Finding and Pursuing Purpose:

A Path to Better Health

In one of her most famous lines, poet Mary Oliver asks "What is it you plan to do with your one wild and precious life?" We know intuitively, maybe even viscerally, that pursuing something we care deeply about is vitally important to our existence.

A strong connection to one’s purpose means that most days a person feels that they are working towards their life’s direction and goal.

❀

Quick Takes

🎯 Purpose = Health Protection People with a strong sense of purpose have better health outcomes. A strong sense of purpose isn't just feel-good psychology—it's protective medicine.

🧠 Reflecting on our purpose does this by lowering cortisol Brain studies show that thinking about purpose activates parts of the brain that ultimately reduce cortisol levels in a healthy way.

🧓🏼 Aging: an opportunity to become happier Typical concerns as we age can shift from pleasure in the here and now to questions about our legacy and the meaning of our life. This shift to eudaimonic concerns typically brings increased happiness and well-being.

📓 We can enhance our connection to our life’s purpose by using a narrative program to reflect on our life. This is likely to improve happiness and well-being, and potentially our immune system and longevity.

Favorite Finds

🌐 Mindfulness Resources for Purpose Clarity

• 8-Week MBSR Program: Combines relaxation, meditation, gentle yoga, and daily practice

• Ziva Online: https://zivameditation.com/pages/online

📓 Best narrative options:


• Birren's Telling the Stories of Life through Guided Autobiography Groups contains "insightful and sensitive prompts" that focus on major life themes including "spiritual life and values" and "goals and aspirations." This is the research-based original that focuses on deep reflection and meaning-making.

• Maybe: This Is My Life: A Guided Journal by Kristen Fogle. I have not looked at this one, and it intuitively appeals less to me but I’ll let you be the judge.

🖥️ Lifebook: While I object to how this program is presented, I must admit that it was a turning point for me. By prompting detailed reflection on “premise,” vision, purpose, and strategy, it really leads us to discover how we want to live life along each of 12 different dimensions.

Recent Podcast: Hidden Brain: “What Is Your Life For?” Outstanding interview with Victor Strecher, PhD, MPH, a public health researcher focused on purpose, who tells his gripping personal story.

Values Reflection Questions:

• What do my actions say about what I believe

• Is there a mismatch with what I truly believe?

• How do I modify my actions to align with my beliefs?
  

Purpose and Authenticity Workbook

• Authenticity Scale self-assessment

• Purpose Discovery Exercise

• Daily Purpose Tracking Tool

Deep Dive: The Science of Purpose-Driven Health

In one of her most famous poems, Mary Oliver asks "What is it you plan to do with your one wild and precious life?" Khalil Gibran puts it even more succinctly: “Your work is your love made visible.”

We have long known that pursuing our purpose in life confers important health and even survival advantages. We hear of the person who worked so hard all his life but unfortunately died within months of retiring, suddenly finding himself with nothing to do all day. Our society is especially focused on what we “do.” A most common question we ask upon meeting a person for the first time is: ”What do you do for work?"

In life coaching classes, the first question coaching students learn to ask is: "What do you want?" It can be quite difficult to fully answer that question. It asks us to reflect on what we most deeply care about.

Health Benefits: Chicken or the Egg?

Having and pursuing a purpose is associated with better mood, energy, and overall health (Boreham and Shutte, 2023). A strong sense of purpose is associated with markers of longevity as measured by epigenetic clocks (Kim et al, 2013), and a healthier immune system as measured by white blood cell counts, CRP, and inflammatory cytokines (Sutin et al, 2023).

But what does this association reflect? Is it that good health allows a person to focus on a purpose, or is it that the passionate pursuit of a purpose somehow engenders good health?

Recent research begins to answer this question.

Benefits are specific, not general

The Health and Retirement Study enrolled almost 13,000 participants and showed that when comparing subjects whose sense of purpose strengthened the most through the study period to those whose sense of purpose was the weakest, positive change in purpose over time was associated with:

• 46% reduced risk of death

• 23% lower stroke risk

• 43% less depression

Notably, there was no association between purpose and a range of other physical health outcomes including diabetes, hypertension, cancer, heart disease, arthritis, overweight/obesity, or chronic pain. So it’s not simply that the healthiest people have the best ability to determine and pursue their purpose. A sense of purpose apparently acts through specific physical channels, for example benefiting mental health and stroke more than it benefits diabetes and cancer.

In part, this effect is mediated by better health practices. However, cancer, diabetes, and weight are also related to health habits, so it's not obvious how finding and pursuing purpose is able to affect some but not other health outcomes.

Thinking about purpose alters brain function and cortisol levels

Studies using fMRI show that an area of the brain called the ventro-medial prefrontal cortex (vmPFC) is activated when a person contemplates aspects of their identity and purpose (D’Argenbeau, 2013).

The desire to contribute to future generations (called “generativity”) is associated with more communication between the vmPFC and other prefrontal cortex regions (Walker et al., 2023). The importance of these connections is that they help us:


• Maintain perspective during stressful situations

• Regulate emotional responses more effectively

• Make decisions aligned with deeper values rather than immediate impulses

The vmPFC exerts an inhibitory effect on the amygdala, which reduces negative feelings and emotional reactivity. This also regulates cortisol secretion, improving the pattern by reducing cortisol appropriately as the day progresses (Urry et al, 2006).

The amygdala is the brain's threat detection center. When it's less active, this indicates:

• Lower perceived threat from life's challenges

• Reduced fight-or-flight response activation

• Less activation of the stress hormone cascade

Those who stay connected to their life’s purpose are able to generate more positive emotion and less internal stress in response to life’s challenges, large and small.

Since focus on purpose is a cause of health, can we strengthen it?

Multiple intervention studies have aimed at increasing a sense of purpose. They range from mindfulness techniques, to psycho-educational, prosocial (promoting altruistic helping behavior), spiritual reminiscence, and narrative programs. The latter, which involves individuals reviewing and writing about their lives to achieve a sense of peace or empowerment, have been found to be the most impactful in improving positive affect and decreasing negative affect (Manco and Hamby, 2021).

Narrative interventions likely improve immune functioning in cancer patients, though effect sizes are modest (Tong, et al., 2014). Nevertheless, certain types of psychosocial interventions have been shown to reduce cortisol for example in patients with breast cancer (Mészáros Crow, et al, 2023).

Interventions combining cognitive behavioral plus mindfulness approaches (though not necessarily the best at improving focus on life purpose) change gut bacteria and the immune system in people with Crohn’s disease (Ilan et al, 2024).

❁

Aging benefits us by helping shift our attention

In conclusion, health and well-being are significantly enhanced by one’s connection to one’s life purpose. Sheldon and Kasser have studied people of different ages and concluded that older people are more likely to have generativity-related goals and fewer in the domains of identity and intimacy (Sheldon and Kasser, 2001).

This reflects Erikson's developmental stages–older adults naturally transition from:

• Identity (adolescence/young adulthood): "Who am I?"

• Intimacy (young adulthood): "Can I love and be loved?"

To:

• Generativity (middle/later adulthood): "How can I contribute and leave a legacy?"

• Ego Integrity (late life): "Was my life meaningful and worthwhile?"

This developmental shift may explain why narrative life review is so powerful for older adults:

• Natural developmental drive: The brain is literally shifting toward meaning-making and legacy concerns

• Reduced identity conflict: Less need for the conflict-processing regions of the brain because core identity questions are largely resolved

• Enhanced purpose: Greater focus on generative activities that feel deeply meaningful

• Stress reduction: Less existential anxiety about "who am I" and more clarity about "what I've contributed"

The narrative approaches tap directly into the developmental shift from “hedonic” (What feels good right now?) to eudaimonic (What gives my life deep significance?) by helping people:

• Integrate their life story (ego integrity)

• Identify their contributions (generativity)

• Find meaning in their experiences (eudaimonic well-being)

• Share wisdom with others (generative legacy)

Examples of narrative programs were listed in the Favorite Finds section, and include books by James Birren and a program teaching people to lead narrative writing groups (Birren method).

REFERENCES

Boreham ID, Schutte NS. The relationship between purpose in life and depression and anxiety: A meta-analysis. J Clin Psychol. 2023

Fisher GG, Ryan LH. Overview of the Health and Retirement Study and Introduction to the Special Issue. Work Aging Retire. 2018

Sheldon KM, Kasser T. Coherence and congruence: two aspects of personality integration. J Pers Soc Psychol. 1995

Sheldon KM, Kasser T. Getting older, getting better? Personal strivings and psychological maturity across the life span. Dev Psychol. 2001

Wood, A. M., Linley, P. A., Maltby, J., Baliousis, M., & Joseph, S. (2008). The authentic personality: A theoretical and empirical conceptualization and the development of the Authenticity Scale. Journal of Counseling Psychology, 55(3), 385–399

Kim ES, Nakamura JS, Strecher VJ, Cole SW. Reduced Epigenetic Age in Older Adults With High Sense of Purpose in Life. J Gerontol A Biol Sci Med Sci. 2023

Sutin AR, Stephan Y, Luchetti M, Terracciano A. Purpose in life and markers of immunity and inflammation: Testing pathways of episodic memory. J Psychosom Res. 2023

Urry HL, van Reekum CM, Johnstone T, Kalin NH, Thurow ME, Schaefer HS, Jackson CA, Frye CJ, Greischar LL, Alexander AL, Davidson RJ. Amygdala and ventromedial prefrontal cortex are inversely coupled during regulation of negative affect and predict the diurnal pattern of cortisol secretion among older adults. J Neurosci. 2006

Walker CS, Li L, Baracchini G, Tremblay-Mercier J, Spreng RN; PREVENT-AD Research Group; Geddes MR. The influence of generativity on purpose in life is mediated by social support and moderated by prefrontal functional connectivity in at-risk older adults. bioRxiv [Preprint]. 2023

D'Argembeau A. On the role of the ventromedial prefrontal cortex in self-processing: the valuation hypothesis. Front Hum Neurosci. 2013

Manco N, Hamby S. A Meta-Analytic Review of Interventions That Promote Meaning in Life. Am J Health Promot. 2021

Tong G, Geng Q, Cheng J, Chai J, Xia Y, Feng R, Zhang L, Wang D. Effects of psycho-behavioral interventions on immune functioning in cancer patients: a systematic review. J Cancer Res Clin Oncol. 2014

Mészáros Crow E, López-Gigosos R, Mariscal-López E, Agredano-Sanchez M, García-Casares N, Mariscal A, Gutiérrez-Bedmar M. Psychosocial interventions reduce cortisol in breast cancer patients: systematic review and meta-analysis. Front Psychol. 2023

Ilan K et al on behalf of the Israeli IBD nucleus. Cognitive behavioral and mindfulness with daily exercise intervention is associated with changes in intestinal microbial taxa and systemic inflammation in patients with Crohn's disease. Gut Microbes. 2024