Written by Dr Lauren Miller-Lewis, Lecturer in Positive Psychology at CQUniversity Australia, and Researcher with the Research Centre for Palliative Care, Death and Dying at Flinders University.
When my postgraduate Positive Psychology students hear me start talking about death and mortality, this initially raises a few eyebrows. That’s perhaps because positive psychology is colloquially considered synonymous with the pursuit of happiness, joy, and gratitude journals. But there’s a lot more to it than that. The field did start out with a strong focus on positive psychological functioning to counteract the more typical deficits-based approach seen in ‘psychology as usual’.1 Recently a more nuanced approach has emerged. In particular, the ‘second-wave of positive psychology’ aims to clarify that positive psychology investigates difficult and painful life experiences, whilst emphasising their role in positive functioning and flourishing as human beings. Positive outcomes like meaning, fulfillment and growth can result from the most dire of circumstances.2,3
The concept of meaning-in-life is one of the central focusses in second-wave positive psychology. Meaning can be found in both positive and challenging situations, and while it can be distressing to acknowledge the darker side of life, it might lead to greater flourishing, resilience, transformation and growth.2,3 The seminal work of psychiatrist and holocaust-survivor Viktor Frankl has been influential in positive psychology.4 Frankl claimed that finding meaning in our lives is our primary motivation for living and a critical component of a life well-lived, and indeed research findings indicate the presence of meaning-in-life is predictive of better mental and physical health outcomes.5 Positive psychology interventions to build wellbeing also often contain exercises to enhance meaning-in-life.6,7 What’s particularly interesting is that these exercises sometimes contain elements that draw people’s attention towards the finite nature of our lives, with the premise being that confronting our mortality enables us to live meaningfully and authentically, which can lead to deeper self-actualisation and death acceptance.8
Whilst the positive psychology space is using mortality awareness as strategy for fostering meaning-in-life and wellbeing, in the palliative care space there’s growing calls for the development of health-promoting palliative care strategies to help the general community build skills for coping with death and planning for the end of life.9,10
We became interested in understanding what role positive psychology concepts such as meaning-in-life might play in influencing the way people adapt to and cope with death and dying, as individuals, families, and communities. The research in this area was scant, particularly when looking at death from a strengths-based capabilities perspective rather than a fear or deficit-based perspective. So, as an optional part of CareSearch’s Dying2Learn Massive Open Online Course11, we conducted a research study to explore the connection between meaning-in-life and death competence.12 The overall study purpose was to develop an understanding of factors associated with perceived death-competence13, and determine whether meaning-in-life, quality-of-life, and socio-demographic characteristics (e.g., age, education) were significantly associated with perceived death-competence in participants at Dying2Learn course commencement. We found that greater presence of meaning-in-life, quality-of-life, age, death experience, and carer experience were each associated with more death competence. What was interesting though was that life-related variables were more strongly associated with death competence than demographic variables, with the presence of meaning-in-life being the strongest predictor of higher perceived competence in coping with death. These findings have important implications for theory and for future efforts to foster adaptive death-coping. Longitudinal research is required to untangle the potential transactional interplay between mortality awareness, meaning-in-life and death-competence. One possibility that aligns with positive psychology theories is that awareness of our mortality is required for a true sense of meaning-in-life to develop, which can in turn lead to the development of competence in coping with death. We have several new research projects underway to try and tease out some of these processes and interactions.
In sum, our research lends support to the idea that our feelings and attitudes towards the meaning in our life and death are linked. This also supports the notion that the positive psychology of death isn’t an oxymoron. A natural synergy between meaning-in-life and death competence seems likely, where they could play mutually beneficial roles working together to lead to a more death-competent and psychologically flourishing community. Perhaps death is the necessary contrast we need to live our most meaningful lives. And perhaps the presence of meaning-in-life might not only foster psychological wellbeing, but it might also play an adaptive role in bolstering our competencies and skills in coping with death and dying. We will continue exploring this field going forward.
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11. Miller-Lewis L, Tieman J, Rawlings D, Sanderson C, Parker D. Correlates of perceived death competence: What role does meaning-in-life and quality-of-life play? Palliative and Supportive Care. 2019;17(5):550-60. https://doi.org/10.1017/S1478951518000937
12. Tieman J, Miller-Lewis L, Rawlings D, Parker D, Sanderson C. The contribution of a MOOC to community discussions around death and dying. BMC Palliative Care. 2018;17(1):31. https://doi.org/10.1186/s12904-018-0287-3
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