Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Sep 1;57(9):924.
doi: 10.3390/medicina57090924.

Existential Suffering in Palliative Care: An Existential Positive Psychology Perspective

Paul T P Wong  1 , Timothy T F Yu  2
Affiliations
Free PMC article
Review

Existential Suffering in Palliative Care: An Existential Positive Psychology Perspective

Paul T P Wong et al. Medicina (Kaunas). .
Free PMC article

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.

Keywords: CALM therapy; COVID-19; existential positive psychology; flourishing; good death; mature happiness; meaning therapy; palliative care; wellbeing.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The Healing Wheel in Holistic Health Care.
Figure 2
Figure 2
A Dual System Model of What Makes Life Worth Living.
Figure 3
Figure 3
Dialectical Mandala Model of Mature Happiness.
Figure 4
Figure 4
Sample Items from Lo et al.’s Death and Dying Distress Scale.
Figure 5
Figure 5
The Golden Triangle.
Figure 6
Figure 6
The Iron Triangle.
Figure 7
Figure 7
The Pathway of Resilience.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Hannon B., Mak E., Al Awamer A., Banerjee S., Blake C., Kaya E., Lau J., Lewin W., O’Connor B., Saltman A., et al. Palliative care provision at a tertiary cancer center during a global pandemic. Support. Care Cancer. 2021;29:2501–2507. doi: 10.1007/s00520-020-05767-5. - DOI - PMC - PubMed
    1. Oluyase A.O., Hocaoglu M., Cripps R.L., Maddocks M., Walshe C., Fraser L.K., Preston N., Dunleavy L., Bradshaw A., Murtagh F.E., et al. The Challenges of Caring for People Dying from COVID-19: A Multinational, Observational Study (CovPall) J. Pain Symptom Manag. 2021;62:460–470. doi: 10.1016/j.jpainsymman.2021.01.138. - DOI - PMC - PubMed
    1. Pastrana T., De Lima L., Pettus K., Ramsey A., Napier G., Wenk R., Radbruch L. The impact of COVID-19 on palliative care workers across the world: A qualitative analysis of responses to open-ended questions. Palliat. Support. Care. 2021;19:187–192. doi: 10.1017/S1478951521000298. - DOI - PMC - PubMed
    1. Wentlandt K., Cook R., Morgan M., Nowell A., Kaya E., Zimmermann C. Palliative Care in Toronto During the COVID-19 Pandemic. J. Pain Symptom Manag. 2021;62:615–618. doi: 10.1016/j.jpainsymman.2021.01.137. - DOI - PMC - PubMed
    1. Araújo L., Ribeiro O., Teixeira L., Paúl M.C. Successful aging at 100 years: The relevance of subjectivity and psychological resources. Int. Psychogeriatr. 2016;28:179–188. doi: 10.1017/S1041610215001167. - DOI - PubMed