Meaning Therapy, also known as meaning-centered counseling and therapy, is an integrative, positive existential approach to counseling and psychotherapy. Originating from logotherapy, Meaning Therapy employs personal meaning as its central organizing construct and assimilates various schools of psychotherapy to achieve its therapeutic goal. Meaning Therapy focuses on the positive psychology of making life worth living in spite of sufferings and limitations. It advocates a psycho-educational approach to equip clients with the tools to navigate the inevitable negatives in human existence and create a preferred future. The paper first introduces the defining characteristics and assumptions of Meaning Therapy. It then briefly describes the conceptual frameworks and the major intervention strategies. In view of Meaning Therapy’s open, flexible and integrative approach, it can be adopted either as a comprehensive method in its own right or as an adjunct to any system of psychotherapy.
A new set of challenges are facing psychotherapists. We are now living in ‘‘a world shorn of moorings and in alarming disarray, doggedly exposing the extreme states of anxiety and confusion’’ (Mendelowitz 2009, p. 339). Existing conceptual categories can no longer accommodate the rapidly shifting values and emerging realities. The future seems more chaotic and uncertain than ever. Advances in scientific research have not increased our ability to predict and control human destiny; we have not found any satisfactory rational explanation and scientific solution to human suffering and evil. The tragic dimension of life has become a big part of consciousness, with images of violence, death and human miseries dominating the mass media. In the post-911 world, the troubles confronting us often reach global and cosmic proportions.
Against the above backdrop, Meaning Therapy offers an integrative and positive existential perspective which capitalizes on the uniquely human capacity to discover and create meanings and values out of the raw and often painful life experiences. Originated from logotherapy (Frankl 1986; Wong 2002), Meaning Therapy employs personal meaning as its central organizing construct and assimilates various models of psychotherapy, from cognitive behavior therapy to positive psychotherapy. Meaning Therapy advocates a psycho-educational approach to equip clients with the necessary tools to navigate the inevitable negatives in human existence and create a life that is worth living. It affirms the hope of finding meaning and purpose, even when one suffers from overwhelming difficulties and intractable problems.
The Defining Characteristics of Meaning Therapy
Meaning Therapy is not a new school of psychotherapy, but a new conceptual framework with a focus on meaning. It is both simple and complex, both cognitive and spiritual, and both individualist and collectivist. Its simplicity comes from its single focus on the inner world of meanings of the client. Its complexity comes from (a) individual differences in their reactions to existential givens and (b) the holistic and multidimensional nature of meaning systems. Given it fluid, dynamic and multi-modality nature of Meaning Therapy, it cannot be readily pigeon-holed. However, the essence of Meaning Therapy can be captured by the following seven defining characteristics:
Meaning Therapy is Integrative/Holistic
In a global village and multicultural society, we need to look at life in the broadest terms, and look at individuals in the most inclusive manner. Openness to integrate different ideas and a willingness to explore new alchemies of therapy may provide new clinical insights. Thus, a flexible integrative approach to psychotherapy may be a more effective and efficacious than a strict adherence to a single theory of therapy (Brooks-Harris 2008; Norcross and Goldfried 2005).
Meaning Therapy is technically eclectic in employing whatever works best for the client, but it is theoretically integrative with Wong’s (2008) meaning management theory—a theory that emphasizes the unique human need and capacity to seek, construct and manage meanings in their adaptation to an ever changing world. Meaning Therapy is primarily based on logotherapy and existential-humanistic psychotherapy, but it also assimilates cognitive- behavioral, narrative and cross-cultural therapies (Wong 1997, 1998a, 1999, 2002, 2006). For example, Meaning Therapy integrates positive psychotherapy (Seligman et al. 2006; Wong 2009a) seamlessly with the usual clinical psychology practices within a dual-system framework which optimizes the interactions between approach and avoidance systems.
Meaning Therapy is inherently integrative by virtue of the holistic nature of meaning, which is shaped and experienced at different levels—biological, cognitive, behavioral, interpersonal, motivational, affective, narrative, and cultural (Hoffman 2009a; Wong and Fry 1998; Wong 2009a, b). Progress in neuroscience has made it abundantly clear that various human functions are inter-related through neural integration (Siegel 2009). Meaning is both individually construed and socially constructed (Wong 1998a). Empirical research on the psychology of meaning provides much the foundation for Meaning Therapy (Wong 2009c; Wong and Fry 1998). Research has also shown the construct of meaning is central to understanding culture and society (Bruner 1990; Wong and Wong 2006); physical and mental health (Wong 2009c; Wong and Fry 1998); spirituality and religion (Wong 1998c); death and dying (Tomer et al. 2008).
Thus, Meaning Therapy assumes that humans are bio-psycho-social-spiritual beings. As Meaning Therapy practitioners, we do not pathologize the client as a case; nor do we exclusively focus on the client’s disorder or deficiency.
Instead, we treat the client as a person with genuineness, empathy and unconditional positive regard (Rogers 1951, 1980). We propose that the best way to achieve a fuller understanding of a presenting problem is to relate to the client as a fellow human being with some difficulties in a specific historical-cultural context.
Meaning Therapy is Existential/Spiritual
Meaning Therapy belongs to the humanistic-existential tradition, which emphasize (a) the importance of addressing existential anxieties (Yalom 1980), and (b) the human needs for meaning and authenticity (Schneider et al. 2001; Wong 2006, 2009a). These existential givens operate at both the unconscious and conscious levels. The motto of Meaning Therapy is: meaning is all we need and relationship is all we have. This motto captures the essence of existential psychotherapy in general and Meaning Therapy in particular (Hoffman et al. 2009; Schneider 2008; Spinelli 2001; van Deurzen 2007; Yalom 1980). Hoffman (2009a) has made the case that ‘‘the attainment of meaning is one of the most central aspects of human existence and necessary to address in existential therapy’’ (p. 45). Hoffman (2009b) explains why meaning plays such a vital role:
‘‘Myth is at the core of Rollo May’s (1961, 1991, 1999a, 1999b) conception of meaning. Meaning, in return, is the central element in the existential perspective of mental health…Meaning provides a stabilizing and centering effect in a world that often is dizzying and disorienting. From an existential perspective, meaning is the ultimate ‘coping mechanism,, but it is also so much more; meaning is a basic human need’’ (pp. 259–260).
The centrality of meaning in Meaning Therapy can be traced to Viktor Frankl’s (1986) logotherapy, which may be translated as meaning-therapy. Existential analysis is the therapeutic process to remove all the unconscious blocks of the primary human motive—the will to meaning. Logotherapy incorporates spirituality; it emphasizes the need to relate and respond to the ultimate meaning of life, and makes clients confront the Logos within them. It focuses on the human responsibility to live meaningfully and purposefully in every situation on a daily basis in order to become what they are meant to be.
According to Frankl (1986), three factors characterize human existence: spirituality, freedom, and responsibility. The spiritual dimension is the very core of our humanness, the essence of humanity. The defiant power of the human spirit refers to the human capacity to tap into the spiritual dimension in order to transcend the detrimental effects of stressful situations, chronic illness or the burden of the past. The human spirit is the most important resource in psychotherapy, because it is the basis for recovery and resilience; it is the essence of humanness, the innermost resource that encompasses conscience, freedom of choice, sense of humor, commitment to tasks, ideals, imagination, responsibility, compassion, forgiveness. Both logotherapy and Meaning Therapy attempt to awaken people’s awareness of the human potential for spirituality, freedom, and responsibility in healing and personal growth.
Based on his observations of observations of both inmates in concentration camps and patients in hospitals, Frankl (1985, 1986) concluded that the will to meaning and self-transcendence are essential for survival and healing. Suffering without meaning will lead to despair and depression. Meaning makes suffering more bearable. We discover meaning by doing what is right—what is consistent with our conscience and highest values. We all have the freedom and responsibility to respond to what life demands of us and to what each situation demands from us. Frankl maintains that it is more important to experience situational meanings from moment to moment than discover a clear answer to the abstract question about the ultimate meaning of human existence. However, meaning in life is limited and unsustainable without reaching out for something greater and higher than self-interest (Wong 1998a, b, c).
Existential vacuum refers to the general sense of meaninglessness or emptiness, as evidenced by a state of boredom. It is a widespread phenomenon in contemporary life, as a result of industrialization, the loss of traditional values, the unraveling of communities, displacement and dehumanization of individuals in urban societies (Frankl 1986). Many people feel that life has no purpose, no challenge, no obligation, no hope, and no escape from their boredom and pain; they try to fill their existential vacuum with material things, hedonic pursuits, addiction and blind ambitions for power, wealth and fame, but such misguided efforts will only lead to frustration and despair. Existential vacuum may lead to existential neurosis when one’s quest for meaning is frustrated continually.
According to Frankl (1986), feelings of meaninglessness underlie ‘‘the mass neurotic triad of today, i.e., depression-addiction-aggression’’ (p. 298). A meaning-oriented therapist can empower and challenge the clients to fill their inner emptiness with sustainable and self-transcending meanings. A Meaning Therapy practitioner can facilitate psychotherapy in both psychogenic and somatogenic cases because ‘‘by filling the existential vacuum, the patient will be prevented from suffering further relapses’’ (Frankl 1986, p. 130). Meaning Therapy recognizes that a primordial void engulfs the human existence since antiquity all goal-directed behaviors are aimed at filling this void. Meaning Therapy assumes that humans are meaning seeking and meaning making creatures—we all want answers and solutions to our problems and fears, and we yearn for happiness and success. Many may not articulate their needs in existential and ontological terms; some may not even give anything thought to the question about meaning of life. But all human beings are always searching for something and striving to achieve to make life better life. Unfortunately, we can never completely fill our void, because of internal and external limitations and the quest for meaning in response to unexpected and negative events (Wong and Weiner 1981). In short, we are all on a lifelong journey or quest, but we are all beset by obstacles along the way and shadowed by the prospect of death. Meaning Therapy assumes that our survival and well-being depends to a great extent on our existential quest: pursuing misguided ambitions will lead to disillusion and self-destruction, while striving for self-transcendent and sustainable higher purpose will result in meaning and well-being. Meaning Therapy provides tools and a roadmap to facilitate clients’ existential quest.
Meaning Therapy is Relational
Meaning Therapy is nothing but relational. Relationship is all we have in a clinical context—it goes beyond building rapport and therapeutic alliance. Meaning Therapy assumes that we are relational creatures with the basic need for belonging and attachment (Adler 1969; Bowlby 1988; Bugental 1999; Yalom 1980; Wong 1998a, b). Thus, relationship provides the basis for assessment, intervention and building a better future. Relationship is both curative and life-expanding. From the first moment of saying Hello to the last moment of saying ‘‘Goodbye’’, each counseling session provides many unpredictable moments of encounter. In each here-and-now encounter, information, and energy flow back and forth between two human beings in a safe and trusting environment. The word encounter implies authenticity and intimacy and bonding in the therapeutic situation (Bugental 1990; May 1999). Each encounter opens up a window of opportunity for looking into the inner workings of the client and touching him/her in a life-changing way. Since a sense of displacement, estrangement, and alienation contributes to one’s problems, then authentic relationship not only provides an antidote to loneliness, but also renews a sense of connectivity and belonging.
In addition, to addressing interpersonal deficits experienced by the clients (Weissman et al. 2000), Meaning Therapy also equips clients with the essential tools to build and maintain a positive, rewarding relationship, such as empathy, active listening and reflecting. In the final analysis, the therapist is the most important instrument in the therapeutic process because the therapist’s personal qualities are just as important as his/her clinical competencies. Meaning Therapy practitioner needs to be a securely centered person, who possesses such qualities as genuineness, empathy, unconditional positive regard, compassion and a hopeful attitude towards life. The very presence of the therapist is therapeutic, because of the positive qualities inside the therapist. Thus, Meaning Therapy emphasizes the need for on-going personal development for the therapist.
Meaning Therapy is Positively Oriented
Meaning Therapy is intrinsically positive, because of its affirmation of life and the defiant human spirit to survive and flourish no matter what. Meaning Therapy emphasizes that there is always something worth living for regardless of circumstances. It is a realistic and dualistic positivity that simultaneously embraces the dark side of human existence and the human potential for transformation. Meaning Therapy assumes that individuals have unlimited capacity to construct meanings that both protect them from the inevitable negative life experiences and empower them to make life worth living in the worst of times. There are no hopeless cases. Healing and recovery can be a long and daunting uphill battle, but the struggle is never in vain. Meaning Therapy affirms that the struggle itself makes us better and stronger and there is always hope for positive change.
The concept of tragic optimism (Frankl 1986; Wong 2009b) characterizes the nature of positivity of Meaning Therapy. Tragic optimism is the kind of hope that can weather the worst storms and disasters. Wong (2009b) has identified the following key ingredients of tragic optimism: acceptance, affirmation, courage, faith, and self-transcendence and found them to be positively related to wellbeing. Meaning Therapy intervention strategies are designed to facilitate these optimism-enhancing practices. In short, Meaning Therapy represents a meaning-oriented positive psychotherapy, which taps into people’s capacities for imagination, meaning making, responsible action, and personal growth. Meaning Therapy seeks to bring about fundamental changes by equipping clients with the tools that enable them to see themselves in a new positive light and pursue their lives in a responsible, purposeful and hopeful manner.
Meaning Therapy is Multicultural
Meaning Therapy is inherently multicultural in its orientation and practice for several reasons: (a) meaning systems are shaped by one’s historical-social-cultural background. (b) Culture has a profound and pervasive influence on people’s behavior and attitudes (Arthur and Pedersen 2008). It not only shapes people’s appraisal of what is stressful, but also what constitutes effective coping (Wong and Wong 2006). (c) Empathy demands cultural sensitivity in working with clients from different racial, ethnic, and cultural backgrounds. Arthur and Pedersen (2008) stress the need for inclusive cultural empathy as an antidote to cultural biases. (d) Meaning Therapy incorporates macro-counselling skills because behavior is always situated macro-systems, which include culture, race, gender, history and the human condition. (e) In a multi-cultural society, personal meaning systems necessarily evolve through the long struggle of navigating the cross-currents of different cultures. In sum, Meaning Therapy assumes that multicultural competencies, such as sensitivity, understanding, and knowledge of the cultural contexts of the client are essential for effective therapy.
Meaning Therapy incorporates many of the main features of multicultural counselling theory (Sue et al. 1996). For example, Meaning Therapy also seeks to understand and motivate clients at different levels, such as personal circumstances, the cultural context, and universal existential givens. We help clients define life goals that are consistent with their life experiences, cultural values, and the universal needs for meaning and relationship. In a globalized world, it is inevitable that cultural barriers need to be replaced by bridges of cooperation. Clashes between civilizations and cultural warfare will eventually descend to the level of barbaric tribal wars. The destiny of humanity hinges on mutual understanding and harmony among nations. Meaning Therapy can play an important role in promoting both interpersonal and international peace.
Thus, on a personal and societal level, the cultural orientation of Meaning Therapy contributes to the positive motivation for change by appealing to clients’ cultural specific values and addresses societal problems resulting from cultural barriers and discrimination.
Meaning Therapy is Narrative
Meaning consists of more than isolated concepts and actions. Only narratives do full justice to the rich lived experience of individuals in their social/cultural contexts. Meaning Therapy assumes that meaning is best understood, expressed and constructed in narratives, because of the ‘‘storied nature human conduct’’ (Sarbin 1986). Human beings lead storied lives. Meaning Therapy is a variety of narrative therapy, because it focuses on human beings’ innate capacity for story-telling and re-authoring, and makes use of different narrative strategies to achieve therapeutic goals. In addition to local stories, Meaning Therapy also makes full use of meta-narratives, such as myths and legends that resonate with clients’ values and motivate them to create a preferred future.
Meaning Therapy agrees with White’s (2007) narrative therapy regarding the importance of why questions in the therapeutic process:
These ‘why’ questions play a profoundly significant role in helping people to give voice to and further develop important conceptions of living, including their intentional understanding of life (for example, understanding their purposes, aspirations, goals, quests, and commitments, their understanding about what they value in life (p. 49).
White (2007) emphasizes that ‘‘effective therapy is about engaging people in the re-authoring of the compelling plights of their lives in ways that arouse curiosity about human possibility and in ways that invoke the play of imagination’’ (pp. 75–76) in much the same way as good literature engages the mind. White wants to makes use of narrative metaphors to stretch people’s mind and facilitate meaning reconstruction of personal narratives. Meaning Therapy maintains that both the local stories and universal myths are important for meaning reconstruction. In some way, all therapists depend on personal stories life histories from their clients for the purpose of diagnosis and treatment. Meaning Therapy goes further and deeper in its emphasis on the power of narratives.
Meaning Therapy makes use of guided life review (Wong 1995a) life history interview (McAdams 2006)to discover adaptive leitmotifs that may help restructure one’s life. In addition, Meaning Therapy explores cultural myths, religious symbols, and meta-narratives that enable clients to gain new understandings of their pains and potential for change.
Meaning Therapy is Psycho-educational
Meaning Therapy favors a psycho-education approach. It is helpful to explain to clients the change process and the tools and strategies employed to facilitate such change. Clients need to understand why Meaning Therapy is concerned with relationship and meaning. More specifically, they will learn:
(a) How to make relationships work not only in the counselling room, but also in real life situations, (b) How to overcome the negatives in life and pursue what really matters to them. A more compelling reason for the psycho-educational approach is that the tools for healing and positive living acquired during therapy can be applied to daily situations even after the termination of psychotherapy.
The Conceptual Frameworks of Meaning Therapy
Meaning Therapy is guided by the meaning–management theory and the dual-system model. Meaning–management theory is primarily concerned with meaning-related psychological processes, while the dual-system model is concerned with the self-regulation processes involved in survival and achieving positive life goals. These two conceptual frameworks provide the basis for both the intervention strategies of Meaning Therapy and the integration of various skills to achieving recovery and personal growth.
Meaning–management theory is based on the central role of meaning in human adaptation (Wong 2006). Meaning encompasses (a) the human quest for meaning, purpose, and understanding as well as (b) the human capacity to discover and create meanings out of the perplexing life experiences. Meaning–management theory recognizes that meaning- seeking and meaning-making entail several basic cognitive processes: (a) the automatic adaptive processes of stress appraisal (Peacock and Wong 1990) and attribution (Wong and Weiner 1981), (b) the executive decision making processes problem solving, goal-setting, making commitments, taking responsible actions, (c) the creative process of symbolization, imagination, and myth-making (May 1991; Maddi 1998).
The quest for meaning is universal because it is a biological imperative (Sommer and Baumeister 1998; Klinger 1998). Survival depends on (a) our capacity to predict and control our environment through learning the significance of events happening to us, and (b) purposeful behavior to meet the basic needs for existence. Meaning quest is also an imperative for self-expansion and personal growth. The higher-order meanings, such as actualizing one’s potentials, living an authentic life, or improving the well-being of humanity, or doing God’s will, are born from the human capacity for self-transcendence, imaginations, and myth-making. Meaning is important in our search for understanding and coherence in the face of uncertainty, chaos, and absurdity. Our worldviews about people and the world are essentially our generalized and crystallized experiences and understandings about human existence; our worldviews play an important role in how we react to the present and plan for the future. Most clients see the world and people in exaggerated negative terms. As a result, their way of life is dominated by the defensive avoidance tendency. In sum, how we manage the inner life of meanings determine how well we live.
The working definition of meaning according to meaning-management theory is that meaning consists of four main components: purpose, understanding, responsible action, and evaluation (PURE). Empirical support for these four ingredients can be found in Wong and Fry (1998) and Wong (2009c). The PURE model of meaning provides the basis for Meaning Therapy interventions. However, meaning is a double-edged sword. It can endow life with a sense of significance or a sense of purposelessness and futility. It can help us navigate through troubled waters or mislead us into dangerous territories. Meaning–management theory is about how we manage and regulate our lives. Therefore, to understand the clients is to understand how they construe the world and their own experiences, and how they manage their thoughts, feelings, motivations, and actions. Meaning– management theory is especially important in understanding and dealing with trauma and abuse, which have shaken one’s assumptive world (Wong and McDonald 2002). Meaning–management theory posits that when we cannot make sense or accommodate unexpected and negative life events, we need to accept the negative reality and transcend it through meaning-reconstruction and tragic optimism (Wong 2009a, b). The intervention strategy of ABCDE, which will be explained later, is guided by Meaning Therapy to address negative life events that are unavoidable and uncontrollable.
The dual-system model is primarily concerned with the how-to aspect of adaptation in midst of hardships. The dual-system model highlights both the simplicity and complexity of Meaning Therapy. Simplicity comes from the fact that all adaptive endeavors can be reduced to two fundamental biological, psychological systems—approach and avoidance. Complexity comes from the fact that each system involves numerous psychological processes and the two basic systems interact with each other. The dual-system model clarifies how these interactions can enhance resilience and achieve positive outcomes.
The duality principle of the dual-system model posits that it is more effective to employ both the approach and avoidance systems than to focus on either one alone. It emphasizes the need to incorporate both approach and avoidance systems as the most effective way to protect individuals against negative aspects of human existence and at the same time empower their quest for meaning and fulfillment. The duality principle also hypothesizes that all negative conditions contain seeds for personal growth and all positive conditions contains hidden dangers. It recognizes the fundamental dualistic nature of human condition; that is, the co-existence of good and evil, benefits, and cost, happiness, and suffering, hope and despair.
The dual-system model embraces the paradoxical and contradictory nature of human existence. It integrates psychotherapy with positive psychology in a comprehensive and coherent manner. The dualistic framework not only addresses clients’ predicaments but also facilitates their quest for happiness and success. The complex interactions between the positive and negative systems provide a roadmap of what makes life worth living in the face of the difficulties and personal mortality.
Meaning Therapy Intervention Strategies
Meaning Therapy’s major intervention strategies are based on the above two conceptual frameworks. The PURE strategy focuses on the approach system of life expansion, while the BACDE strategy focuses on the avoidance system of life protection.
The PURE Strategy of Life Expansion
PURE can also be referred to as the four treasures of Meaning Therapy, because they represent the best practices of building a healthier and happier future.
- Purpose—The motivational component, including goals, directions, incentive objects, values, aspirations, and objectives. It is concerned with such questions as: What should I do with my life? What are my strengths and what can I do best? What are my dreams and interests? What does life demand of me? What should I do with my life? What really matters in life? What do I value most? What is worth living and dying for?
- Understanding—The cognitive component, encompassing a sense of coherence, making sense of situations, understanding one’s own identity and other people, effective communications, It is concerned with such questions as: What has happened? Why me? Why does God allow this to happen to me? Why isn’t it that all the prayers and hard work do not get me anywhere? What does it mean? What kind of person am I?
- Responsible action—The behavioral component, including appropriate reactions and actions, doing what is right, finding the right solutions, making mends, and taking actions that are congruent with highest values. It is concerned with such questions as: What is my responsibility in this situation? What is the right thing to do? Given the circumstances and my own limitations, what real options do I have? What choices should I make? What option is most consistent with my beliefs and values? Have I made amends for my mistakes? Have I expressed my gratitude to my parents? Have I done anything to help my family?
- Evaluation—The affective component, including assessing levels of satisfaction or dissatisfaction with the situation or life as a whole. Evaluation is a key component in self-regulation. If the outcome is negative, then one may need to re-evaluate the situation and make adjustments. Evaluation is concerned with such questions as: How is my life unfolding? Have I achieved what I set out to do? Am I satisfied with how I have lived my life? If this is love, why am I still unhappy? Why am I so unhappy in my profession? What is the best thing I have done in my life?
Each of these components requires a set of interventions that manage negative and positive areas of life in an adaptive manner. Some of the commonly used skills include challenging unrealistic or irrational thoughts, clarifying values, goal-setting, prioritizing, reality check, fast-forwarding of consequences of choices, Socratic questioning, the use of Wong’s Personal Meaning Profile (Wong 1998a, b). These four components work together. With each successful completion, one’s level of positivity moves up. However, when one encounters a serious setback or danger, the avoidance system kicks in and the ABCDE strategy comes to the aid.
The ABCDE Strategy of Life Protection
The ABCDE intervention strategy is the main tool in dealing with protracted negative life experiences. Totally different from the ABCDE strategy of rational-emotive therapy (Ellis 1962, 1987), the meaning-centered ABCDE is similar to Acceptance and Commitment Therapy (Hayes 2005) in its emphasis on action and commitment to values. In Meaning Therapy, A stands for Acceptance, B for Belief and affirmation, C for Commitment to action and specific goals, D for Discovering new meaning and understanding, and E for Evaluation the outcome and enjoying positive results. This strategy entails several psychological principles: (a) accept and confront the reality—the reality principle. (b) Believe that life is worth living—the faith principle. (c) Commit to goals and actions—the action principle. (d) Discover the meaning and significance—the AHA principle. (e) Evaluate the above—the self-regulation principle.
The Power of Acceptance
Acceptance of reality and limits is central to Meaning Therapy. Recovery begins with accepting the fact that something is seriously wrong and change is needed. Regardless whether the problem is addiction or physical illness, over the long haul denial kills while acceptance heals. All clinicians have faced the challenges of client resistance and denial. A seasoned therapist will employ a variety of skills to empower the clients to confront reality and awaken their yearnings for positive change.
I want to make it clear that acceptance does not mean giving up or passivity. It does require that we honestly recognize and confront our limitations and the dark side of the human condition. It also means that we need to learn how to transcend and transform what cannot be changed. Meaning Therapy recognizes different levels of acceptance: (a) cognitive acceptance—rationally acknowledging that something has happened. (b) Emotional acceptance— willing to confront and re-experience the painful emotional reactions to the event. (c) Full acceptance—recognizing honestly and unflinchingly the full impact of the event on one’s life. (d) Integrative acceptance—leaning to integrate the negative life event with the rest of one’s life. (e) Existential acceptance—leaning to endure and live with what cannot be changed. (f) Transcendental acceptance— willing to rise above the acceptance, let go the past and move forward. (g) Transformative acceptance—learning to transform the negative event into something positive. Here are some interventions and exercises that will facilitate acceptance: reviewing the traumatic events in details, normalizing adversities, accept one’s own limitations and weaknesses, practicing gratitude and forgiveness, mindful meditation, praying, and re-authoring.
The Power of Belief and Affirmation
Acceptance without affirmation will lead to despair and depression. Clients need to affirm the intrinsic value and meaning of being alive. They also need to cling to the belief in hope. If they affirm that progress is attainable, they are more likely to stick to the regimen of change. The road to recovery is often steep and hard, fraught with setbacks and pains, but one must learn to endure and persevere. Belief helps. Whether it is religious or humanistic, belief begets hope and inspires them to move forward.
Meaning Therapy is not value-free—it is always committed to the well-being of the clients and the curative value of hope. Meaning Therapy practitioners will explore every avenue to instill a sense of hope in the potential for positive change. Belief offers a gold mine for intervention. It is a jump-off point to explore the PURE model—to explore clients’ beliefs and values. Meaning therapists can explore a wide variety of interventions to cultivate hope, such as affirmation, appreciative inquiry, reflective journaling, visualizing, and myth-making.
The Power of Action
Meaning Therapy emphasizes the potency of action. Real change is possible only when one takes the first concrete step in a new direction. As the Chinese proverb says, a journey of a thousand miles begins with one step. We need to act as if it is true. Just do it, even when we do not feel like it. Both Morita therapy (Ishiyama 2003) and Acceptance-Commitment therapy (Hayes 2005) stress the importance of action and experience over feeling and thinking.
Here is another gold mine for intervention. Commitment is also a jump-off point to connect with the PURE model. Recovery depends on commitment to pursuing certain values and recovery also depends on taking responsible action for making changes in various areas of life. Development of persistence (Wong 1995b) is needed to succeed in making lasting changes and forming new patterns of thinking and behaving. Meaning Therapy therapists need to clear and specific in assigning homework, whether the exercises are physical, psychological, relational or spiritual. It is helpful to contract with the clients to (a) develop and implement plans of action, (b) set concrete and specific goals, (c) practice small steps towards achieving each goal. The therapist uses modeling and reinforcement to encourage commitment.
The Power of Discovery
Frankl (1985) has repeatedly emphasized that meaning is discovered more than created, and for good reason. Whatever actions we may take to create meaning, ultimately it requires an Aha response, a spark of awakening, to really reignite the passion for living. In the darkness of confusion and despair, suddenly a light turns on and therapy begins to make sense. Therapists need to pay special attention to these moments of awakening. There are moments of Eureka, awe, and wonder. But they may also be a moment of recounting and regrets. Meaning Therapy therapists needs to alert the clients the many possibilities of discoveries, such as the forgotten aspects of one’s painful past, the hidden strengths of oneself, and the sacred moments in mundane routines. Many skills can be used to help clients see life and see themselves in a new way; these tools include mindful meditation, dream work, expressive therapy, magic questions, journaling, self-reflection, Socratic questioning, cognitive reframing, meaning construction, and restoring.
Evaluating and Enjoying the Outcome
Evaluation represents the affective component of self-regulation. If nothing seems to work and there is no reduction of symptoms and no improvement in the pursuit of positive life goals, then some adjustment is necessary. Positive emotions such as joy, relief, gratitude, and confidence are inevitable if the previous four strategic steps of ABCDE are successful. Positive feelings and outcomes reinforce positive changes.
The Double-Vision Strategy
This two-pronged strategy is also important for Meaning Therapy for two main reasons. Firstly, it enhances the motivation for change by linking the short-term solution to long-term life goals. Secondly, it helps the clients break out from their self-made prisons and take a larger and higher view of their lives. Double-vision expands their horizon and re-ignite their dreams. If we focus only on the trees, we may lose sight of the forest. We can gain a proper perspective of problems by looking at the big picture of macro forces and universal existential givens. The 123
social-economic-political-cultural forces are often the major causes of the client’s predicaments. Meaning Therapy would resort to various societal/national/international resources to help alleviate clients’ problems. Meaning Therapy will also tap into religious and ethnic-cultural communities to support the clients’ endeavors.
Double-vision helps open up conversations on the universal existential givens and the importance of beliefs and myth-making. By relating clients’ personal problems to a preferred meta-narrative, the clients may gain a deeper insight into their personal problems. They may also become attuned to the spiritual, transcendental sources of wisdom and hope in their daily struggles. Double-vision help contextualize, normalize, and transcendentalize clients’ predicaments.
In sum, Meaning Therapy equips clinicians with the fundamental principles and skills to (a) motivate and empower clients in their struggle with their personal problems and in their pursuit of meaning and happiness, (b) to tap into people’s capacity for meaning seeking and meaning making in order to help clients restore purpose, faith, and hope in their predicaments, (c) to provide the necessary tools for clients to overcome personal difficulties/anxieties and make life worth living, and (d) establish a genuine healing relationship with clients.
Meaning Therapy incorporates not only evidence-based counseling practices but only relevant research findings from social-personality psychology and positive psychology. Furthermore, conceptual frameworks of Meaning Therapy and The dual-system model provide a helpful road map for psychotherapy.
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