Psychotherapy with Dignity E-Book

Elisabeth Lukas

• Herausgeber: Elisabeth-Lukas-Archiv GmBH
• Kategorie: Fachliteratur
• Sprache: Englisch
• Veröffentlichungsjahr: 2021

Seitenzahl: 333

Beschreibung

Founded by Viktor E. Frankl, logotherapy is a form of psychotherapy that has proven itself over decades - through periods of war and prosperity - to work for the happiness and mitigate the unhappiness of all sorts of people. It has an impressive track record of success. It helps people to remain mentally supple in crisis situations and opens up new possibilities for discovering meaning. Its sophisticated methods all rely on the inalienable dignity of the unique person - who is trusted, in the interplay of freedom and responsibility, to outgrow his or her own problems and weaknesses. In this book, two experts in logotherapy report on their experiences. Through real case histories and expert discussion, readers discover for themselves just how beneficial this form of psychotherapy can be.

Leseprobe

Living Logotherapy

Published by

www.elisabeth-lukas-archiv.de

© 2021 Elisabeth-Lukas-Archiv gGmbH

Dr. Heidi Schönfeld

Nürnberger Straße 103a

D-96050 Bamberg

[email protected]

This English edition published in German as Psychotherapie in Würde, Logotherapie konkret © 2020 Elisabeth-Lukas-Archiv gGmbH, Bamberg

Elisabeth Lukas, Heidi Schönfeld

Psychotherapy with Dignity, Logotherapy in Action

Translated from the German by:

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

Cover design, typesetting and layout:

Bernhard Keller, Köln

Print and distribution: tredition, Hamburg

ISBN 978-3-00-066694-0 (paperback)

ISBN 978-3-00-066693-3 (eBook)

Elisabeth Lukas – Heidi Schönfeld

PSYCHOTHERAPY WITH DIGNITY

Elisabeth Lukas – Heidi Schönfeld

Psychotherapy with Dignity

Logotherapy in Action

LIVING LOGOTHERAPY

A publication series of the Elisabeth-Lukas-Archive

Contents

Foreword for the Series “Living Logotherapy”

(Heidi Schönfeld)

Translator's Note

A Brief Introduction to Logotherapy

(Elisabeth Lukas interviewed by Bernd Ahrendt)

Case Studies from a Logotherapist's Practice

(Elisabeth Lukas and Heidi Schönfeld)

Introduction

Dealing with Self-Pity

Dealing with Lovesickness

Dealing with Anxiety

Dealing with Compulsive Thoughts

Dealing with Feelings of Guilt

Dealing with Trauma

Dealing with the Pain of Grief

Brave Odette

Frankl on “True Love”

(Elisabeth Lukas interviewed by Heidi Schönfeld)

Making Up and Making Good

(Heidi Schönfeld)

The “Top Ten” Frequently Asked Questions

(Elisabeth Lukas

About the Authors

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 is a collaborative project combining discussions of the theory of logotherapy by Lukas with numerous case studies by Schönfeld, and the second book is a textbook by Elisabeth Lukas on the fundamental concepts of logotherapy and their applications.

This third book is a further collaboration between Lukas and Schönfeld. It mainly consists of case studies supplemented with theoretical analyses of how these cases illustrate the practical application of logotherapy. The book includes a short introduction to logotherapy and ends with discussions of a number of topics from a logotherapeutic perspective.

We sincerely hope that this practical guide to the application of logotherapeutic methods will be helpful and illuminating for English speaking practitioners and other interested parties and will clearly illustrate the effectiveness and applicability of logotherapy.

Dr. Heidi Schönfeld Director of the Elisabeth-Lukas-Archive

Translator's Note

Logotherapy presents a particular challenge for the translator. Viktor Frankl's own works are full of humour and metaphor, and his distinctive way of making his point often relies heavily on wordplay, poetic forms of expression and nuances of language that combine colloquial language with philosophically suggestive formulations distilled from a profound understanding of the history of European thought. He coined a number of original terms and concepts that play a key role in his work. Frankl was often dissatisfied with the published translations of many of these key terms, and his own translations, where available, provide valuable clues to his thinking.

Elisabeth Lukas has a distinctive written style that shares the aforementioned features of Frankl's writing. She has continued in Frankl's footsteps linguistically as much as she has intellectually and spiritually. Frankl never saw the logotherapy he had originated as something finished and set in stone, but as a system of thought that should continually be developed in response to the inexhaustible insights into human nature arising from his focus on meaning and the possibilities of the human spirit. In this book, Elisabeth Lukas and Heidi Schönfeld have produced a remarkable testimony to how therapeutically effective this system of thought is in practice.

Translations of Frankl’s works have, where possible, been taken from the standard editions of his works in English cited in the footnotes. Where this is not possible, I have cited the German editions, and the translations are my own.

I would also like to thank Heidi Schönfeld for her close collaboration in producing this translation. Without her help, an accurate and faithful English-language account of Frankl’s methods in action would have been impossible.

Dr. David Nolland

A Brief Introduction to Logotherapy

(Elisabeth Lukas interviewed by Bernd Ahrendt)

Bernd Ahrendt is a Professor of Business Administration, with a particular interest in human resources management, working at the FOM University in Hannover. In 2018, he travelled to Vienna to interview Elisabeth Lukas. Bernd Ahrendt has agreed for passages from his interview to be reprinted here to provide readers with an introduction to the basic concepts of logotherapy.

Ahrendt: Prof. Lukas, could you sum up the essence of logotherapy in a few words?

Lukas: Viktor Emil Frankl, born in 1905, began his research as a young doctor with two basic questions that interested him as a prospective psychiatrist. The first question was: “What makes a human human? Is there anything that is unique to being human?” The second was: “What keeps humans psychically healthy, or enables them to get healthy again if they are ill?” The second question was particularly innovative in Frankl's time, because all the psychiatric experts of that time considered only the causes of becoming ill, and not the basis for getting healthy again.

To answer his first question, Frankl began to investigate the human “spirit”, which, according to his definition, is the third dimension of being human. One should bear in mind that according to the philosophy current at that time, one only talked about the “body” (the first dimension) and the “soul” (the second dimension), and that in the developing field of psychology, the traditional concept of “soul” was simply translated as “psyche”. So all of our cognitions and emotions were subsumed under the heading of psyche. This left out everything that is specifically human, because thoughts and feelings also exist to a certain extent for animals. If one wants to pick out what is uniquely human, one must venture into the third dimension, in which Frankl located phenomena such as our (potential) freedom of will and responsibility, our ethical and artistic sensibilities, and our search for meaning and our yearning for an ultimate meaning (God?). These phenomena take us beyond the horizon of the animal world, and in a modern context also beyond the horizon of intelligent computers and robots.

To answer his second question Frankl discovered the immense significance of one's perspective on meaning for the stability of the human psyche (and body). It is precisely when life becomes difficult that it becomes decisively important whether one sees a meaning in continuing to live. But even in comfortable circumstances, life becomes less satisfying when it is empty of meaning. In the light of these two groundbreaking realisations, Frankl founded his “meaningcentred psychotherapy”, which he called “logotherapy”. It can be seen as a “psychotherapy from the spiritual and towards the spiritual”.

Ahrendt: What did Frankl find in the course of his research?

Lukas: In the 1930s, Frankl worked at the psychiatric hospital “Am Steinhof” in Vienna. There he had the opportunity to talk with hundreds of sick and severely depressive people. Amongst other things, he heard about the hardships of their childhoods, about their disappointments and psychic injuries. It was there that he had the idea to carry out a controlled experiment, in which he interviewed numerous healthy people (doctors, nurses, students) and found that these inconspicuous and psychically “normal” people, who were pursuing their professions and getting on with their daily lives without difficulty, had typically had just as many traumas, disappointments and injuries in their lives as his patients. As a result, Frankl abandoned Sigmund Freud's trauma theory. He recognised that there are certainly pathogenic, that is, illness-causing factors in life, but at the same time there are also protective factors. And that when enough protective factors are present, the illness-causing factors become less dangerous. This thesis is now undisputed. It has been known for a long time from general medicine that, for example, infections have an effect when a person's immune system is already weak, and cause little damage when the organism's resistance to illness is well-developed. In the psychic domain, a person's inner meaning fulfilment is one of the most powerful protective factors. Frankl deduced from this that any form of finding and fulfilling meaning contributes to psychic healing. It can be seen from his many well-documented case studies that this really works in practice.

I would like to add one more thing: recent resilience studies have confirmed Frankl's discoveries 100%. People who pick themselves up after a severe blow of fate has knocked them down, do so on the basis of affirming a particular meaning perspective. Instead of always looking back on what they have suffered, they live primarily in the present, which they shape as best they can according to a valueoriented vision of the future. In this way they rescue themselves from the unhealthy miasma of their trauma (much as Baron Münchhausen pulled himself out of a swamp by his own ponytail).

Ahrendt: But then why are so many people stuck in their negatively perceived past?

Lukas: There are many explanations for this. It is easier to complain about something than to make it better, it is easier to blame someone else than to do something on one's own initiative, and so on. The way of thinking of traditional psychoanalysis is also partly responsible for our unhelpful tendency to look backwards. It has propagated the idea of delving into the past. But I do not want to blame psychotherapy, because it is a very new discipline, only about 120 years old. Every evolutionary process proceeds by trial and error, and this has also been the case with psychotherapy. Therapeutic methods have been developed one after another, always needing to be corrected. Frankl himself was an important corrector. Meanwhile, the psychoanalytic illusion that a psychic illness will disappear when its causes are discovered has melted away. Strategies based on uncovering causes have not proved successful, quite apart from the part that they are usually associated with too much unprovable speculation.

Ahrendt: Does this also have to do with the fact that there is often more than one cause that leads or can lead to a psychic illness?

Lukas: The progress made in neurobiology and psychology since Freud's time has shown that the causes of illness are closely interrelated. Genetic research has revealed that many more psychic conditions than we thought can be traced back to genetic predispositions. One does not only inherit blonde hair or blue eyes from one's genes, one also inherits character dispositions such as a tendency to addiction, hysteria or depression. This does not mean that the corresponding illness will necessarily occur, only that one should be careful in certain situations. These endogenous dispositions interact with exogenous influences, and not just from parents and teachers. The media also has a powerful influence, and the effect of societal trends should not be underestimated.

But all this is still not the heart of the matter. For amongst all these diverse influences is the human capacity for self-determination, which shapes each person as an individual. Even children already have their own personalities and make their own individual choices. Although the spiritual dimension in little people is still partly dormant or not yet fully developed, it still permeates the psychophysical level and helps to determine what the little person becomes. Children are not determined by how they are brought up by their parents, and adults are not pure victims of their past circumstances.

Ahrendt: This would mean that all people have a significant influence on their own lives. Even as a child, but also as an adult.

Lukas: Yes. According to a famous analogy by Frankl, a person is like a builder. Genetic predispositions and the various influences from one's environment form the building material that each person has to work with. Unfortunately this building material is not fairly distributed. Some inhabitants of this world have excellent building material: loving parents, a healthy body, they live in a peaceful country. Others have inferior building materials available: an antisocial milieu, poverty or the ravages of war. This is when the third dimension comes into play: the builder uses this material in a unique way. And one finds that some builders who have been given the best marble blocks to work with (an outstanding musical talent or a superb role model for loving behaviour, for example) leave these blocks unworked and squander their time away. Other builders, who have been assigned only crumbly sandstone (for example a low birth weight or poor educational opportunities) use them to build a cosy cottage or a pretty chapel by the wayside. Frankl said, “Man is the being who always decides.” And what does he decide? “What he will be in the next moment.”

Ahrendt: You have told us about the concept of meaning, which plays a big role in Frankl's terminology. Could you explain this term in more detail?

Lukas: First, I would like to differentiate between the concept of “meaning” and the concept of “values”. Values are “meaning universals”. Meaning, on the other hand, is unique. This means that the “meaning of the moment”, as Frankl calls it, always exists with reference to a particular person in a particular set of circumstances. It is the optimal result (for all people involved) that this particular person can achieve in this particular situation. What one is “called” to, so to speak. To illustrate this with the two of us: for me the “meaning of the moment” is to answer your questions as well as I can. If I, for example, said, “The weather is beautiful today, Professor, so I think it would be meaningful to take a walk,” you would answer, “No, Mrs Lukas, that would not be meaningful at this time. I have travelled all the way from Germany to interview you. You agreed to this. So what is meaningful is to sit here and continue to talk with me!” What this example shows is that although a pleasant walk on a sunny day certainly has a value, this value is not what is important right now. It is not its turn to be actualised. Later this afternoon, after we have said goodbye, it may be very meaningful to go for a walk before bed instead of continuing to sit here.

Likewise, the “meaning of the moment” is different for each person. Later, when you leave me, something different will be waiting for you than for me. In other words, meaning is ever-present, and ever-different. As long as we are conscious, there exists some meaningful possibility for us, whatever our situation. People who have a well-developed system of values, who acknowledge many sources of value in their lives, naturally find it easier to discover the “meaning of the moment” than those for whom a single value is always in play. Nevertheless, they must take care to keep their other values waiting in their order of precedence and not be pressurised by them. And it is also important to remember that rest and leisure time also has a high value.

Ahrendt: What about the three categories of value that Frankl developed?

Lukas: Frankl spoke of three “main avenues of meaning-discovery”: creative values, experiential values and attitudinal values. Creative values and experiential values are shared by almost everyone. They build a bridge between a person and the world. Creativity allows one to bring something new into the world. For example, a woman knits a sweater. She gives it to “the world” and she is happy if it fits the recipient well. In contrast, experiential values have to do with receiving something good from the world – the world gives something to us. This presupposes that we are open to receive this gift and that we know how to appreciate its value. For example, walking outdoors is only a valuable experience for someone who is receptive to the beauty of nature. People who stomp around complaining and pay no attention to the surrounding flowers and fields destroy the experiential value for themselves.

Then we have the attitudinal values. For Frankl, these were the highest possible values that can be actualised by a person, because they are the hardest to actualise. They have nothing to do with joy (as creative or experiential values do) but with suffering, because they can be chosen in the case of misfortune, loss of hope, or when people come up against insurmountable obstacles. If action can still be taken in such cases to improve the unfortunate situation, of course this action (inspired by creative values) takes precedence, it has the higher priority. If, for example, someone has lost his or her job, it is certainly meaningful to look for a new one. If, however, nothing more can be done to eliminate the misfortune, if one is confronted with unalterable suffering, for example on the loss of a loved one, then the question is how one bears and endures this suffering. One can always adopt various attitudes. One can wildly shout out one's anger and non-acceptance of fate, one can sink into dull despair, but one can also win through to an heroic acceptance of fate and in this way adopt a valuable attitude (actualise an attitudinal value). This value is superior. For example, someone may think, “I have received many good things in life. I enjoyed the company of the person I loved for many years, and I will be thankful for this, even if I am now alone. My love does not end with death, it remains alive in my heart…” This is a wonderful attitude to adopt in the face of mourning and loss.

The significance of attitudinal values is particularly apparent in the following context. According to the laws of biology, frustration automatically produces aggression. At the psychophysicalanimalistic level, aggression is nothing more than a spurt of energy. If, for example, an animal is being hunted by another animal, this is a frustration in biological terminology, and the animal responds by becoming aggressive, that is, hormones are released which give it the energy to fight for survival or to flee. With humans, frustrations are usually psychic pressures that similarly give rise to aggression, but unlike animals, humans can choose what to do with the biological spurt of energy. Humans can also fight or flee, or even harm themselves (which animals do not do), or they can transform their energy into an admirable attitude – in cases where it would not be meaningful to fight or to flee.

Ahrendt: But one does feel this enormous anger in oneself.

Lukas: Yes, that is true. This is why many people are tempted to let their anger out somehow, to direct it against someone. They are like a tiger in the zoo that attacks its keeper because it has a toothache. The toothache is not the keeper's fault! In technical language we call this a “displacement” (of the aggression onto the wrong person). But a human is more than a tiger, which is why displacements like this are unethical in human society. If a man who is annoyed at his boss comes home in the evening, kicks the dog and shouts at his wife, in other words if he takes out his feelings on the innocent and the uninvolved, it doesn't help him that much. He just adds to the suffering in the world, and it does not solve his problem. It is much better either to address the conflict constructively with his boss (actualising creative values) for example by speaking out clearly, changing work priorities, etc. or – if there is no alternative – to adopt a positive attitude to the situation, for example by saying to himself that at least he has a job, that it is good that he can feed his family and he will learn how to handle the idiosyncrasies of his boss without losing his calm. This would be an admirable attitude for him to develop.

Ahrendt: You are asking a lot from people: on the one hand selfreflection, to allow one to recognise what is going on in the situation, and on the other endurance of suffering.

Lukas: I am not the one who is asking it; the logos is asking it. It is the only meaningful way to deal with pain and sorrow; everything else increases pain and sorrow, and this is the last thing we need as a human family.

I would like to add one more thing. True heroes are not people whose statues are on monuments, because they conquered lands and won battles, true heroes are often simple people. They are more common than you imagine, Professor Ahrendt. Countless people have the sensitivity to break the chain of suffering when necessary; one must recognise them and honour their achievements. Suppose a woman is lying in the hospital and can't sleep at night because of the pain of her wounds. In the morning a nurse comes into the room and the woman smiles and wishes her a good morning. What has happened there? The sick woman has undergone a terrible night, but she manages a friendly greeting. She has experienced something bad and yet she spreads goodness. That is heroism! And that – not just the perpetuation of evil – is within the capabilities of every person. It is not impossible to respond to a bad experience by spreading love – and this is what we are called to do by the logos.

Ahrendt: Do you mean that there is a higher power calling on us to do this? Calling us to work for good in the world?

Lukas: It does not matter what you call this mysterious “higher power”. The fact is that humans are not the creators of everything. We are not the creators of meaning. We can only seek meaning with humility, find it, follow it or dismiss it, but we cannot twist its message around according to our own wishes. Frankl laconically remarked that it is not a case of what we can expect from life, but of what life expects from us. For the most part, we sense what is expected from us. If we are walking in the street and an elderly man falls on the pavement, we feel deep down what life expects from us in that moment. Of course we can just walk past the man who has fallen. Meaning cannot compel us to do anything. But it is clearly asking us to stop and help the fallen man.

Ahrendt: Are these not just moral ideas that I have picked up?

Lukas: They are, but this is not the whole story. As you grew up, you received guidance not just from those around you, but also from your human nature. You have a “meaning organ” – your conscience. There are many studies showing that people can calmly throw overboard the wisdom they were taught in childhood. People who were raised with strict moral views tend to rebel against them and revel in forbidden amusements. Others bravely walk away from a criminal household environment. As already discussed, it is the builder – the spiritual person – who oversees the work, whatever building material is at hand.

To be human means to have an agency in oneself that perceives the call of the logos. To be human also means to possess the power to decide whether to ignore this call or to make it one's guiding principle.

Ahrendt: But where does one learn how to do this? Where can I learn how to feel this power and to know what I am called to in a particular situation? What is the meaningful thing that I should be doing now, that is sometimes not centred on me, but on others?

Lukas: You are right that, from the point of view of meaning, the self is not the centre point of spiritual endeavours. The divide between selfishness and altruism, however, is an illusory one. If one wants to commit oneself to another person, one has to keep oneself in good shape. People who overwork massively and treat themselves like slaves are not behaving meaningfully – even if they are slaving away for the service of others. Their service will continually diminish in quality, as will their own competence. We are also familiar with the opposite evil: people who are only interested in themselves and their own welfare are sucked into an existential vacuum that robs them of joy in life. Soon they are bored by everything, because they are no longer good for anything or for anyone. Meaning is just the guardian of the balance between being for something or for someone, and carefully polishing up one's own being, to make it shine. Meaning is always meaning for everyone who is involved in a given life situation.

Ahrendt: Clearly this means that one must be sensitive enough to recognise the meaning in a situation, but it could also make it necessary to say no to someone else's wishes and thereby appear harsh to others.

Lukas: Have Faith, Professor! We humans are equipped with a profound sensitivity for meaning and values. Our biggest problem is not to perceive what is right, but to do it.

Ahrendt: But where does one get this trust? And what happens with someone whose parents have not provided them with basic trust?

Lukas: Stop! Who says that it is the parents who provide children with basic trust? Of course it is important and of lasting relevance whether parents provide their children with a safe nest. There is no doubt that adults who have experienced that safety at home find it easier to develop trust in others than those who have had to do without parental love and affection. But basic trust is a uniquely human phenomenon, which is an inalienable part of being human. It can be shaken by bad experiences, but it can never be completely extinguished. There is always a spark remaining, and through this basic trust can always be restored, whether with therapeutic help or through one's own efforts.

Ahrendt: But when I meet people who tell me that they have no basic trust…

Lukas: Then they are mistaken. Or they are just making excuses. For example, in court, people like to argue that criminal offences can be traced back to childhood neglect. One can accept this as a mitigating circumstance, but only with reservations. No person is a preprogrammed machine. Freedom and basic trust, conscience and individual responsibility are inalienable possessions, which are “breathed in with the Spirit,” to express it biblically. This makes it possible for us not to capitulate in the face of unfavourable starting conditions. Statistics support this thesis more than they contradict it. Yes, there are many human disasters involving people who have had difficult histories. But also, a surprising percentage of neglected, abused, even exploited people have turned things around with the help of the “defiant power of the spirit” and have developed into decent, upright human beings.

Going back to basic trust, it is weakened today much more by noise and distractions than by bad childhood experiences. This generation is constantly exposed to audio-visual stimuli, and has hardly any opportunity for reflection. If one is uninterruptedly distracted by multitasking and staring at electronic screens, one cannot hear the quiet voice of one's inner feel for meaning. In order not to lose contact with this feel for meaning, one should regularly withdraw into silence, even if it is only for 10 to 15 minutes a day, in a place where one will not be disturbed. This is immensely fruitful.

Ahrendt: Does this make it possible to get one's basic trust back?

Lukas: At the very least, it leads to deeper insights. Basic trust does not suggest that everything will always go well. What it says is that everything has a hidden meaning, whether we understand it or not, whatever the outcome. It says that there exists an ultimate harmony that we cannot and do not need to grasp, that takes into account all our troubles and suffering, even guilt and death. Human beings need to believe in something, whether they want to or not. Even convinced atheists believe that there are deeper connections that are beyond human imagining, that transcend the boundaries of human knowledge. Anyone who recognises a boundary also recognises that there is something on the other side of the boundary, otherwise it would not be a boundary. Directly or indirectly, we all bow down before what is on this other side, even if we have no words or images for it.

Ahrendt: How can one win back basic trust?

Lukas: That is an interesting question, because we know analogous processes in psychotherapeutic practice. To achieve a desired goal, a sustained investment must be made. We have already seen this in our explanation of experiential values: one has to be innerly open to a value before one is able to live it out as a value. Anxiety disorders are a striking example of this. First, while one is still shaking with fear, one has to submit oneself to the imagined object of fear (for example in the case of a fear of flying one has to get into an airplane) in order to be able to live a life ultimately less constrained by fear. The same thing applies to addictions. First, while one is still addicted, one has to behave as if one were already free from addiction (one has to practise abstinence) in order to be ultimately free from addiction. Even in the case of interpersonal conflicts, “advance investments” of this sort, as they are called in logotherapy, are the only way to achieve peace. One first has to reach out a hand to one's enemy in order to be able to make the enemy into a friend. I have described this very briefly, but the principle is clear: without advance investments of courage, perseverance, humour, forbearance, one can expect no gain. The same principle applies to the winning back of basic trust: every advance investment of trust in life will be rewarded.

Ahrendt: You say that humour as well as courage is needed?

Lukas: Let us consider anxiety disorders again. Suppose that a man has an extreme fear of dogs, cynophobia. If he sees a dog in the distance, he either turns around or takes a detour. This is an indication that there is an advance investment to be made, which he can make easier with the use of humour. One should walk with him past a little dachshund (perhaps for the first time) to which he should (paradoxically) say, jokingly: “Go ahead, show your teeth! You won't get succulent legs like mine every day, so go ahead and enjoy them…!” The dachshund will probably run past without paying any attention. The man should whisper after it: “What a coward you are! You didn't even manage a small bite…” In this humorous way the man will gain the confidence to walk more and more often past bigger and bigger dogs.

Situations of escalating conflict are less humorous, but one still needs courage to put an end to them. Suppose a married couple is caught in a vicious circle: the man is always critical because his wife does not like him, and his wife does not like him because he is always critical. How can this vicious circle be broken? Each person justifies inappropriate behaviour by appealing to the inappropriate behaviour of the other person. Everyone is waiting for the other person to put an end to the inappropriate behaviour first. They may both wait for a long time, unless one of them makes an “advance of love”. For example, the man could suddenly put an end to his criticism (even though his wife rejects him). Or the wife could begin to treat her husband with graciousness and respect (even though he is always critical). This changes the situation, because the reason for the inappropriate behaviour is removed for one of the parties. Why would the husband be critical when his wife is nice to him? Why would the wife reject her partner if he controls his behaviour? The vicious circle is broken. If both of them make an “advance of love”, it collapses immediately.

Ahrendt: That requires a huge amount of trust – trust that something will change.

Lukas: Yes, it does. People who want to change the world must change themselves. Trust is necessary, but so is the awareness that we are free to make changes. And that every individual plays an important role in deciding which things will change, and whether for the better or the worse. Freedom is primarily the freedom to act responsibly or to choose not to.

Ahrendt: That sounds very different from what many people understand by freedom.

Lukas: Frankl taught us that freedom is never freedom from something (from our circumstances), but for something, namely to adopt a stance with respect to our circumstances, and to shape them creatively.

Ahrendt: But how is that freedom, if I cannot free myself from something, for example something unpleasant?

Lukas: Allow me to sketch a well-known logotherapeutic model for you. We can break down each concrete situation experienced by a given person into two parts. The left hand part we call the “domain of fate”, the right hand part is the “space of personal freedom”.

The domain of fate is defined as everything that is not (or is no longer) under the control of this person in this given life situation. This is admittedly a large domain. It includes the whole previous history of this person from the moment of his or her birth up until the present. None of this can be changed. This domain also includes the person's physical and psychic state as it now is. This can be changed in the future, but not in the present moment. It also includes everything that is decided either by other people, or by a transcendental fate that no one can grasp. It is an enormously large domain.

On the right hand side of the model is the space of personal freedom. What do we find there? After a bit of thought, it consists of two things: the behaviour and attitudes of the person in the here and now. The person can choose what to do and what not to do, and what inner attitudes will be adopted towards every detail of the domain of fate, as well as towards options for the future.

One of Frankl's most brilliant ideas was to reduce the whole of the enormous left hand side, the domain of fate, to “nothing”, insofar as we can see it as the region in which we have no choice. Whereas on the small right hand side we have a galaxy of choices, from which we have the opportunity to pick out one of the “stars” and bring it to actualisation. This galaxy of stars is admittedly constrained. If someone is severely ill and bedridden, or in prison, that person's choices are restricted. Nevertheless, they exist – right up until the last breath of life.

Let us pursue this thought further. Are these stars in the galaxy which are available to us all equally valuable and worthy of being actualised? Is it a matter of indifference which one we choose? By no means! Our possible choices include completely stupid ones. We can jump off a balcony, we can dye our hair bright yellow and purple, and so on. We also have possible choices which are evil, as the newspapers report on a daily basis. The art of life consists of identifying, selecting and realising the possibility that is most worthy of being actualised. In the terminology of our model: to identify the brightest (= most meaningful) star in the galaxy of possibilities on the right hand side, and transfer it to the left hand side, to our life history, whereupon it becomes an abiding and inviolable truth about our self.

We should be clear about the fact that it is possibilities and not actualisations that disappear. Stars that are not chosen fade away. If I do not jump from the balcony, this possibility disappears from my present life. If I do jump, this possibility ceases to be a possibility and becomes (a tragic) part of reality. Together with all of its consequences, it becomes a part of my past, from which it can never be removed. Everything which is once chosen becomes eternal.

This model can be very helpful in logotherapeutic practice. Patients seek help because their domain of fate includes something bad that they cannot deal with. It may be a trauma, a tragedy, fears, conflicts, bad habits or depressive moods. A clear diagnosis is always necessary. But then we need to direct patients' attention to the domain of individual freedom and point out the galaxy of stars that exists in their present situation. To let them be surprised by the richness of possibilities that exists for them despite and in the midst of their darkness. And to invite them to reach out for their brightest star – to discover the best of all their possibilities. Logotherapy is not a psychotherapy of uncovering, but of discovering.

What must be discovered is the one thing in the here and now that will do good to the person and also in the world. Unfortunately this is not necessarily the most pleasurable or preferred option for the patient. Sometimes it is something that is very difficult to do. But, 1. it is always something that the patient can do (otherwise it would not be in their domain of freedom) and 2. it is always something that they should do, because it is in harmony with their conscience. Patients must always decide for themselves what they will do, but we can offer them help in putting it into practice, and we can honestly assure them that the darkness around them will grow lighter when they enrich their life with the light of the star that is worthy of being made real.

Ahrendt: Is the key question what is good for us and the world in a particular situation?

Lukas: One could put it like that. Frankl said, “Every deed is its own monument”. This means that every action that is performed or omitted, but also every inner stance and attitude, is carved into our own monument, our own identity. Happy people are those who can live content with themselves. And one can only be content if one has a life filled with meaning.

Ahrendt: It sounds like we have an incredible responsibility for our own lives!

Lukas: For ourselves and the effect that we have. Frankl made the point well when he wrote in his book The Doctor and the Soul:

“…there is something fearful about man’s responsibility. But at the same time something glorious! It is fearful to know that at this moment we bear the responsibility for the next, that every decision from the smallest to the largest is a decision for all eternity, that at every moment we bring to reality – or miss – a possibility that exists only for the particular moment.” 1

Ahrendt: Dr. Lukas, thank you very much for this instructive talk!

1 Viktor E. Frankl, The Doctor and the Soul, New York, Vintage Books, 1986, p. 35.