, C. A. (2020). The evolution of life worth living: Why we choose to live. C. A. Soper.
  12. Sotillos, S. B. (2022). The eclipse of the soul and the rise of the ecological crisis. Spirituality Studies, 8(2), 34-55. https://www.spirituality-studies.org/dp-volume8-issue2-fall2022/36/
  13. Vallurupalli, M., Lauderdale, K., Balboni, M. J., Phelps, A. C., Block, S. D., Ng, A. K., Kachnic, L. A., Vanderweele, T. J., & Balboni, T. A. (2012). The role of spirituality and religious coping in the quality of life of patients with advanced cancer receiving palliative radiation therapy. The Journal of Supportive Oncology10(2), 81–87. https://doi.org/10.1016/j.suponc.2011.09.003
  14. Wong, P. T. P. (1993). Effective management of life stress: The resource-congruence model.
  15. Stress Medicine, 9, 51-60. https://doi.org/10.1002/smi.2460090110
  16. Wong, P. T. P. (2015). Meaning-seeking, self-transcendence, and well-being. In A. Batthyany (Ed.), Logotherapy and existential analysis: Proceedings of the Viktor Frankl Institute (Vol. 1; pp. 311-322). Springer.
  17. Wong, P. T. P. (2021). The Frankl cure for the 21st century: Why self-transcendence is the key to mental health and flourishing. The International Forum for Logotherapy, 41(2), 33-50.  Doi: 10.31234/osf.io/tbx3f
  18. Wong, P. T. P. (2022). Review of The Evolution of Life Worth Living: Why we choose to live. International Journal of Wellbeing, 12(3), 101-112. https://doi.org/10.5502/ijw.v12i3.2395
  19. Wong, P. T. P. & Laird, D. (in press). The suffering hypothesis: Viktor Frankl’s spiritual remedies and recent developments. In C. McLafferty, Jr. and J. Levinson (Eds.), Logotherapy and Existential Analysis: Proceedings of the Viktor Frankl Institute of Logotherapy Frankl Institute Vienna (Vol. 2). Springer Research.
  20. Wong, P. T. P., & Weiner, B. (1981). When people ask “Why” questions and the heuristic of attributional search. Journal of Personality and Social Psychology, 40(4), 650-663.
  21. Wong, P. T. P., & Yu, T. T. F. (2021). Existential suffering in palliative care: An existential positive psychology perspective. Medicina, 57(9), 924. https://doi.org/10.3390/medicina57090924
  22. Wong, P. T. P., Cowden, R. G., Mayer, C.-H., & Bowers, V. L. (2022). Shifting the paradigm of positive psychology: Toward an existential positive psychology of wellbeing. In A. H. Kemp (Ed.), Broadening the scope of wellbeing science: Multidisciplinary and interdiscipinary perspectives on human flourishing and wellbeing.
  23. Wong, P. T. P., Ho, L. S., Cowden, R. G., Mayer, C.-H., & Yang, F. (Eds.) (2022). A new science of suffering, the wisdom of the soul, and the new behavioral economics of happiness: towards a general theory of wellbeing. Frontiers in Psychology. https://www.frontiersin.org/research-topics/42594/a-new-science-of-suffering-the-wisdom-of-the-soul-and-the-new-behavioral-economics-of-happiness-towa


Wong, P. T. P., & Yu, T. T. F. (2023, February 17). A relativity theory of sustainable wellbeing [Virtual presentation]. 2nd Global Virtual Summit on European Public Health & Healthcare, London, UK.