Logotherapy E-Book

Elisabeth Lukas

• Herausgeber: Elisabeth-Lukas-Archiv GmBH
• Kategorie: Fachliteratur
• Sprache: Englisch
• Veröffentlichungsjahr: 2020

Seitenzahl: 395

Beschreibung

Viktor Emil Frankl, the founder of logotherapy, ranks amongst the twentieth century's most important researchers into the human condition. He developed a form of psychotherapy with an intriguingly dignified concept of human beings and the world which has an impressive track record of rapid success in practical application. Numerous universities around the world have honoured Frankl for his achievements. The present book provides a structured insight into his work. It explains the anthropological foundation of logotherapy and the healing concepts that are built on this foundation.

Leseprobe

Living Logotherapy

Published by

www.elisabeth-lukas-archiv.de

© 2020 Elisabeth-Lukas-Archiv gGmbH

Dr. Heidi Schönfeld

Nürnberger Straße 103a

D-96050 Bamberg

[email protected]

This English edition published with the kind permission of Profil Verlag. Originally published in German as Lehrbuch der Logotherapie, Menschenbild und Methoden © 2014 Profil Verlag GmbH München, Wien

Elisabeth Lukas

LOGOTHERAPY

Principles and Methods

Translated from the German by:

Dr. David Nolland, Oxford

Edited by:

Dr. Heidi Schönfeld, Bamberg, and Dr. David Nolland, Oxford

Cover design, typesetting and layout:

© Bernhard Keller, Köln

Print and distribution: tredition GmbH, Hamburg

ISBN 978-3-00-066678-0 (paperback)

ISBN 978-3-00-066679-7 (eBook)

Elisabeth Lukas

LOGOTHERAPY

Principles and Methods

Elisabeth Lukas

LOGOTHERAPY

Principles and Methods

LIVING LOGOTHERAPY

A publication series of the Elisabeth-Lukas-Archive

Contents

Foreword

Translator’s Note

Logotherapy’s Concept of Man

Classification of Logotherapy

The Concept of Dimensional Ontology

The Dialectic of Fate and Freedom

Conscience, the “Organ of Meaning”

The Dialectic of Vulnerability and Intactness

The Dialectic of Pleasure Orientation and

Meaning Orientation

An Intermediary Case Study

Two and three dimensional interpretations

The Dialectic of Character and Personality

Self-knowledge and Dealing with Oneself

The Logotherapeutic Form of Conversation

Keywords as a Guarantee Against the Imposition of Values

The Problem of Ambivalence: the Torn Human Being

The Problem of Non-acceptance: People Who are Frozen

by Protest

The Problem of Ignorance: the Person Walled-in

by Indifference

Reflections on a “Rhetoric of Love”

The Methods of Logotherapy

The Categories of Neurosis According to Viktor E. Frankl

The Origin of Anxiety Neuroses

Curing Anxiety Neuroses

Keeping the Compulsive Neurotic Character in Check

A Bit of Unkindness: Hysteria

Rescue by Renunciation

A Multidimensional Concept for Dealing with Addiction

Eating Disorders – a Problem Complex with Two Roots

Preventing Iatrogenic Damage

Supporting Patients with Somatic / Endogenous Illness

Dealing with the Blows of Fate

Noogenic Neuroses and Depressions

Ways Out of the Existential Vacuum

How Sleeping Disorders and Sexual Disorders are Created

A Recipe for Avoiding Egocentricity

Prevention and Aftercare

The Value of Life

The Pathogenesis of Mental Disorders

Further Developments in Logotherapy

Being Able to Decide Well

Principles of Meaning-Centred Family Therapy

Perceiving Oneself in a Completely Different Way

The Author

Foreword for the Series “Living Logotherapy”

“In our time, people usually have enough to live on. What they often lack, however, is something to live for.” This is how Viktor E. Frankl, the Viennese psychiatrist and founder of logotherapy, summarised a problem that is just as relevant today as ever. Elisabeth Lukas, a clinical psychologist and psychotherapist, has an international reputation as Frankl’s most important student. In her many books, she illustrates how logotherapy provides help in cases of mental illness, enriches the everyday life of healthy people and inspires us all to lead a meaningful, fulfilling life. Her books illustrate how humane, authentic and up-to-date a “living logotherapy” can be. The main objective of this new series is to make her books, which have enjoyed lasting success in the German-speaking world, more accessible to speakers of English.

Many people have worked hard to make it possible for the Elisabeth Lukas Archive to publish this new series. Particular thanks are due to our translator Dr. David Nolland, who has produced a fluid text that remains very close to the original. He has excellent knowledge in the field of logotherapy and supervises this series in all matters relating to the English-speaking market. Thanks are also due to Prof. Dr. Alexander Batthyány, who supported us from the beginning and will accompany this series as a guide. The formatting and layout is due to Bernhard Keller, and the beautiful presentation of the books is wholly attributable to his expertise.

The first book in this series was a collaborative project combining discussions of the theory of logotherapy by Lukas with numerous case studies by Schönfeld. The present book, the second in the series, is a textbook by Elisabeth Lukas on the fundamental concepts of logotherapy and their applications. This book has been reprinted in German many times, but there has not, until now, been a satisfactory translation available in English.

Thanks to Dr. Kagelmann of Profil Verlag, the holder of the rights for the German version of the books, for generously giving his permission for an English language version.

The third book, which will appear shortly, is a further collaboration between Lukas and Schönfeld, combining case studies with discussions of how these cases illustrate the practical application of logotherapeutic methods.

All that remains is to wish all of these books on the practical application of logotherapy success in the English-speaking world. May it give readers a glimpse into the vitality and relevance of these lifechanging therapeutic methods!

Dr. Heidi Schönfeld

Director of the Elisabeth-Lukas-Archive

Translator’s Note

Logotherapy is notoriously tricky to translate, as indicated by Frankl’s dissatisfaction with the translations of his own works. In developing his ideas, Frankl made use of nuances of language: metaphor, wordplay, and poetry, and it is not always possible to render these into another language. What is important is to make sure that Frankl’s intentions are respected, that his underlying respect for the human spirit in all its responsibility and freedom is kept in focus.

Elisabeth Lukas is a student of Frankl who followed very closely in his footsteps, and this classic work illustrates her achievements in developing the practical applications of Frankl’s logotherapeutic methods. To do justice to these methods, and provide a satisfactory reference work for an English-speaking world, we have to be careful that the nuances do not become misleading. To stay on track, we simply need to recall that meaning is always there to be found, and that we have, inalienably, within ourselves, everything we need to find it.

A note on the many Frankl quotations in this book. Most of these have been cited from German originals, and in these cases the translations are all mine. In many cases there is no English translation available, and even where there is, we often felt that a new translation was better suited to the needs of Lukas’ text.

Dr. David Nolland

LOGOTHERAPY’SCONCEPT OF MAN

Classification of Logotherapy

Logotherapy was founded by the Viennese psychiatrist and neurologist Viktor E. Frankl (1905-1997). It can be categorized amongst the many therapeutic approaches existing today by noting to two main points of view:

1. According to W. Soucek, logotherapy is the “Third Viennese School of Psychotherapy”, where Sigmund Freud’s psychoanalysis is the “First Viennese School of Psychotherapy” and Alfred Adler’s Individual Psychology is the ”Second Viennese School of Psychotherapy”. There is a simple rule of thumb to help us remember the emphases of these three approaches: Sigmund Freud focused on the “will to pleasure”, Alfred Adler on the “will to power”, and Viktor E. Frankl on the “will to meaning”. Naturally these are only simplified descriptions, which cannot claim to do full justice to the corresponding schools of psychotherapy. They merely characterise typical areas of research. Freud’s comprehensive theories focus on human drives – in particular the gratification of the sexual drive – which, if suppressed, become a source of psychic disorder. Adler examined the relationship of the individual to the social environment and derived the theory that deepseated feelings of inferiority lead to compensatory striving for power. Frankl ultimately saw human beings as entities who want to shape life in a meaningful way, and who can become psychically ill when their will to meaning is frustrated.

2. In American textbooks logotherapy is considered a “third force” in psychotherapy, a third approach, though in a somewhat different sense than for Soucek. In the USA, psychoanalysis is regarded (purely historically) as the ‘first force’, behavioural therapy is regarded as the “second force” and so-called existential psychiatry, which became well-known in Europe through Charlotte Bühler’s concept of “humanistic psychology”, is regarded as the ‘third force’. Logotherapy is seen as part of this third force, although Frankl’s concepts differ in one important respect from the ideas of humanistic psychology. In logotherapy, self-actualization is not recognized as the highest goal of human existence, as is the case for all of the many versions of humanistic psychology. In logotherapy, self-actualisation is not recognized as the highest goal of human existence, as is the case for all of the many versions of humanistic psychology. In logotherapy, the self-transcendence of human beings rates higher than self-actualisation. What this means will be explained below. Here it must only be established that in the American context logotherapy is assigned to the third force of psychotherapy, even though its content goes beyond it.

“People who set themselves an objective such as selfactualisation overlook and forget that ultimately human beings can actualise themselves only to the extent to which they fulfil a meaning in the external world, not within themselves. In other words, self-actualization evades being defined as an objective insofar as it occurs as a side-effect of other objectives. This is what I call the ‘self-transcendence’ of human existence.”1

Again, there is a simple rule of thumb for distinguishing the emphases of these three major groups of psychotherapy according to the American classification. This is what it says: Psychoanalysis sees humans as “abreacting beings”; behavioural therapy sees humans as “reacting beings”; logotherapy sees humans as “acting beings”. These are also simplified descriptions, whose memonics are a play on words: each time a prefix is deleted. Ab-re-acting represents the drive dynamic which is the brainchild of psychoanalysis. Re-acting represents the conditioning and learning processes which are the focus of behavioural therapy. And the capacity for acting in freedom emphasises human freedom of will, which is highly regarded in logotherapy.

Giambattista Torello once asserted that logotherapy is the last complete system in the history of psychotherapy. What he meant by “complete” is that logotherapy as a therapeutic approach is based on a finely honed concept of human beings and of the world. He was not mistaken, for the edifice of logotherapeutic thought is supported by three “pillars”, which Viktor E. Frankl designated as

freedom of will – will to meaning – meaning of life

The two outside pillars are axioms which elude scientific proof, as many thinkers and philosophers before Frankl had already established. The middle pillar, the will to meaning, can and has been proven by experimental psychological studies to be a primary motivating force for human beings. Let us look at the three pillars in detail:

Pillar 1

The question of how “free” or “unfree” humans really are has been asked throughout history. According to logotherapy, every human being has freedom of will, at least potentially. This potential freedom of will can be constrained at times by illness, immaturity, or senility, or can even be overridden, but this does not affect its fundamental existence. Logotherapy is a “non-deterministic” psychology.

“Logotherapy’s concept of man is based on three pillars, the freedom of will, the will to meaning, and the meaning of life. The first of them, the freedom of will, is opposed to a principle that characterises most current approaches to man, namely, determinism. Really, however, it is only opposed to what I am used to calling pan-determinism, because speaking of the freedom of will does not in any way imply any a priori indeterminism. After all, the freedom of will means the freedom of human will, and human will is the will of a finite being. Man’s freedom is no freedom from conditions but rather freedom to take a stand on whatever conditions might confront him.”2

Pillar 2

The motivational concept of will to meaning means that every human is animated by a striving and yearning for meaning. The fulfilment of meaning is the meeting of two complimentary parts: an “internal” part – this striving and yearning for meaning – and an “external” part, the meaning offered by a situation. If the will to meaning in human beings is constrained by illness, immaturity or senility, which does sometimes happen, then this is an impairment in the perception of the external part and not an attrition of the internal part, which remains a proof of humanness even in the case of serious disorders. Logotherapy is meaning-centred psychotherapy.

“Meaning is something objective, and that is not just an expression of my own private and personal worldview, but something which has been verified by psychological research. Max Wertheimer, one of the founders of gestalt psychology, explicitly pointed out that every situation possesses the character of a demand, namely ‘the meaning’ that the person who is facing the situation has to fulfil. ‘The demands of the situation’ are to be responded to as ‘objective qualities’. What I call the will to meaning seems to lead to something like a gestalt concept. James Crumbaugh and Leonard T. Maholick describe the will to meaning as the specifically human ability to discover objective meaning not only in the actual, but also in the possible.”3

Pillar 3

The postulate of meaningfulness of life expresses the logotherapeutic conviction that life has an unconditional meaning which it cannot lose under any circumstances. This meaning can, however, evade human comprehension. Insofar as this meaning is too big to be grasped by humans, it must always be perceived and sensed anew. It follows that logotherapy is a positive worldview.

“There is no situation in life that is really meaningless. This is because the seemingly negative aspects of human existence, especially the tragic triad which consists of suffering, guilt and death, can also be fashioned into something positive, into an achievement, if only they are faced with the right composure and attitude.”4

The figure shows that each pillar corresponds to a disciplinary form of logotherapy. Freedom of will is the basis for its concept of the human being and shapes its anthropological foundations. The will to meaning is the starting point and pivotal point of its therapeutic approach and therefore pervades all of its psychotherapeutic methods. The meaning of life, that is, belief in the unconditional meaningfulness of human life under any and all circumstances, belongs to its worldview, to its philosophy.

In this textbook of logotherapy we will principally be thinking about logotherapy as a therapeutic approach. To apply its methods successfully, it is essential to get to know at least the main features of its concept of the human being. It is just as essential to apply the worldview of logotherapy to preventative and follow-up care. For this reason, and to provide a broader view of the philosophy of its teachings, a brief description of the anthropological foundations of logotherapy is given first, followed by an explanation of how logotherapy deals with psychic disturbances.

Before we begin, it is appropriate to answer a frequently asked question: how scientific can a structure of thought be, when it is built on two pillars which cannot be empirically verified, as is the case with the first and third pillars? Well, every form of psychotherapy has its own specific axiomatic basis. The entire field of medicine requires at least one such pillar to justify its existence, namely the belief that human life is of value and is to be preserved. Without this axiom there would be no reason to treat sick people, or to operate on them; one could simply allow them to die. It cannot be scientifically proven that there is any advantage in prolonging life, especially in the context of global overpopulation. We should not, however, allow our belief in the fundamental importance and value of human life to be shaken; it resonates deeply within us, and it is strengthened in logotherapy by the elements of meaningfulness.

The problem of freedom of will is even more controversial. But here as well, all forms of psychotherapy must at least agree on the basic assumption that a patient is capable of changing. Without this assumption, therapeutic efforts would be pointless from the outset, and yet such a capacity for change cannot be proved, or if so, only in retrospect.

“Logotherapy and existential analysis are admittedly based on clinical practice, but one cannot evade the fact that they flow into a meta-clinical theory, as all psychotherapies have as an implicit basis; and this theory implies a vision, that is, the vision of a concept of the human being. In this way we come full circle: clinical practice is always determined and influenced to a large extent by the concept of the human being that the doctor brings to the patient, even if it is unconscious and uncontrolled. In fact, every psychotherapy plays itself out against an a priori horizon. There is always an anthropological concept at its base, whether the psychotherapy is conscious of it or not.” 5

The Concept of Dimensional Ontology

Viktor E. Frankl presented his concept of the human being by means of his concept of “dimensional ontology”. He unfolded being human into three dimensions: somatic, psychological, and spiritual. The analogy with the three-dimensionality of space makes it clear that this is not a theory of three “layers”. The human dimensions of being interpenetrate one another as completely as the three dimensions of space: length, height and breadth. For example, it would be ridiculous to say that the spatial dimension “width” begins where the spatial dimension “length” ends. It is the same for human beings: for a human all three dimensions of being meet at every “point”. Frankl spoke of a “unity in spite of diversity”.

The somatic level of a human is easy to define: it corresponds to all physical phenomena. It includes organic cell activity and biological-physiological bodily functions, including all associated chemical and physical processes.

The psychic plane of the human being is to be understood as the sphere of condition: mood, instincts, desires, affects. To these psychic phenomena we add intellectual talent, acquired patterns of behaviour, and social formation. In short, cognition and emotion are “at home” in the psychic dimension.

What is left over for the spiritual plane? An endless amount! The “primal human” aspect, namely the freedom to determine one’s attitudes to body and condition. Independent decision-making (“intentionality”), technical and artistic interests, creative activity, religiosity and ethical sensibility (“conscience”), an understanding of values and love are all located in the spiritual dimension of the human being.

If we were to divide the living beings on earth according to their participation in the different dimensions of being, we would arrive at the following, with a minimal number of transitional forms:

We see that the spiritual plane (which has nothing to do with intelligence or understanding) is the real human one, the “uniquely human” dimension; in logotherapy it is also called the “noetic dimension”, from the Greek word nous (spirit or mind). The other two levels, which humans share with animals, i.e. the somatic and the psychosocial dimensions (animals also have emotions and cognition to a certain extent!), are characterised in logotherapy as the “psychophysical” or the “subnoetic dimensions”.

Because logotherapy focuses primarily on the noetic dimension, Frankl used the formulation: “Logotherapy is a psychotherapy from the spiritual and towards the spiritual.” In this respect, it stands out from the other schools of psychotherapy, which focus more on the psychic dimension, dedicating themselves to the elucidation of buried drives or of human learning and developmental history. The results, particularly those which have been verified experimentally, are by no means questioned by logotherapy, but they are identified as localised on a two-dimensional plane. Frankl’s contribution was to integrate the uniquely human aspects of being human into conventional psychotherapy, which until then had literally been “spiritless” psychotherapy.

“In this three-dimensional schema, it is now apparent from the three-dimensionality of the human being that the uniquely human can only appear when we venture into the spiritual dimension. A human is only visible as a human once we take this “third” dimension into consideration: only then do we see the human as such. While the vegetative life of man can be explained within the bodily dimension, and his animalistic life, if necessary, within the psychic dimension, human existence as such, personal spiritual existence does not fit into this two-dimensional “plane” of mere psychosomatics. Homo humanus can at most be projected onto this two-dimensional plane. In fact, the essence of what we call projection is that one dimension is sacrificed – that is, projected onto the nextlower dimension.

Such a projection has two consequences: It leads to 1. ambiguity and 2. contradictions. In the first case the reason for this consequence is the following: different things are mapped onto the same thing by projection. In the second case, the reason is found in the following fact: one and the same thing maps onto different things in different projections.”6

Psychotherapy with its many different approaches is not exactly lacking in ambiguities and contradictions … with reference to Frankl’s words, it can be assumed that it still suffers from the consequences of improper projections. The most human things in man, like value structures or the inborn desire for meaning, must not be lost in the jungle of psychological interpretations. Logotherapy endeavours to avoid this error by perceiving the spiritual as its own human dimension – the real one, if not the only one – and by investigating whether the influence of the spiritual on the other two dimensions can be used for therapeutic purposes. For this reason, it does not neglect the psychic-social and physical dimensions, but it sets itself the specific research goal of exploring the extent to which the spiritual forces in humans can be mobilised and it can look back on more than 70 years of research, from which some very important results have emerged. Where traditional psychology essentially uncovers ‘psychic dependencies’, logotherapy promotes ‘spiritual independence’, and where traditional psychotherapy analyses ‘neurotic arrangements’, logotherapy registers ‘existential commitment’. This is an extraordinary extension, an additional entry point, otherwise achieved only by pastoral care, which is, however, normally only available to a subset of people: believers with denominational affiliations.

a) to remove spiritual frustrations,

b) to correct mental disorders

c) to alleviate (psycho)somatic suffering,

It goes without saying that each patient must be helped at the level of existence in which his or her disorder is present. For this reason, at the somatic level, medication (including psychotropic drugs) or, if necessary, electric shock therapy is needed, and at the psychic level cathartic relief, behavioural therapy exercises, cognitive problemsolving strategies, and so on, and in the area of overlap between the physical and the psychic, relaxation techniques (autogenic training, yoga) and suggestive methods. However, to be properly equipped for holistic treatment also requires therapeutic methods that penetrate into the noetic dimension, and logotherapy, ideally combined with therapy operating at a sub-noetic level, fills this gap. This is quite apart from its excellent potential for being combined at its own level with pastoral care or with all forms of art (therapy) or with (promotion of) education.

From the explanations so far, it is clear that it is important to distinguish the psychic and spiritual dimensions from one another and not to mix them together. (There is less confusion in this regard at the somatic dimension.) To acquire a deep knowledge of logotherapy, one has to incorporate into one’s thoughts the “noo-psychic antagonism”, which according to the theses of logotherapy characterises human existence. This is nothing less than the possibility of fruitful interaction between “psyche” and “spirit” within a person.

“Man is a point of intersection, a crossroads of three levels of being: the physical, psychic, and spiritual. These level of being cannot be separated cleanly enough from one another. Nevertheless, it would be wrong to say that a human is a ‘sum’ of the physical, the psychic, and the spiritual: man is a unity and totality, but within this unity and totality, the spiritual ‘interacts’ with the physical and the psychic. This creates what I once called the noopsychic antagonism. While psychophysical parallelism is obligatory, noo-psychic antagonism is optional: it is always only a possibility, a mere power, but a power which can always be appealed to, and which has to be appealed to on the medical side: again and again it has to call upon the ‘defiant power of the spirit’, as I have called it, against the seemingly so powerful psychophysical reality.

The noo-psychic antagonism thus states that the psychic dimension and the spiritual dimension of man are not just somehow juxtaposed, but have a relation with one another, and are sometimes even in opposition to one another. Therefore, in the following chapters the differentiation criteria for both levels should be examined carefully in order to make the enormous potential of their “antagonistic power” transparent for psychotherapy. These are the four distinguishing criteria: fate and freedom, vulnerability and integrity, pleasure orientation and meaning orientation, character and personality. Where they are not heeded, and instead all spiritual phenomena are traced back to psychic ones, which is equivalent to projecting the third dimension into the second dimension, it produces a distorted concept of the human being against which Frankl rightly warned. Specifically, there are four distorted concepts:

Pan-determinism Whoever denies human spiritual freedom must logically define humans as being subject to fate.

Psychologism Whoever loses sight of the integrity of spiritual existence, soon sees a human only as a vulnerable psychic apparatus.

Reductionism Whoever ignores the meaning orientation of the human being is tempted to interpret every motive as an expression of a (secret) instinctual need.

Collectivism Whoever ignores the personality of the individual is quickly ready to judge him or her solely by character type.

These mistakes are to be excluded in logotherapeutic anthropology, because they are sins against the “spirit”, from which nothing good proceeds.

2nd human dimension:“psyche ”

3rd human dimension:“spirit”

False reduction of the 3rd dimension to the 2nd one leads to:

A

fate

freedom

pan-determinism

B

vulnerability

intactness

psychologism

C

pleasureorientation

meaningorientation

reductionism

D

character

personality

collectivism

The Dialectic of Fate and Freedom

The scientific discipline of psychotherapy began at the beginning of the 20th century with the idea that childhood fatefully predetermines a person’s whole life. The reason for this deterministic conception is to be sought in the naturalism of the late nineteenth century, a period in which people (especially in the European cultural environment) had a feeling of being at the mercy of fate. Many discoveries were being made, which increased this sense of dependency and “smallness”. Advances in astronomy had revealed the vastness of the cosmos, which made the earth seem like an irrelevant grain of sand. Insights into the relations between societal structures and socioeconomic conditions had made the individual seem like a tiny cog in an unstoppable machine. The rapid development of technology further exacerbated this feeling of fatality; there emerged robotic models of thought, with which people identified themselves. They saw themselves as “programmed”, controlled by automatically stored influences.

Existential philosophy developed as a counter-movement, but it split into two camps: one more life-affirming and one more sceptical. It saw humans as beings “thrown into life”, who must find their own essence for themselves, but who can, so to speak, recapture the principle of action. Logotherapy has its theoretical roots here, especially in the life-affirming form of existential philosophy.

Amongst the pioneers of psychotherapy, Frankl was the first to reaffirm the element of human spiritual freedom, which, of course, is not freedom “from” something, from outside influences, but a freedom “for” something, namely a freedom to put outside influences in their place: to affirm them, to deny them, to follow them, or to resist them.

“We in no way deny the life and world of human drives. We deny neither the external world, nor the inner world; … What we emphasise, however, is the fact that a human as a spiritual being is not only confronted with the world – the external world as well as the inner world – but also takes a position with respect to it, can always respond to the world with some “attitude” or “behaviour”, and this position is a free one. A human being takes a position at every moment of existence, both to the natural and social environment, to the external milieu, as well as to the vital psychophysical inner world, to the inner milieu.”8

Let us consider the logotherapeutic concept of freedom by looking at three examples.

1. Example: anxiety

Anxiety – with the exception of loving care for someone or something valuable in the world – is an unpleasant mental feeling of being threatened. It “sits” in the second dimension and is closely linked to physical symptoms such as heart palpitations, pallor, or tremors in the first, somatic, dimension. Because it sits or appears there, there is no choice about it at the time of its appearance, and this means that it is “fate”. The causes of anxiety may or may not have been possible to avoid, but the feeling of anxiety cannot easily be ignored when it has crept up in a human being.

On the other hand, the decision about how to react to this anxiety lies in the third, spiritual, dimension: whether one takes it seriously or whether one ignores it, whether one runs away because of it or persists in a situation in spite of it. Here there is something about which a choice can be made, here there is some freedom. So we see that we are not free from fear, but free despite fear …

2. Example: a bad childhood

People who have suffered an unhappy childhood are not free from its effects, but they are free to adopt different positions towards it. Some parents say: “I was beaten when I was growing up, so beating is in me. If I get angry, I’ll beat my children too!” Other parents say, “Because I was beaten as a child, I want to make things better for my children. That’s why I do not beat them!”

Upbringing undoubtedly has a powerful influence, but not an allpowerful one. With a certain degree of maturity, every human being is free to educate him or herself. The act of self-education is then less and less dependent on “the will of the parents”, rather than on an “ought that should be experienced by the individual as his or her own” (Frankl).

3. Example: instinctive actions

An animal cannot act against its instincts. If it is hungry and sees food, it “must” pounce on it and devour it. A person, on the other hand, can be hungry (– fate), and still give the last piece of bread which he or she still possesses to a comrade who might need it more urgently (– freedom). In the first, somatic, dimension, the stomach will growl and the sinking blood glucose level will cause discomfort. In the second, psychic, dimension, the desire for bread and fantasies about food will cause torments. This is the “psychophysical parallelism” mentioned by Frankl, in which the first two levels are interwoven. But in the third, noetic dimension, a person separates him or herself from the fact of hunger, and decides – if this is what he or she wants for any meaningful reason – to overrule the inner psychophysical pressure.

Humans thereby prove themselves able to respond to the conditions of fate in freedom, and, in doing so, they are responsible for their response. The non-deterministic outlook of logotherapy implies the re-admission of responsibility and possible guilt in the psychotherapeutic concept of the human being.

Where there are no choices at a given time, there can be no guilt. Since we have no ability, for example, to change our past, we cannot be guilty towards it. (This says nothing about whether we were guilty in the past, at the time when we could still make choices about it.) On the other hand, when we have choices, we are responsible for the choice made. And it may happen that a bad, a wrong choice is made. The terms “good or bad” or “right or wrong” are difficult to define, which is why they are replaced in logotherapy by the words “more or less meaningful”. In other words they are measured according to the concrete meaning of the corresponding life situation. Guilt is then: choosing against meaning.

“Humanity has developed a maximum of consciousness – of knowledge, of science – and a maximum of responsibility; but at the same time it has developed a minimal sense of responsibility. The man of today knows much more than ever, and is also responsible for many things - for more than ever; but what he knows less about than ever, is his responsibility.”9

According to a logotherapeutic outlook, fate never fully explains a person’s behaviour, for a human is not a victim, but a co-creator of his or her destiny. Logotherapy abhors the widespread “victim ideology” in psychology, and the tendency to provide psychological excuses by asserting human dependencies. To assert, for example, that a murderer had to murder because of terrible childhood circumstances or long-suppressed feelings of hatred, is too facile. This criticism on the part of logotherapy does not, of course, apply to cases in which there is limited responsibility as a result of psychosis. It applies to authentic cases such as the following: A 41-year-old Swede was released because of a supposedly severe mother complex after he strangled his wife and stabbed his two children. The court sent him to a psychiatric institution, where he was discharged as cured after a few months. He took the money from his wife’s life insurance and started a nice new life with his girlfriend, in which his wife and children would have been in the way.

Logotherapy asserts that a person can always take a position with respect to his or her childhood circumstances, feelings of hatred, mother complexes, etc., and decide what he or she makes of them; and that it is actually the worst “condemnation” to be denied this last room of manoeuvre and seen as a spiritually incapable marionette, a “homo-automaton”, a product of heredity and environment who is unalterably subservient to external conditions. It is precisely this statement that characterises pan-determinism, which commits the error of sparing nothing from deterministic interpretation. However, in fact, there are always still personal choices that are not defined, there always remains a small amount of unpredictability in human life.

Logotherapy has reversed the old deterministic question, which asks what determines a person’s feelings and actions, and asks where this ineliminable residue of indeterminateness, which is still present in distress and illness, comes from. Its answer: it comes from the noetic dimension. Thanks to it, human beings can defy their fate, dissociate themselves from their inner states, resist their external circumstances or accept their limitations heroically. On the psychological level, such freedom does not really exist: nobody can choose his or her condition. Anxiety, feelings of anger and instinctual drives are not selectable, conditioning cannot be annulled, social formation cannot be shaken off, limitations of ability cannot be lifted. Reducing the spiritual to the psychic, as pan-determinism does, deprives human beings (at least theoretically) of individual responsibility and delivers them to fate.

What does all this mean for practical psychotherapy? Simply: if we admit that even a psychically disturbed human being has spiritual freedom, we must also respect that human being. A patient shares responsibility for his or her own healing – to the extent that the spiritual dimension is still “open” – and also has the freedom to destroy his or her life. Ultimately, healing is not “do-able”; it can only be promoted, and relies on the self-healing powers of the body and the psyche, and the willingness of the spirit to be healed. Therefore, one of the basic rules of logotherapy is:

One should offer help,but not take away responsibility!

Unfortunately, psychotherapy often works the other way around, because a therapist strictly avoids giving instructions or disappears behind an impenetrable wall of non-comment. On the other hand, too much responsibility is taken away from the patient, in that all internal and external difficulties are traced back to conflicts initiated by others, and this makes the patient a helpless victim. In logotherapy, concrete help is offered, but responsibility remains with the patient.

Conscience, the “Organ of Meaning”

We have illustrated the noo-psychic antagonism by means of the dialectic between fate and freedom. Here the psychic “determinateness” of the human, everything which is fated, stands against the spiritual “indeterminateness”, everything which is free. We contrasted what is psychically imposed with what can be chosen by the spirit. From the resulting freedom (not from, but for something), we deduced the basic responsibility of the human and the possibility of guilt. But this does not end the chain of logical consequences. For, as freedom presupposes choice, a more or less meaningful choice presupposes the recognition of meaningful and not meaningful, and to ensure this recognition a special “organ” is needed in the human organism: the conscience.

“Meaning not only must but can be found, and human conscience is the guide in the search for it. In a word, the conscience is a meaning organ. It could be defined as the ability to perceive the unique and one-off meaning hidden in every situation.”10

What conscience reveals to humans is a trans-subjective meaning, which applies to values in the world, their preservation and multiplication, and not subjective meaning in the service of individual need satisfaction. It would be very dangerous to restrict the decisions of conscience to the perception of what seems “subjectively meaningful ”. This would mean that a terrorist could claim that it seemed meaningful to him to plant bombs. But this sort of “meaning for him” is not what is meant. Rather, it is a matter of “meaning in itself”, the meaningfulness which arises from the thing and the situation. It is fits into someone’s plans. Of course, many questions arise when assessing a situation and mistakes cannot be excluded. Anything human can be mistaken. Nevertheless, an orientation towards objective meaningfulness is the best measure we have for the decisions of conscience.

For a closer understanding of how something as subjective as conscience can sense something as objective as the “meaning of a situation”, consider the analogy of a compass: North is the objectively most meaningful thing that corresponds to the life situation of a person. The compass is the spiritual organ belonging to this human being that receives the “call to the individual”. And the compass needle is the “indicator” of conscience, which points to the individual’s concrete task. This means that the consciences of two people who are in exactly the same position would have to indicate the same thing if neither of them were mistaken. This is, of course, only a fictitious consideration, because two life situations are never identical, neither in the course of a single life, nor when comparing several people. This is why Frankl described the meaning which is to be found as “unique and one-off”.

Now the conscience can be mistaken, which can be symbolised by a fluctuating compass needle that does not point north. But human beings remain free to act against their conscience, metaphorically, to march south with a working compass in hand. Inner freedom on the noetic level is also freedom to act against conscience (although it is no freedom with respect to the indications of conscience). Probably this sort of “marching south” is much more common than a faulty indication of conscience itself, and it has bitter consequences: “north” gets ever further away! From psychotherapeutic practice, we know how many spiritual disorders can be traced back to not being in harmony with one’s own conscience, to a life led against one’s better self.

For a long time, the conscience was identified by psychology with the “superego”, and according to Frankl this is not permissible. As defined by Freud, the superego is the set of handed-down norms and customs, that is, the moral consciousness of tradition, which has been inculcated in us by parents, teachers, church and state authorities. The conscience, on the other hand, is an understanding of values that precedes all morals, which each of us intuitively carries within ourselves. It is the ethical feeling, unconscious of its origins, which belongs to our existential “basic equipment”. If a criminal claimed to have a poorly developed conscience, one would have to contend that his or her superego might be poorly developed, but that his or her conscience “speaks” just like that of other people.

In a human being the superego normally coincides with the voice of conscience. A theft, for example, is contrary to the morals of society and is also rejected by the conscience as an “unsocial act”. However, one can conceive of situations in which someone’s personal conscience could advocate theft as “meaningful”, for example to save children from starvation. To use a metaphor again, one could say that the superego is like the traffic rule we learn to stop at a red traffic light and go through a green one. If the road to be crossed is empty, personal conscience certainly has no objection to driving through the traffic light even if it is red. If, however, an old, visually impaired man starts to cross the road, conscience will forbid one to go through the light even when it is green. We see that the conscience is oriented to the meaning of the particular situation, the superego to established and handed down laws.

Frankl put forward an interesting thesis that breaks with tradition in the history of mankind are often due to an increasing gap between the superego and the consciences of a large number of people. One of the examples cited is slavery, which was “blessed” by popular opinion for centuries. Nevertheless, there was an ever-growing discomfort with it on conscientious grounds, until one day this discomfort became manifest and found its final expression in the abolition of slavery. We might currently be at the point of a similar break with tradition with respect to another longstanding norm of the superego: the defence of the fatherland. The importance of protecting native territory is deeply rooted in human beings, both biologically and sociologically. Nevertheless, at the end of the twentieth century modern weapons, which respect no borders, evoked a new worldwide uneasiness that conflicts with this traditional super egotistical norm. Many began – and continue – to question, whether it wouldn’t be more meaningful in the age of nuclear weapons to make the fatherland defenceless than to continue to accumulate weapons …?

In the context of psychotherapy the problem of the superego is clearly recognisable and can be distinguished from the real considerations of conscience. A patient who is tormented by what “people” think is listening to his or her superego. One who struggles in the decision-making process about the meaningfulness of a thing is communicating with his or her conscience.

The Dialectic of Vulnerability and Intactness

Viktor E. Frankl assumed that a person can be ill at the somatic and psychological levels, but never in the noetic dimension. “Mental illnesses”, as psychotic disorders are called in popular science, are normally not even psychic illnesses, but disturbances in the nerve cells, in other words they are somatogenic. And, of course, people with psychosis, confusion, dementia, Alzheimer’s patients, etc., have an intact spiritual dimension, even if it is sometimes inaccessible, blocked by the processes of a psychophysical illness.

“Anyone who knows about the dignity, the unconditional dignity of every single person, also has unconditional reverence for a human person, even for a sick person, even for the incurably ill, and even for the incurably mentally ill. There are no “spiritual” illnesses. For the “spirit,” the spiritual person, cannot get sick, and remains present even behind psychosis, even when “invisible” to the psychiatrist.”11

The human spiritual dimension cannot be lost. It is latent in the child – not yet unfolded – just as language is latent in the newborn child and has simply not yet been developed. It resides in people ravaged by age and people with cerebral damage, although hidden by disruptive biological factors, and in schizophrenics, although restricted by neurochemical impairments. It flourishes in the drug addict, although crippled by artificial influences. The fact that human spirituality is always potentially present is what guarantees the inviolable dignity of the human being.

From the outside, the progressive blocking of the spiritual dimension largely hides what is uniquely human. Thus, a small child, a drunk or an imbecile can hardly be distinguished from an intelligent animal, because in them spiritual freedom and power of judgement – and thus human decision-making capability and responsibility – are drastically reduced. Nevertheless, there remains a difference in potentiality that cannot be lost – a dimension that is beyond health and illness (or intelligence and lack of intelligence), even though – temporarily or permanently – it can no longer come to expression in the other dimensions of being.

This has implications for establishing indications and contraindications for logotherapeutic treatment. Where a person’s noetic dimension is “asleep”, meaning that the patient is completely benighted by unconsciousness, immaturity or illness on the other levels of being, no logotherapeutic help is possible. Logotherapy can be used in all other contexts, even with older children and adolescents, and even with senile, mentally disabled or psychotic people to a limited extent, depending on the extent of their spiritual freedom – which is, according to experience, often greater than one initially thinks.

The overview makes it clear that there are qualitative gradations within the psychic dimension (and analogously within the somatic one). There are many gradations between “sick” and “healthy”, “abnormal” and “normal”, or – as one prefers to say today – between having or not having a “disorder”. Each of us at any time is somewhere on this continuum between the two poles, as regards both spiritual and physical condition.

On the spiritual level, it is more a question of quantitative accessibility between the extremes of “completely open” and “completely blocked”. While a severe illness, abnormality or disorder is not a contraindication for logotherapy in the psychic (or even somatic) areas, a loss of accessibility of the noetic dimension represents the only important contraindication for applied logotherapy. With small children, and in cases of significant impairment of consciousness, serious physiological brain defects, complete loss of sense of reality, chronic personality breakdown, and so on, we no longer reach the spiritual person to whom all logotherapeutic arguments and appeals are addressed.

Let us now specify the areas in which the logotherapeutic seed can grow and bear fruit. They include physical and mental disorders which have an effect on the spiritual level, and spiritual frustrations which have an effect on the psychic and the psychosomatic level. Wherever logotherapy is applied, it always deals with the interaction between the psychophysical and the spiritual. However, this is characterised by the rhythms of human life as a whole: the alternation and interplay between the material and the ideal, the vulnerable and the intact, the transitory and the permanent.

And when it is denied that there is something “intact”, unbroken and unbreakable in the human being? That something can be intact even though it falls outside the norm, yes, that there exists truth in spite of illness and suffering in spite of health? Well, then we arrive at a view of a human as a machine in need of repair. In this view, deviations from the norm only reveal functional weaknesses, and anyone who does not function in the expected way is sick. If, for example, a patient is not immediately enthusiastic about a therapist, this is “resistance”; if a searcher asks about the meaning of life, this is “autoaggression”; if an artist struggles to produce a creative design, this is an “inferiority complex”. We quickly end up with a general discrimination against spiritual concerns and achievements, with a “hyper-diagnosis” of all human statements that no longer recognises that there is something in human beings that is beyond health and illness. Something which is capable of engaging with content, something which cannot be interpreted merely as a product of psychological and psychopathological development, as psychologism and the related approach of pathologism try to do.