Giving meaning by patients with a life-threatening disease. A study in the Netherlands to determine differences and similarities in the experience of contingence and personal goal striving by Muslims, Christians and people who interpret life in nonreligious ways.

People may suddenly be stricken by an event that shakes the very foundation of
their lives. Learning that they suffer from a life-threatening disease can have
such an impact to a greater or lesser extent. Such an unforeseen event is
called an experience of contingence. In philosophy a contingent event is
defined as *possible but not necessary* (Dalphert 2003; Dalphert & Stoellger
2000; Esterbauer 1989). Because the event need not have happened at all, it
makes a person ask why it happened and, more particularly, why did it have to
be me?
To fit an experience of radical contingence into one*s life story and make it
meaningful one has to reconstruct one*s image of past and future. To this end
patients invoke the interpretive system that they developed in the course of
their lives.
In this study an interpretive system is described in terms of *ultimate
concerns*, a term derived from Tillich (1957, 1963). The things people find
important and meaningful in their personal experience in interaction with the
environment, religion and culture are imprinted on memory in the form of a
concern. Concerns may be seen as imprints on memory that, when prompted,
activate emotions and thoughts that call to mind goals and motivate the person
to act (Emmons, 1999, 2005; Frijda, 2007). Ultimate concerns, which rank
highest among these, integrate lesser, sometimes conflicting concerns and
constitute a kind of golden thread, an existential theme (Emmons 1999, 2005;
McAdams 1993). Ultimate concerns are expressed in goals that cannot be achieved
immediately, if ever, such as *ensuring that my children will grow up to be
happy*, *contributing to a just society* or *living according to God*s will*.
Such personally chosen, supreme goals enable people to live coherently and
meaningfully. Because ultimate concerns come to life when the precious thing
that they embody is threatened - thus triggering emotions and thoughts - they
affect the experience of a contingent event.

The research objective is to build a new theory of the biographical
reconstruction process among people suffering from a life-threatening disease,
focused on giving meaning and based on contingence theory and motivation
theory.

Explanatory note:
*Biographical reconstruction process* indicates people*s reorientation to
their past, present and future.
Contingence theory can be used to study various aspects of events (including
illness) and how people experience them.
Motivation theory can be used to study the personal goals people pursue in
their lives and the ultimate values in which these are grounded.

The study uses semi-structured interviews. Various techniques are used to
explore the sources (respondents outline their lives* ups and downs, select
from lists of experienced emotions, pick cards with words reflecting their
experience, and substantiate their choice).
Interviews are conducted by trained interviewers.
The interviews are recorded anonymously and transcribed.
Analysis is done by way of a Grounded Theory computer program (Kwalitan) and
SPSS.

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