Existential Suffering: Intensive Caring and Existential Therapy Informed Communication for Serious Illness Care.

Existential concerns are common in serious illness and may include confronting questions about meaning, purpose, and mortality. The salience of these issues can vary between patients and throughout illness, and can oscillate between existential suffering, demoralization, normative processing, and even existential growth. Through analysis of a clinical composite case, this article illustrates dimensions and cues of existential suffering during serious illness. Recognizing the sources and manifestations of existential distress can help expand therapeutic imagination in serious illness care. Guided by existential principles, we draw on the tenets of Intensive Caring and Dignity in Care to offer practical language and psychotherapeutically informed communication strategies for general palliative care practice. These techniques aim to ease existential suffering, strengthen relational connection, and support patients in living meaningfully through the end of life.