Meaning in life in chronic pain patients over time: associations with pain experience and psychological well-being

Abstract

We explored the relationship between meaning in life and adjustment to chronic pain in a three-wave, 2 year, longitudinal study of 273 Belgian chronic pain patients. We examined the directionality of the relationships among the meaning in life dimensions (Presence of Meaning and Search for Meaning) and indicators of adjustment (depressive symptoms, life satisfaction, pain intensity, and pain medication use). We found that Presence of Meaning was an important predictor of well-being. Secondly, we used a typological methodology to distinguish meaning in life profiles, and the relationship of individual meaning in life profiles with indicators of adjustment. Five meaning in life profiles emerged: High Presence High Search, High Presence Low Search, Moderate Presence Moderate Search, Low Presence Low Search, and Low Presence High Search. Each meaning in life profile was associated with a unique adjustment outcome. Profiles that scored high on Presence of Meaning showed more optimal adjustment. The profiles showed little change over time and did not moderate the development of adjustment indicators, except for life satisfaction. Practical implications and suggestions for future research are discussed.

A Comprehensive Approach to the Patient at End of Life: Assessment of Multidimensional Suffering

“…9,10 Viktor Frankl, a psychiatrist and Holocaust survivor, was perhaps the first to study meaning making in the context of modern medicine. Frankl outlined three types of suffering: physical (pain, somatic diseases), psychological (emotional hardship, psychological disorders), and spiritual (lack of a meaningful life, moral dilemmas).…”

“…11 This theoretical foundation has since been supported by longitudinal research showing that individuals with high levels of meaning in their lives are less likely to experience pain. 10 …”

“…9,10,14 The psychospiritual process of meaning making can reduce stress on the body. Conversely, spiritual struggles increase physiological stress and promote increased morbidity and mortality.…”

“…Ironically, maladaptive searches for meaning, or lacking current meaning, may cause more psychophysiological stress than not searching at all. 10 Among medically ill individuals who do not have an established religious framework to approach the concept of meaning making, better psychophysiological outcomes may occur if a psychotherapist can guide the search for meaning. 10 For individuals who already experience high levels of personal meaning in their lives, however, continuing to search for new outlets of meaning may create additional psychophysiological stress and negative health outcomes among medically ill individuals.…”

The “self” in pain: the role of psychological inflexibility in chronic pain adjustment

“…Throughout the process of accepting the post-injury self, psychological flexibility is essential to allow malleability in self-concept structure such that behaviors can be changed or redirected according to personal long-term values (Hayes et al, 1999;Whiting et al, 2015). Similarly, studies have elucidated the importance of adjusting life goals and expectations in patients with chronic pain (Dezutter et al, 2015;Schmitz et al, 1996). Flexible goal adjustment, referred to as accommodative coping, serves as a buffer to attenuate the negative impact of the pain situation on disability and psychological health (Schmitz et al, 1996).…”