Experiencing pain not only affects patients’ biopsychosocial functioning but also the existential domain. Attention to the existential, in addition to the biopsychosocial domains, might thus be important in chronic pain care. Therefore, we investigated: (a) how satisfied patients were with the attention of their practitioners to the impact of pain on biological, psychological, social, and existential life domains, and (b) how satisfaction with each domain was related to patient functioning. Pain patients (N = 163) were questioned on their satisfaction with the attention of their practitioners to biological, psychological, social, and existential life domains, and on pain intensity, pain disability, life satisfaction, and depressive symptoms. Patients reported low satisfaction with the attention of their practitioners to the social and existential domains. Satisfaction with each domain was negatively related with pain intensity, pain disability, and depressive symptoms and positively related with life satisfaction. Only satisfaction with the existential domain was able to predict all functional outcomes above and beyond all other satisfaction variables modeled simultaneously. Patients reported not feeling satisfied with the attention to the social and existential life domains. Furthermore, practitioners’ attention to the existential domain seems highly important for patient functioning. Openness to existential concerns of pain patients might thus be an important aspect of chronic pain care.

Making sense of our existence is one of the most demanding aspects of being human. Studies have shown that meaning is robustly associated with well-being and mental health. In this study with 358 Dutch-speaking participants during the covid-19 pandemic, we tested if the practice of contacting one’s felt sense (focusing attitude) would predict life satisfaction, psychological distress, and existential anxiety. We also tested whether the effect of this focusing attitude would be partially mediated by the experience of meaning in life. Our hypotheses were confirmed. This suggests that the focusing attitude predicts more life satisfaction, less psychological distress, and less existential anxiety. The associations are also partially mediated by the experience of meaning in life. Focusing training variables suggested that attending one’s felt sense can be learned. However, our study also suggests that focusing-partnership deserves closer study.

Although probably all psychotherapists and counselors care for the lives of their clients, not every therapist is invested in helping their clients make sense of their existence. Departing from the question if clients are actually bringing their existential concerns to therapy, studies actually show that a significant proportion of clients brings their ultimate concerns to the consultation room. However, therapists do not always feel comfortable with the existential concerns of their clients. Therapists seem to underestimate their clients’ existential needs. Furthermore, therapists and counselors report that the existential concerns of clients can be overwhelming and evoke an existential quest in therapists. Existential empathy, or the capacity to resonate with the client’s existential concerns and to communicate this empathy, could be enlarged in therapists in order to help clients find different avenues to be with their human condition. Inspired by Tillich, Rank, and Rogers, grounding in ‘being’ is suggested to help therapists being fully present with the clients’ ultimate concerns.

Incarceration has been described as a distressing experience, marked by important losses and accompanied by deep existential crises. Some prisoners “hit rock bottom” and are confronted with the fact that their life does not make sense anymore. Surprisingly, loss of meaning among prisoners has not been studied in a quantitative way before. In this study, we explored the relationship between loss of meaning inflicted by incarceration and distress. In a sample of 365 prisoners, univariate analyses and hierarchical multiple regression analyses confirmed that a loss of meaning positively predicted distress in prison. Differences between prison regimes predicted distress, but had no influence on the loss of meaning. Unsentenced incarceration, in contrast, did not have a direct relationship to distress, but amplified the effect of loss of meaning on distress. Psychotherapy and chaplain support did not affect the relationship between loss of meaning and distress during incarceration.

Meaning in life and searching for meaning are central in how people organize their lives and deal with various challenges during them. Studies on meaning and the search for meaning among prisoners are virtually nonexistent. Based on the presence of meaning in their lives and on their search for meaning, we discovered four different profiles in a sample of 365 prisoners: High Presence High Search, High Presence Low Search, Low Presence High Search, and Low Presence Low Search. Compared to prisoners with low meaning profiles, those whose profiles were marked by higher levels of meaning displayed less distress, more positive world assumptions, and higher levels of self-worth. They also show more empathy for others. Older prisoners and prisoners who were sexually abused during childhood were more represented in the profile that was marked by extremely low levels of meaning and low levels of search for meaning.