9. The Four Ultimate Concerns

How might cognitive distortions lead to blocks in finding meaning, connection, freedom and quality of life?

4 Ultimate Concerns– On Meaning, Connection, Freedom, Mortality

Finding balance between meaning and meaninglessness, connection and isolation, freedom/free will and oppression/repression, and life and death may be Joy

How are your cognitive distortions and self-defeating beliefs affecting your ability to find balance?

(2026): "A growing body of clinical research is naming a kind of psychological suffering that the diagnostic manual cannot. It is often called existential distress, meaning-related or existential suffering, or simply an existential crisis. Whatever the label, the phenomenon is increasingly understood as a distinct concern rather than a variant of depression or anxiety."

Existential psychological therapies: An overview of empirical research Thérapies existentielles : une revue de la recherche empirique (Vos, 2023) https://www.sciencedirect.com/science/article/abs/pii/S1269176323000469

A large body of empirical literature supports the key therapeutic existential concepts, competences, and outcomes. The discussion compares this literature with other therapies, showing that existential therapies have similarly strong empirical support.

(2024): "Existential psychotherapy has evolved out of an appreciation for how concepts fundamental to existential philosophy can help relieve human suffering. ...the primary focus is on empowering the client to develop a greater tolerance for suffering, while also encouraging a deeper experiential engagement with existence. This is accomplished within the bounds of a personal and sustaining therapeutic relationship that is designed to bolster clients in their efforts to change."

The researchers ... found that coherence had the strongest negative correlation with depression. Coherence refers to an individual’s ability to make logical sense of their experiences and fit them into a systematic worldview. People who easily integrated both pleasant and terrible events into their life story showed the lowest depression levels.

Existential hypnotherapy for ADHD: A novel approach to authenticity-based treatment (2026) "address not only symptom reduction but also the lived experience and meaning-making processes of individuals with ADHD."

"the reported insights were highly similar across the two types of reports, and only minor differences were observed between classic and non-classic psychedelics (**including ketamine**). Regression analyses indicated that metacognitive and value insights were positively associated with perceived improvements in positive affect, while mystical-type insights predicted increased meaning in life. These findings suggest that both psychedelic substances and meditation can facilitate a broad range of insights that are not fully captured by existing questionnaires. The results highlight similarities between psychedelic and meditation experiences supporting the notion that transformative experiences are not exclusive to classic psychedelics but can be facilitated through various means." Meditation and psychedelics facilitate similar types of mystical, psychological, and **philosophical-existential insights predictive of wellbeing**: a qualitative-quantitative approach (Jylkkä, et al, 2025)

Your brain on nature: A scoping review of the neuroscience of nature exposure (Baquedano, et al, 2026)

**Were there creative outlets you left behind? Did you have goals or interests you got distracted from? Was there something you always wanted to try?**

(2026):"Researchers suspect that these positive psychological shifts rely heavily on the quality of a person’s initial experience while under the influence of the drug. People who report feelings of spiritual connection or a sense of ego dissolution often show the greatest long-term psychological changes. Ego dissolution refers to a temporary loss of one’s sense of self and a feeling of deep connection with the surrounding world. This temporary state may create opportunities for emotional healing."

From the journal Innovation in April 2026: Quantum evidence of nonlocal consciousness during clinical death (2026) "If consciousness can operate under quantum principles, then the boundaries between life, death, and cognition are far more permeable than current science allows... NDEs positively correlated with neuroplasticity during Cardiac Arrest. Biomarker models explained up to 56.8% of the variance in recall. These findings compel a radical rethinking of clinical death: consciousness may persist—quantum-bound, detectable, and not yet defeated.

Certain anesthetics and psychoactive agents, especially ketamine—a
dissociative NMDA antagonist—are well-documented to induce phenomenological states that closely mimic spontaneous NDEs. These include out-of-body experiences, time distortion, depersonalization, and profound tranquility or transcendence.104–106 A large-scale semantic analysis of subjective reports has confirmed that ketamine-induced states are more similar to NDEs than those associated with serotonergic psychedelics.105 These similarities support the hypothesis that shared neurochemical mechanisms—such as transient NMDA receptor blockade and glutamatergic dysregulation under extreme stress—may underpin NDEs. One speculation is that the dying brain might endogenously release ketamine-like compounds or enter a disinhibited cortical state, temporarily supporting heightened internal awareness. These findings reintroduce anesthesiology into broader debates on the neural correlates of consciousness, including theories that embrace non-classical processes such as quantum brain dynamics. Notably, our study found correlations between verified quantum entanglement effects and conscious recall, lending empirical support to theoretical models—such as the Hameroff and Penrose (2014) theory57—that attempt to explain how awareness might emerge under otherwise suppressive conditions."