BY KELSEY JAGER, PHD, LPCC-S
Suffering is an unavoidable human experience. To live is to have moments of pain, fear, loss and shame. But with loss comes the opportunity for life enhancing learning experiences. It is through tragedy, death, and other traumas that people are forced to take on new perspectives in life that enhance well-being, empathy, and purpose.
In the chronic illness and disability literature, my specialty area, one theory on loss is in the Meaning-Reconstruction Model (Neimeyer, 2000), which conceptualizes loss as opportunities for growth through re-learning what was once taken for granted. People have a natural inclination to develop meaningful self-narratives, which contribute to a sense of personal significance. In an ideal circumstance, one’s internal perceptions of meaning are validated by one’s social and cultural context. When a loss or divergence unexpectedly occurs, assumptions are threatened or destroyed and thus require rebuilding. Newly constructed meaning is created over time and is unique to each person.
The Meaning-Reconstruction Model has its roots in constructivist assumptions and applies concepts from grief therapy. For example, one constructivist assumption is narrative truth, or that there is no one “true” reality that exists; rather, reality is individually constructed based on the storytelling used to make sense of life. Loss can either validate or invalidate assumptions we have about the experience. Meaning reconstruction offers a contrasting view to the more commonly held belief that living with a disability is a tragedy.
To reconstruct meaning, one must complete three steps (Gillies & Neimeyer, 2006). First, people have to strive to find reasons “why” the loss happened. They are thrown into doubt and turmoil about what brings meaning and purpose to life at this sense-making stage, especially among those with chronic illness. The second step is benefit-finding, or building new narratives that incorporate—or are even build upon—the new circumstances created by the loss itself. The final step is identity change, whereby, in reconstructing meaning in loss, individuals reconstruct themselves.
Counselors have the potential to explore the justification process and facilitate ‘meaning reconstruction’ with their clients. Meaning reconstruction is a process whereby the traumatic circumstance is reinterpreted, or “made sense of,” to establish a positive self-identity in the aftermath of a major personal loss (Neimeyer, 2000). I often see clients faced with a collision between previously held goals and assumptions about life and specific stressful events, such the loss of their identity as a healthy person after a diagnosis such as muscular dystrophy or multiple sclerosis. One’s personal experiences slowly diverge from that of a typical person, a realization that deeply disrupts the life story. To grieve is to make sense of “why” this illness is a part of life, and reinterpret commonly held assumptions about what makes a life worth living. Finding benefits in the circumstance is part of reconstructing a new life story that incorporates the loss with positivity and resonance.
Postmodern approaches are a natural fit for clients coming to therapy for a loss. Logotherapy focuses specifically on the meaning one intends to fulfill in life despite tragic circumstances (Frankl, 1946; Zeligman et al., 2018). Discovering one’s values (e.g., family, love, inner peace, creativity, wealth, authenticity) are an essential part of the meaning making process, as values help individuals make decisions about what to do to actively construct a meaningful life. Narrative therapy also lends itself well to meaning reconstruction because it puts the client in an active position to reflect upon the past and intentionally create the future.
Reconstructing meaning is one way to personally develop after a life-altering event, promoting posttraumatic growth. Otherwise termed “existential growth” or “thriving,” posttraumatic growth is a cognitive process that promotes growth through suffering (Middleton, 2016). Scholars have begun to examine posttraumatic growth for individuals living with various chronic illnesses, such as stomach cancer (Sim et al., 2015), chronic fatigue syndrome (Arroll & Howard, 2013) and HIV/AIDS (Amos, 2015). Standing in opposition to the traditional role of a sick person passively depending on healthcare professionals to manage chronic illness, those who have endured threats to psychological survival are willing and able to manage their own conditions as partners with professionals (Middleton, 2016). It is important for counselors to consider the meaning that can be made from a traumatic experience because to be educated on the growth that can occur because of difficult circumstances might increase positive adjustment for the client.
Amos, I.A., (2015). What is known about the post-traumatic growth expereince among people diagnosed with HIV/AIDS? A systematic review and thematic synthesis of the qualitative literature. Counseling Psychology Review, 30(3), 47-56.
Arroll, M. A., & Howard, A. (2013). The letting go, the building up, [and] the gradual process of rebuilding: identity change and post-traumatic growth in myalgia encephalomyelitis/chronic fatigue syndrome. Psychological Health, 28(3), 302- 318.
Frankl, V. (1946). Man’s search for meaning. Boston, MA: Beacon Press.
Gillies, J., & Neimeyer, R. A. (2006). Loss, grief, and the search for significance: Toward a model of meaning reconstruction in bereavement. Journal of Constructivist Psychology, 19, 31-65.
Middleton, H. (2016). Flourishing and posttraumatic growth. An empirical take on ancient wisdoms. Health Care Analysis, 24, 133-147.
Neimeyer, R. A. (2000). Searching for the meaning of meaning: Grief therapy and the process of reconstruction. Death Studies, 24, 541-558.
Sim, B. Y., Lee, Y. W., Kim, H., & Kim, S. H. (2015). Post-traumatic growth in stomach cancer survivors: Prevalence, correlates and relationship with health-related quality of life. European Journal of Oncology Nursing, 19(3), 230-236.
Zeligman, M., Varney, M., Grad, R. I., & Huffstead, M. (2018). Posttraumatic growth in individuals with chronic illness: The role of social support and meaning making. Journal of Counseling & Development, 96, 53-63.