MEANING – THERAPY
(a) Paul T. P. Wong, PhD,
CPsych
Meaning Conference 2012
Toronto
LEARNING OBJECTIVES
 Learning an integrative and innovative way to repair
the worst and bring out the best.
 Learn how to develop the meaning-mindset as the
basis for personal transformation
 Learn how to use the strategy of double vision in
achieve optimal effective coping.
 Learn how to use the PURE strategy to build a
meaningful and rewarding future.
 Learn the apply the basic ABCDE intervention
strategy to a variety of problems.
Why we need an integrative approach
THE MEANING MINDSET
Meaning Fulfillment
Sacrificial
Life
Ideal Life
Failure
Success
Wasted
Life
Shallow
Life
Emptiness
LIFE ORIENTATION SCALE
1.
I can find something meaningful or significant in ever yday events.
2.
There is a reason for ever ything that happens to me.
3.
There is no ultimate meaning and purpose in life.
4.
There is no point in searching for meaning in life .
5.
No matter how painful the situation, life is still wor th living .
6.
The meaning of life is to “eat, drink and be happy .”
7.
What really matters to me is to pur sue a higher purpose or calling
regardless of per sonal cost .
8.
I would rather be a happy pig than a sad saint.
9.
I am willing to sacrifice per sonal interests for the greater good .
10. Personal happiness and success are more impor tant to me than
achieving inner goodness and moral excellence .
CHOOSING THE ROAD LESS TRAVELLED
MEASUREMENTS OF MEANING &
PURPOSE IN LIFE
Life Orientation Scale (LOS; Wong, 2012)
Personal Meaning Profile-Brief (PMP-B; Wong,
2012)
The PURE Test (Wong, 2011)
Meaningful Living Scale (MLS; Wong, 2011)
Coping Schema Inventory – Revised (CSI-R;
Wong, Reker, & Peacock, 2006)
THE MOTTO OF MT
 Meaning is all we have.
 Relationship is all we need.
 Effective therapy depends on making full use of our
capacity for meaning making and relating.
WHAT IS MEANING-THERAPY (MT)
 It evolves from logotherapy and cognitive behavioral
therapy.
 It is part of the third wave of psychotherapy which
involves powerful new concepts such as acceptance,
commitment, self-transcendence, and meaningmaking.
 Viktor Frankl is the father of logotherapy.
WHO IS VIKTOR FRANKL?
 1905-1997
WHAT IS LOGOTHERAPY?
 Logotherapy literally means therapy through
meaning.
 It is a spiritually-oriented approach towards
psychotherapy.
 Existential analysis is needed to make the clients
aware of their spirituality and capacity for meaning .
 “Inasmuch as logotherapy makes him aware of the
hidden logos of his existence, it is an analytical
process” (Frankl, 1984, p. 125).
THE BASIC TENETS OF LOGOTHERAPY
 Freedom of will: Not only freedom from some
negative condition but also freedom to something
rewarding.
 Will to meaning: Striving to find a meaning in one’s
life is the primary motivational force.
 Meaning of life: One can always discover meaning in
life regardless of life’s circumstances.
THREE BASIC PATHWAYS TO MEANING
 Creative value: giving something to the world through
creative works.
 Experiential value: receiving something from the
world through appreciation and gratitude.
 Attitudinal value: taking a heroic stand towards
suffering and fate.
EXISTENTIAL VACUUM
 Many people seek healing of inner emptiness
because of a felt sense of existential vacuum.
 Frankl believes that existential vacuum may lead to
both the tragic triad and neurotic triad. Meaning
therapy is uniquely suitable to address these mental
health issues.
THE TRAGIC TRIAD
pain
guilt
death
THE NEUROTIC TRIAD
depression
aggression
addiction
EXISTENTIAL ANXIETIES
 According to Irwin Yalom (1980), there are at least 4
universal existential anxieties:
1.
2.
3.
4.
Loneliness or alienation
Freedom of choice (basic ontological crisis)
Death anxiety
Meaninglessness (related to the above three)
 Many psychiatric symptoms such as depression and
anxiety are manifestations of the underlying
existential anxieties.
THE DEFINING CHARACTERISTICS OF MT
 Integrative/holistic
 Existential/spiritual
 Relational
 Positively oriented
 Multicultural
 Narrative
 Psycho-educational
LAYING THE GROUNDWORK FOR
POSITIVE CHANGE
Carl Rogers’ 3 pre-conditions for effective
counselling.
1. Empathy
2. Unconditional positive regard (nonjudgmental)
3. Congruence or genuineness
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THE THERAPEUTIC PRESENCE
 Who we are is more important than what we say.
 Rogers’ three pre-conditions need to be the personal
characteristics of counsellors.
 Personal wholeness of the therapist is important.
 The messenger is the message.
 The therapist is the therapy.
 The counsellor brings a healing presence.
 The counsellor models meaningful living.
 The counsellor practices counselling by osmosis.
HEALING THROUGH RELATIONSHIP
 Building rapport and trust is essential to effective
therapy.
 Authentic and caring relationships has more healing
power than therapeutic alliance.
 Accepting resistance and negative reaction as part of
the healing process.
 The ground rule of respect and caring applied to both
the therapist and the client.
 Recognize that each individual is both unique and
similar.
DIFFERENT LEVELS OF RELATING
 At the social level, two strangers get to know each
other in a trusting and non-judgmental environment.
 At the existential level, two human beings share their
common humanity.
 At the professional level, the therapist is responsible
for achieving desirable therapeutic goals.
 Therapy involves the reciprocal influence between
the therapist and the client.
LEVELS OF LISTENING
1.Listening
2.Listening
3.Listening
4.Listening
5.Listening
6.Listening
7.Listening
with one’s ears
with one’s eyes
to one’s cultural voice
with one’s head
with one’s heart
with one’s soul
to the spirit
BARRIERS TO CLEAR COMMUNICATION
 Confusing fact with fiction
 Confusing emotion with intention
 Confusing past with present
 Biases and assumptions
 Lack of empathy and sympathy
 Lack of attention and focus
 Delayed emotional explosion
 Making dispositional attributions
 Different styles of communication
 Different levels of listening
THERAPEUTIC GOALS
 To awaken the client’s awareness of personal
responsibility and meaning in life.
 To achieve a deeper understanding of the problem
from a larger perspective.
 To help the client discover their true identify and
place in the world.
 To help the client pursue what really matters in life.
THERAPEUTIC GOALS CONT’D
 To grow and develop the client’s full potential.
 To make life better for self and others.
 To transform a victim’s journey into a hero’s
adventure.
 To discover meaning and hope in boundary
situations.
 To learn principles and skills to achieve positive
outcomes and transform negative outcomes through
meaning.
THERAPEUTIC PLAN
 Cultivating a healing presence.
 Creating a safe and trusting environment.
 Explaining to clients the MT approach.
 Listening proactively to discover the nature of
presenting problems and unspoken needs.
 Agreeing on the priority of issues to be addressed.
 Developing a concrete plan for actions.
 Emphasizing the demand for responsibility and
restoration of meaning and purpose.
THE ART OF QUESTIONING
 Responsibility questions
 Choice questions
 Trajectory questions
 Quest questions
 Eight enduring existential questions
 Magic questions
 Diagnostic questions
EIGHT ENDURING EXISTENTIAL
QUESTIONS
1.
2.
3.
4.
5.
6.
7.
8.
Who am I?
How and where do I find happiness?
What should I do with my life?
How can I avoid making the wrong choices in the
major areas of my life?
Where do I belong?
What is the point of all my striving?
What will happen to me after I die?
What would make my life more meaningful and
significant?
MEANING-CENTERED
INTERVENTIONS
Part 1:
The Double
Vision
Strategy and
the PURE
Principles
DOUBLE VISION
 Try to identify the underlying existential anxiety for
each presenting problem.
 Solution-focused therapy needs to consider both the
immediate problem and the larger personal issue.
 Short-term goals need to be related to larger life
goals.
 Do not focus on the leaves and ignore the forest.
 Keep one eye on the ball and another eye on the
goal.
MICRO VS. MACRO SKILLS
 Micro-skills refer to interventions that target specific
situational problems.
 Attribution retraining
 Cognitive reframing
 Macro-skills refer to interventions that target larger
societal, ecological, cultural, and existential
problems
 Advocating for social change and community reform.
 Identifying the macro-forces that contribute to one’s
problems.
THE PURE PRINCIPLES
The four treasures of MT:
 Purpose – the motivational component
 Understanding – the cognitive component
 Responsible action – the behavioral component
 Evaluation – the affective component
PURPOSE
 Including goals, directions, incentive objects, core
values, aspirations and intentions.
 What do I want to get from this situation? What
should I do with my life? What really matters in life?
 Deciding on one’s ultimate concern: The happiness mindset vs. the meaning-mindset (Wong, 2011).
 Beware of the pitfalls of the pursuit of happiness.
UNDERSTANDING
 Encompassing self-understanding, a sense of
coherence, making sense of situations and other
people.
 Having a clear sense of who one is, what one is and
what one’s place in the world is.
 Don’t be a stranger to oneself – dare to open the
dark rooms and secret chambers in one’s life.
 Knowing another person’s true intention and feelings
thru effective communication
 Having the practical wisdom to make sound
judgments and good decisions.
RESPONSIBILIT Y
 Freedom and responsibility go hand in hand.
 Doing the right thing and finding the right solution.
 Choosing appropriate reactions and actions in
situations of conflicting values and demands.
 Holding oneself accountable for one’s own behavior.
 Discovering to what extent one is responsible for a
given problem. Blaming only makes things worse.
 Take ownership of one’s life and assume full
responsibility for building a preferred future.
ENJOYMENT/EVALUATION
 Assessing degree of satisfaction with the situation or
life as a whole
 Living a life of purpose, understanding and
responsibility does not always guarantee happiness.
 Have I achieved what I set out to do?
 Am I happy with how I have lived my life?
 If this is love, why am I still unhappy?
 Self-regulation depends on self-reflection and
evaluation.
SOURCES OF MEANING
According to Wong (1998), there are 8 sources of
meaning and the good life.
1. Achievement
2. Acceptance
3. Transcendence
4. Intimacy
5. Relationship
6. Religion
7. Fairness
8. Positive emotions
A MEANINGFUL LIFE IS A BALANCED ONE
Religion/
Spirituality
Achievement
Acceptance
Intimacy
Relationship
Self-transcendence
Fairness
Situational and
Cultural Context
Healing and
Flourishing
DEFINITION OF A MEANINGFUL MOMENT
1. It is deeply felt – It touches your emotions in a
deep and lasting way. More than a fleeting feeling,
it reaches your inner most being.
2. It is deeply processed – It involves deeper layers of
meaning beyond the factual and superficial.
3. It is enlightening – It provides a solution to some
puzzling problems or leads to some new discovery.
4. It is transforming – It enriches your life, changes
your life’s direction or restores a sense of purpose
and passion to your life.
Meaning-mindset
(Overall
Orientation)
Meaningful
moments
(Experiences)
PURE Framework
(Structure)
Sources of
meaning
(Content)
Frankl’s 3 basic
tenets and values
of meaning
(Foundation)
MEANING-CENTERED
INTERVENTIONS
Par t 2:
ABCDE Model
of Resilience
Tragic
Optimism
The DualSystems Model
WHEN TRAGEDY STRIKES
 The best built house can be destroyed.
 No one is immune from suffering and tragedies.
 Bad things do happen to good people.
 There is a breaking point for everyone.
 The challenge is to recover and become stronger.
FOUR LIFE TRAJECTORIES
PATTERNS OF RESILIENCE
 Recovery: Bouncing back and returning to normal
functioning.
 Invulnerability: Remaining relatively unscathed by
the adversity or trauma.
 Post-traumatic Growth: Bouncing back and becoming
stronger.
ABCDE STRATEGY
 Accept and confront the reality -- the reality
principle.
 Believe that life is worth living – the faith principle.
 Commit to goals and actions – the action principle.
 Discover the meaning and significance of self and
situations – the Aha! principle.
 Evaluate the above – the self-regulation principle.
ACCEPTANCE
 Accepting what cannot be changed.
 Accepting reality, limitations, loss, trauma,
existential givens.
 Acceptance does not mean giving up or resignation.
 Confronting one’s worse fears with courage and
tragic optimism.
 Transcending and transforming the tragedy.
THE COURAGE OF SELF -ACCEPTANCE
LEVELS OF ACCEPTANCE
 Cognitive acceptance
 Emotional acceptance
 Realistic acceptance
 Integrative acceptance
 Existential acceptance
 Transcendental acceptance
 Transformative acceptance
BELIEF
Affirming one’s ideals and core values.
Recognizing the intrinsic value and meaning of life.
Receiving support and help from others.
Turning to a personal God or higher power.
Growing and striving for positive transformation.
Believing in an eventual triumph of good over evil.
Recognizing the worthwhileness and authenticity of
one’s mission.
Recognizing and using one’s competencies, character
strengths and virtues.
COMMITMENT
Moving forward and carrying out one’s responsibility
with determination.
 Doing what needs to be done regardless of feelings
or circumstances.
 Striving to fulfill one’s responsibility no matter what.
 Enduring hardship and pain for your cause.
 Problem-solving and effective coping.
 Avoiding errors and temptations.
 Practicing the PURE principle.
 Pursuing realistic goals.
 Re-authoring one’s life story.
DISCOVERY
Learning something new about the self and life.
 Digging deeper, exploring farther, and searching
higher.
 Discovering one’s hidden courage and strength.
 Discovering the power of faith and spiritual
resources.
 Grasping the complexities of life and people.
EVALUATION
Savoring small successes or re-assessing one’s
progress.
Feeling relief that the worse is over.
Monitoring progress.
Savoring the moments of small success.
Reflecting and reviewing one’s life.
Receiving feedback from others.
Conducting assessments and making adjustments.
ELEMENTS OF TRAGIC OPTIMISM
 Acceptance of the worst.
 Affirmation in the value and meaning of life.
 Self-transcendence (altruism).
 Faith in God and others.
 Courage to face adversity.
DUAL-SYSTEMS MODEL
 We can best achieve adaptive success through
integrating approach and avoidance systems.
 The approach system – life expansion
 The avoidance system – life protection
 Employ offence and defence at the same time.
A Dual-Systems Model
Individual differences and personal resources
Positive
Conditions
Negative
Conditions
PURE
Approach
Avoidance
ABCDE
Cultural and Contextual Variables
Positive
Outcome
Negative
Outcome
INTERACTIONS BETWEEN THE TWO
SYSTEMS
 We instinctively approach what is perceived as
appetitive, and avoid what is perceived as aversive or
noxious.
 The approach and avoidance systems involve
different emotional-behavioral processes and neurophysiological substrates.
INTERACTIONS BETWEEN THE TWO
SYSTEMS (CONT’D)
 The positive system seeks to do what is desirable
and preferable.
 The aversive system serves as a warning about what
is wrong in one’s life and what is potentially
threatening.
 There is a downside to positives and upside to
negatives.
INTERACTIONS BETWEEN THE TWO
SYSTEMS (CONT’D)
 Together, these two self-regulation systems provide a
road map to make life worth living through good and
bad times.
 Meaning management helps integrate both negative
and positive systems.
POSITIVE TRIAD OF HEALING AND
FLOURISHING
ABCDE
Tragic Optimism
Approach
Avoidance
PURE
MEANING-BASED MODEL OF
WELL-BEING AND MENTAL HEALTH
Complete Mental
Health and Flourishing
Reduced Negativity &
Increased
Resourcefulness
Personal Growth,
Character Strengths, &
the PURE Model
(Factor II)
Broaden-and-Build
Model of Positive
Emotions
Experience of Positive
Emotions (Factor I)
Deep-and-Wide Theory
of Effective Coping
(Factor III)
Sources of Meaning