Existential Suffering in Palliative Care: An Existential Positive Psychology Perspective

Abstract

The COVID-19 pandemic has exposed the inadequacies of the current healthcare system and needs a paradigm change to one that is holistic and community based, illustrated by the healing wheel. The present paper proposes that existential positive psychology (PP 2.0) represents a promising approach to meet the rising needs in palliative care. This framework has a twofold emphasis on (a) how to transcend and transform suffering as the foundation for wellbeing and (b) how to cultivate our spiritual and existential capabilities to achieve personal growth and flourishing. We propose that these objectives can be achieved simultaneously through dialectical palliative counselling, as illustrated by Wong’s integrative meaning therapy and the Conceptual Model of CALM Therapy in palliative care. We then outline the treatment objectives and the intervention strategies of IMT in providing palliative counselling for palliative care and hospice patients. Based on our review of recent literature, as well as our own research and practice, we discover that existential suffering in general and at the last stage of life in particular is indeed the foundation for healing and wellbeing as hypothesized by PP 2.0. We can also conclude that best palliative care is holistic—in addition to cultivating the inner spiritual resources of patients, it needs to be supported by the family, staff, and community, as symbolized by the healing wheel.

Editorial: COVID-19 and Existential Positive Psychology (PP2.0): The New Science of Self-Transcendence

“…Bates (2016) suggested that physicians can be trained to address existential suffering so that "it is possible for patients to transition from feeling hopeless to feeling more alive than ever." More recently, Wong and Yu (2021) point out that even the dreaded time of dying can be transformed to a time of deep joy and liberation from human bondage through radical acceptance, faith in God, and support from family and community. That is why the mission of existential positive psychology is to investigate ways to reduce human suffering and transform it into human flourishing (Wong, 2009a(Wong, , 2011(Wong, , 2019a(Wong, , 2021a.…”

“…“Themes common to the descriptions of existential suffering included lack of meaning or purpose, loss of connectedness to others, thoughts about the dying process, struggles around the state of being, difficulty in finding a sense of self, loss of hope, loss of autonomy, and loss of temporality.” This type of suffering calls for different ways of coping and interventions. Bates ( 2016 ) suggested that physicians can be trained to address existential suffering so that “it is possible for patients to transition from feeling hopeless to feeling more alive than ever.” More recently, Wong and Yu ( 2021 ) point out that even the dreaded time of dying can be transformed to a time of deep joy and liberation from human bondage through radical acceptance, faith in God, and support from family and community. That is why the mission of existential positive psychology is to investigate ways to reduce human suffering and transform it into human flourishing (Wong, 2009a , 2011 , 2019a , 2021a ).…”

Optimism in dire times: The buffering role of optimism in the relationship between food insecurity and mental health during the COVID-19 pandemic

“…An examination of optimism in the context of FI in times of a worldwide pandemic requires a complex and dialectical understanding of the balance between positives and negatives, between hope and suffering [ 55 , 56 ]. Therefore, to enhance our understanding of the findings, we conceive 'optimism' not as a state of mere positivity, but rather as a form of 'tragic optimism' - a positive outlook of life that concurrently acknowledges suffering and hardships [ [54] , [55] , [57] , [58] ]. This conceptualization is informed by Victor Frankl's [ 59 ] proposition of 'tragic optimism', defined as optimism in the face of tragedy despite pain, guilt, and death.…”

“…However, our recommendation is that optimism should not be discouraged in general. Rather, it should be utilized in a way that integrates the negative with the positive [ 55 ]. In such ways, food-insecure individuals may transform challenges into hopes and genuine changes in their lives.…”

Existential Positive Psychology (EPP): A Positive Tool for Healing Existential Anxieties in South Africa during, and after, the COVID-19 Pandemic

“…The model has three notions: firstly, that through suffering existential concerns are revealed during the pandemic; secondly, that existential anxiety damages humanity’s capacity to find meaning in life; and thirdly, that nurturing meaning will alleviate existential anxiety, which will allow human growth and facilitate flourishing. The model can be used by practitioners with those who are suffering during the COVID-19 pandemic by integrating the theory into applied clinical work [ 46 ].…”