How to Promote a Sense of Meaning and Purpose in Your Depressed Clients

At the heart of depression may lie a sense that life has little value or meaning.

True happiness … is not attained through self-gratification, but through fidelity to a worthy purpose.

– Helen Keller

“My life just seems empty! What’s the point of anything? It wouldn’t make any difference if I wasn’t here!”

These are common sentiments indicative of a depressed mindset. But they also indicate a sense of meaninglessness and purposelessness. At their heart may lie a sense that life has little value or meaning.

It often seems to me that once we connect to a purpose bigger than ourselves, suffering, privations, indignities, and difficulties fade as they begin to play ‘second fiddle’ to our primary cause, which is above and beyond the self.

Emile Zatopek, the long-distance runner and multiple Olympic gold medal winner, had a great sense of purpose, which was to be the best and make his country proud. He said of his training: “Is it raining? That doesn’t matter. Am I tired? That doesn’t matter, either. Then willpower will be no problem.”

When we feel I matters less than we, or perhaps an abstract idea like ‘truth’ or ‘good’, then personal problems feel less important – or even a necessary part of the journey, like potholes on the road to an important destination.

There’s an obvious caveat here, though.

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Not all that shines is gold

Of course, a profound sense of transcendent meaning is one of the attractions of cults in which a sense of purpose is used as a tool to manipulate. The desire to ‘change the world’ and serve a ‘higher purpose’ than the self drove many Nazi youth members in 1930s Germany and Red Guard nationalist students in 1960s Maoist China. Both movements were widely destructive.

And yet just because a human drive can be misdirected doesn’t mean it isn’t valid. The same biological mechanism that glugs down neat gin also serves to keep us alive when we drink water.

As when we meet any primal human need, nature ‘rewards’ us by conferring benefits. A strong sense of meaning and purpose confers all kinds of mental¹ and physical² health benefits, even helping us live longer.³

So what of the opposite? What does a lack of a sense of meaningful living do to us?

Hopeless drudgery

Often our clients are aware of their depression. They know they feel bad but may not be really aware of a general sense of meaninglessness beneath the depression.

If a strong sense of depression is primarily a self-focused condition (and I describe it in this way not judgmentally but descriptively), it follows that living with a strong sense of meaning and purpose is a natural antidepressant.

Purpose in life entails a more active engagement with life and can help us cope with suffering because we are in the service of something greater than ourselves.

But when life starts to feel meaningless, every day might feel hard to get through.

One client described her life as being”stuck at sea in a sailboat with no wind at all and no change in scenery.” Another talked of the “hopeless drudgery” of day-to-day existence.

But the connection between depression and a sense of meaning may be a two-way street.

Depression may be in part caused by lack of a sense of meaning – and, in turn, rumination⁴ on that meaninglessness – but it may also make what once felt meaningful no longer feel significant.

We hear depressed people plaintively say such things as “I used to love my work, but even that doesn’t interest me anymore!”

But what determines what may feel meaningful to us in the first place?

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What does it mean to live meaningfully?

We are interested in and motivated by what feels meaningful to us. But the question remains: What is a meaningful life?

Paradoxically, trying to live more meaningfully because it will make us happier is still about serving the self rather than something other. We will only really benefit when we care less about how we can benefit and more about how we can deliver benefit to the meaningful focus of our lives.

In the Western world, religion as a focus of meaning has largely fallen away. So too, families all too often fragment and disperse like vaporous leaves in autumn. It may be that we are living in a meaninglessness epidemic of sorts.

Meaning may be found in work, family, friends, religion, politics; in development of the self in some way; in helping make the world a better place; in contributing.

It’s even been found that simply doing a manageable task, something you’re good at that has a beginning, middle, and end (like mowing the lawn, or baking a cake) has a measurable benefit for your sense of wellbeing.⁵ We have made a difference, however small, to the fabric of reality! This is one reason why behavioural therapy can be so powerful.

When we feel we are needed, that we have value and are helping the wider world, then a sense of meaning starts to flow and inhabit our very being.

When we see a sense of meaning as both an amplification of the self (that partakes of wider realities) but also a minimization of the self (that focuses narrowly on what is perceived as self-interest), then the following story as it relates to meaning makes sense.

The African Violet Queen

Once upon a time in the 1950s, Dr Milton Erickson paid a visit to a patient. She was a wealthy, unmarried woman with no children, residing alone in a vast inherited estate. Stricken by illness and confined to a wheelchair, she found herself sinking into the depths of despair.

Her days felt empty, purposeless, devoid of meaning. She pondered whether the world would even notice her absence considering her isolated existence. Once an active member of her church and community, she now shied away from attending services, feeling embarrassed by her wheelchair and reluctant to draw attention to herself. Perhaps, she contemplated, it was time to bid farewell permanently.

During Dr Erickson’s visit, as they roamed through her grand yet desolate home, they eventually reached the greenhouse where she tended to African violets, a challenging endeavour for the uninitiated. As she animatedly described her cultivation process, Dr Erickson observed a spark of vitality and fervour in her demeanour, a glimpse of her former self.

Having grown up on a farm, he recognized the dedication and skill required for such horticultural pursuits. In that moment, he saw a new path for her. With compassion and insight, Dr Erickson confronted her with a truth she hadn’t considered: She was neglecting her duty as a Christian! Despite her wealth and ample leisure time, she had yet to share her talents with the world.

Though it was undoubtedly a shocking way to address a woman of her stature in 1950s America, Erickson didn’t shy away from delivering his message. He offered her a simple yet profound directive: Compile a list of significant milestone events for your church community – births, deaths, and so forth. For each occasion, propagate one of your African violets, pot it thoughtfully, and have your chauffeur deliver it. She did as Erickson requested, and bit by bit the depression cracked and broke away.

Years later, upon her passing, the Milwaukee newspapers eulogized her as the beloved “African Violet Queen of Milwaukee”.

Her legacy was one not of isolation and self-pity but of warmth and generosity, illuminating the lives of many through her simple act of sharing, letting her “light shine brightly beyond the confines of her greenhouse” as Erickson himself put it.

Erickson had discerned that what she lacked, what she hungered for without knowing it, was… meaning.

So how can we help our clients find a greater sense of meaning and therefore purpose?

Step one: Ask them about their values

Meaning is tied to values. Something is only meaningful to us if we connect it to what we feel is important. If we value success and personal development, then the pursuit of success will feel meaningful to us.

Likewise, if we value health and fitness then eating well and working out will feel meaningful to us. Up to a point. But to try to make our lives solely about improving things for ourselves may, because we are social and perhaps spiritual creatures, naturally dry out a sense of meaning through the years. Being fit can feel extremely meaningful at 20, but less so at 40 (though still important!).

So what wider values does your client have? If they value kindness, then spreading kindness may feel purposeful. If discovery or societal improvement is a value, in what possible way might your client contribute to that?

You could present them with a list of values – knowledge, skills, community, friendships, education, family,and so on – and ask them to pick out the ones that are most meaningful to them. Ask how and why those values resonate with them, then work with them to discover ways in which they can begin to live those values more fully.

Along with values, we can ask clients about their passions – past and present – and also help to identify their strengths and talents which, when utilized optimally, will provide a greater sense of meaning.

After all, few things drain a sense of meaning faster than a sense that our talents are being wasted!

Next, we can work to recapture the actual sensation of greater meaning.

Step two: Ask them what has been meaningful and revivify it

I worked with one guy, Sam, who spoke wistfully of what it had felt like to start his business and see it grow 20 years earlier. How he had loved bringing on his whole team and seeing them benefit from the burgeoning business. Now life had grown stale. He was uncomfortably comfortable. Managers ran the business for him. He’d become bored and the ‘spark’ had gone.

I asked in detail about times when life had felt “shot through with meaning”. He described such times in detail. I then used hypnosis to regress him back to those times to really experience all those purposeful feelings, when it was easy to get out of bed and life felt like one big rich adventure.

He seemed to bloom and expand with positivity even as I sat with him. I further suggested during our hypnotic work that he was going to find something new which would give him a very powerful sense of meaning.

Three weeks later he told me he had started raising money for a children’s hospice. It was taking up a lot of time, but he loved it!

Sometimes remembering what meaning feels like can help us find meaning again.

And finally, we can remind our clients that no man or woman is an island.

Step three: Build connection

It’s almost a cliché to say that “money doesn’t buy happiness”. But it might be truer to say that if the pursuit of financial success can (and, for many, does) feel meaningful, then the wealth and success itself, once attained, can often start to feel meaningless.

An 85-year Harvard study found that relationships, not success and money, are what boosts our wellbeing and life satisfaction.⁶ And I suspect that this has more to do with a sense of deep meaning than anything else.

Consider this: A Gallup Poll carried out over 139 countries discovered that having given to a charitable cause in the previous month had a similar effect on happiness as a doubling of household income (and it’s certainly easier to do!).⁷

This held true not just for higher-income countries, where giving to charity is more affordable, but everywhere. And the correlation also existed for other forms of helping, such as volunteering and being helpful towards neighbours and colleagues.

I’m not suggesting you necessarily tell your clients to start giving to charity (after all, they may be very hard up for cash). In fact, I suspect doing something for others may enhance a sense of living meaningfully more than simply signing a cheque.

I’ve certainly asked clients to, alongside gratitude exercises, do three things for other people before their next session. For one man this meant going to the store for an elderly neighbour, volunteering at his kids’ school sports day, and simply helping an old man across a busy road.

Thanks to my directive, he started looking for ways to help others.

Now we often assume that connecting to other people means more socializing – going to parties and so on. But what bonds people together more deeply is mutual support. In fact, people tend to like us more when we let them help us, the so-called Ben Franklin effect.

Sharing is at the heart of intimacy: We share ideas, attitudes, and even our bodies with those we love.

Of course, depression can be complex, and just getting depressed clients to help others and make connections may not work as a sole therapeutic intervention, as it seemed to with the African Violet Queen. There may be many steps to take with our clients before life can feel at all meaningful for them.

But it’s also true that meaning comes through action, and action that helps lighten the load of others is profoundly meaningful.

A Framework to Lift Depression Quickly

It’s easy to become bogged down in the mire of a client’s depression. A framework for approaching depression treatment can be wonderfully empowering for both therapist and patient. Mark has developed this approach to depression treatment over more than 25 years’ practice. Read more about his online depression treatment course here.

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About Mark Tyrrell

Psychology is my passion. I've been a psychotherapist trainer since 1998, specializing in brief, solution focused approaches. I now teach practitioners all over the world via our online courses.

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