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Listening to the Unheard Cry for Meaning

In former days, people frustrated in their will to meaning would probably have turned to a pastor, priest, or rabbi. Today, they crowd clinics and offices. The psychiatrist, then, frequently finds himself in an embarrassing situation, for he now is confronted with human problems rather than with specific clinical symptoms . Man’s search for a meaning is not pathological, but rather the surest sign of being truly human. Even if this search is frustrated, it cannot be considered a sign of disease. It is spiritual distress, not mental disease. How should the clinician respond to this challenge? Traditionally, he is not prepared to cope with this situation in any but medical terms. Thus he is forced to conceive of the problem as something pathological. Furthermore, he induces his patient to interpret his plight as a sickness to be cured rather than as a challenge to be met. By so doing, the doctor robs the patient of the potential fruits of his spiritual struggle. (Frankl, 1973, p. 93)

As this quote implies, the will to meaning, a fundamental and basic human need, is relevant to each and every human being. Therapists, clinicians, and scholars are constantly confronted with existential questions, about which existing textbooks and diagnostic manuals carry little, if any, information. This is especially relevant in the fast-paced, digital, and global world of today, where mental health professionals need to address the pressing challenges of cultivating a sense of meaning in everyday life. Despite the mounting research findings underscoring the importance of meaning for human coping and thriving (e.g., Damon, 2008; Linley & Joseph, 2011; Melton & Schulenberg, 2008; Ryff & Singer, 1998; Steger, Oishi, & Kashdan, 2009), little research has focused on methods one can follow in order to nurture or reinforce it (Nelson, Fuller, Choi, & Lyubomirsky, 2014).

The current literature discusses the distinction between hedonic and eudaimonic well-being, of which meaning is more closely related to the eudaimonic approach . While hedonic well-being is most commonly understood as the accumulation of positive affective experiences of the individual, eudaimonic well-being is understood as a deeper feeling of striving toward meaning and a virtuous purpose, beyond the experience of positive affect (Friedman, 2012; Ryan & Deci, 2001; Ryff & Singer, 1996; Ryff, Singer, & Dienberg Love, 2004). Eudaimonic well-being can be achieved by pursuing activities that are in congruence with the individual’s personal values (Waterman, 1993), or in congruence with the individual’s strengths or personality traits (Seligman, 2002). Therefore, an individual will experience meaning and will thrive when he/she pursues activities that are intrinsically meaningful and important, in comparison to pursuing activities motivated by external concerns (i.e., the hedonic approach). Yet, interventions designed to cultivate the meaning component of general well-being have received only scant research attention (Shin & Steger, 2014; Steger, Bundick, & Yeager, 2012).

Interest in meaning-oriented interventions is on the rise, and they are increasingly being used in various settings and contexts by researchers and practitioners alike. However, as of today, no single source provides an integrated, comprehensive overview of the conceptual, theoretical, and practical aspects of this varied work. Moreover, despite extensive research examining the benefits of meaning and purpose for individual growth and development, knowledge regarding its promotion and cultivation is limited (Shin & Steger, 2014). Empirical research is slowly uncovering the many positive psychological, spiritual, and physical effects of meaning and purpose for the individual, contributing to our understanding of areas ranging from academic achievement (DeWitz, Woolsey, & Walsh, 2009) and occupational adjustment (Steger & Dik, 2009; Steger, Pickering, Shin, & Dik, 2010), to happiness (e.g., Ryff & Keyes, 1995; Steger et al., 2009) and life satisfaction (e.g., Drescher et al., 2012; Steger, Frazier, Oishi, & Kaler, 2006; Steger, Kashdan, Sullivan, & Lorentz, 2008). Several criticisms have emerged from Shin and Steger’s (2014) review of existing interventions, namely that most do not focus specifically on meaning and purpose but rather on overall happiness or well-being. For example, several happiness-enhancing interventions have been empirically studied including, but not limited to, practicing gratitude (Emmons & McCullough, 2003), forgiveness (McCullough, Pargament, & Thoresen, 2000), and thoughtful self-reflection (King, 2001; Lyubomirsky, Sousa, & Dickerhoof, 2006). Secondly, that they address mainly recuperative and protective aspects of meaning rather than aspects of its wider normative developmental process. And thirdly, that they are built on the basis of conceptual frameworks that are “insufficiently systematic to counter the lack of data about interventions” (p. 91). In addition to Shin and Steger’s (2014) attempt to analyze meaning-enhancing interventions, Parks and Biswas-Diener (2013) have attempted to set several of their own criteria in order to integrate and refine current conceptualizations. More specifically, they argue that a successful positive intervention must have the primary goal of building some sort of “positive” target variable (e.g., meaning, among others), empirical evidence must exist proving that the intervention causes some change in the target variable, and in addition, must prove that enhancing this target variable is beneficial to the individual and surrounding society.

Parks and Biswas-Diener (2013) claim that current interventions in the literature do not achieve all of these goals. For example, many interventions focus on creating meaning through writing as a way of helping the individual to form a coherent narrative about his or her life, which is viewed as essential to the experience of meaning (Pennebaker & Seagal, 1999). Conflicting evidence exists as Lyubomirsky et al. (2006) found that in some cases, writing about a positive event actually lowered life satisfaction when compared to controls. More recent approaches focus on personal narratives regarding positive events (e.g., King, 2001; Seligman, Rashid, & Parks, 2006). For example, Sheldon and Lyubomirsky (2006) showed that mere thinking about being one’s best possible self (and not actually writing it) was enough to demonstrate benefits. However, this has been shown to backfire for some individuals who are prone to anxiety or depression. These examples demonstrate the lack of empirical evidence demonstrating change in the target variable. In other words, empirical literature is lacking an extension of the application of these interventions and therapeutic mechanisms across a wider variety of contexts and populations (Shin & Steger, 2014).

When considering the psychological operationalization of meaning within different life contexts, it is possible that similar mechanisms are at work. Meaning can take on quite diverse properties and roles, each connected to the different research traditions of meaning-oriented psychologies. According to this narrative, the existential tradition, and especially recent empirical work on experimental existential psychology (e.g., Terror Management Theory , or TMT), views meaning mainly as a buffer against existential anxiety, uncertainty, and the impasses of the conditio humana. In contrast, positive psychology conceptualizes meaning and purpose awareness primarily as an activating mechanism to elicit optimal functioning and satisfaction with life. Another perspective less often addressed in this context is known as the cognitive tradition, which views meaning not so much as a way of coping and striving, but as the matrix by which we decipher and understand the structure of complex things or situations, and in this case, our place in the world.

Prima facie, we encounter what appear to be very different accounts and definitions of what meaning could mean in psychological terms , and yet, on closer inspection it turns out that these three connotations are in no way exclusive, but rather are complementary to each other in that they are different paths that lead to one basic phenomenon. Hence, if we have found that on an applied and clinical level, each of these meaning concepts is related to one another, we have naturally also found a bridge to overcome the apparent, or real, differences between their related psychological theories and disciplines. Indeed, it turns out that each of these potential roles of meaning relates in some way or the other to our general psychological make-up and functioning, and often enough, the quest for one type of distinct meaning clearly relates to another. For example—a number of research studies suggest that lack of meaning awareness is a potent risk factor for substance abuse (e.g., Kinnier, Metha, Keim, & Okey, 1994); other studies suggest that meaning awareness is a potent factor in the treatment of substance abuse disorders (e.g., Klingemann, 1991); and yet another set of studies suggest that people’s general life satisfaction is significantly higher if they are existentially fulfilled, and hence are assumed to be less likely to revert to self-destructive behavior (e.g., Newcomb & Harlow, 1986).

Therefore, while conducting theoretical and empirical research it may be possible, and at times even necessary, to address each of these connotations separately, as this type of compartmentalization and specialization no longer works when addressing these same issues in the clinical context, and when dealing with real people. While it may well be that artificial disciplinary or traditional boundaries (such as, for example, positive psychology’s notion that meaning is predominantly a positive resource for flourishing and striving, whereas some branches of experimental existential psychology , such as TMT, merely view it as a buffer against mortality anxiety and existential threat) help to further scientific progress in this area through debate and dialogue, they may very well also hinder it. For example, certain preconceived notions inherited from tradition (in one area of psychology), rather than being necessary or inherent parts of the respective theory or discipline itself, blank out certain aspects that may turn out to be crucially important for understanding and addressing some of the unresolved questions regarding the potential role, or roles, of meaning in psychology as understood by another area. Take, for example, the question whether search for meaning is a defense mechanism or a genuine human motivation: traditional existentialist schools of psychotherapy, such as Frankl’s logotherapy and existential logotherapy , hold that the search for meaning is an irreducible psychological variable. However, none of these schools so far has come forth with plausible arguments why these two perspectives on meaning describe alternative, rather than complementary models of meaning(s).

Sure enough, some of these questions are likely to remain unanswered insofar as they touch upon philosophical problems which are, in fact, unlikely to be resolved by any amount of rational or empirical inquiry. And yet, from an existential point of view, if we seriously consider the human quest for meaning, the question is no longer merely whether the meaning fulfillment many seem to seek, and some at least sometimes experience, achieves the purpose of equipping us with certain psychological advantages in striving, coping, and defense but also, and with equal relevance, whether human beings genuinely strive for meaning for its own sake, or whether a simpler motive is concealed behind the striving, for which the question of meaning is only a means to an end. Therefore, even if psychology will not be able to, nor is it expected to, resolve questions on the nature of meaning it can, and at least needs to, acknowledge that one of the core issues of research of the construct is whether it is a fundamental variable in our psychological functioning, or whether it is reducible to other, more basic drives and psychological mechanisms, even if only for the sake of intellectual honesty.

Still, it is instructive to understand the reasons and causes for the distinction between positive and existential psychologies of meaning, despite their large thematic and therapeutic overlaps. For example, existential psychologists, especially its European founders and pioneers, such as Ludwig Binswanger (1942), Medard Boss (1957), Viktor E. Frankl (1946), and Viktor Von Gebsattel (1954), made ample use of the phenomenological method, i.e., they were trying to apply Husserl’s and Merleau-Ponty’s introspectionist psychology to the “metaphysics of everyday life.” Against the background of its historical setting, within the context of Europe’s tragedies of the past century (i.e., the two World Wars), and the massive collective traumas brought about by the Holocaust, the movement of early European existential psychologists and psychiatrists toward the phenomenological method in psychology with its emphasis on individual experience, narrative, and quest, is understandable. Even more so, this approach seems appropriate when it comes to the attempt to comprehend the individual in his or her search for a place in the world, understanding of one’s role in life, and for the relentless question of whether meaning can be found in suffering and tragedy, too.

Simultaneously, and often even within the very same university departments where these early existential psychologists and psychiatrists were trying to grasp the richness and complexity of individual narratives and their deeper meaning, empirical psychologists attempted to establish psychology as a scientific discipline using quantitative rather than qualitative research. This caused a move away from narrative, phenomenological, and other more “subject-based” soft approaches to human psychology (Wertz, 2014). Indeed, once quantitative research methods gained prominence, questions regarding the metaphysics of everyday life may not have seemed worthwhile or even accessible research endeavors, as they did not lend themselves to experimental study and quantitative analysis (at least they did not for a long time—cf. recent developments in experimental existential psychology; Greenberg, Koole, & Pyszczynski, 2004). As a result, for the better part of the second half of the twentieth century, researchers in the field of psychology were prone to ignore the clinical relevance, or even authenticity, of existential questions altogether.

Building on the aforementioned methodological factors , one further reason for this relatively nonchalant handling of existential issues may be that once one is even tentatively willing to get involved in existential questions from a psychological perspective, one is at once confronted with a myriad of philosophical problems about the reality, nature, and type of meaning and purpose in an individual’s life—and thus with questions that are, by definition it seems, out of reach for empirical research and quantitative analysis. But ignoring a question of course does not mean that it is not relevant for a deeper understanding of the issues at hand; it only means that within a certain discipline, or within a certain school of thought within this discipline, the question is usually not addressed. And yet it is one thing to claim that certain problems are difficult to grasp, and quite another to claim that it is therefore irrelevant or that it does not exist or that it is reducible to other, better studied, mechanisms.

As a case in point, the past decades have seen an unending stream of popular publications designed to help readers to find meaning and purpose in their lives, and to find their place in the world (e.g., Leider, 2015; Millman, 2011). This outpouring of publications has provided, and continues to provide, constant testimony to the fact that there is a widespread interest in existential questions and, as the renowned existential psychiatrist Viktor Frankl put it, a “will to meaning,” or, as described in a critical title of one of his later publications, an “unheard cry for meaning”:

More and more a psychiatrist today is confronted with a new type of patient, a new class of neurosis, a new kind of suffering the most remarkable characteristic of which is the fact that it does not represent a disease in the proper sense of the term. This phenomenon has brought about a change in the function - or should I say mission? - of present day psychiatry. In such cases, the traditional techniques of treatment available to the psychiatrist prove themselves to be less and less applicable. (Frankl, 1973, p. 93)

Hence, after a detour during which the psychological role of the quest for meaning and purpose was first ignored due to the difficulty with which scientific psychologists found it to connect to earlier phenomenological research, subsequently, it was ignored due to the perspective of most of the more orthodox psychological schools of thought, according to which existential questions were under the general suspicion of being either psychologically inconsequential or the expression of sublimation or compensation of more basic drives and needs. Finally, meaning made an unexpected return and once again became a prominent issue within psychology and psychotherapy. As hinted at above, and as demonstrated by the sheer number of recent psychological studies on the question of meaning (Batthyany, 2011; Batthyany & Guttmann, 2005; Schulenberg, Hutzell, Nassif, & Rogina, 2008; Thir, 2012), one likely contributing factor to this renewed interest may be the fact that, since around 1970, psychological thought in general has opened up to new ideas, especially since increasing numbers of academic psychologists began to become concerned with the conceptual and therapeutic limits of orthodox psychoanalysis. At the same time, behaviorism, which for several decades was a particularly strong force within experimental psychology, has lost much of its original dominance. Both developments in the history of ideas of psychology took place largely due to the so-called cognitive turn in the behavioral science, which then soon spread into clinical and experimental psychology (Gardner, 1986).

This turn not only brought about a rediscovery of the central role of internal representations of the world, which logotherapy had identified long before as being crucial for understanding human experience and behavior (Frankl, 1946); the increased openness to less mechanistic or purely psychodynamic models also led researchers to abandon some of their earlier, almost exclusive, focus on deficits, and instead sparked interest in looking again at those inner resources by which real and apparent deficits can be overcome or regulated in a psychologically mature and healthy way. Frankl, too, considered much of the “old psychologies” to be disproportionately concerned with deficits and limits, and held that—put simply—they often tended toward a reductionist pathologism, which attempted to explain even such deeply human and existential concerns, such as the need for meaning and authenticity, not as expressions of human maturity , but as mere compensations for psychological defects and frustrated “lower” needs (Frankl, 1946, 1973). In brief, for a long time, psychology was largely deficit- based rather than resource-oriented. Frankl, on the other hand, consistently emphasized and appealed to those remaining resources that, even during precarious times in a client’s or a patient’s life, can exert a protective effect in crisis prevention and a curative influence in crisis intervention. He further held that awareness of individual meaning and purpose is the most potent of such resources, and in turn also the most effective in activating other psychological resources.

For several decades now, positive psychology has tied in with these ideas on a broader level (Seligman & Csikszentmihalyi, 2000). Again, looking at the positive sides of human existence is not an entirely new idea in the history of scientific psychology: in parallel with Frankl and as early as the 1930s, Charlotte Bühler had proposed to study not only the life histories of the mentally ill, but also those of individuals who had remained mentally healthy under the same or similar life conditions, in order to determine which resources they activated. In other words, her proposal was to investigate not just what makes people sick, but also what keeps them healthy (Bühler, 1933). Still, the systematic scientific pursuit of a broad-based, resource-oriented psychology is a relatively new undertaking, and at least to existential psychotherapists, it did not come as a surprise that research in this area would soon find that meaning is a central psychological (and existential) resource (Klingberg, 2009). Thus while the phenomenological method , once so prominent in early European existential psychology, has never quite been rehabilitated in contemporary research, one of its core findings—that human beings are not only concerned with surviving everyday life, but that they are also deeply concerned with the meaning of their lives and their individual future—has been rediscovered. More specifically, one has to take first-person accounts seriously in order to learn something about human nature and motivation which, by other methods, may not be so easily accessible. This, then, is but one example that illustrates that the differences between diverging approaches in psychological modeling of meaning and purpose (as both a resource and a potent coping factor) have been illusory rather than real.

The Clinicians’ Perspective

In our earlier volume, we argued that only an increase in research and dialogue between the several branches of meaning-oriented psychology will one day enable us to disentangle this question, and related questions, on the nature and function of meaning and meaning awareness. And while, as a whole, our former volume may have accomplished some advances in this direction, the present volume tackles these questions from yet another set of perspectives, namely the social, applied, and clinical perspectives, without which any debate on the metaphysics of everyday life would be incomplete and easily misleading. It is this application to our everyday lives which brings together all perspectives and forces psychological theorizing out of the ivory tower of armchair philosophy and psychology. Moreover, it assists in bridging the gaps between disciplines and branches of meaning-oriented psychologies , which even the most careful and unbiased reasoning may not be able to achieve. Additionally, the inclusion of these perspectives may ultimately lead to the insight that, given that it is built on the encounter with real humans in real situations, much of the divergence between meaning concepts is based on the fact that life itself is so complex that no one single discipline or research branch will be able to address, let alone understand, human existence and the quest for meaning as a whole.

Yet rather than merely acknowledging that once we put meaning on the landscape of psychological theory, our theorizing will reach a degree of complexity that renders the development of a full-blown explanatory model unlikely. Frankl based his model on the notion of nonreductionism as a heuristic principle. Furthermore, he understood nonreductionism to imply that each aspect or dimension of a human being—the physiological, the psychological, and the noetic (or spiritual)—represents a layer of properties and functions that interact with each other, but nonetheless is ontologically and (at least to a certain extent) causally independent of each other (Frankl, 1946). However, each of these are aspects of what constitutes a human person, and therefore none can be discarded or ignored in our quest to truly align psychology with what it means to be human.

This heuristic also works well as a basis for acknowledging, understanding, and researching the three different functions and concepts of meaning, i.e., striving, coping, and understanding. While each is likely to be, to a certain extent, independent of each other, and none is reducible to the other, they still refer to the one basic existential quest to find a home in this world and to being able to discover one’s personal tasks and calling. As the contributions collected in this volume attest to, the nonreductionist approach to meaning in clinical psychology allows for an unbiased and fresh look at the roles meaning, or meanings, have in contemporary and, no doubt, future psychologies.

The work presented in this current volume emphasizes the claim that some of the differences and disagreements between these schools of thought may be illusory rather than real. Moreover, they suggest that once the ideas, methods, and concepts of these schools of thought are translated into and tested in everyday clinical practice, many of these differences lose much of their former grip as it comes to real, and existential, encounters with other human beings and ourselves as part of the therapeutic experience .

About this Book

This book is about personal meaning and purpose in both clinical/therapeutic and empirical contexts. In addition, it presents theory and research concerning the circumstances under which people from all walks of life can find meaning and purpose, and how the presence or absence of awareness of meaning and purpose affects their psychological functioning, mental health, and existential fulfillment. Furthermore, the broader picture regarding meaning interventions painted in this volume serves to enhance both the individual thriving of members within the general public, as well as coping mechanisms within specific populations such as cancer patients, those who have survived ethno-political warfare, and individuals experiencing mental illness . As previously mentioned, while this book is complete in itself, it is the natural development of an earlier volume discussing meaning and purpose and their role in psychological theory and practice (Batthyany & Russo-Netzer, 2014a). In this earlier volume, we gave an overview of the theoretical framing and understanding of meaning and purpose within the two branches of psychology, i.e., positive and existential psychology. In short, we attempted to map out contemporary thinking within meaning-oriented psychologies, while at the same time trying to negotiate the common ground and differences in how both of these research traditions model and conceptualize meaning as a psychological and existential variable:

An integrative, balanced and holistic view – that takes into account controversies and disagreements, as well as strengths and points of agreement – can provide a more comprehensive understanding of the question of meaning. This “collage” or “montage” of ideas, perspectives and conceptualizations is also manifested in the multicultural landscape and contributions from both well-known and established scholars as well as younger researchers from both fields, in order to present a comprehensive and rich view on the issues discussed. (Batthyany & Russo-Netzer, 2014b, p. 19)

Ultimately, the outcome was much more than merely a collage or a montage. Indeed, we learned much previously undiscovered common territory between the two disciplines than we could have expected to find at the outset. Therefore, one of the outcomes of the debate we had facilitated between researchers and practitioners from both traditions seemed to be that to a large extent, the differences between the two disciplines’ theorizing about meaning may, in the end, stem not so much from conceptual points of contention, but rather from their very different backgrounds and respective histories of ideas, different vocabulary for often very similar ideas, and, of course, their different methodologies. An additional reason for the real or apparent disagreements seemed to lie deeper, and more accurately, within the subject itself. If life itself is too complex to be captured by one single discipline, worldview, or outlook, so is the personal meaning that is, in ways yet to be defined, at least a potential part of this life. Hence, given life’s immense complexity, it would seem unlikely that different schools of psychology would dedicate equal attention to the same aspects of meaning(s), and it is even less likely that they should reach the same (or even similar) conclusions regarding meaning and purpose and their psychological impact at different stages in life. And yet, while it may be obvious to empirically examine these different meanings within the context of research, how to connect them under the umbrella of the individual’s subjective experience of meaning is less clear. The current volume attempts to address this theoretical obstacle.

The building blocks for extending the theoretical bridge between existential and positive psychology can be found in the overarching goals and objective of this book. Insights regarding themes such as resilience, thriving, comprehension, coping, the pursuit of goals, and the practice of logotherapy have been selected in order to emphasize the commonality between the disciplines of existential and positive psychology, as well as ground their contribution to the existing meaning literature in empirical research. Furthermore, additional chapters address the importance of meaning in diverse therapeutic settings and through a range of methods of therapy, as well as offer outlines for facilitating meaning-oriented interventions.

This volume seeks to extend the current literature by addressing novel findings in this rapidly growing and promising area of meaning and purpose by means of providing broad international and interdisciplinary perspectives in order to enhance the empirical findings. Moreover, while the book is practical in nature with respect to therapeutic practices, it is also deeply grounded in the scientific method, and a careful review of theoretical and conceptual literature is provided. As such, each chapter includes a section of “Key Takeaways,” points for the reader to reflect on and consider when planning meaning-oriented interventions, as well as offers directions for future research and practice.

Moreover, this volume also explores topics such as spirituality , multiculturalism , posttraumatic growth, and nostalgia as additional areas of interest within the realm of meaning which assist in broadening our understanding and application of the construct in our everyday lives, as well as overall human psychological well-being. Some authors address topics relating to meaning-making while facing physical health challenges, while others focus on integrating meaning into everyday life from the perspective of the positive health movement. In addition, some chapters discuss some of the more technical factors of meaning-making, such as when in life it may be particularly important to cultivate meaning and in which cultures it is valued. Such a diverse and varied examination of the construct encourages the reader to integrate his or her thoughts from both existential and positive psychology perspectives, as well as from clinical and empirical approaches, and guides the theoretical convergence to a unique point of understanding and appreciation for the value of meaning and its pursuit.

Chapter Overview

The title of this introductory chapter captures the book’s three main components—Understanding, Coping and Thriving—reflecting a contemporary, threefold perspective regarding meaning in positive and existential psychotherapy. In addition, contributions to this volume represent an international perspective, encompassing a wide range of contexts and countries, from the United States, the United Kingdom, Austria, Israel, Spain, Switzerland, Canada, Russia, South Africa, Colombia, and Italy.

In the first section, the volume addresses “understanding,” and presents a broad conceptual overview comprised of a host of contexts, objectives, and considerations. Together, these chapters provide an important foundation for applying meaning in therapeutic settings. Chapters include work by Thaddeus Metz, who refers to the aims of therapy as a contribution to a meaningful life, and Julie M. Pomerleau, Kenneth I. Pargament, and Annette Mahoney, who emphasize the importance of the spiritual dimension of meaning. Following these works, Joel Vos presents a framework for working with meaning in life in the field of mental health care through a systematic literature review of current practices. Emily Stagnaro, Laura E.R. Blackie, Erik G. Helzer, and Eranda Jayawickreme examine meaning and control in the context of ethno-political warfare. Louis Hoffman, Nathaniel Granger Jr., and Monica Mansilla highlight multiculturalism and meaning in positive and existential psychology, and finally, Dmitry Leontiev reviews a variety of practices relating to meaning-oriented interventions.

The next two sections present various utilizations of meaning-oriented therapy in the context of human coping and thriving. The second section addresses “coping” and suggests meaning-oriented interventions for human coping in a variety of clinical settings, based on positive and existential perspectives. Lauren N. Weathers, Bethany J. Aiena, Meredith A. Blackwell, and Stefan E. Schulenberg begin the section with their discussion on the significance of meaning in conceptualizations of resilience and posttraumatic growth. Joel Vos then reviews the effectiveness of meaning-centered therapies in the context of chronic or life-threatening diseases. Efrén Martínez Ortíz and Ivonne Andrea Flórez present a logotherapeutic approach to the treatment of substance use disorders, and Matti Ameli presents logotherapy as a bridge between cognitive-behavior therapy and positive psychology in the treatment of depression. Next, William Breitbart and Melissa Masterson outline a meaning-centered psychotherapy intervention in the context of oncology and palliative care, Peter Claudio, Simon Kunz, Andreas Hegi, and Daniel Stirnimann discuss the experience of meaning for those with spinal cord injury, and Todd DuBose’s chapter concludes this section, addressing the lived meaning of meaninglessness.

The third section addresses “thriving” and integrates positive and existential perspectives regarding the application of meaning in order to cultivate human flourishing. This section includes the work of Thomas R. Egnew who addresses meaning in the context of medicine and healing, and Paul T.P. Wong’s integrative view of meaning therapy, translating logotherapy into existential positive interventions. Clay Routledge, Christina Roylance, and Andrew A. Abeyta highlight nostalgia as an existential intervention for meaning-making, while Ofra Mayseless considers the importance of caring and meaning in therapy. Following their efforts, Hadassah Littman-Ovadia and Ryan M. Niemiec examine character strengths and mindfulness as core pathways to achieving meaning in life, Kendall Cotton Bronk and Susan Mangan offer strategies for cultivating purpose among adolescents in clinical settings, and finally, Paul T.P. Wong provides an overview of a meaningful living group project as an exemplar of mental health intervention. As editors, it is our hope that these fascinating and thought-provoking chapters will stimulate deeper understanding of that which makes us uniquely human.