Meaning Centered Coaching for Chronic Illness

How to rebuild purpose, steadiness, and self-trust when your life and health have changed

There is a particular kind of grief that comes with chronic illness.

Not just grief for what hurts, or what changed, or what you can’t do on certain days.

But grief for the sense of continuity.

The feeling that your life used to make sense in a straightforward way, and now it requires constant renegotiation.

You become someone who calculates everything.

How much energy will this take? Will I pay for it later? Is this a “push through” day or a “protect the baseline” day? Do I tell them the truth about how I’m doing, or keep it simple?

Even on good days, illness can pull your attention toward maintenance. Symptoms. schedules. limitations. decisions. survival.

And somewhere inside that, a quieter question often rises:

Who am I now? What is my life about now? How do I live in a way that still feels like me?

Meaning-Centered Coaching is one of the ways I help people answer those questions.

What Meaning-Centered Coaching is (and isn’t)

Meaning-Centered Coaching is a coaching adaptation inspired by Meaning-Centered Psychotherapy (MCP), an evidence-informed approach developed to support meaning, purpose, and spiritual well-being in the face of serious illness and major life disruption. It is rooted in Viktor Frankl’s work on meaning-making and the human capacity to choose our stance toward suffering.

In coaching, we use this framework in a practical, lived way.

No philosophy lecture. No “find the silver lining” exercise. No pressure to be positive.

Meaning-Centered Coaching is about widening the lens.

It helps you notice:

• what still matters to you

• where you still have choice

• what kind of life you want to build inside the reality you did not choose

This is not about denying what’s hard. It is about giving you steadier ground to stand on while it is hard.

Why meaning matters when you live with chronic illness

Chronic illness can shrink life in ways that are hard to explain to people who haven’t lived it.

It can shrink your calendar. Your social world. Your spontaneity. Your sense of certainty.

And if you’re not careful, it can slowly shrink your identity.

Suddenly you are “the person who cancels.” “The person who is tired.” “The person who can’t commit.” “The person with the condition.”

Even when you are doing your absolute best.

Meaning work is a way of reclaiming identity without pretending the illness isn’t real.

It helps you hold two truths at once:

This is hard. And my life can still be mine.

That “both/and” matters.

Because thriving with chronic illness is not about eliminating struggle.It is about building enough inner steadiness, support, and clarity that struggle does not become the whole story.

The four sources of meaning

Meaning-Centered Coaching uses four “sources of meaning” as pathways: Historical, Attitudinal, Creative, and Experiential. 

You can think of these as four doors you can walk through when you feel stuck, discouraged, or disconnected from your own life.

You do not have to use all four at once. In fact, it often works best to focus on one for a few weeks at a time.

Below, I’ll walk through each source with simple explanations and real-life examples.

1) Historical meaning: your life story and your through-line

Historical meaning is the meaning you create by connecting to your story: the life you have lived, what you’ve carried, what you’ve learned, and what you want your life to stand for over time.

Chronic illness often creates a sharp “before” and “after.” It can feel like you became someone else overnight.

Historical meaning helps stitch continuity back together.

It’s not about romanticizing your hardship. It’s about naming the truth of who you have been, who you still are, and what has remained steady inside you.

Coaching might sound like:

• mapping the chapters of your life (pre-illness, diagnosis, major flare, turning points)

• naming the strengths you learned in each chapter

• identifying the values that have remained true across seasons

  
  

Example: Maybe you used to define yourself by productivity and reliability. Illness disrupted that. Historical meaning helps you ask: What else has always been true about me? Perhaps you have always been someone who cares deeply. Someone who adapts. Someone who keeps showing up, even when it costs you.

That matters.

Because your life is more than what your body can do on a given day.

Try this reflection:

• What is one sentence that links your past self and current self?

  (Example: “I have always found a way to care deeply, even when I’m tired.”)

2) Attitudinal meaning: your stance, agency, and inner freedom

Attitudinal meaning is the meaning you create through the stance you choose toward what you cannot fully control.

This is the one that can get misunderstood.

It is not: “Just be grateful.” It is not: “Everything happens for a reason.” It is not: “Mindset your way out of it.”

Attitudinal meaning is much more grounded than that.

It’s the practice of separating:

• what is happening to you

  from

• who you are

• 
  

It’s the practice of finding the places where you still have choice, even if the choices are small.

Because chronic illness can reduce external control. Attitudinal meaning strengthens internal control.

Coaching might look like:

• identifying what is out of your control, partly in your control, and in your control today

• setting boundaries that protect your health

• noticing the harsh inner narrator and practicing a kinder, more accurate alternative

  
  

Example: You might not be able to control a flare. But you can choose how you speak to yourself inside the flare.

You can choose to shift from: “I’m falling behind again” to: “My body is asking for care, and I can respond with steadiness.”

That does not fix symptoms. But it changes the emotional ground you are standing on.

Try this reflection:

• Where do I still have choice today, even if it’s small?

  
  

3) Creative meaning: values in action, within real capacity

Creative meaning is the meaning you create through what you do and choose: the life you actively build, the relationships you nurture, the responsibilities you accept within your capacity.

Chronic illness often forces intention.

You cannot “accidentally” live well when your body requires pacing, rest, and care. You have to design a life that fits your energy instead of constantly grieving the life you think you should be living.

Creative meaning helps you translate values into doable commitments.

Not lofty goals. Not a reinvention project. Just practical alignment.

Coaching might look like:

• choosing 2–3 core values and brainstorming low-energy and medium-energy ways to live them

• creating routines that protect your baseline (sleep, meals, movement, rest)

• building a “yes list” and “no list” that reflects your capacity

  
  

Example: If one of your values is connection, you may not be able to do long social outings. But you might be able to send voice notes, schedule a short walk, or attend a low-pressure support group.

Creative meaning says: Let’s build the version of connection your body can tolerate.

Try this reflection:

• What would a “good day” look like if it were designed around my current capacity?

  
  

4) Experiential meaning: connection, love, beauty, humor, the senses

Experiential meaning is the meaning you receive through experiencing life: connection, beauty, awe, humor, spirituality, sensory presence.

This source matters so much for chronic illness because there are seasons where “doing” shrinks.

During flares, fatigue, medication changes, or grief-heavy periods, your output may drop.

But your ability to receive can still exist, even in small doses.

Experiential meaning helps restore aliveness.

Not through achievement. Through moments.

A warm mug. Your dog’s head on your lap. Music that makes your shoulders drop. A funny video that breaks the heaviness for thirty seconds. Sunlight on the floor.

These moments are not trivial.

They are often how people survive.

Coaching might look like:

• building a “connection menu” of low-demand ways to feel less alone

• practicing sensory grounding to reduce overwhelm

• creating a tiny library of beauty and humor to lean on when your nervous system is overloaded

  
  

Try this reflection:

• What reliably helps me feel connected to life, even briefly? 

How this looks in real coaching

Meaning-Centered Coaching is not just journaling. It is not just talking.

It is a structured way to build steadiness over time.

A typical approach might look like this:

• Pick one source of meaning to focus on for 2–4 weeks

• Choose 1–2 reflection questions to explore

• Choose one micro-practice that fits your real energy

• Revisit and adjust after flares, transitions, or capacity shifts

  
  

And through all of it, we work with the reality that chronic illness brings:

• energy is not consistent

• motivation is not the issue

• pacing is not giving up

• support needs to be sustainable

  
  

Meaning work is not a performance. It’s a relationship with your own life.

If you’re not sure which source you need, start here

When people feel stuck, one of these tends to be true:

• You feel like you lost yourself

  Start with Historical meaning

  
  

• You feel overwhelmed, ashamed, or trapped

  Start with Attitudinal meaning

  
  

• You feel like your life is misaligned or unsustainable

  Start with Creative meaning

  
  

• You feel disconnected from joy or aliveness

  Start with Experiential meaning

  
  

And if you are in a season where everything feels like too much, that matters too.

Sometimes the most meaningful starting point is simply: one small moment of gentleness. 

A gentle reflection

If chronic illness has been asking you to rebuild your life in a new way, consider this:

What do you want your life to stand for in this season, given what your energy allows?

You do not have to answer perfectly. You just have to begin.

Want support applying this framework to your real life?

If you want help exploring these sources of meaning in a way that feels practical, grounded, and sustainable, I offer one-on-one coaching through Tenacious Wellness Coaching.

You do not need to be “ready.” You do not need to have it figured out. You just need a willingness to start where you are.

A free Discovery Call is available if you want a calm space to talk it through and see if coaching feels like a fit.

Book Discovery Call

Friendly note

Meaning-Centered Coaching is coaching, not psychotherapy, and is not a substitute for medical or mental health care. If you are in crisis, actively suicidal, or experiencing severe depression or anxiety, please seek professional support.

Sources:

· Applebaum, A. J. Stand By Me: A Guide to Navigating Modern, Meaningful Caregiving. (Referenced for language and interpretation of the sources of meaning.)

· Breitbart, W. and colleagues (Memorial Sloan Kettering Cancer Center). Meaning-Centered Psychotherapy / Meaning-Centered Group Psychotherapy: development and overview (various publications and manuals).

· Thomas, L. P. M. et al. “Meaning-Centered Psychotherapy.” 2014 (overview article; notes MCP’s grounding in Viktor Frankl).

· Lichtenthal, W. G. et al. “Meaning-Centered Psychotherapy and Cancer.” 2020 (describes sources of meaning as historical, attitudinal, creative, experiential).

· Applebaum, A. J. et al. “Meaning-Centered Psychotherapy for Cancer Caregivers (MCP-C).” 2015 (explicitly lists the four sources of meaning).