Logotherapy

Logotherapy was developed by neurologist and psychiatrist Viktor Frankl. It is considered the "Third Viennese School of Psychotherapy" after Freud's psychoanalysis and Adler's individual psychology. It is a type of existentialist analysis that focuses on a will to meaning as opposed to Adler's Nietzschean doctrine of will to power or Freud's will to pleasure. Rather than power or pleasure, logotherapy is founded upon the belief that it is the striving to find a meaning in one's life that is the primary, most powerful motivating and driving force in humans. A short introduction to this system is given in Frankl's most famous book, Man's Search for Meaning, in which he outlines how his theories helped him to survive his Holocaust experience and how that experience further developed and reinforced his theories.

Basic principles

The notion of Logotherapy was created with the Greek word logos ("meaning"). Frankl’s concept is based on the premise that the primary motivational force of an individual is to find a meaning in life. The following list of tenets represents basic principles of logotherapy:

• Life has meaning under all circumstances, even the most miserable ones.
• Our main motivation for living is our will to find meaning in life.
• We have freedom to find meaning in what we do, and what we experience, or at least in the stand we take when faced with a situation of unchangeable suffering.

The human spirit is referred to in several of the assumptions of logotherapy, but the use of the term spirit is not "spiritual" or "religious". In Frankl's view, the spirit is the will of the human being. The emphasis, therefore, is on the search for meaning, which is not necessarily the search for God or any other supernatural being. Frankl also noted the barriers to humanity's quest for meaning in life. He warns against "...affluence, hedonism, [and] materialism..." in the search for meaning.

Discovering meaning

According to Frankl, "We can discover this meaning in life in three different ways: (1) by creating a work or doing a deed; (2) by experiencing something or encountering someone; and (3) by the attitude we take toward unavoidable suffering" and that "everything can be taken from a man but one thing: the last of the human freedoms – to choose one's attitude in any given set of circumstances". On the meaning of suffering, Frankl gives the following example:

Once, an elderly general practitioner consulted me because of his severe depression. He could not overcome the loss of his wife who had died two years before and whom he had loved above all else. Now how could I help him? What should I tell him? I refrained from telling him anything, but instead confronted him with a question, "What would have happened, Doctor, if you had died first, and your wife would have had to survive you?:" "Oh," he said, "for her this would have been terrible; how she would have suffered!" Whereupon I replied, "You see, Doctor, such a suffering has been spared her, and it is you who have spared her this suffering; but now, you have to pay for it by surviving and mourning her." He said no word but shook my hand and calmly left the office.

— Viktor Frankl

Frankl emphasized that realizing the value of suffering is meaningful only when the first two creative possibilities are not available (for example, in a concentration camp) and only when such suffering is inevitable – he was not proposing that people suffer unnecessarily.

Philosophical basis of Logotherapy

Frankl described the metaclinical implications of logotherapy in his book The Will of Meaning: Foundations and Applications of Logotherapy. He believed that there is no psychotherapy apart from the theory of man. As an existential psychologist, he inherently disagreed with the “machine model” or “rat model”, as it undermines the human quality of humans. As a neurologist and psychiatrist, Frankl developed a unique view of determinism to coexist with the three basic pillars of logotherapy (the freedom of will). Though Frankl admitted that man can never be free from every condition, such as, biological, sociological, or psychological determinants, based on his experience in the Holocaust, he believed that man is “capable of resisting and braving even the worst conditions”. In doing such, man can detach from situations, himself, choose an attitude about himself, determine his own determinants, thus shaping his own character and becoming responsible for himself.

Logotherapeutic views and treatment

Overcoming anxiety

By recognizing the purpose of our circumstances, one can master anxiety. Anecdotes about this use of logotherapy are given by New York Times writer Tim Sanders, who explained how he uses its concept to relieve the stress of fellow airline travelers by asking them the purpose of their journey. When he does this, no matter how miserable they are, their whole demeanor changes, and they remain happy throughout the flight. Overall, Frankl believed that the anxious individual does not understand that his anxiety is the result of dealing with a sense of “unfulfilled responsibility” and ultimately a lack of meaning.

Treatment of neurosis

Frankl cites two neurotic pathogens: hyper-intention, a forced intention toward some end which makes that end unattainable; and hyper-reflection, an excessive attention to oneself which stifles attempts to avoid the neurosis to which one thinks oneself predisposed. Frankl identified anticipatory anxiety, a fear of a given outcome which makes that outcome more likely. To relieve the anticipatory anxiety and treat the resulting neuroses, logotherapy offers paradoxical intention, wherein the patient intends to do the opposite of his hyper-intended goal.

A person, then, who fears (i.e. experiences anticipatory anxiety over) not getting a good night's sleep may try too hard (that is, hyper-intend) to fall asleep, and this would hinder his ability to do so. A logotherapist would recommend, then, that he go to bed and intentionally try not to fall asleep. This would relieve the anticipatory anxiety which kept him awake in the first place, thus allowing him to fall asleep in an acceptable amount of time.

Depression

Viktor Frankl believed depression occurred at the psychological, physiological, and spiritual levels. At the psychological level, he believed that feelings of inadequacy stem from undertaking tasks beyond our abilities. At the physiological level, he recognized a “vital low”, which he defined as a “diminishment of physical energy”. Finally, Frankl believed that at the spiritual level, the depressed man faces tension between who he actually is in relation to what he should be. Frankl refers to this as the gaping abyss (Frankl; page 202). Finally Frankl suggests that if goals seem unreachable, an individual loses a sense of future and thus meaning resulting in depression. Thus logotherapy aims “to change the patient’s attitude toward her disease as well as toward her life as a task” (Frankl, page 200).

Obsessive-compulsive disorder

Frankl believed that those suffering from obsessive-compulsive disorder lack the sense of completion that most other individuals possess. Instead of fighting the tendencies to repeat thoughts or actions, or focusing on changing the individual symptoms of the disease, the therapist should focus on “transform[ing] the neurotic’s attitude toward his neurosis” (Frankl; page 185). Therefore, it is important to recognize that the patient is “not responsible for his obsessional ideas”, but that “he is certainly responsible for his attitude toward these ideas” (Frankl; page 188). Frankl suggested that it is important for the patient to recognize his inclinations toward perfection as fate, and therefore, must learn to accept some degrees of uncertainty. Ultimately, following the premise of logotherapy, the patient must eventually ignore his obsessional thoughts and find meaning in his life despite such thoughts.

Schizophrenia

Though logotherapy wasn’t intended to deal with severe disorders, Frankl believed that logotherapy could benefit even those suffering from schizophrenia. He recognized that roots of schizophrenia in physiological dysfunction. In this dysfunction, the schizophrenic “experiences himself as an object” rather than a subject (Frankl; page 208). Frankl suggested that a schizophrenic could be helped by logotherapy by first being taught to ignore voices and end persistent self-observation. Then, during this same period, the schizophrenic must be led toward meaningful activity, as “even for the schizophrenic there remains that residue of freedom toward fate and toward the disease which man always possesses, no matter how ill he may be, in all situations and at every moment of life, to the very last” (Frankl, page 216).

Terminally-ill patients

In 1977, Terry Zuehlke and John Watkins conducted a study analyzing the effectiveness of logotherapy in treating terminally-ill patients. The study’s design used 20 male Veterans Administration volunteers who were randomly assigned to one of two possible treatments – (1) group that received 8-45 minute sessions over a 2 week period and (2) group used as control that received delayed treatment. Each group was tested on 5 scales – the MMPI K Scale, MMPI L Scale, Death Anxiety Scale, Brief Psychiatric Rating Scale, and the Purpose of Life Test. The results showed an overall significant difference between the control and treatment groups. While the univariate analyses showed that there were significant group differences in 3/5 of the dependent measures. These results confirm the idea that terminally-ill patients can benefit from logotherapy in coping with death.

Critiques

Authoritarianism

Some critics argue that logotherapy is, in essence, authoritarian. Rollo May, for example, suggested that Frankl’s therapy presents a plain solution to all of life’s problems, an assertion that would seem to undermine the complexity of human life itself. May contended that if a patient could not find his own meaning, Frankl provided a goal for his patient. In effect, this would negate the patient’s personal responsibility, thus “diminish[ing] the patient as a person”. Frankl did not outwardly contest May’s accusations until the 1970s, when he did so through a written dialogue, sparked by Rabbi Reuven Bulka’s article “Is Logotherapy Authoritarian?”. In this dialogue, May reasserted his belief that logotherapy was authoritarian, suggesting that in Bulka’s case study of Frankl's treatment of a schizophrenic patient, logotherapy had the “same authoritarian characteristic as fundamentalist religion”. Frankl responded during the same year, 1978, that as a medical doctor, he makes the best recommendation to the best of his knowledge for the purpose of his patient’s recovery, but does not believe this in any way to reflect authoritarianism.

Religiousness

Frankl received a strict religious upbringing, even remaining kosher until World War I when it became unrealistic. After the death of his wife during the Holocaust, he used religion to cope with her death, affirming his beliefs in God or a higher meaning. As a result, some argue that religion plays too prominent of a role in logotherapy. As a result of May’s accusations in the 1960s, Frankl stopped the apparent advocacy of religion in connection with logotherapy. The debate between Frankl and May, however, showed that Frankl never completely addressed the religious tones of logotherapy. Though he briefly denied that faith played a part in defining his theoretical orientation, he recognized that his logotherapy ultimately led to meaning through faith. Others did not find the distinction between religion and logotherapy so subtle. As Edith Weisskopf-Joelson asserted: “by proposing a secular equivalent to the concept ‘God.’...Logotherapy reveals itself as...a faith more than a scientific therapeutic school.”

Time spent in concentration camps

In Man's Search for Meaning, Frankl depicted his experience during the Holocaust, describing the time he spent in four Nazi concentration camps. He especially emphasized his time in Auschwitz death camp. Some question the validity of his claims, asserting that he exaggerated his experiences leading the readers to believe that he spent more time in concentration camps than he actually did. Examination shows that in 1942, based on his employment as a medical doctor at Rothschild hospital, he and his family were initially sent to Theresienstadt, a “model ghetto” where he lived for two years. This “model ghetto” presented many of the hardships similar to concentration camps, such as, overcrowding, starvation, and malnutrition. In 1944 he was sent to Auschwitz, though he spent only three days and two nights in that particular camp. In total, Frankl spent six months in concentration camps. Though some may say he amplified his experiences to promote logotherapy, his father, mother, brother, and wife died in the camps.

Political membership and questionable research

In February 1934, Frankl became a member of the Fatherland Front, a sect of Austrofacism. Under the rule of this political movement, opposing political parties were banned and members of such groups were forced into detention camps. From 1936 to 1938, Frankl was associated with the Nazi-oriented Austrian branch of the Goering Institute eventually being published in its journal.

As a branch of existential psychology, logotherapy places a great deal of emphasis on the importance of people solely due to the uniqueness of being human. Between 1940 and 1942, after being employed at the Nazi Rothschild hospital as a “Jewish specialist”, Frankl experimented on other Jewish individuals who had committed suicide. Some assert that this type of research was highly controversial ethically, as he was working under Nazi supervision. Consequentially, Frankl’s personal background raises questions of his development of logotherapy.

Too dependent on his own experiences

During his time in the camps, Frankl’s existential beliefs permitted him to find meaning throughout a degrading and dehumanizing time. Frankl postulated that the prisoners at the camp discovered a “freedom” through suffering. Critics maintain there is no evidence that this was a realistic view of the camps. While Frankl personally found “freedom” in suffering, his outlook may have been indicative of his personal way to cope with the trauma he endured.

See also

• Buddhism
• Stoicism
• Rong Qiqi
• Ludwig Wittgenstein
• Language-game
• Dialectical behavior therapy

Bibliography

• Frankl, Viktor. Man's Search for Meaning. Preface by Gordon W. Allport. 

External links

• Viktor Frankl and existential psychotherapy
• Logotherapy Institute at Vienna University
• Viktor Frankl Logotherapy Institute, Berkeley