Meaning and Purpose in Life and the Implications for Long Term Recovery
“What gives your life meaning and purpose?” One might assume that this question would be asked in an introduction to an Existential philosophy class but would one be surprised to learn that this question was recently posed to a group of recovering individuals with co-occurring substance use disorders and severe forms of mental illness. This is a story about success and how finding meaning and purpose in life appears to be a factor in long term recovery for individuals regardless of diagnoses. As a therapist who works with individuals with co-occurring disorders, this author wanted to share her client’s stories with the hope that they inspire others, both clients and treatment providers, to believe that recovery is possible despite tremendous obstacles. Prior to a discussion of the relevance of finding meaning and purpose in life, however, the author wanted to introduce the individuals that made this story possible.
All of the individuals in this story are currently members of an out-patient therapy group located in a mid-Western city. The group is designed specifically for individuals who have been diagnosed with co-occurring disorders and whose goal, related to their substance use disorder, is abstinence. All of the clients are in either the action or maintenance stage of change, and the most commonly used substances were “crack” cocaine, alcohol, and marijuana. The majority of the clients have also been diagnosed with a mental health disorder and the most frequent diagnoses are Schizophrenia, Major Depressive Disorder, and Bipolar Disorder. A few of the clients also struggle with personality disordered traits and many are trauma survivors. Other relevant stressors include involvement with Child Protective Services and the criminal justice system, poverty, physical health concerns, lack of positive social supports, unsafe housing, and learning disabilities.
One might wonder why an exploration of meaning and purpose in life was pursued given the multitude of issues the clients in this story are struggling with, however, at this point in their treatment all of the group members have been able to remain abstinent, are stable psychiatrically, and are well versed in the “basics” of alcohol and drug treatment. The author, therefore, felt it was important to begin to address more complicated questions including what brings meaning and purpose to life when one is no longer actively using alcohol and drugs. The author has to admit that this was not a sudden inspiration on her part, but resulted after a lively group discussion prompted by a client who asked “why am I here when I am a mentally ill drug addict?” which the author found not only surprising but enlightening.
In order to begin the search for meaning and purpose in life the construct needed to be defined therefore the group members were asked what meaning and purpose in life meant to them. Responses included: “having purpose” (E.S.); “being constructive and creative – staying focused” (S.H.); “becoming a better person in the present than I was in the past – having direction and goals” (L.B.); “a human being, thoughtful, useful – striving to accomplish goals and striving to be successful” (J.W.); “trying to find success – something that has substance and makes you happy” (D.M.); “knowing how to live your life – doing things that count” (S.P.); and finally “never giving up – never giving in” (S.H.).The group members were also asked to describe what it would be like to have no meaning and purpose in life and reported that: “if I had no reason to go on it would be chaos – I may as well stay high 24-7” (E.S.); “no purpose equals no reason to live” (W.P); “without meaning I might lose focus – might make it difficult to stay focused – might have to deal with the consequences” (S.H.); “no meaning equals worthlessness – just exist with no purpose (J.W.); “no meaning would be futile, boring, sad” (D.M.); and finally “no meaning equals sadness” (S.P.).
The group members were also asked to describe what gives meaning and purpose to their lives. They were asked to think about what it is that gets them up and out of bed in the morning, and what are the people, places, and things they look forward to in the course of the day. They were also asked to think about how this might have changed since they stopped using alcohol and drugs. According to L.B., “I give thanks every morning to my higher power who I choose to be God… I know in my heart and soul that I am a survivor. I can’t undo what has already happened but I can look back on all the pain that I’ve endured and put others through and move forward with the help from above to healing and making wise and constructive changes in my life for the future.” L.B. also commented that her relationship with her family also gives her life meaning and purpose and that “I’ve made so many mistakes that caused me to lose them in the past… even though I still have a lot of bad situations with working things out to make things become better the good that comes from the bad helps me to be stronger and grateful. Today I am setting goals for the things I want and need in life and I’m striving hard every day to achieve them.”
W.P. contrasted meaning and purpose in life as a child with meaning and purpose in life as an adult and his hopes for the future. “As a child I didn’t ask my parents what was the purpose of life. My life purpose as a child just started to form or shape itself. I was running, playing, laughing so hard until I cry and then I would eat and go to sleep without a care in the world. Hoping and praying that this purpose would never end. But then I became a teenager and my feelings and thoughts changed and kicked in and said ‘hey’ put away all that foolishness, no more time for running, playing, laughing, and laying on your ass sleeping and eating. Can you see all those fine ‘honies’ out there? Here, try some weed, have a beer, drink some wine. Hoping and praying that this would never come to an end. Now that I have lived to become a man I have heard that they say once a child, twice a child. I hope that this is true so I can run again, play again, and laugh and cry again, and wake up in heaven where there will be no more tears and cares.”
J.W. discussed the importance of goals and how working towards his goals has allowed him to recover from his substance use disorder and his psychotic disorder. “Before I started my recovery for my multiple diagnoses as a drug addict and mentally ill person my life was merely an existence. I had no ‘strive’ to survive or do anything positive. I hurt persons that I knew loved me regardless of my faults. Living this way was mere hell so one day I joined a support group that dealt with both my addiction and mental illness. Now my life is beginning to make sense to me. I have the ‘strive’ to complete my goals. Life has purpose and direction. I am going places now.” S.H. discussed the importance of people and how positive social supports have helped him to stay clean and sober. “Sometimes when I wake up in the morning I have to push myself because I wake up too early. God, my group facilitator, and my group members, and music, and people I know that don’t use - this keeps me motivated… staying away from people, places, and things… I also take into account the fact that drugs can lead me to jails and institutions, and death. Going to church also helps me to stay clean and sober.”
R.S. commented that “the purpose in life is to achieve and succeed in a prosperous manner so that your loved ones, and others, can see that you are a pillar of the world. You bring meaning and understanding to how people can live drug free and be happy.” Another group member discussed how her life has changed since she stopped using and reported that “…I’ve lived just a little over 5 months sober and I’ve never felt better. I can go to bed with a clear head and I can wake up with a clear mind. Everything I set out to do gets done. My life is no longer put on hold for a habit I felt I had no control over. My biggest appreciation for life and sobriety today is that I can look back and not regret but be humble of not where I was but now where I am heading. I plan to work on my health, my education, and on ways to make my life even better.”
S.H. and L.B. also discussed how the activities and relationships that bring meaning and purpose to life have changed since they stopped using alcohol and drugs. S.H. commented that “people never brought meaning to my life because I was spending money on them and they used to trigger me so I just stayed away”. L.B. stated that “when I was using I never was able to set goals and see them through. I woke up every day and just lived my life making decisions and doing things on the spur of the moment… I had no meaning for life nor a purpose except to destroy everything that came close to assisting me… I had so many excuses for being a failure and things going wrong was everybody else’s fault but my own… I felt I couldn’t trust nobody – I was trapped in a cold, dark, lonely world and too ashamed to ask or believe that there was help for me or anybody out there that cared…I felt like God, the only one who could solve all my problems and fix me, had turned his back.”
In conclusion, it can be seen that the question “what brings meaning and purpose in life” appears to be relevant for many individuals regardless of diagnoses. Many of the clients in this story have been able to find meaning and purpose in life and this author believes that this has contributed to their recovery from both their substance use and mental health disorders. L.B. has been granted unsupervised visits with her daughter with the goal of reunification. It should be noted that when we first started working together, Child Protective Services was considering termination of her parental rights. W.P. has recently joined a local “club” that is designed specifically for individuals with a mental illness. He is currently exploring different vocational and educational opportunities. As a result of W.P.’s decision to join the club, D.M. recently toured the facility and has “taken off her running shoes.” D.M. has found that in the past she tended to “run” from her problems which frequently led to relapse. J.W. completed the registration process at a local university despite his “economizing nature” and is scheduled to start classes in the fall. E.S. continues to work part time and has been able to make more positive decisions related to his interpersonal relationships which have been a frequent source of extreme distress. S.H. has begun to “come out of his shell” as witnessed by E.S. who recently observed him “flirting” with a woman at the local mall. S.H. has been spending more time in the community involved in positive activities and relationships and has also been attending church on a regular basis. S.P. recently celebrated a year of sobriety and has been able to avoid further legal problems.
One of the group members had recently asked “what do we need to do to graduate from the program” and the author responded by stating that “you need to find something that brings meaning and purpose to your life other than alcohol and drugs.” As the group members began to identify the activities and relationships that are currently bringing meaning and purpose to their lives the author was gently reminded that it is time for several of the members to leave what many of them describe as their “safe” place. Prior to their departure, however, and in honor of Recovery Month this author wanted to share their stories. The author also wanted to say “thank you” to all of the individuals that made this story possible. Their success inspires this author on a daily basis to remain involved in an activity that brings meaning and purpose to her life.