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| Meaning in the Preparation Stage: Reassessing Goals |
Meaning in the Preparation Stage: Reassessing Goals
While the inner search for one’s positive qualities and resources can be the foundation for establishing a positive sense of self, living in keeping with one’s values is the basis for a meaningful life. The process of introspection in the Preparation stage includes the identification of one’s core values. These values represent higher-order goals (Emmons, Colby and Kaiser, 1998), and can be thought of as one’s ‘valued directions’ in life (Hayes and Strosahl, 2004). ‘Taking stock’ during this stage leads some people to decide that they no longer have the personal resources to continue the pursuit of their valued goals, or at least, not at the same level as they had before the illness:
I had to realize a change in my career goals. I hold a BS degree in biology and completed an additional two and a half years toward an MD degree. The stress of medical education overwhelming me, I withdrew from medical school. (Henderson, 2004, p. 85)
When circumstances rob a person of their anticipated future, they need to ‘dream a new dream’ (King, 1998). Abandoning goals that are no longer attainable, rather than signalling resignation and failure, can represent a healthy adjustment to a changed situation, enabling resources to be applied to attainable goals (Brandtst€adter, 2009).
This can serve to preserve psychological well-being. Many abandon their careers or education early in the illness, and so, during recovery, need to reassess their capacity to re-establish their former goals, or find alternative ways to pursue their valued directions. This process is described here by McDermott (1994):
[I] realized that I was on the planet for a purpose, and through meditation and introspection, probed for my life purpose and developed short-term and long-term goals to serve the purpose. (p. 65)
Living according to one’s valued directions gives meaning to the work of recovery, and for this reason, some people hold on tenaciously to their goals. For example, Schmook (1994), a divorced mother, was told by her therapist that if she did not go on welfare she would fail and lose her children. However, she had a strong work ethic and believed strongly in providing for her family herself. She tells:
I told her I could not see her any longer because she was trying to force me to go against my conscience. I knew what I had to do to get better. What I wanted was to find a doctor and therapist who would support my desire to be healthy again. (p. 2)
The courage behind this decision cannot be overstated, as at this time, Schmook, who had been diagnosed with paranoid schizophrenia, had never heard of recovery and had been told that ‘people with mental illness did not get better’ (p. 1). In a later article, Schmook (1996) cites Leete (1994) as stating: ‘We must each facilitate personal growth by discovering what makes life valuable and enriching to us as individuals’ (p. 12).
The reordering of values and priorities has often been construed as a benefit of loss, illness or disability (e.g. Schaefer and Moos, 1992; Tedeschi and Calhoun, 1995; Davis, Nolen-Hoeksema and Larson, 1998; Emmons, 1999a). Davis, Nolen- Hoeksema and Larson (1998) identified two construals of the concept of ‘finding meaning’ in loss. These are sense-making – making sense of the event; and benefitfinding – finding some good in the experience. Davis et al. asserted that sensemaking was important in the early days of adjustment, while benefit-finding was more important later. The chosen meaning of the illness discussed in the Awareness stage can be associated with sense-making, while the reordering of priorities in the Preparation stage is akin to the process of benefit-finding. In Elliott, Kurylo and Rivera’s (2002) model of positive growth following acquired disability, adaptive people often ‘look inward to exercise control over internal states when external events are beyond their control’ (p. 692). Those who try to accept their situation and find positive meanings tend to show better adjustment, while those who ruminate and take a ‘victimization’ stance may fail to find meaning and direction in their circumstances. Sometimes the benefit found in mental illness is the ability to help others who are struggling with similar problems. This often provides a meaningful goal for the person. For example, Armstrong relates:
I learned that I want to dedicate myself to this recovery process for myself and others . . .. I am able to keep going forward learning real job skills, which I never had from those years on the streets, in the psychiatric rehabilitation field. (Armstrong, 1994, p. 53)
Although the reordering of priorities and setting of new goals is well-documented in adjustment to various forms of loss and trauma, Emmons, Colby and Kaiser (1998) found that goal conservation is also a common response. Lack of goal change was found to be associated with recovery from loss. There are at least two possible explanations for these results. First, the nature of the loss or trauma experienced may not have necessitated goal change (e.g. the loss of a parent).
While the inner search for one’s positive qualities and resources can be the foundation for establishing a positive sense of self, living in keeping with one’s values is the basis for a meaningful life. The process of introspection in the Preparation stage includes the identification of one’s core values. These values represent higher-order goals (Emmons, Colby and Kaiser, 1998), and can be thought of as one’s ‘valued directions’ in life (Hayes and Strosahl, 2004). ‘Taking stock’ during this stage leads some people to decide that they no longer have the personal resources to continue the pursuit of their valued goals, or at least, not at the same level as they had before the illness:
I had to realize a change in my career goals. I hold a BS degree in biology and completed an additional two and a half years toward an MD degree. The stress of medical education overwhelming me, I withdrew from medical school. (Henderson, 2004, p. 85)
When circumstances rob a person of their anticipated future, they need to ‘dream a new dream’ (King, 1998). Abandoning goals that are no longer attainable, rather than signalling resignation and failure, can represent a healthy adjustment to a changed situation, enabling resources to be applied to attainable goals (Brandtst€adter, 2009).
This can serve to preserve psychological well-being. Many abandon their careers or education early in the illness, and so, during recovery, need to reassess their capacity to re-establish their former goals, or find alternative ways to pursue their valued directions. This process is described here by McDermott (1994):
[I] realized that I was on the planet for a purpose, and through meditation and introspection, probed for my life purpose and developed short-term and long-term goals to serve the purpose. (p. 65)
Living according to one’s valued directions gives meaning to the work of recovery, and for this reason, some people hold on tenaciously to their goals. For example, Schmook (1994), a divorced mother, was told by her therapist that if she did not go on welfare she would fail and lose her children. However, she had a strong work ethic and believed strongly in providing for her family herself. She tells:
I told her I could not see her any longer because she was trying to force me to go against my conscience. I knew what I had to do to get better. What I wanted was to find a doctor and therapist who would support my desire to be healthy again. (p. 2)
The courage behind this decision cannot be overstated, as at this time, Schmook, who had been diagnosed with paranoid schizophrenia, had never heard of recovery and had been told that ‘people with mental illness did not get better’ (p. 1). In a later article, Schmook (1996) cites Leete (1994) as stating: ‘We must each facilitate personal growth by discovering what makes life valuable and enriching to us as individuals’ (p. 12).
The reordering of values and priorities has often been construed as a benefit of loss, illness or disability (e.g. Schaefer and Moos, 1992; Tedeschi and Calhoun, 1995; Davis, Nolen-Hoeksema and Larson, 1998; Emmons, 1999a). Davis, Nolen- Hoeksema and Larson (1998) identified two construals of the concept of ‘finding meaning’ in loss. These are sense-making – making sense of the event; and benefitfinding – finding some good in the experience. Davis et al. asserted that sensemaking was important in the early days of adjustment, while benefit-finding was more important later. The chosen meaning of the illness discussed in the Awareness stage can be associated with sense-making, while the reordering of priorities in the Preparation stage is akin to the process of benefit-finding. In Elliott, Kurylo and Rivera’s (2002) model of positive growth following acquired disability, adaptive people often ‘look inward to exercise control over internal states when external events are beyond their control’ (p. 692). Those who try to accept their situation and find positive meanings tend to show better adjustment, while those who ruminate and take a ‘victimization’ stance may fail to find meaning and direction in their circumstances. Sometimes the benefit found in mental illness is the ability to help others who are struggling with similar problems. This often provides a meaningful goal for the person. For example, Armstrong relates:
I learned that I want to dedicate myself to this recovery process for myself and others . . .. I am able to keep going forward learning real job skills, which I never had from those years on the streets, in the psychiatric rehabilitation field. (Armstrong, 1994, p. 53)
Although the reordering of priorities and setting of new goals is well-documented in adjustment to various forms of loss and trauma, Emmons, Colby and Kaiser (1998) found that goal conservation is also a common response. Lack of goal change was found to be associated with recovery from loss. There are at least two possible explanations for these results. First, the nature of the loss or trauma experienced may not have necessitated goal change (e.g. the loss of a parent).
The second explanation is that those goals that were of a ‘higher order’ may not have required changing. For example, Emmons et al. found that spiritual goals were associated with recovery from loss or trauma.
A person’s strongly held values provide guiding principles for the identification of value-congruent lower-order goals. Such goal congruence is associated with wellbeing, satisfaction with life and meaning in life (e.g. Emmons, Colby and Kaiser, 1998; Little, 1998; McGregor and Little, 1998; Sheldon and Kasser, 2001).
McDermott (1994) explains how she scaled down her goals, while continuing to reflect her core values:
[I] gave up the grandiose idea that I could ‘save society’ and concentrated on seeking inner peace and harmony by being a constructive influence with my family, peers and professionals. (p. 66)
A person’s strongly held values provide guiding principles for the identification of value-congruent lower-order goals. Such goal congruence is associated with wellbeing, satisfaction with life and meaning in life (e.g. Emmons, Colby and Kaiser, 1998; Little, 1998; McGregor and Little, 1998; Sheldon and Kasser, 2001).
McDermott (1994) explains how she scaled down her goals, while continuing to reflect her core values:
[I] gave up the grandiose idea that I could ‘save society’ and concentrated on seeking inner peace and harmony by being a constructive influence with my family, peers and professionals. (p. 66)
As Henderson (2004) says, ‘One must give serious thought to what he/she wants out of life and define what recovery means for him/herself – and pursue it’ (p. 87). Once the person has an increased sense of agency and a sense of direction for their life, they are ready to take more concrete steps towards getting their life back on track.
