logotherapy meaning therapy and spirituality.ppt [compatibility mode]

8/10/2019 Logotherapy Meaning Therapy and Spirituality.ppt [Compatibility Mode]

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18 TH ANNUALCONFERENCE

OF JAPANESE ASSOCIATIONOF CLINICALTHANATOLOGY

Logotherapy,Meaning Therapy,

& Spirituality Paul T. P. Wong


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Overview

n The role of meaning in spiritual care for cancerpatients

n Dr. FranklsLogotherapy& his concept ofspirituality

n Wongs Meaning Therapy in tapping into thehuman capacity for meaning making


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BreitbartsMeaning-Centered GroupTherapy for Cancer Patients

n Session 1 Concepts of meaning and sources of meaningn Session 2 Cancer and meaningn Session 3 Meaning and historical context of lifen Session 4 Storytelling, life projectn Session 5 Limitations and finiteness of lifen Session 6 Responsibility, creativity, deedsn Session 7 Experience, nature, art, humorn Session 8 Termination, goodbyes, hopes for the future


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Itamis Meaningful Living Therapy

with Cancer PatientsReynolds (1989) - The basic principles for the patient of M.L.T. are:1. To take major responsibility in the fight against the disease.2. To live a life devoted to fulfilling daily goals.3. To be helpful to others.4. To undergo training in coping with the anxiety associated with

illness and the fear of death.5. To contend with death naturally and constructively by accepting

the principle that everyone inevitably dies.6. To avoid being a "sick person" even though ill.7. To live out the remainder of life positively, undefeated by the

disease.


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Katsutaro Nagatan WHO professor,

psychosomatic medicineand psychopharmacology

n Logotherapyapproach topain & illness

n Logotherapyas effectivetreatment for chronicpain


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Dimensions of Suffering(Mak, 2007)

n Physical physical symptoms & pain

n

Psychological helplessness, hopelessness, &uncertainty

n Social isolation & relational conflict

n Spiritual lack of meaning in life


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The Good Deathn A comfortable & pain-free death

n A harmonious deathn A meaningful deathn A hopeful death

n A peaceful death


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Aspects of Spirituality n Pertain to ultimate meaning and purposen Discover a sense of meaning, calling, & significancen

Involve certain spiritual practicesn May involve a set of religious beliefs & ritualsn Believe in a Higher Being and a spiritual realityn Experience sacred momentsn Cultivate a transcendental connectionn Seek spiritual direction & formation


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An Instrument Approach to

Spiritual Care:(Based on what you say and do with patients)

n Addressing patients spiritual needs

n Addressing patients existential needs

n Taking a spiritual history of patients

n Incorporating appropriate spiritual practices

n Involving chaplains and spiritual leaders

n Involving the appropriate faith community


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A Transformative Approach to

Spiritual Care:(Based on what you say and do with patients)

n The healing silence listening to the inner voice

n The healing touch touching the heart & souln The healing connection establishing an I-You

relationship

n The healing presence providing a caring,compassionate presence

n The healing process nurturing spiritual growth


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Coping with Death Anxiety Elizabeth Kubler-Rosss (1969) five stages of coping

n Denial Death avoidance and extreme sports

n Anger Aggression, violence and terrorism

n Bargaining Doing good deeds or worshipping gods

n

Depression Disengagement and isolationn Acceptance Engagement in life


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Three Types of Death Acceptance(Wong, Reker, & Gesser, 1994)

1. Neutral - facing death rationally as aninevitable end of every life

2. Approach - accepting death as a gateway to abetter afterlife

3. Escape - choosing death as a betteralternative to a painful existence


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Positive Death Acceptance

Death Acceptance is the only antidote to Death Anxiety.

n Acceptance of ones life as worthwhilen Readiness to let go things of this worldn Recognition of the spiritual connection with a

transcendental realityn Hope in sharing spiritual life with loved ones

for all eternity


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Pathways to Death Acceptancen Life review (Wong, 1995)n Self-acceptance (Wong, 1998)n Religious/ spiritual beliefs (Wong, 1998)n Embracing ones own lifen Death education

To contemplate our death is to contemplate ourlife that leads to death.


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Coping with Death Anxiety

The Japanese Perspectiven NaikanTherapy focuses on inner looking &

self-cultivation; life review of ones relationship

with a significant other, resulting in a morerealistic sense of self & relationships

n Morita Therapy learning to accept & live

with negative emotions without judgment,focuses on taking control of own behaviour inspite of how one feels


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The Life-Death Connectionn To solve the problem of death, one must first

solve the problem of life, living life (Dennis Yoshikawa)

n To be prepared for death is to be prepared

for living; to die well is to live well (KonosukeMatsushita)


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Living well and dying wellinvolve enhancing ones sense

of self, ones relationships withothers, and ones understandingof the transcendent, the

spiritual, the supernatural.(Kuhl, 2002)


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Living and Dying well through

Meaning & Spirituality Human beings are born with the innate need for meaning &spirituality.

Finding meaning and purpose can make a big difference inhow we live & how we die.

The psychology of meaning management helps deepen ourspirituality and existential understanding.

Meaning management helps construct an effectivepsychological and spiritual model.

Meaning management motivates us to embrace & assumeresponsibility for our personal lives.


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Viktor Frankl &

the Medical Ministry n Logotherapyis adjunct to medical

treatments.n Healing needs to occur at the spiritual

level.n Needs to address questions of suffering

and deathn Meaning can be found in the most

horrible situations.n Needs to awaken the defiant human

spiritn For more information, visit

www.meaning.ca
http://www.meaning.ca/http://www.meaning.ca/


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n Logotherapy literally means therapy throughmeaning.

n It is a spiritually-oriented approach towardspsychotherapy.

n Existential analysis is needed to make the clientsaware of their spirituality and capacity for meaning.

n Inasmuch as logotherapymakes him aware of thehidden logos of his existence, it is an analyticalprocess (Frankl, 1984, p. 125).

What is Logotherapy?


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n Many people seek healing of inner emptinessbecause of a felt sense of existential vacuum.

n Frankl believed that existential vacuum maylead to both the tragic triad and neurotic triad.Meaning therapy is uniquely suitable to addressthese mental health issues.

Existential Vacuum


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The Tragic Triad

death

pain

guilt


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Freedom & Responsibility n Logotherapyemphasizes the responsible &

meaningful use of freedom.

n

Human existence can only be understood interms of responsibility.

n The will to meaning is based on a sense of

responsibility.n Responsiblenessmeans meeting the demand

quality of every situation.


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The Will to Meaningn It is the primary motivation for living.

n Everyone needs to find the true meaning of

ones own life.n Will to meaning is essential for resilience and

well-being to the extent that it means ones

capacity to live in spite of pain & suffering(similar to the will to live, sei no yokubo, inMeaningful Life Therapy)


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Meaning of Lifen Life has meaning under all circumstances. It is

our responsibility to respond to lifes demands.

n Each person must discover the meaningpotential of each situation.

n The ultimate meaning lies in its pursuit.

n The situational meaning can be experiencedthrough three avenues of value.


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n Creative value : giving something to the worldthrough creative works.

n Experiential value : receiving something fromthe world through appreciation and gratitude.

n Attitudinal value : taking a heroic standtowards suffering and fate.

Three Basic Pathways to

Meaning


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Noetic Dimensionn The dimension of the human spirit

n It is the healthy core or medicine chest of

logotherapy.n It contains uniquely human attributes, such as:

will to meaning, ideals, creativity, faith, love,

conscience, self-detachment, self-transcendence,humor, goal-striving, and taking oncommitments & responsibilities.


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n It evolves from logotherapyand cognitivebehavioral therapy.

n It is part of the third wave ofpsychotherapy which involves powerful

new concepts such as acceptance,commitment, meaning-making, and re-storying.

What is Meaning Therapy?


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Meaning Therapy is Integrative

n Existential meaning Logotherapy& Existential Therapyn Cognitive meaning Cognitive-Behavioural Therapy

n Narrative meaning Narrative Therapyn Positive meaning Positive Psychotherapyn Cultural meaning Cross-cultural & Indigenous Therapy


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n Who we are is more important than what we say.n Rogers three pre-conditions need to be the personal

characteristics of counsellors.

n Personal wholeness of the therapist is important.n The messenger is the message.

n The therapist is the therapy.

n The counsellor brings a healing presence.n The counsellor models meaningful living.

n The counsellor practices counselling by osmosis.

The Therapeutic Presence


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n At the social level, two strangers get to know each otherin a trusting and non-judgmental environment.

n At the existential level, two human beings share theircommon humanity.

n At the professional level, the therapist is responsible forachieving desirable therapeutic goals.

n Therapy involves the reciprocal influence between thetherapist and the client.

Different Levels of Relating


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n To awaken the clients sense ofresponsibility and meaning.

n To achieve a deeper understanding of theproblem from a larger perspective.n To help the client discover their true

identity and place in the world.n To help the client pursue what really

matters in life.

Therapeutic Goals


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n To grow and develop the clients full potential.n To make life better for self and others.n To transform a victims journey into a heros

adventure.n To discover meaning and hope in boundary

situations.n To learn principles and skills to achieve positive

outcomes and transform negative outcomesthrough meaning.

Therapeutic Goals Contd


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n Responsibility questionsn Choice questionsn Trajectory questionsn Quest questionsn Eight enduring existential questionsn Magic questionsn Diagnostic questions

The Art of Questioning


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1. Who am I?2. How and where do I find happiness?3. What should I do with my life?4. How can I avoid making the wrong choices in the major

areas of my life?5. Where do I belong?

6. What is the point of all my striving?7. What will happen to me after I die?8. What would make my life more meaningful and

significant?

Eight Enduring

Existential Questions


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The four treasures of Meaning Therapy:

n

Purpose the motivational componentn Understanding the cognitive

componentn

R esponsible action the behavioralcomponentn Enjoyment the affective component

The PURE Principles


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n Accept and confront the reality -- thereality principle.

n Believe that life is worth living thefaith principle.

n Commit to goals and actions theaction principle .

n Discover the meaning and significance of self andsituations theAha! principle.

n Evaluate the above theself-regulation principle .

The ABCDE Strategy


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n Cognitive acceptancen Emotional acceptance

n Realistic acceptancen Integrative acceptancen Existential acceptancen Transcendental acceptancen Transformative acceptance

Levels of Acceptance


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Affirming ones ideals and core values.n Believing in the intrinsic value and meaning

of lifen Believing in an Ultimate Rescuer or HigherPowern Believing in the eventual triumph of good& justice

Belief


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Moving forward and carrying out ones responsibilitywith determinationn Doing what needs to be done regardless of feelings

or circumstancesn Striving to fulfill ones responsibility no matter whatn Enduring hardship and pain for a worthy cause

n Practicing the PURE principlen Pursuing realistic goalsn Re-authoring ones life story

Commitment


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Learning something new about the self and life.n Digging deeper, exploring farther, and

searching higher.n Discovering ones hidden courage and

strength.n Discovering the power of faith and spiritual

resources.n Grasping the complexities of life and people.

Discovery


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Savoring small successes or re-assessing onesprogress.n

Feeling relief that the worst is over.n Savoring the moments of small success.n Reflecting and reviewing ones life.n Receiving feedback from others.n Conducting assessments and making adjustments.

Evaluation


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SOURCES OF MEANING

1. Achievement2. Acceptance

3. Transcendence

4. Intimacy

5. Relationship6. Religion

7. Fairness

8. Positive emotions

According to Wong (1998), there are 8 sources ofmeaning and the good life.


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1. It is deeply felt It touches your emotions in a deepand lasting way. More than a fleeting feeling, it reaches

your innermost being.

2. It is deeply processed It involves deeper layers ofmeaning beyond the factual and superficial.

3. It is enlightening It provides a solution to somepuzzling problems or leads to some new discovery.

4. It is transforming It enriches your life, changes your lifes direction or restores a sense of purpose andpassion to your life.

Definition of a

Meaningful Moment


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n Recovery : Bouncing back and returning tonormal functioning.

n Invulnerability : Remaining relativelyunscathed by the adversity or trauma.

n Post-traumatic Growth : Bouncing backand becoming stronger.

Patterns of Resilience


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Four Life Trajectories


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