Meaning-making: a underestimated resource for health? A discussion of the value of meaning-making in the conservation and restoration of health and well-being
Keywords:meaning, meaning-making, health, spiritual practices, everyday activities
This article discusses the function, development and maintenance of meaning and the importance of meaning-making from different perspectives, as it is based on a collaboration between professionals from health science and psychology. The aim is to discuss how meaning-making processes can be employed in the health context to enhance individuals’ well-being. Starting point is a description of the common basis of the understanding of meaning-making. Afterwards brief examples from the different professional areas will show how meaning-making can improve health care practice. We will focus on the processual nature of meaning-making, its existential layers, as well as the ways in which meaning-making is at play in everyday activities and limit situations, such as illness or suicidality.
Ahmadi, F., & Ahmadi, N. (2018). Meaning-making methods for coping with serious illness. London and New York: Routledge.
Alsaker, S., & Josephsson, S. (2010). Occupation and meaning: Narrative in everyday activities of women with chronic rheumatic conditions. OTJR – Occupation, Participation and Health, 30(2), 58–67. https://doi.org/10.3928/15394492-20100312-01
Alsaker, S., & Josephsson, S. (2011). Stories stirring the quest of the ‘good’: Narratives of women living with chronic rheumatic conditions. Scandinavian Journal of Disability Research, 13(1), 53–70. http://doi.org/10.1080/15017411003711809
Alsaker, S., & Ulfseth, S. (2017). Narrative Imagination. Staff’s stories of relational change. Journal of Occupational science, 24(4), 535–545. http://doi.org/10.1080/14427591.2017.1375968
Bauereiss, N., Obermaier, S., Ozunal, S. E., & Baumeister, H. (2018). Effects of existential interventions on spiritual, psychological, and physical well-being in adult patients with cancer: Systematic review and meta-analysis of randomized controlled trials. Psycho-Oncology, 27(11), 2531–2545. https://doi.org/10.1002/pon.4829
Bern-Klug, M., & Ellis, K. (2004). End-of-Life care in nursing homes. In J. Berzoff, & P. R. Silverman (Eds.), Living with dying: A handbook for end-of-life health care practitioners (pp. 1–17). New York: Colombia University Press.
Boyle, P., Barnes, L., Buchman, A., & Bennett, D. (2009). Purpose in life is associated with mortality among community-dwelling older persons. Psychosomatic Medicine, 71(5), 574–579. https://10.1097/PSY.0b013e3181a5a7c0
Breitbart, W., Gibson, C., Poppito, S. R, & Amy, B. (2004). Psychotherapeutic Interventions at the End of Life: A Focus on Meaning and Spirituality. The Canadian Journal of Psychiatry, 49(6), 366–372. https://doi.org/10.1177/070674370404900605
Breitbart, W., Rosenfeld, B., Gibson, C., Pessin, H., Poppito, S., Nelson, C., Tomarken, A., Timm, A. K., Berg, A., Jacobson, C., Sorger, B., Abbey, J., & Olden, M. (2010). Meaning-centered group psychotherapy for patients with advanced cancer: a pilot randomized controlled trial. Psycho-Oncology, 19(1), 21–28. https://doi.org/10.1002/pon.1556
Bruner, J. (1986). Actual minds, possible worlds. Cambridge: Harvard University Press.
Bruner, J. (1990). Acts of meaning. Cambridge: Harvard University Press.
Charmaz, K. (2014). Constructing Grounded Theory. Los Angeles: SAGE.
Cutcliffe, J. R., Hummelvoll, J. K., Granerud, A., & Eriksson, B. G. (2015). Mental health nurses responding to suffering in the 21st century occidental world: accompanying people in their search for meaning. Archives of Psychiatric Nursing, 29(1), 19–25. https://doi.org/10.1016/j.apnu.2014.09.008
DeMarinis, V. (2018). Foreword. In F. Ahmadi, & N. Ahmadi (eds.), Meaning-Making methods for coping with serious Illness (pp. X–XVI). London and New York: Routledge.
Drageset, J., Haugan, G., & Tranvag, O. (2017). Crucial aspects promoting meaning and purpose in life: perceptions of nursing home residents. BMC Geriatrics, 17(1). https://doi.org/10.1186/s12877-017-0650-x
Duppen, D., Machielse, A., Verté, D., Dury, S., & De Donder, L. (2019). Consortium D-S. Meaning in Life for Socially Frail Older Adults. Journal of Community Health Nursing. 36(2), 65–77. https://doi.org/10.1080/07370016.2019.1582160
Ferlay, J., Colombet, M., Soerjomataram, I., Dyba, T., Randi, G., Bettio, M., Gavin, A., Visser, O., & Bray, F. (2018). Cancer incidence and mortality patterns in Europe: Estimates for 40 countries and 25 major cancers in 2018. European Journal of Cancer, 103, 356–387. https://doi.org/10.1016/j.ejca.2018.07.005
Frankl, V. E. (1985). Man’s Search for Meaning. Washington: Washington Square Press.
Frankl, V. E. (2014). The Will to Meaning. Foundations and Applications of Logotherapy. New York: Plume. Penguin Group.
George, L. S., & Park, C. L. (2014). Existential mattering: Bringing attention to a neglected but central aspect of meaning?. In A. Batthyany, & P. Russo-Netzer (eds.), Meaning in Positive and Existential Psychology (pp. 39–52). New York: Springer.
Hagen, J., Hjelmeland, H., & Knizek, B. L. (2017). Connecting with suicidal patients in psychiatric wards: Therapist challenges. Death Studies, 41(6), 360–367. https://doi.org/10.1080/07481187.2017.1284955
Hagen, J., Knizek, B. L., & Hjelmeland, H. (2018). Former suicidal inpatients’ experiences of treatment and care in psychiatric wards in Norway. International Journal of Qualitative Studies on Health and Well-being, 13(1). https://doi.org/10.1080/17482631.2018.1461514
Hagen, J., Knizek, B. L., & Hjelmeland, H. (2020). “… I felt completely stranded”: Liminality and recognition of personhood in the experiences of suicidal women admitted to psychiatric hospital. International Journal of Qualitative Studies on Health and Well-being, 15(1). https://doi.org/10.1080/17482631.2020.1731995
Hall, E. M., & Hill, P. (2019). Meaning-making, suffering, and religion: a worldview conception. Mental Health, Religion & Culture, 22(5), 467–479. https://doi.org/10.1080/13674676.2019.1625037
Haugan, G. (2014a). Meaning-in-life in nursing home patients: a correlate to physical and emotional symptoms. Journal of Clinical Nursing, 23(7), 1030–1043. https://doi.org/10.1111/jocn.12282
Haugan, G. (2014b). Meaning-in-life in nursing home patients: a valuable approach for enhancing psychological and physical well-being?. Journal of Clinical Nursing, 23(7-8), 1830–1843. https://doi.org/10.1111/jocn.12282
Haugan, G. (2014c). The relationship between nurse-patient-interaction and meaning-in-life in cognitively intact nursing home patients. Journal of Advanced Nursing, 70(1), 107–120. https://doi.org/10.1111/jan.12173
Henry, M., Cohen, S. R., Lee, V., Sauthier, P., Provencher, D., Drouin, P., Gauthier, P., Gotlieb, W., Lau, S., Drummond, N., Gilbert, L., Stanimir, G., Sturgeon, J., Chasen, M., Mitchell, J., Huang, L. N., Ferland, M. L., & Mayo, N. (2010). The Meaning-Making intervention (MMi) appears to increase meaning in life in advanced ovarian cancer: a randomized controlled pilot study. Psycho-Oncology, 19(12), 1340–1347. https://doi.org/10.1002/pon.1764
Hughes, C., van Heugten, K., & Keeling, S. (2015). Cultural meaning-making in the journey from diagnosis to end of life. Australian Social Work, 68(2), 169–183. https://doi.org/10.1080/0312407X.2014.939668
Jongenelis, K., Pot, A. M., Eisses, A. M. H., Beekman, A. T. F., Kluiter, H., & Ribbe, M. W. (2004). Prevalence and risk indicators of depression in elderly nursing home patients: the AGED study. Journal of Affective Disorders, 83(2-3), 135–142. https://doi.org/10.1016/j.jad.2004.06.001
Kidd, D. C., & Castano, E. (2013). Reading Literary Fiction Improves Theory of Mind. Science, 342(6156), 377–380. https://doi.org/10.1126/science.1239918
Kleinmann, A. (1980). Patients and healers in the context of culture. Berkeley: University of California Press.
Koch, L., Jansen, L., Herrman, A., Stegmaier, C., Holleczek, B., Singer, S., & Brenner, H. (2013). Quality of life in long-term breast cancer survivors – a 10-year longitudinal population-based study. Acta Oncol, 52(6), 1119–1128. https://doi.org/10.3109/0284186X.2013.774461
Koenig, H. G. (2012). Religion, Spirituality, and Health: The Research and Clinical Implications. International Scholarly Research Network, 2012. https://doi.org/10.5402/2012/278730
Krause, N. (2009). Meaning in life and mortality. Journals of Gerontology, 64B(4), 517–527. https://doi.org/10.1093/geronb/gbp047
Kuzmanic, M. (2012). Suicide from an existential-phenomenological perspective: Sense or non-sense? PhD Thesis, Faculty of Arts, University of Ljubljana, Slovenia.
Lancet Commissions (2014). Culture and Health. https://doi.org/10.1016/S0140-6736(14)61603-2
Lehmann, O. V. (2018). The cultural psychology of silence. Treasuring the poetics of affect at the core of human existence (Doctoral dissertation). NTNU Norwegian University of Science and Technology, Trondheim, Norway. http://hdl.handle.net/11250/2484902
Lehmann, O. V., & Brinkmann, S. (2019). “I’m the one who has written this”: Reciprocity in writing courses for older adults in Norway. International Journal of Qualitative Studies on Health and Well-Being, 14. https://doi.org/10.1080/17482631.2019.1650586
Lehmann, O. V., Kardum, G., & Klempe, S. H. (2019). The search for inner silence as a source for Eudemonia. British Journal of Guidance & Counselling, 47(2), 180–189. https://doi.org/10.1080/03069885.2018.1553295
Mattingly, C. (1998a). Healing Dramas and Clinical Plots. The narrative structure of experience. Los Angeles: University of California Press.
Mattingly, C. (1998b). In Search of the Good: Narrative Reasoning in Clinical Practice. Medical Anthropology, 12(3), 273–297. https://doi.org/10.1525/maq.1922.214.171.1243
Mattingly, C. (2006) Reading Medicine: Mind, Body, and Meditation in One Interpretive Community. New Literary History, 37(3), 563–581. https://doi.org/10.1353/nlh.2006.0050
Meek, K., Bergeron, M. C., Towne, S. D., Ahn, S., Ory, M., & Smith, M. L. (2018). Restricted social engagement among adults living with chronic conditions. International Journal of Environmental Research and Public Health, 15(1). https://doi.org/10.3390/ijerph15010158
Michel, K., Maltsberger, J. T., Jobes, D. A., Leenaars, A. A., Orbach, I., & Stadler, K. (2002). Case study. Discovering the truth in attempted suicide. American Journal of Psychotherapy, 56(3), 424–437. https://doi.org/10.1176/appi.psychotherapy.2002.56.3.424
Mori, H., & Lehmann, O. V. (2014). In O. V. Lehmann (ed.), Acompanar la finitud. Optimismo, Sentido y Trascendencia ante la Incertidumbre del Dolor, el Sufrimiento y La Muerte (pp. 253–281). Buenos Aires: San Pablo.
Oh, P. J., & Kim, S. H. (2014). The effects of spiritual interventions in patients with cancer: a meta-analysis. Oncol Nurs Forum, 41(5), E290–301. https://doi.org/10.1188/14.ONF.E290-E301
Park, C. L., & Folkman, S. (1997). Meaning in the context of stress and coping. Review of General Psychology, 1(2), 115–144. https://doi.org/10.1037/1089-26126.96.36.199
Park, C. L. (2005). Religion and meaning. In R. F. Paloutzian, & C. L. Park (eds.), Handbook of the Psychology of Religion and Spirituality (pp. 295–314). New York and London: The Guilford Press.
Park, C. L. (2010). Making Sense of the Meaning Literature: An Integrative Review of Meaning Making and Its Effects on Adjustment to Stressful Life Events. Psychological Bulletin, 136(2), 257–301. https://doi.apa.org/doi/10.1037/a0018301
Park, C. L. (2013). Positive Psychology Perspectives Across the Cancer Continuum: Meaning, Spirituality, and Growth. In B. I. Carr, & J. Steel (Eds.), Psychological Aspects of Cancer (pp. 101–117). Boston, MA: Springer US.
Park, C. L., & Folkman, S. (1997). Meaning in the context of stress and coping. Review of General Psychology, 1(2), 115–144. https://doi.org/10.1037/1089-26188.8.131.52
Pennebaker, J. W. (1999). Writing About Emotional Experiences as A Therapeutic Process. Psychological Science, 8(3), 162–166. https://doi.org/10.1111/j.1467-9280.1997.tb00403.x
Prince, M., Patel, V., Saxena, S., Maj, M., Maselko, J., Philips, M. R., & Rahman, A. (2007). No health without mental health. The Lancet, 370(9590), 859–877. https://doi.org/10.1016/S0140-6736(07)61238-0
Proulx, T., & Inzlicht, M. (2012). The five “A”s of meaning maintenance: Finding meaning in the theories of sense-making. Psychological Inquiry, 23(4), 317–335. https://doi.org/10.1080/1047840X.2012.702372
Reed, N. P., Josephsson, S., & Alsaker, S. (2018). Community mental health work: Negotiating support of users’ recovery. International Journal of Mental Health Nursing, 27(2), 814–822. https://doi.org/10.1111/inm.12368
Schraube, E., & Højholt, C. (2016). Psychology and the Conduct of Everyday Life. London: Routledge.
Sekse, R. J. T., Dunberger, G., Olesen, M. L., Østerbye, M., & Seibæk, L. (2019). Lived experiences and quality of life after gynaecological cancer—An integrative review. Journal of clinical nursing, 28(9-10), 1393–1421. https://doi.org/10.1111/jocn.14721
Selby, D., Seccaraccia, D., Huth, J., Kurppa, K., & Fitch, M. (2017). Patient versus health care provider perspectives on spirituality and spiritual care: the potential to miss the moment. Annals of Palliative Medicine, 6(2), 134–152. https://doi.org/10.21037/apm.2016.12.03
Sellin, L., Asp, M., Wallsten, T., & Wiklund, G. L. (2017). Reconnecting with oneself while struggling between life and death: The phenomenon of recovery as experienced by persons at risk of suicide. International Journal of Mental Health Nursing, 26(2), 200–207. https://doi.org/10.1111/inm.12249
Sherman, A. C., Simonton, S., Latif, U., & Bracy, L. (2010). Effects of global meaning and illness-specific meaning on health outcomes among breast cancer patients. Journal of behavioral medicine, 33(5), 364–377. https://doi.org/10.1007/s10865-010-9267-7
Steultjens, E., Dekker, J., Bouter, L. M., van Schardenburg, D., van Kuyk, M. A., & van den Ende, C. (2002). Occupational Therapy for Rheumatoid Arthritis: A Systematic Review. Arthritis and Rheumatism, 47(6), 672–685. https://doi.org/10.1002/art.10801
Sæther, W. (2018). “Jeg våger mer nå” – Teaterscenen som formidlingsarena for livserfaringer for mennesker med psykiske helseproblemer. Tidsskrift for psykisk helsearbeid, 15(2-3), 191–201. https://doi.org/10.18261/ISSN.1504-3010-2018-02-03-10
Søberg, A. I. B., Haug, S. H. K., Danbolt, L. J., Lien, L., & Sørensen, T. (2018). Existential themes in the treatment of people at suicide risk. Understandings and practices of specialist healthcare professionals. Mental health, Religion & Culture, 21(6), 588–600. https://doi.org/10.1080/13674676.2018.1524860
Thauvoye, E., Vanhooren, S., Vandenhoeck, A., & Dezutter, J. (2019). Spirituality among nursing home residents: A phenomenology of the experience of spirituality in late life. Journal of Religion, Spirituality & Aging, 32(1), 80–103. https://doi.org/10.1080/15528030.2019.1631939
van der Spek, N., Vos, J., van Uden-Kraan, C. F., Breitbart, W., Cuijpers, P., Holtmaat, K., Witte, B., Tollenaar, R., & Verdonck-de Leeuw, I. M. (2017). Efficacy of meaning-centered group psychotherapy for cancer survivors: a randomized controlled trial. Psychological Medicine, 47(11), 1990–2001. https://doi.org/10.1017/S0033291717000447
van der Spek, N., Vos, J., van Uden-Kraan, C. F., Breitbart, W., Tollenaar, R. A., Cuijpers, P., & Verdonck-de Leeuw, I. M. (2013). Meaning making in cancer survivors: a focus group study. PLoS One, 8(9). https://doi.org/10.1371/journal.pone.0076089
Vos, J., Craig, M., & Cooper, M. (2015). Existential therapies: a meta-analysis of their effects on psychological outcomes. Journal of Consulting and Clinical Psychology, 83(1), 115–128. https://doi.org/10.1037/a0037167
White, C., Lentin, P., & Farnworth, L. (2013). An investigation into the role and meaning of occupation for people living with on-going health conditions. Australian Occupational Therapy Journal, 60(1), 20–29. https://doi.org/10.1111/1440-1630.12023
WHO (1948). Constitution of World Health Organization (WHO). Geneva: WHO.
WHO (1984). Health promotion: a discussion document on the concept and principles: summary report of the Working Group on Concept and Principles of Health Promotion, Copenhagen, 9–13 July 1984, ICP/HSR 602(m01). Copenhagen: WHO Regional Office for Europe. https://apps.who.int/iris/handle/10665/107835
WHO (1998). The World Health Report 1998. Life in the 21st century. A vision for all. Report of the Director-General. Geneva: World Health Organization. https://www.who.int/whr/1998/en/whr98_en.pdf
WHO (2013). Global action plan for the prevention and control of noncommunicable diseases 2013–2020. http://www.who.int/nmh/events/2013/revised_draft_ncd_action_plan.pdf
WHO (2018). Ageing and health. 5 February 2018. Key facts. https://www.who.int/news-room/fact-sheets/detail/ageing-and-health
WHO (2019a). Suicide. 2 September 2019. Key facts. https://www.who.int/news-room/fact-sheets/detail/suicide%20
WHO (2019b). What is the evidence on the role of the arts in improving health and well-being? A scoping review. Health Evidence Network (HEN) synthesis report 67. Copenhagen: WHO Regional Office for Europe https://apps.who.int/iris/bitstream/handle/10665/329834/9789289054553-eng.pdf
Wright, J., & Cheung Chung, M. (2001). Mastery or mystery? Therapeutic writing: A review of the literature. British Journal of Guidance & Counselling, 29(3), 277–291. https://doi.org/10.1080/03069880120073003
Webb, D. (2010). Thinking about suicide: Contemplating and comprehending the urge to die. Herefordshire: PCCS Books.
Ørjasæter, K. B., Davidson, L., Hedlund, M., Bjerkeset, O., & Ness, O. (2018). “I now have a life!” Lived experiences of participation in music and theater in a mental health hospital. PLoS ONE, 13(12). https://doi.org/10.1371/journal.pone.0209242
How to Cite
Copyright (c) 2021 Birthe Loa Knizek, Sissel Alsaker, Julia Hagen, Gørill Haugan, Olga Lehmann, Marianne Nilsen, Randi Reidunsdatter, Wigdis Sæther
This work is licensed under a Creative Commons Attribution 3.0 Unported License.