Dear (name),
I know we all understand “meaning” and “purpose” in our own lives—but here’s a new take on them. How Life Works—A User’s Guide to the New Biology (University of Chicago Press, 2023) by the former editor of Nature, Philip Ball, posits that meaning and purpose are fundamental biological phenomena in human beings because they guide our survival. For example, one’s purpose might be to find a better job; or, if starving to find food. Each has survival meaning, albeit in quite different ways. Ball avers that purpose and meaning are not, as many biologists believe, ephemeral, ill-defined phenomenon best left to the philosophers and clergy, rather, that they are fundamental biological processes. His lucid argument in this fascinating book compels a new understanding.

What gives us meaning and purpose? From Darwin, our overarching purpose is to survive and to procreate. Abraham Maslow (Toward a Psychology of Being, Van Nostrand Co. 1962) made more specific how we do this. He proposed that there is a hierarchy of progressively higher-level needs that have meaning for us and determine our purposes (Figure: Maslow’s Hierarchy of Needs; CC-BY-SA-3.0). Our first purpose must be to meet basic (physiological) needs, such as for food and water. We next seek safety (security of the body, job, housing, family, and property). Then, we pursue meaning at the higher level of love and belonging (friendships, family). After that, humans’ purposes extend to establishing esteem (confidence, achievement, respect of and by others). Finally, self-actualization provides further meaning (morality, creativity, nonprejudicial, acceptance of facts). While the list has been considerably updated from the initial version, its message is still clear: survival needs create meaning and purpose for us from physical challenges to our personal and social lives.
To illustrate the biological importance of meaning and purpose in health, research by Jie Guo and colleagues provides a good example (Psychological well-being trajectories preceding incident mild cognitive impairment and dementia, Neurology Neurosurgery and Psychiatry 2024: 0: 1-7). Cognitively intact at the outset, older community-based adults were evaluated yearly for up to 14 years to detect onset of mild cognitive impairment and dementia, as determined by a neuropsychologist. Each year the authors also evaluated psychological well-being (self-acceptance, autonomy, environmental mastery, purpose in life, positive relations with others, and personal growth). Compared to those who remained cognitively intact, significantly lower levels of purpose in life were seen 3 years before a diagnosis of mild cognitive impairment and lower levels of personal growth were observed 6 years prior to diagnosis. Falling levels of purpose in life and decline in personal growth may, therefore, predict future cognitive impairment in older adults. Interventions to offset this have the potential to maximize subsequent cognitive health. These findings (and many similar ones) fit with Ball’s idea that purpose in life is of basic biological significance.
How do purpose and meaning relate to HAS MEDICINE LOST ITS MIND? Its message is to better treat mental disorders so that these unhappy people can establish purpose and meaning in their lives beyond their now fruitless hopes of finding help.
HAS MEDICINE LOST ITS MIND? is now nearly ready to go to press. I’m working with my publicist, Joanne McCall, to spread the word about its publication next March. Busy times. Keep the feedback coming, it helps me beef up our revolutionary message about how we must bypass medicine and go directly to the public and its politicians to correct the mental health crisis.
Take care and be well!
Bob
PS—On a personal note, we have moved to Battle Creek, MI. Also, I was honored to recently receive the following award.
