7 - (3-MIN 2) When Meanings Collide at the End of Life: A Process-based Perspective

People approaching the end of life often experience a psychological paradox: fear of dying may coexist with comforting meanings such as reunion with loved ones, spiritual continuation, or a sense of moral completion. These meanings often arise from different sources and do not always function smoothly together, creating a distinctive form of psychological tension near the end of life.

Clinical and cognitive-behavioral approaches frequently focus on individual beliefs or emotional responses. While this is effective in many contexts, it offers limited guidance when multiple meanings operate simultaneously within the same person. In such situations, distress may be less about the content of any single belief and more about whether these meanings can temporarily work together in a psychologically usable way.

This presentation introduces a process-based perspective that shifts attention from belief content to meaning integration under existential threat. The concept of cultural-system coherence is used to describe the degree to which a person’s assembled meanings can function as an emotionally tolerable and stabilizing system. This perspective helps clarify how end-of-life distress may be better understood—and clinically formulated—by focusing on the organization and functioning of multiple meanings rather than attempting to resolve them one by one.