Alla Lapshevskaya (Latvia), Natalya Ivanova (Latvia) The living power of meaning (afterword to a research project)

In the course of work at a volunteer project of psychological rehabilitation of people after blood stroke it seemed important to help the participants of the project become the subjects of their own rehabilitation. Therefore we undertook a research into personal meaning of responsibility for one’s health before and after a blood stroke with the aim to analyse not only personal meanings themselves but also their nature, the processes of their generation and transformation and the conditions that may advance or hinder the process.

Our respondents were the participants of a rehabilitation project at the Vigor society (“life force” or “life energy” in Latin). We applied the methodology of phenomenological analysis in order to study the personal sense of responsibility for their health as experienced by the people who had a blood stroke, comparing the data before the blood stroke and during the period of rehabilitation.

The quest for meaning is one of the most important human needs. Satisfying this need depends on the person’s ability to be responsible for his or her choices, actions, fulfilment of his or her goals and, ultimately, life. Following Leontyev, we define personal meaning as experience of meaningfulness bestowed on certain objects, situations, actions and events, which reflects the person’s understanding of them, of their role and place in the person’s life (Leontyev, 1977).

By telling about their experience of rehabilitation and by reflecting on this experience, our respondents discovered their personal meanings of their choices and of the actions associated with regaining their abilities, which gave and continues to give them vitality and self-confidence to get on with their life and persevere in their daily exercises for regaining and maintaining health. It was important for them to voice and to become aware of their personal life meanings and notions of their responsibility for regaining and maintaining their health as the content of their personal values.

Each participant of the study discovered his or her central meaning that guided his or her behaviour associated with regaining and maintaining health.

After a blood stroke, a person often becomes confused regarding his or her own image and feels lost and depressed. During this period, characterized by loss of stability in life, the person is facing a challenge to his or her own self, which makes him or her reconsider and revalue many things. Following a blood stroke, a person seems to lose the track and sense of direction of his or her life. However, there is no longer an imperative to make everything in the ‘right’, socially acceptable way, what matters is that everything should be true (Ivanova, 2009).

According to Emmy van Deurzen, such a situation gives the person a chance to arrive at an authentic way of life (van Deurzen, 2001). It is the movement from helplessness to genuine mastery over life. In this case, the meaning of life becomes the determining factor.

Blood stroke is a turning point in one’s life, and it means some considerable and inevitable changes. The choice he or she makes at this stage determines the subsequent development. A person’s ability to make active and conscious choices cannot be activated without activating meanings and values: the person must realize what he or she wants to do and can do, as well as who he or she is (Rubinstein, 2002).

For our respondents, personal sense of responsibility over one’s health was and is manifested in the fact that they considered and performed their activities in rehabilitation independently, acting on their own initiative, and they viewed their goal as a personal one, showing will power in overcoming difficulties.

In telling their stories, the participants commented on important objective conditions, which enabled their physical and psychological rehabilitation and which simultaneously determined their positive dynamics of personal sense of responsibility for their health after a blood stroke. First of all, they spoke about the support and help their received from their family and professional specialists, who helped them overcome their helplessness and reinforced the participant’s spiritual well-being through their belief and care, which unlocked the participants’ inner resources necessary for rehabilitation.

Among subjective conditions that advanced the productive dynamics of personal sense of responsibility for one’s health, the participants highlighted their experience of achieving the first positive results. This experience is characterised by joy, exultation at overcoming their helplessness and, for them, it becomes the source of believing in one’s power to overcome the consequences of blood stroke as well as being the source of responsibility for rehabilitation.

What were the resources that supported our respondents in their trials during the period of rehabilitation, as they discovered new senses of their rehabilitation? According to them, these were insistence and determination, the sense of humour and optimism, responsibility for their family and for themselves, as well as their ability to see the events as a whole and to acknowledge the positive and negative aspects of the situation. Also essential was the ability to rejoice at small things, to value what they already have, to maintain interest in life and in other people.

The search for and the discovery of new personal meanings that motivate the respondent to act in order to regain and maintain his or her health is another condition of rehabilitation after a stroke. The need to find the meaning of one’s rehabilitation and the meaning of life in general after a stroke is transformed into the need to be responsible for the present events: one needs to live to the full and to create one’s life in one’s own way (Muzdybayev, 2010). Moreover, the search for meaning is important for successful adaptation to a crisis or disability (Dorozhevets, 1998).

Productive dynamics of personal meaning of responsibility for one’s health was common for all our participants: it is the understanding of the meaningful relationship between one’s activities aimed at rehabilitation and the results of these actions (Leontyev, 2003).

Meanings emerge out of the person’s realization of his or her inability to fulfil his needs in life, making him or her look for alternative meanings or ‘construct’ these meanings in order to renew one’s active life and to acquire motivation for regaining and maintaining one’s health (Vasilyuk, 1984). Experiencing the inability to fulfil one’s needs, the respondent has to look for alternatives actively, but these alternatives must be meaningful for him or her.