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| Meaning in the Awareness Stage: Need for a Purpose in Life |
Meaning in the Awareness Stage: Need for a Purpose in Life
In the Awareness stage, the person strives to assimilate the illness into their ‘world view’, developing an understanding of why it occurred and what the implications are for his or her future (e.g. Emmons, Colby and Kaiser, 1998). In the section on Identity, above, we saw how the adoption of an explanation of mental illness enabled a person to separate the self from the illness. Seeking a meaning of the illness in the Awareness stage can be explained by theories of cognitive control, in which one tries to understand unexplainable negative events by finding a reason for them (e.g. Taylor, 1983; Jaffe, 1985; Janoff-Bulman, 1992). For example, people with serious physical illnesses try to determine the cause of the illness, thus enabling them to take action in curing, managing or preventing a recurrence of the illness (Taylor, 1983).
In the case of mental illness, the ‘chosen meaning’ provides a foundation for the person to start working towards recovery (Pettie and Triolo, 1999, p. 260).
Agentic, rather than resigned, acceptance of the illness goes hand-in-hand with the need to find meaning in life. Awareness of an agentic self, and the possibility of a positive identity, accompanies the perception that life as a ‘mental patient’ is empty and meaningless. The person is acutely aware of the loss of, or failure to acquire, meaningful goals and roles. Chovil (2005) describes how, once he stopped believing in his delusions, he realized the damage that had been done to his life:
What if Saint Francis d’Assisi had one day realised that there was no God, that he had been talking to the birds instead of acquiring career training, courting his future wife, building equity to buy a home, and ultimately raising a family. What if he realized that he had nothing concrete to show for the last ten years of his life . . . and now he was face to face with the one person who specialized in his loss, a psychiatrist? (p. 70) Chovil went on to explain that he eventually realized that neither the psychiatrist, nor anyone else, could undo the damage that had been done, and that it was up to him to improve his situation. While continuing psychiatric care and medication, he took responsibility for solving the problems of his life.
In the Awareness stage, the person strives to assimilate the illness into their ‘world view’, developing an understanding of why it occurred and what the implications are for his or her future (e.g. Emmons, Colby and Kaiser, 1998). In the section on Identity, above, we saw how the adoption of an explanation of mental illness enabled a person to separate the self from the illness. Seeking a meaning of the illness in the Awareness stage can be explained by theories of cognitive control, in which one tries to understand unexplainable negative events by finding a reason for them (e.g. Taylor, 1983; Jaffe, 1985; Janoff-Bulman, 1992). For example, people with serious physical illnesses try to determine the cause of the illness, thus enabling them to take action in curing, managing or preventing a recurrence of the illness (Taylor, 1983).
In the case of mental illness, the ‘chosen meaning’ provides a foundation for the person to start working towards recovery (Pettie and Triolo, 1999, p. 260).
Agentic, rather than resigned, acceptance of the illness goes hand-in-hand with the need to find meaning in life. Awareness of an agentic self, and the possibility of a positive identity, accompanies the perception that life as a ‘mental patient’ is empty and meaningless. The person is acutely aware of the loss of, or failure to acquire, meaningful goals and roles. Chovil (2005) describes how, once he stopped believing in his delusions, he realized the damage that had been done to his life:
What if Saint Francis d’Assisi had one day realised that there was no God, that he had been talking to the birds instead of acquiring career training, courting his future wife, building equity to buy a home, and ultimately raising a family. What if he realized that he had nothing concrete to show for the last ten years of his life . . . and now he was face to face with the one person who specialized in his loss, a psychiatrist? (p. 70) Chovil went on to explain that he eventually realized that neither the psychiatrist, nor anyone else, could undo the damage that had been done, and that it was up to him to improve his situation. While continuing psychiatric care and medication, he took responsibility for solving the problems of his life.
For Berman, it was a sense that meaningful life had been passing him by whilst he had struggled for 20 years to maintain professional employment in ‘marshmallowclouded concentration’ on lithium:
Finally, too much, much too much of life had passed me by while I dwelled in a semialive state. Barely functioning . . .. Never really being able to enjoy the rather rare pleasant things that came my way . . .. Life, as I experienced it, was through my marshmallow . . .. (Berman, 1994, p. 42)
Berman explains that he decided to go off medication, as any chance of experiencing a satisfying life was worth the risk of continued symptoms. The need for a more meaningful life can require a change of attitude that can involve some very difficult and threatening decisions. For Berman it involved giving up hope of further professional employment and considering himself retired. At the other end of the scale, another author, who had worked professionally before the onset of illness, writes of a change of attitude which saw him accept participation in a rehabilitation programme, involving work in a sheltered workshop, as a first step towards returning to meaningful employment (Anonymous, 1994a). Acceptance of his illness and his limitations enabled him to consider the rehabilitation process as ‘just a phase’ (p. 16).
Leibrich (1997) explained how, her life in ruins after having received all available help without recovering, suicide had seemed like a rational decision. A failed attempt and subsequent hospitalization provided the catalyst for her recovery: But I failed and there was another hospital admission. This time I went less willingly.
Once again I was forced to take drugs I didn’t want. Now I felt imprisoned within a prison within a prison. For the first time, I realised that the treatment was becoming a disease. (Leibrich, 1997, p. 39) While some people never had the opportunity to secure meaningful adult roles prior to the illness, others lost high-status positions and families because of the illness.
Against professional advice, Schmook (1994) desperately clung to her roles as mother and provider, and sought a doctor who would support her efforts to get well: My therapist tried to convince me to go on welfare; to get food stamps; to get housing assistance; to get aid for families with dependent children. I told her that, in good conscience I couldn’t do that. I wanted to get better. (p. 2)
As we noted in Chapter 3, our personal goals imbue our lives with meaning (Emmons, Colby and Kaiser, 1998; King, 1998; Little, 1998). In the Awareness stage, the desire for a better life, the separation of self from the illness, and an emerging sense of agency are manifestations of goal-directed thinking. Frankl (1984) asserted that the ‘primary motivational force’ (p. 121) in human beings is the ‘will to meaning’ and this is manifested by finding a purpose. Purpose in life is a key component of psychological well-being, which has been conceptualized as striving to reach one’s full potential (Ryff and Keyes, 1995). The consumer stories illustrate how, even in the depths of despair, this need for meaning and purpose in life can break through, providing the motivation to work towards a fulfilling life, by establishing goals that transcend coping with, and management of, the illness.
Finally, too much, much too much of life had passed me by while I dwelled in a semialive state. Barely functioning . . .. Never really being able to enjoy the rather rare pleasant things that came my way . . .. Life, as I experienced it, was through my marshmallow . . .. (Berman, 1994, p. 42)
Berman explains that he decided to go off medication, as any chance of experiencing a satisfying life was worth the risk of continued symptoms. The need for a more meaningful life can require a change of attitude that can involve some very difficult and threatening decisions. For Berman it involved giving up hope of further professional employment and considering himself retired. At the other end of the scale, another author, who had worked professionally before the onset of illness, writes of a change of attitude which saw him accept participation in a rehabilitation programme, involving work in a sheltered workshop, as a first step towards returning to meaningful employment (Anonymous, 1994a). Acceptance of his illness and his limitations enabled him to consider the rehabilitation process as ‘just a phase’ (p. 16).
Leibrich (1997) explained how, her life in ruins after having received all available help without recovering, suicide had seemed like a rational decision. A failed attempt and subsequent hospitalization provided the catalyst for her recovery: But I failed and there was another hospital admission. This time I went less willingly.
Once again I was forced to take drugs I didn’t want. Now I felt imprisoned within a prison within a prison. For the first time, I realised that the treatment was becoming a disease. (Leibrich, 1997, p. 39) While some people never had the opportunity to secure meaningful adult roles prior to the illness, others lost high-status positions and families because of the illness.
Against professional advice, Schmook (1994) desperately clung to her roles as mother and provider, and sought a doctor who would support her efforts to get well: My therapist tried to convince me to go on welfare; to get food stamps; to get housing assistance; to get aid for families with dependent children. I told her that, in good conscience I couldn’t do that. I wanted to get better. (p. 2)
As we noted in Chapter 3, our personal goals imbue our lives with meaning (Emmons, Colby and Kaiser, 1998; King, 1998; Little, 1998). In the Awareness stage, the desire for a better life, the separation of self from the illness, and an emerging sense of agency are manifestations of goal-directed thinking. Frankl (1984) asserted that the ‘primary motivational force’ (p. 121) in human beings is the ‘will to meaning’ and this is manifested by finding a purpose. Purpose in life is a key component of psychological well-being, which has been conceptualized as striving to reach one’s full potential (Ryff and Keyes, 1995). The consumer stories illustrate how, even in the depths of despair, this need for meaning and purpose in life can break through, providing the motivation to work towards a fulfilling life, by establishing goals that transcend coping with, and management of, the illness.
