Fundamentals of Medical Psychology: Psychodiagnostics and Psychotherapy in Everyday Practice (1925)
Dr. med. Heinz Fendel, Specialist of Internal Medicine and Nervous Disorders
Hoechst, Frankfurt on the Main River, Germany
Publisher: Urban & Schwarzenberg
Berlin Friedrichstrasse 106 B / Vienna I Mahlerstrasse 4
Chapter 20: Logotherapy
The main medium of every psychotherapy is the spoken word. It is therefore obvious that the verbal message, aside from its activating principles, can be by itself a method. As Dubois emphasized when he stated: “the only weapon of the doctor—when one leaves aside the power of suggestion or hypnosis–is clear understanding, a gift, to communicate facts to the patient clearly, and free from false assumptions.” It is notable that such healing influence on the soul that can be transmitted merely through word based on reason (Logos), requires certain characteristics of the patient and the doctor: It comes into play in the case of certain patients, who have a refined psyche and experience structure. It requires from the doctor the highest mastery of verbal capacity, style, and content, to express such welled up realities. Constating the initially unrecognized complaints, doubts and objections of the patient, exploring deeper to bring out the correcting counter arguments based on their own presenting observations and declarations, that leads to an appreciation of the absurdum of the illogical conception of illness, is the great art, that confronts us in Dubois’ work. To whomever this process “seems really primitive” (Heyer), must not yet have fully appreciated the finest possibilities of psychological healing. Certainly, just like in the case of other forms of psychotherapy, the formal, suggestive, affective, and irrational elements are also at work, however, from simply a methodological point of view, it is an art to be able to utilize this tool.
As much as the content of the logotherapeutic intervention matters, it is also important and difficult to arrive to what is right and to avoid what is wrong. As a principle, the rule not to harm, ranks higher than the bid to use. Kretchmer says: “Whoever has not hurt their patients psychologically is already a good psychotherapist.” Who among us doctors can boast with such “never?”
Specifically, doctors have the duty not to reveal an unfavorable diagnosis, when that has no vital significance to the patient, further, to avoid any communications with the patient that can lead to overexaggerated and erroneous conclusions. How often these rules are disrespected! Especially those who are charged with the care and healing of accident victims. There, through quite unbelievable and construed connections between the harm and subjective difficulties, the dynamics of accident neurosis is brought into motion. For sick notes, literally, and therapeutic measures are much more convenient and “gratifying,” than the clarification of the real (psychogenic) nature of suffering. Since the latter often requires great self-denial. Whoever is only interested in their name and in their practice can never become a true psychotherapist.
Psychotherapeutic activity stands in strict opposition to the anti-psychotherapeutic “goal-directed neglectfulness” (Bruns). To the point that one could speak directly of a “methodical neglect-therapy.” As Dubois explains: “In a case of aphonia that lasted already for six months, I intentionally engaged in a negative suggestion procedure, because I did not only simply ignore the aphonia, but I did not concern myself about it at all. The patient had a host of neurotic disturbances: sleeplessness, diarrhea, pain in the legs. During the first visit, she complained with a toneless voice: ‘Doctor, I can still not talk!’ I still said nothing in response and instead started to ask her about all her other symptoms. I wanted her to forget about her suffering from the aphasia. This went so well that after two days, she started to talk with a loud voice.”
In other cases, and now we arrive to the actual theme of this chapter, it is absolutely necessary to take a detailed look at the patient’s complaints in order to empathize with their condition and even the most subtle aspects of it, whilst, nevertheless, steadfast holding on to the psychological nature of their disturbance. Only from this base one can build the required trust in the words of the doctor.
The methodical principle of restoring sanity comes with clarification. We shall say to the patient: “You are wrong about yourself. Your consideration and judgement are based on false premises. Let’s establish what is clear,” which Dubois put into these words:
“The human machine is so complicated that each and every day we could constate a disturbance somewhere. In can be a gastric disturbance, an undefined pain, heart palpitations, a fleeting neuralgia. But out of full trust in our good health, we forgo this trivia. The hypochondriac, however, paves the path to illness, just from the mere thought.”
What is the best advice so that hypochondriac thoughts do not materialize? Humor (good cheer) and confidence have been proven by science to lead to healthy patterns that support wellbeing and break the chain of harmful patterns. Away with self-tormenting ruminations. These ruminations themselves become the cause.
Pascal’s words: “Man is just a pipe, weakest in nature, but a thinking pipe,” can have two layers: It is possible for us to remedy our weaknesses through knowledge, prudence, and care. However, it is also possible for us through hyper-reflection and through hypochondriacal brooding to exaggerate shortcomings and disturbances to such extent that they arise from nothing. It is an advantage to these latter types of people who have a tendency for such rumination to be thinking beings.
Think about it! Not the reality, not the absolute givens, what may be so serious, but the mental mediation of the absolutes is the greater source of suffering. One fears the hereditary, transmissible, or other sources of illness. Attempt to think about these things in a philosophical manner! What do we know about reality and its relation to us? We have found a couple of categorical formulas that should reveal to us something about the absolute. However, those who have reverence understand that we have not the slightest idea if we can really understand.
“Everything to which much consideration is given, becomes thinkable,” said Nietzsche. To them, everything becomes possible, because they think about it a lot. They judge too swiftly. Whoever makes him or herself the subject of gruesome self-criticism must come across insufficiency and limitation.
Look at it another way! Others can do much less to you than you to yourself. But they worry less, and they have fewer inhibitions.
They have already proved to themselves that they can cope well with real misfortune and adversity. You can conclude from this to your advantage that for you, only intellectual mediation is at the stake.
You will reply: “I do not think about the illness, I am not just imagining something, it is the illness that finds me too often, surprises me and ambushes me at every turn, without my slightest wish or defense against it; I only think and hope for my recovery and wellbeing.”
Alas, you are wrong. Even while you are ignoring the symptoms and try not to think about them, you fear them unconsciously. You may not believe the power of these unconscious thoughts that can overtake our entire ego and have a more direct connection to our bodily organs than those thoughts that we have conscious awareness of. As you are hoping for recovery, the thought of not being healthy is already there, and unconsciously you may be already doubting if you will be healthy.
Visualize your childhood. How effortlessly and naturally everything flew. As soon as you went to bed, you feel into deep sleep. You did not think at all about sleep when you went to bed. You would have been just as ready to remain awake. This is how children fall asleep automatically, without any wish or prohibition to do so. What do you do now? You think about sleep maybe during the day already and calculate the chances of not getting enough sleep. Surely, you do this at the time of going to bed. Sleep is important to you. You interpret it in terms of your health and ability to function. You overrate this function quite a lot. Each time you think about sleep, and long for it, and fear sleeplessness, you whisk it away. On the other hand: if you did not care so much about sleep and while lying sleeplessly in bed you could say to yourself: “I am resting, even if I am not asleep,” with a peaceful mind, calm images would arise—and you would fall asleep.
Or: Our you are in the grip of anxiety. But not the anxiety, but the anxiety from the anxiety, is what is causing the most anxiety and suffering.
So, you suffer, without intending to, without knowing, that it is almost entirely suffering because of your thoughts, anticipation, and worries. On the other hand, the fact that you suffer should be a ground for trust and for comfort. Because the fact of suffering, anxiety, need, and the feeling of insufficiency, are the proof that with sound thinking and critique you can overcome these phenomena. You know that in the case of serious mental disorders this is not the case, and these feelings are taken for granted.
For the time being, while you have direct encounter with such feelings as weakness, excitement, lack of restraint, you must know that you have the capacity to achieve your final goal. You will get there. In Nietzsche’s words, “Everything important happens anyway.” Do not mistakenly overestimate the disadvantages of such nervousness. Von Speyr has expressed it directly: “Only the neurasthenic achieves something.” Keep in mind that this nervosity is the sign of a high sensitivity that is also the prerequisite of achievements and enjoyment, that other people may not have access to.
All in all, you will have a calmer life and greater life enjoyment if you manage to master the challenging art of whenever possible to look away from yourself, reach out to your environment, nurture your relationship with yourself, value and compare yourself against you, spend less time in self-reflection and self-mirroring to others than to genuinely seek to live for others and to think of others.
Humanity lost paradise in the moment when human beings became concerned about themselves. They can regain it in the moment when they can re-dedicate themselves again to things and people in their environment with original naivety and with the joy of unlimited self-giving.
We must learn and re-learn to gaze upon the objective instead of the subjective. Since all sorts of difficulties stem from circumstantial thinking that are just the products of themselves. If one takes things as out there, without reference to us, without relevance to our need and plans, they lose their sting against us. One learns to identify tangential thinking.
Specifically, one gets fulfilled in fulfilling others, with the freedom to look into the eyes of the objectively given facts, and take them for what they are, instead of drawing personal connections that result in self-depreciating and judgmental thoughts that weight the soul down. So, let us beware of overvalued ideas, complexes, and all other forms of painful manifestations of mental mediation.
We do not need to act with suspicion. Always establish the objectivity of the facts first. Whether it is ambiguous telephone conversations or messages, not to let these right away alter one’s inner landscape. There is the possibility for a goal-directed evaluation of the content and managing of the experience.
Caveat! The proposed objective look at the experience is not for the sake of eventually disclosing an inherent self-interest as means to an end, but rather for a finer understanding of the invaluable asset of the acquisition of finer and more refined psychological knowledge, according to which unwanted and automatic, unconscious impulses are more likely to take advantage of disorganized thought processes.
Objectivity should therefore aid to ward off the inner experiences that mentally take over to the detriment of mental and bodily functioning.
The art of objectivity –with respect to observing the ideas—is not realism or materialism, but rather a subjectivism; to the end that this subjectivism could lead to a richer and stronger development of the subject, after he or she had learned how to overcome hypochondriacal limitations and unrealistic connections.
In this regard, you can understand the doctor’s clarifications with respect to the entirely unnecessary, obsessional, and harmful conclusions of thinking. Dubois already illuminated the logical failures of nervousness! Think about what this means! The nervous person uses their mental powers to artistically make themselves sick!
They feel limited in their surroundings, in their families. This stems from a unique perception of reality, a wrong conclusion. The closest to them in fact, is who gives them motivation to work and a goal. This shows you the helplessness and the indifference that they fall into when they distance themselves from those close to them.
Their exhaustion and tension are the consequence of something conscious or unconscious mentally mediated feelings of displeasure, not an actual bodily exhaustion. Any young woman can confirm this who will feel fresh and poised to go for a walk after an entire night of dancing, while another feels miserable and tired after an uninspiring company the night before.
Their heart palpitations, as unexpected and as unbelievable, are directly related to their unconscious expectations. Why would these manifest exactly while lying down when the heart is required to make the least effort? Because in the absence of divertissement and other thought contents, these hypochondriacal ideas freely step in. Strong associations build up between going to bed, climbing the stairs, and chasing the tram, and the unconscious expectation of heart palpitations that are quite automatically enacted. If they had once experienced coming late in the theatre or the concert, climbed the stairs, rushed in, and stumbled unexpectedly into the middle of a captivating performance, the heart palpitations were not noticed then because the affective excitement left no space for attention to the heart.
Dubois explained the key to the reason of feeling unwell to a lady suffering from the strongest heartaches the following way: “I suppose you have paid a lot of attention to both circumstances, and as a rule, in your case, they occur together. But please, for once try to put an end to this fateful shortcut between cause and effect! As long as you are convinced that they will occur together and you expect to see heartaches show up at the end of your period, they will really occur. Ignore the observation, as logical as it may be, and hold on to the idea: I am young, strong and healthy. I do not suffer from heart problems, no organic reasons for heart disease can be found, and from a simple nervous suffering, it is impossible that I can die! Then the anxiety will disappear, your heart will stop beating wildly, and you will sleep like a child.”
Their sadness, upset, and their anxiety is not without a ground, since it is unleashed by earlier traumatic memories or thoughts which may reoccur as a result of the chemical state of their personality, but this is exactly the time when they should sit down with themselves and have a dialogue with themselves until this content is made indifferent, and they are over it, and the phase is ended. Digestive problems, even pains and vomiting—as long as there is no evidence of medical reasons—are not the best to treat with dieting. First of all because the unconscious anchoring of the symptoms of illness may persist without patient’s slightest awareness and lock the symptoms into a pattern. Second, because of the loss of energy can lead to physical illness.
The derivation and the propagation of such and similar unhelpful thought processes is the task of logotherapy to tackle. After understanding the symptom, and the individual situation of each patient, we appeal to their individual capacities to take an intellectual and moral stand. “There is something praiseworthy in each and every person: they may be intelligent, reasonable, or have a depth of feeling and heart. Even religious feelings can come handy to mentally uphold the sick” (Dubois).
The goal of therapy is to influence the disposition of the psyche. In this task, everything can be helpful that is at its disposal for comfort and healing that is a renewable daily resource: The art through which we can influence our mental wellbeing (Dasein) , that allows us to be mindful of the uplifting knowledge that we are members and partakers of a spiritual world, ever living, that no death can destroy, and able to overcome time and brokenness—this knowledge given to humanity through religion. Dejerines’ assertion according to which the religious person cannot become nervous or hysterical sure sounds very enthusiastic, and it contains a grain of truth because in it lies, in a sense, living psychotherapy. Eucken said: “In the struggle for a spiritual self-preservation that one is driven to religion.” Nietzsche adds: “Religion and religious significance brings sunshine to plagued human beings and makes their very sight to themselves bearable, refreshed, refined, and capable of making the most of their suffering to even sanctifying and just ends.”
The innate desire of every human being to believe in something more than the self, comes back with vengeance when it has been for a long time suppressed. It fills the resulting vacuum with artificial blockades, jams, absurdities, and pointlessness. In the case of those suffering from neurasthenia, this leads to a cacophony and discord. The so-called religious people live not only more satisfied and happier lives in their huts and in poverty, but they also live with less conflicts and carefree lives in the palaces of riches.
Therefore, “even those who do not regret the appearance of religious illusions in today’s cultural world, admit that they offer to those bound by them the strongest protection against the danger of neurosis, as long as they have strength.” (Freud in “Mass Psychology and Ego Analysis”).
Interview with Elisabeth Lukas, PhD, by Stephan Baier (Grandios Magazine, Regensburg, February, 2022). Translated by Maria Marshall, PhD
How does the capacity to trust arise and grow?
In what ways does parenting affect trust?
Can one do well without a basic trust in life’s meaningfulness and a positive mage of the world?
These are the topics of the following interview that was conducted with Dr. Lukas by Stephan Baier at the GRANDIOS Magazine Studios in February 2022.
SB: Trust; what is this concept? The capacity to trust; are we born with it, or do we have to gradually learn it? And finally, is trust like a talent that one can be endowed with more of, or less with, or is it a decision to trust or not to trust. These are the topics that we are going to discuss with Dr. Elisabeth Lukas. Dr. Lukas is one of the most well-known psychotherapists in the German speaking world, and most certainly, the most prominent student of Dr. Viktor Frankl. Viktor Frankl was the father of logotherapy, also known as The Third Viennese School of Psychotherapy.
Dear Dr. Lukas, prior to this interview, you gifted me with this booklet (“Wolken vor der Sonne?” Lukas, 2021), that I would like to cite from, since I found something very interesting here that brings us right to our topic: You write that trusting people live not only longer lives, but they get along more harmoniously with others, and they can tolerate loneliness better than others. Why is this so?
EL: Yes, well, trusting people are of course more sympathetic because when it comes to communication and living together, one gets along easier with someone who is trusting than with someone who is skeptical, and when one meets others with a spark of trust, it is easier to get along right away then if one is met with suspicion. This trust that one grants in advance to the other, perhaps more than what they deserve, motivates the other to do something good in return, not to shatter the expectation. In this way one locks the other in trust that presupposes and expects that something good will happen. Of course, one sometimes pays a price for this, if one gives more trust than what was reasonable, one is going to be disappointed, but one needs to accept this. It is better to let oneself experience a bit of disappointment than to be stuck in a steady climate of skepticism and mistrust.
SL: But how do I become this trusting person?
EL: This question has to do with the basis of trust. You raised the question if one naturally has the tendency for trust, or one has to develop it? In principle, each newborn brings with them the capacity to trust, just as they take their first breath. Even babies are born with this innate tendency to expect help when they are helpless, and we know that human babies are more helpless than any baby animal. They are totally dependent on help. They have to trust that help will come. They only way they can signal if they need help is by crying and then help comes, maybe not right away, but it arrives. And this strengthens the experience that help comes when help is needed.
SL: But is there not a disappointment as well if the parent is not responsive? For example, if a mother responds late but does respond eventually, is it not a rhythmic change from disappointment to trust and from trust to disappointment, this rhythm of back and forth and back and forth between trust and disappointment?
EL: Human babies come into the world with a complex neural system that is incredibly adaptable. First, it makes the connection that help is on the way. That it comes. And learns to observe: Observe lights and shadows, observe movements. Also, to perceive those processes that are going to result in help. For example, they can hear the steps, or when spoken to. They learn to associate words with help. When they are spoken to, help will soon come, they will be comforted. When babies grasp the meaning of the events in the world around them through such associations, they can also wait. Here I would like to highlight a point that I think is important: Subjective sense of time. Subjective time is different from the objective amount of time that may have passed. Subjective perception of time changes in the course of life. For a younger person, the same time feels longer than for someone older. For a ten-year-old a year is a very long time. For a 16-year-old, a year passes in a blink. For a baby, an hour seems an eternity. When they cry the whole night or days go by before anyone responds to their cries of help, then for the child that affects their trust.
SL: When we experience pain or suffering, time seems to pass much slower than other times.
EL: You are exactly right. For a small child or for baby with a long time of no help and discomfort seems a very long time. Most parents know this and they stay up most of the night and watch their baby and are attentive to their needs. I do not mean to say by this that parents need to be always one hundred percent available and run as soon as their child begins to fuss, there must be some learning on the part of the child as well, of a bit of toleration and waiting for the parent to help. When one has a good communication than one feels integrated in the milieu where one feels safe and protected in the home, one feels at home, and one trusts that help will arrive when it is needed even if it may take for some time to arrive.
SL: The older a child is, the greater the disappointments can get when they understand that the world does not operate according to their wishes. One needs to take this disappointment seriously and learn from it, that the world is not always the way we wish it to be. How can trust grow, despite the disappointments that children and youth need to experience?
EL: A child develops. However, from the beginning, they bring with them a sense of basic trust. This is so deeply engraved in people in all cultures in people from all walks of life and through all concepts and images of God, that there must be behind something or someone that we can trust. I’d like to point out that the fairy tales also do not paint us an ideal world, there are elves, and witches, and dragons, and all sorts of things that occur in them. Yet, what the fairy tales show to us is a clear world. Clear, since there is good and bad. In the stories the good always wins. It always has the final say. People can be saved, changed, and, at the end, the good comes through. This is what reinforces and re-states the notion of basic trust in children. When they grow, they understand of course that the reality is not always like that, the good characters are not always good, the bad characters are not always bad, and between good and bad there are all these ways of in-between, but by that time children have the capacity to distinguish and decide. They can differentiate between their external reality and their inner feeling of trust and security. In the external world, there may be a lot of things that do not match, that do not work, but in their inner reality, there can be something there that wins, that remains. It is otherwise when children from a very early age are subjected to abuse, violence, and aggression, and have experienced grave disappointments, and, as a consequence, they see the world as a hostile and dark world in which the good can not be taken for granted. The negative experiences in this case can stifle a sense of trust that remains hidden inside.
SL: We talked about the positive case, when children feel protected and well taken care of, and parents in such families can also do certain things right and maybe certain things wrong. What can they do to keep trust alive? You gave us one tip, to tell their children stories to reinforce basic trust. What else would you suggest doing?
E.L.: With the example of the fairy tales, I just wanted to illustrate how in the folk tradition there is already a sense of basic trust. In the early years what fosters trust in consistency. This means rules so that children have a routine, and they can tell what is going to happen next. They learn that now it is bath-time, then we are walking for a walk, now it is time to sleep. This works well for the elderly as well; they function better when they have a structure that they are familiar with. Flexibility comes in-between. In the milieu of such structure, children learn to differentiate that certain people have different traits, different behaviors, reactions, but when their own reference person, a person who they trust, act inconsistently, that upsets children. Children can tolerate and learn very well how people have some different ways o reacting or doing things. However, strong emotional outbursts by the same person, or inconsistencies, and inconsistent reactions manifested by their main caregiver are troubling for children. This happens for example if mothers are over-exerted, under extreme stress, or under the influence of drugs and alcohol, where they show instability, lability, and there are outburst of emotion or temper. When the main caregivers have a loss of self-control emotionally, that confuses children because they learn that they can not trust someone if they are friendly because it is not for sure that this friendliness will last and for how long. It makes children fearful and anxious and loose trust.
SL: Caregivers model trust to their children themselves?
EL: There are no perfect families, but we can say that the intact family is the place of the highest feeling of security on earth. The reason of it is that in other places, one is judged according to one’s abilities and contribution. For example, if I have good recommendations as a speaker, I am being sought after. But if I shy away from people and remain in seclusion, no one will think that I am a good speaker. This is not the same in the family. In the family, when it is intact, one feels valued. Regardless of one’s appearance, even if one is unproductive, one is valued for who one is, whether one is young or old, smart, or not so smart, in the family, one is valued because one is part of the family. I know that this is an ideal, but the family is the place of this ideal. What is wanted to express is that in the family, one is valued for one’s personhood and for one’s inherent value. When children experience this, they develop a sense of self-worth, that helps them to face whatever may come their way.
SL: Is this not inherent in every person to want to be loved and accepted for who they are?
EL: Yes, although in the family it is also important to consider the other part of the question. Everyone wants to be loved but one needs to offer love as well to the others. One wants to be understood, but does one understand the other? It must be a two-way process.
SL: When a child does not experience that, then what happens? For most children, they know that they are loved, valued, and accepted. They know that their parent loves them even when they are corrected or scolded. What happens to those who never experience such validation or acceptance? What do they then feel that they can give to the other when they have received little, and how can they then think that the world is still a good place?
EL: This is a fundamental question you are speaking about. One discusses this is psychotherapy a lot, and we need to reach back to one’s view of the human person. The view of the human person influences how one sees oneself and others. It is not true that a person is a “Tabula Rasa” and that everything that a person becomes is because of what their caregiver has written on this board. This is simply not the case. People come even genetically with a lot of influences; we know this thanks to modern research. One brings even psychological tendencies, both positives and negatives, strengths and weaknesses. On top of that one has the influences of the environment, the influence if the parents, influence of media, etc. At any rate, people are not merely the product of their genetic inheritance and the impact of their environment. Frankl always said, there is a third given, and this is the spirit of the person, which is an entire novum. Each person is unique, a new creation.
SL: And here lies our potential, right?
EL: Yes, here lies our potential in spirit, and thus a potential for molding and creating oneself. This is what I wish to emphasize. From the beginning, a young person reacts to their environment and to their circumstances in the way that they develop themselves and use their talents for self-discipline, and for self-development to bring the best out of what a person is capable of becoming. A person can take a stand toward their environment when they give their “yes,” or “no” or when they resist something. In other words, there is a capacity that one has for resistance. This is the case when one may be coming from a very miserable background and one had a misfortune of accumulating negative life experiences, this capacity to develop oneself and change oneself is still there and can be developed. When one distances oneself from such negative influences, quite conscientiously decides to distance oneself from repeating what was mistaken, when one can distance oneself, and one decides “What I do not want” and “This is what I do not want to repeat” that is when Frankl speaks of the defiant power of the human spirit. “I will do it better, and I will do it differently.”
SL: This is a different message, right? If one came to you in psychotherapy and said to you, “I have been totally ruined in my childhood, and for that reason I am unable to go on with my life,” is it that you would have good news for them?
EL: It is a hypothesis that one is “ruined” and comes from being outspoken, but the spiritual person is never “ruined.” They have within themselves the capacity to make everything renewed and different. Also, from the experience of suffering one can develop an advantage of warning. “One knows what not to want, what will not work, and to be even stronger and determined to achieve it. In other words, the new generation does not need to repeat the mistakes of the old generation. They can grow through it and build something new and better. This old sadness may be there and come back at times, but one also has the defiant power of the human spirit through which it is possible to overcome the past and to build something new.
SL: You were talking about basic trust that each person is born with. This can not be destroyed but it can be disturbed. So then if a person seeks your advice who trust has been shaken, what is your advice? How could one correct this?
EL: One question is how I could help someone, as you say, “correct this.” The other question is, how can one help oneself? Two different questions. How would I help a child, for example, shall we start with that?
EL: Children are by nature incredibly robust. Nature built them incredibly strong. When they come into contact with a person who has a positive influence of them, they can easily relax and open up. What one can offer, on the one hand, is caring conversations in which one points out connections. For example, a parent is under extreme stress, or ill. By this, what I mean to say, not to gloss over but to speak frankly and honestly, so they can process what happened. To illustrate connections and links, so that they can understand is helpful. When we understand things, we can process them better and is such way one fosters insight that is age appropriate and possible. The second point I wish the emphasize is the importance of building on children’s strengths. You see, children are capable of becoming very enthusiastic and when one notices and encourages their strengths and talents in the areas it may be in, technical, musical, sports, cooking, dance, arts and crafts, then these activities let them remain enthusiastic while their wounds are healing. They discover that they are good for something, they are good at something, and enjoy their activities, which reinforces the view that there are nice things in the world, not only the bad they experienced. Then they go on with life and grow with more elasticity and this is not an exaggeration, but a very helpful bandage for the wounds to grow with.
SL: For us to go on with our tasks, we need to believe that the world is good place, that for me personally, the world is good place, for me it is meaningful, that there is a meaning to discover. Do we need such a sentiment to be able to keep on living?
EL: I will start with the first part of your question, “do we need to know that the world is a good place” I would like to question this. Our world is not a very good place. It has good sides and bad sides. It is not about if the good in the world needs to outweigh the bad in the world. There is a lot of suffering it the world. There is a lot of grief. Frankl spoke about the tragic triad of grief, death, and pain. We all have sorrows, we all make mistakes, and we will die. Realistically, about whether the world is a good place, I do not know. About the other part of your question, if being has meaning, that is a different question. This has to do with a very deep search in people, a wish to find meaning in everything that there is. This is a quite deep search engraved in the human soul. The question is there is a last or ultimate meaning, despite all the grief and suffering. Basic trust is not at all the belief that at the end, everything will turn out fine. Basic trust is the conviction that there is a higher dimension, beyond our dimension, in which even our suffering can have meaning. It is the question if all the uncertainty of our life can culminate in a final harmony, even if we may not be able to grasp the individual pieces. Dr. Frankl, who was a survivor of the holocaust during the Second World War, explained that the prisoners walked to the gas chambers with their heads held high and a prayer on their lips. The prisoners did not think that God will appear and intervene and save them from the gas chambers. They knew that God will not intervene to stop this great injustice, but they entered the gas chambers with a prayer on their lips. This is basic trust. It remains a mystery why there is so much misery in the world and suffering. Frankl said we need to bow in front of this mystery. And we need to trust that in this higher dimension everything retains its meaning.
SL: Do you think it is easier for religious people to accept that there is such dimension? The reality of God in a higher dimension would be perhaps easier to grasp for someone who is religious.
EL: Frankl offered a very beautiful metaphor to illustrate this. Imagine a scale with two arms, an antique scale, with two wide arms. He said, take one side where one can place the idea that the whole entire reality is a nuisance with no meaning. Everything will be lost, the planets will disappear, the suns will get sucked into a dark hole, everything is nothing and leads to nothing. This is on one side of the scale. One the other side of the scale is the conviction that everything has meaning, beyond even human comprehension. This entails the belief that the reality of creation is more that what is available to us and that the whole of creation expresses the will of God. And Frankl said, with logic and reason one cannot decide for one side or for the other. The two sides weigh the same.
SL: Life would be nicer, if this side weighed more.
EL: Well, yes, but Frankl said that the only way to make one side weight more than the other is to place one’s entire existence on one side or the other. This side will, for this person, personally weigh more than the other. There are simply no statistics that will help with the decision. There are statistics of other kind, however. Two of them can be found in my book. One of them is by Stephen Covey who wrote a bestseller that you may be well familiar with, on the habits of highly effective people. These people who do very well in life, Covey found in his research, believe that there is such an ultimate meaning. They affirm the meaningfulness of life. The other research is by Leonard Sargon who followed a large group of people with longevity and found that many factors played a role, and among genetics and lifestyle, he established that a personal outlook on life also played a role. People who lived very long lives confirmed the meaningfulness of life. It appears that it is more helpful to believe that life is meaningful than it is to think that it offers no meaning, or nihilism.
SL: Can we establish then that those people who see a general meaning in life are more likely to experience their own lives as meaningful?
EL: When everything has meaning than of course every small part must have a meaning. Yes.
SL: When someone opts for the other arm of the scale, how do you help them? When everything seems absurd? Where does one reach then? One sinks into depression, or anxieties, or sadness?
EL: We need to know that everyone needs to make a decision for themselves. We can bring arguments, illustrations, and examples, but at the end the decision lies with every person. But every person can have time when they wrestle with the question. At these times it is very helpful what has been recognised in psychotherapy, a method, or the knowledge of the possibility of taking a “leap of faith.” How can one take a leap of faith? One has the capacity for self-distancing. What do we mean by self-distancing? One can step away from oneself and one can observe oneself from a distance in the present or in the past. One can also place oneself into the future and observe oneself there. One can look at oneself from the position that one is in right now and look in the future; my very best version of myself, for example in the future, and see what that would look like, and step by step advance towards that image that one wishes to become. This is the concept of the “leap of faith” [to advance toward something that is chosen and desirable out of one’s free will, to make that a reality when it is yet only in the future as an ideal].
For example, a person addicted to alcohol. How can she step out of tis habit? She must imagine, “One day, I will be sober, and I will stop drinking.” One can give help, but ultimately, people need to do it by themselves. This “one day” they need to live it as if they were already free. But it is not in the reality. They can set it into the reality step by step. The body is still dependent on alcohol but the “one day” can be already alcohol free. Maybe a day, maybe a week, maybe a month, maybe a year. One day, this can become reality. Or an overly anxious person. How can they break the disturbance? One can help them. But again, there is a point at which they need to do it themselves. They need to go into the depth of the deep of the anxiety and face it. Entering the situation and the moment one dares to face anxiety and realizes that one has strength and freedom that one did not know existed before. He or she may go with trembling knees, and perhaps the second time will be a bit easier than it was the first, and then one can elaborate it in the context of a story such as entering the lion’s den to find out that the “roaring lion” was a in fact a “pussy cat.” The courageous facing of anxiety allows this leap of faith. When I come back to your question about how one can help someone who is experiencing a lack of trust to re-gain that trust, we need to establish that there is nothing that one can do, because one can not force oneself to trust, one can only advise or challenge oneself to live as if one had trust. One leaps into a life of trust and lets oneself be surprised.
I often work with women who have difficulty trusting men because they had a bad experience in a relationship. They may have felt take advantage of, betrayed, used, you name it. Now they have a new man in their lives, and they do not trust this friend. They tell me they have pictures from the previous relationship come to their mind, they fear being taken advantage of, etc. So, I tell them, “But your new friend is of course entirely not guilty of your previous experiences.” The women conclude it themselves that “He does not deserve to be mistrusted,” and “I deserve to get to know a nicer side of life.” At this point then I advise them to take a leap of faith and proceed by being open to the other person with this self who is still experiencing suffering because of the repeating images in the mind, but the “I who I want to be, and can be” in the future. This often works. If there are no further disappointments, the relationship succeeds.
SL: Trust for adults it is a decision-making process then. An adult can decide in their freedom to want to trust and hold fast to this decision. Is this so?
EL: No. To want to trust is not the right word. But to decide to trust is the right word. Decision and trust belong together. This is a pair. When you decide, you must trust. When you trust, you must reach a decision. That is, you would not have to trust if you were always sure that something will work out fine. Thus, always in the uncertainty is that we need to have trust, and in the uncertainty the possibility of a decision is there. When you are applying for a job, you do not know yet if everything will work out fine; when you start a relationship and choose a partner, you do not know if everything will work out fine, and the relationship will be viable. At each point, you need to make a step into the uncertainty, and make a risk and a leap of faith; this is what is basic trust. Trust and decision work together just like uncertainty and taking a risk do. People who lack trust have a hard time deciding. Professor Frankl used a very beautiful expression about trust when he spoke to his American students: One has to act “half sure but who-hearted.” Maybe not sure, but with full trust.
About the subject of will, I like to mention that there are phenomena that cannot be intended. They can not be brought about by will. For example, one cannot intend to intend, one cannot “will” to love; one either loves or not. One cannot want to believe. One can not want to trust. These phenomena have prerequisites, from which they flow. For example, something valuable, brings forth valuing. Something loveable, brings forth to love it. Something believable brings it forth belief. Something trustworthy brings forth trust. So, will is intended toward these prerequisites. This is what we can intend for, to want. We can look for something valuable in the world; something loveable; something credible; something trustworthy. This is what we can want to intend for. This is what we can “will.” We can look in the world to find them; we can seek them out. We can search and find. Whoever searches, finds.
There are a lot of things that are worthwhile in the world. When I find this what is worthwhile, beautiful, and trustworthy, it will automatically elicit my will, and elicit my trust.
SL: How is it with self-esteem?
EL: This is an exciting topic in psychotherapy. Psychotherapy has to do with a lot of people who suffer from their confidence being shaken. Self-confidence has to do with the evaluation of one’s own inner resources. Self-esteem can be too low or over-inflated and neither of these has a good outcome. Either one’s level of performance will be low because of low self-confidence, and one does not develop one’s potentials as much as one could, or one over-estimated one’s capacities and one needs to touch ground at some point. However, self-confidence has another aspect that I would like to address. When one accomplishes what one committed oneself to do, this correlates highly with inner satisfaction and well being. One can plan a lot and accomplish little of those plans. Or one can break one’s promises, change one’s decisions, sabotage oneself from accomplishing the tasks that one set out for oneself, and this will have a negative impact on self-confidence. Imagine the example that one orders some work being done and the handyman says he will be there at such and such time on such and such day. You wait the whole day, but they do not show up. You phone them, agree on a new date and time. The time, comes, and they do not show up, but give you all sorts of excuses. The following time, when they do not show up, you will not take any of the excuses but really get mad at them. This is how people who sabotage themselves or let themselves down feel about themselves. When people sabotage their own plans, the feeling is a sense of failure, or impotence, “I can’t do it,” “I can’t do well anything.” So, in therapy how this plays out is not that we have to persuade people who do not trust themselves to make a leap of faith and convince themselves to accomplish small tasks that they can feel good about. Rather, often we have to advise them to request from themselves as little as possible, and as less demanding as possible, but that little that they then really make a commitment to fulfill, regardless of their feelings, as much as possible, so they can develop a healthy stand.
SL: For healthy self-confidence we have to have a realistic view of ourselves and know what we can do and what we are not so good at, right? For example, if I think that I am a great cook, but experience shows otherwise, I need to adjust the view of my abilities.
EL: Yes, for those who over-value themselves, there can be a series of disappointments, and sometimes they need to learn the hard way. The question is how one can learn from experience and adapt self-experience. For example, it could be a learning process for someone who thought they were a great cook but found out that they are not such a great cook after all, to start with something small, a salad and a simple menu that they can pull off with no difficulty. So, it is important that one does not give up and says, “I can not cook at all,” but make it little by little, step by step, try out this and try out that, and end with the conclusion that “Well, not so bad after all.” I think that the more one can learn from one’s experience about the difference between one’s self-confidence and the requirement of situations, the more one can use this knowledge to one’s advantage. In this sense, even negative experiences can be helpful because they can lead to development and growth.
SL: Do we need to be able to trust ourselves to be able to trust others?
EL: You pose very good questions.
SL: Do I need to have a firm anchor in myself to trust others?
EL: Well, maybe not if you take a leap of faith.
We can not say that only those people who have been loved can love. Maybe one is still able to give a positive attempt and make an effort to be positive towards others and, as a reward, receive self-confirmation. To come out of the difficulty does not require convenient circumstances. But to get back to your question, do we need to trust ourselves to trust others? That is a very good question.
I have spent thousands of hours in therapy with patients and I noticed that the pictures that they formed had something in common. Those who had a more positive self-image, had more likely a more positive relationship with others and a more positive relationship with God. Those who had a negative self-image tended to have more unfavorable interpersonal relationships and an image of God as unforgiving and punishing. So, I could conceptualize it in this way: Imagine that in the course of the life of a person one could unroll a transparent film that is lighter or darker in color. All the experiences in life are projected onto this transparent film. The difficult experiences that get projected to a lighter part of this transparent film can still retain their sparkle. While even nice experiences that are projected onto a dark part of this film, loose from their sparkle somehow.
A man who takes a higher position and projects everything onto a dark film, will think of the downside of the new job: the mishandling, the rivalry, the incompetence, etc. But a man who loses his job, but this experience falls onto a bright film, that man may look at this experience as a good thing: “I will find a better job.” So, it has to do with this “the glass is half-full or half-empty mentality.” This is the background onto which the experience is projected that can differ and determines how it will be interpreted. So, self-confidence, confidence in others and in God can fall on a dark film or a bright film. This is what makes the difference.
SL: Very interesting. This far we have only talked about the positive side of trust. Now I would like to bring up its opposite side, naivity. There is an expression that goes with it, we say someone is “gullible.” Are some people gullible because they trust too easily and too much, and they fall for swindlers and robbers and you name it. How can gullibility be avoided and trust somehow trained?
EL: Even in the fairy tales there is a warning about not to trust everyone. Not to trust evil. But I think that today being overly trusting is not a virtue anymore. The internet is full of deceiving advertisement, the news full of fake news. One needs to learn caution and measure one’s trust. Whom to trust and not to trust, which was you question, and how to prepare for making good decisions, has to do with critical thinking. One needs to form opinions and informed choices based on credible sources. Such choices can be made in conversations, observing different options, perspectives, which is possible in democratic countries. Even in democratic systems there is one challenge with finding space and time to calmly consider options and alternatives. This happens when parents in a family are very stressed than perhaps there is little time for such earnest discussions of different sources and information. Honest discussions with others have great advantages. For example, it has been shown that is schools, violence could be reduced through the introduction of a course on rhetoric. It is important to be able to express oneself and put into words one’s feelings; what one hopes for or what one is bothered by. Round-table discussions in politics can also lead to de-escalation. If one can express one’s inner self better, one gains trustworthiness because of the word. Words can be used for lying as well. One can see if one’s words are consistent with one’s actions and vice versa.
SL: Can we apply this in the society about people’s trust in institutions? It has been reported in sociological studies that the trust in major institutions such as the church, government institutions and agencies has dramatically decreased. Do you find this dangerous?
EL: I find this a pity. “Errare humanum est.” When one is human, one makes mistakes. As long as the responsible individuals are making an effort to correct the mistakes that have led to the decrease of trust, I think that is a good sign. I think in most instances there is a willingness to look critically at making good decisions. The understanding of a problem and capacity to solve it go together. Sometimes the attempt to solve certain problems can bring new problems that were not there before. For example, a new road can pose some inconvenience to the habitants. One arrives to the next problem. So, it is not that politicians, or church persons can not do anything at all well, rather they cannot do everything always well. I think it is these instances that need to be corrected because things have many perspectives. In addition, no one can have the capacity to foresee the future. Sometimes, in hindsight is easy to see and to make a judgement, but in foresight it is hard to always see the full consequences. When protesting, one should consider these facts and try not to just negate people in the position of power.
SL: Who I trust and whom I trust, is it then a personal decision?
EL: One can trust institutions, but not to forget that they are led by individuals. Certain individuals are corrupt. Certain individuals are untrustworthy. To make generalisations and to say “all” politicians, or all theologians, etc. is not helpful because it does not correspond to the truth. One can seek out individuals and examine their credibility on the basis of what they say and what they do. I think that it is all right to let oneself get disappointed at times. We also may have at some point let someone down. It is not always that we may have kept the confidence that was invested in us. Wittingly or unwittingly, there are so many misunderstandings that can happen. It is better to look at individual cases because out of these individuals is that the system is made of. The individual influences the system and the institution is expressed in society that influences the institution.
SL: For the final question: Whom or what do you personally trust?
EL: I think that I am fortunate that my chosen film is bright. Therefore, my self-image, and my image of God, carry a rather bright tone. I have also no fear of disappointments. I think I can deal with them well because I am mild on people. In my profession I worked with thousands of people, and I have seen that we can all have weaknesses. A very nice saying comes to my mind, it was said by an author, whose name I now fail to recall, but it goes like this: We are all angels with one wing. One wing that represents all the good and the beautiful we can do. What makes us grand. We have another wing that is just a small stump, that is not well formed. There is something wrong with it. And so, the author continued, if the angels once decided that they embraced each other, then they could have two wings and they could fly. This is what I trust in: that if we embrace each other, and we are not too hard on each other, and we understand that the other also has a wing that is not perfect and has weaknesses, but if we hold on to each other, we have two healthy and strong wings, and, together, we can fly.
SL: Let’s keep flying together. Thank you very much!
“We are each of us angels with one wing, and we can only fly by embracing one another” (Luciano de Crescenzo, Italian writer 1928-2019).
If I was to arrange my memories with Dr. Elisabeth Lukas in a photo album, the album would span several decades. In this essay, I will draw out my favorite pictures from the album and share them with you.
My first memory reaches back to 1982. There is a beautiful Christmas tree in my grandparents’ home. It is set on a table with glorious decorations and best of all, marzipan candies covered in chocolate and colorful, shiny wrapping paper. It is comfortable to sit under the tree and listen to the conservation of the adults sitting around the dinner table in the kitchen, adjacent to the living room. My father leads the conversation. He talks about Dr. Frankl and Dr. Elisabeth Lukas. He visited Dr. Frankl a few years earlier and is in touch with him about setting up a local telephone hotline for the prevention of suicides. It is the first initiative of this kind in our region. A lot of psychiatrists, psychologists and social workers will collaborate under my father’s guidance. The line will be available twenty-four hours a day, seven days a week, so many volunteers are required who are willing to help. The discussion shifts to Dr. Frankl’s book, “Man’s Search for Meaning” and the second world war. The memories of my grandmother are still vivid from the time when children she used to play with on the street were forcibly taken to unknown locations, neve to be seen again. The memories are fresh for my father as well, since his great grandfather perished in Auschwitz and his father came back alive from the forced labor camps. Everyone is silent for a while. My grandmother wipes tears from the side of her eyes. Then, my grandfather proposes to try my grandmother’s pie.
The second picture is from 1989. It is a chilli but sunny, beautiful, spring morning. My father leaves to work on his bicycle early in the morning to start work at 7:30 a.m. at his hospital. I have some time before I need to leave for school. There is a noise at the door as the flap of the mailbox closes. I run downstairs to empty the contents and retrieve a brown envelope with my father’s name and address on it. It is written with a blue fountain pen and impeccable spelling of our address 16 Vase Stajića, Subotica, Jugoslavien. The sender is Dr. Lukas and her husband, Mr. Gerhard Lukas, at the South German Institute of Logotherapy in Fürstenfeldbruck, Germany. I place the envelope on the living room table, ready for my father to open when he comes home from work. That evening, I see for the first time some images of Dr. Frankl and Dr. Lukas in the Jahresbericht (the Annual Report) of Dr. Lukas’ Institute. I sit in a comfortable armchair covered with grey velvety fabric and spend hours taking in the images.
The third picture is from 1991. There is a war in Yugoslavia. Everyone suspected that war would break out, but no one was really prepared for it. As soon as I arrive home for the summer holiday after my first year of university, my parents send me back to Hungary with the earliest train in the morning. All I can take with me is a backpack. They reassure me that they will join me later that day, when they cross the border in their large van with my six siblings, pretending to go on a holiday. They give me the address where I should go and wait for them. The day seems like an eternity. Finally, late in the evening, they arrive. They made it and got through the border safely. The van is packed to the brim. Even then, there is only one suitcase for each person. Inside mine, I discover the few books by Frankl that my father owns and used to read in the dim light at night, with pen in the hand. The books are heavily used, and the pages somewhat discolored brown, with shorthand side notes, and some exclamation marks. The yearly reports from the South German Institute are there as well, the whole package enveloped into a few T-shirts. This is the only literature that travels with us during the next few weeks while we wait to receive the immigration papers to Canada. The waiting seems unending. We wash our clothes in rivers. We sleep in abandoned parking lots or quiet streets, in the car. Finally, after two months of hope against all the odds, the visas are granted. We book plane tickets for nine persons: two adults and seven children, to Calgary, Alberta. We are off to the “unknown.” The suitcases are boarded onto the plane. They fly with us to this new land.
The fourth picture is from 1997. Nearly ten years have passed since we have been in Canada. The date is September 2. I am in the Counselling Psychology Doctoral Program at the University of Alberta and have just received a list of signatures from committee members who approved that my doctoral research with the title, “The Applications of Viktor E. Frankl’s Logotherapy in Counselling Psychology” can go ahead. Six committee members have approved the proposal and recorded their signatures in black ink. I am beyond words, elated. I have no idea that thousands of kilometres away, on the other side of the ocean, in Vienna, Dr. Viktor E. Frankl passed away on this day. I do not have e-mail and no internet. But I do have Dr. Frankl and Dr. Lukas’ books with me, and that is enough to get me started in my work.
The fifth picture is from the year 2000. I have just finished my Doctoral Dissertation a few months ago. It is November, and I am walking toward the South German Institute of Logotherapy. Dr. Lukas has invited me to be her special student at the South German Institute of Logotherapy. After participating in several presentations that she offered in Canada, the United States and in Germany, today is the day of the final exams. The class time seems to have passed very fast. It was a stellar opportunity to hear Dr. Lukas speak and demonstrate how she applies the principles of logotherapy in practice. As she talks, my attention is all on her. I soak in every word and every movement. I feel that I understand her very well, even though when she askes me if there are any nettles in Canada, I get so embarrassed that I stutter something like: “I do not think so.,” in German. To which Dr. Lukas says that that maybe I live in places where there are no nettles! There is a wonderful book that she hands out as a present to the class, written by one of her former students. It is about “Ortie” a little nettle who grows up to be different from the other plants around her, and must learn that she too has an important place to fill in the world. In this class, I get to know people who become life-long friends and colleagues. Among them are Dr. Alexander Batthyany, in charge of the Viktor Frankl Archives at that time, and the late Dr. Cvijeta Pahljina, a psychiatrist from Croatia, who knew my father. Everyone in the class is very supportive and I quickly forget that speaking German is not effortless. Will I do well on this final exam? I spent the entire night reading through the books again.
The sixth picture is about the final exam in Dr. Lukas’ office. It is the end of November, and Christmas is approaching fast. We are sitting around a large, round, glass table. In the middle is a candle. Dr. Lukas light it, which gives a reassuring sense of comfort and peace. She asks me a few introductory questions and then to describe the qualities of the human spirit. I do know some things, and she adds a few more concepts about the relevance of the resources of this specifically human dimension in health care. We speak about the first and the second Creed in Frankl’s logotherapy, according to which the essence of the person, the spirit can not become ill. It is a healthy core and resource. A person can become ill, but behind the mask of the illness, the spirit is always present. A person may be disturbed, but they can not be destroyed. At the end of the exam, Dr. Lukas does not tell me if I passed or failed, because this is not a pass or fail exam. I find out why. Dr. Lukas trusts me to keep learning and applying logotherapy and she has confidence in me. We walk to the front of her office where all of Frankl’s book and her books are exhibited on shelves. She invites me to indicate, from among all the books that I see on the shelves, the ones that I already have, and which ones I do not have yet. I am hesitant to admit how many books I still do not have, but I want to be honest, so I point to all the beautiful new editions, one more desirable than the other. One by one, Dr. Lukas lifts the books from the shelf and gives these books to me as a present! I have no words for her kindness and no words to describe how I feel. I am now the proud owner of almost each of her available books, and several new editions of Dr. Frankl’s books in German.
My book collection has been growing ever since. This is thanks partially to my husband, Edward, who has the same love for logotherapy as I do. Together, we direct the Ottawa Institute of Logotherapy in Ottawa, Canada. We have five children ad we distribute our time between taking care of the children, seeing patients, research, writing, and teaching logotherapy and related topics. Our connection with the Vienna Institute is fostered through a bond of friendship and collegiality that has endured the past twenty years.
What was Dr. Lukas’s influence on me? More than what one can express in words and write in an essay. I look up to Dr. Lukas as pioneer in presenting and teaching the applications of logotherapy in clinical practice and transmitting the ideas of Dr. Frankl in their purest form. I admire her work ethic and sound judgement. I admire her wisdom and her peaceful manners. I am in awe of the number of books she has written over the years and the knowledge and experience that she has in the areas of logotherapy and existential analysis that is helpful for clinical practice and for everyday living. I like her charming sense of humor and her sophistication. More than any other female psychologist, Dr. Lukas is a role model whose influence I cherish. Despite the distance in miles, Dr. Lukas feels close in spirit.
Nowadays, I am with Dr. Lukas, each time I cite her books, articles, or presentations. She is mentioned and referenced in most all the books that we have ever published through the Ottawa Institute of Logotherapy. Thanks to technology, I can regularly follow her presentations on the television or radio and get notified about her new publications.
With Dr. Lukas, Viktor Frankl’s Logotherapy and Existential Analysis continues to be an invitation to keep learning, reading, thinking, and comprehending, to be able to give and to give generously. Finally, to live, and to live to the fullest.
“Two roads diverged in the wood, and I-I took the one less traveled by, and that has made all the difference”
In “The Will to Meaning,” we find a paragraph where Frankl reports that he has been asked by some of his students about conscience. Specifically, about how Hitler ended up the way he was? He replied that “Hitler would have never become what he did unless he had supressed within himself the voice o conscience.” (Frankl, 2014b:46). He went on to say that “…only an erroneous conscience will demand a person to commit suicide, homicide, or genocide” (Frankl, 2014b:46).
Frankl understood human beings as entities who want to shape their lives in a meaningful way(Lukas, 2000). He made it clear that “Logotherapy is a life-affirming stance” (Frankl, 2014b:46). In the same paragraph, he explained that “…No logotherapist can pretend they know the value and know what makes sense and what does not” (Frankl, 2014: 46). No therapist can impose their values on others. But what they can do is to refer people back to their own conscience to show what is of value and what is meaningful or not.
There is a description of what conscience is in Elisabeth Lukas and Heidi Schőnfeld’s (2019) book entitled “Meaning-centered Psychotherapy.” Conscience has been denoted as the meaning organ, a resource of the human spirit, a specifically human phenomenon, whose function is to intuit, and discern what is meaningful. Meaning is present in a value that stands in relation to a person. In Frankl’s definition, meaning is objective and not subjective (Frankl, 1994). It is subjective only to the extent that it is person, and situation specific. It is an objective reality through which a human being is called every moment and in every instance.
We can be either consciously or unconsciously in search for meaning. The actualization of the value that we intuit is the most meaningful in a particular situation, brings it into the reality, makes it appear in a concrete and visible form this value that we “make our own.” This is the case with creative values, when we put into the word something that was not there before. We literally, co-create. It is evidenced in the case of experiential values, were we take something from the world in relationships with nature, or persons. Attitudinal values represent our inner stand through the defiant power of the human spirit. Meaning is thus actualized in the context of a relationship between a person and a value, in that a person reaches out to a value that he or she intuits, recognizes, and acknowledges as the meaning of the moment.
Conscience has intuitive, aesthetic, and creative capacities. Intuitive refers to the capacity to anticipate outcomes and points to what really matters, a “vision,” of what ought to be. Aesthetics refers to what seems in harmony and flow freely, what “should be.” Creative refers to possibilities, what “could be.” The three aspects of conscience encompass the realms of Intuition (Ethical Conscience); Inspiration (Aesthetic Conscience) and Justice (Moral conscience). These aspects correspond to the aspects of meaning as Truth, Beauty, and Goodness (Marshall & Marshall, 2022). Not every possibility that we can think of or can think of is equally meaningful. In general, what is meaningful to us in a particular moment is what is tailored to our context, our abilities, possibilities, and responsibilities (Batthyány, 2021).
Furthermore, the values that we choose to actualize need to conform to the aspects of meaning: they need to be true, good, and beautiful. At least, we need to aim for the actualization of the best possible alternative in a situation. The best is what reduces the suffering in the world as much as possible, and at least, does not harm the other and does not harm the person. The value that we actualize needs to conform to the “Laws of the Universe” and to the laws of universal values, to be meaningful. Universal values consider the dignity and uniqueness of each person, the value of each life, the dignity of the person. The meaning of the moment must be in harmony with “Ultimate Meaning” (Frankl, 2000). There needs to be a connection and a relationship between the here and now and the eternal, and when this connection is lost, alienation is inevitable (Marshall & Marshall, 2022).
When conscience is ignored, supressed, or repressed, when its voice is not brought to consciousness, or pushed back to the unconscious, one’s actions will not be meaningful. Most likely, they will not be in line with universal values and thus, not in line with harmony in the universe, not in line, in deep spiritual terms, with the “Will of God.”
This can happen when conscience is not formed to conform to the laws of the universe, when the spiritual muscles atrophy, and when a person chooses to turn away from the call to bring out the best that they can, are able to, and are called to, in the world.
The consequence of this alienation is objectification. The person will see their objectives in treating others as means to ends. They can even consider them as replaceable, their value depending on their utility for one’s own self-imposed goals. However, at the root of their actions will be a motivation by primitive instincts and fear, science Basic Trust, a belief in life’s ultimate meaningfulness and value, is compromised.
As the will to meaning remains unheard and frustrated, one may reach to power to enforce one’s ways. Violence, aggression, the blatant disregard for human rights and freedoms, mass murder, can happen when the other is alienated to the point of being objectified, and denigrated to the level of the less than human as one projects one’s own faulty image of the person onto others to justify one’s erroneous and mistaken actions.
When reflection to hear the voice of conscience to discern value is not heard, the loud screams of violence take over. Worse yet, a calculated and cold mastermind can spread suffering and destruction in the world, foreshadowing his or her own demise.
Frankl distinguished between subjective meanings, based on feelings, and objective meaning, that are actualized in the world (Frankl, 1968). He referred to rat experiments that were conducted in California, whereby brain regions of rats were stimulated with LSD, giving them the sensation of instant satisfaction, orgasm, and elation. The rats habituated to the drug very quickly and pressed the lever with increasing frequency, to the point that they cared only for the feeling and rejected actual sexual partners and real food. Frankl explained, that when one resorts to subjective meaning, one by-passes real meaning possibilities in the store because they seek for meaning within themselves, and neglect objective meaning that is waiting as potential to be fulfilled in the world. Once we have actualized the potentiality, we rescued it into the past, where no one can take it away. But the other way it is true: what we did not actualize is lost forever. Within this realm lies our responsibility. No one can always actualize every meaning possibility, but that is part of human reality, of fallibility and vulnerability and does not hinder the actualization of objective meaning, exactly in the face of transitoriness, fallibility, and vulnerability. We have to aim not to pass by transitory potentialities, for once we actualize them, we have rescued them forever (Frankl, 1968).
Only what is meaningful will remain in the world. Only what was courageously suffered, the guilt that was overcome, the consolation that was given, the unavoidable suffering courageously faced, the goodness shared. What is meaningless will remain meaningless and return to meaninglessness, into nothingness, into non-existence.
The basis of existence is self-transcendence (Frankl, 2014a, 2014, 2019). Human beings reach to a value, reach toward a cause to make their own and a person to love, or a difficult situation to handle. Through actualizing creative, experiential or attitudinal values is that they actualize meaning. One of the characteristics of human beings is the ability to make decisions and to be able to reflect on their values and the consequences of their actions. Thus, human beings are free, within their potential freedom as a finite, vulnerable and fallible human being, to “create themselves:” to shape themselves, mold themselves, to re-form themselves. They can make the choice to break an unhealthy habit and to shift from habitual or dysfunctional ways into a new direction. When one embraces meaning, one may travel the path “less travelled.” In other words, it may not be the most convenient, obvious, or easy path. However, one takes this road considering its promise: to conforms to the person in the image and likeness of that which was intended form the beginning—a self-transcendent and meaningful life that shows response-ability, responsiveness, and responsibility toward the self, toward others, toward the environment, toward the world, and the Transcendent.
What one has become, one has become through one’s choices. When one actualizes a wrong possibility, they become that what they chose. A person ordering the murder and killing of others becomes a murderer. A person who steals things from others becomes a thief. A person that does teel the truth becomes a liar, and so on. But they are still a person with the possibility to let meaning imbue their being and per-sonat, sound through their being in the world (Lukas & Schőnfeld, 2021).
The person is conditioned, but not determined. The person retains his or her value. To the last breath, one can bring meaning into the world a flood one’s life with meaning. But for that to happen, one needs to alter course, change heart. Have an honest conversation with oneself in the light of what the rules of the universe demand, what universal human values point to, what one is asked to do. One does not, one can not and one should not invent meaning and create it, because ultimately that is not the truth. It is a self-deception to think that one is leading a meaningful life if one created and fabricated meaning oneself without consulting one’s conscience and acknowledged the truth.
Meaning can not be invented, created, or fabricated. That is where the mistake lies. Conscience is creative because it can help us actualize a value that was intended in the circumstances in ways that it is possible for us to accomplish with our resources that are given and available.
The voice of conscience can be awakened by being present and being with. It cannot be done in isolation, talking to ourselves. It is not just a monologue to oneself, it needs to be in a dialogue with what is meant in an honest encounter in the light of truth, beauty, and goodness.
Quite frankly, “Life is not something, it is the opportunity for something,” Frankl affirmed (Frankl, 2019:50 quoting Hebbel, a German poet 1813-1863).
In a lighthearted way, he remarked, “…I am quite convinced that God knows when someone has made a confusion of Him with oneself…” (Frankl, 1994:284).
Batthyány, A. (2021). La superación de la indiferencia. Overcoming Indifference. Herder & Herder.
Frankl, V. E. (1994). Logotherapie und Existenzanayse. Texte aus sechs Jahrzehnten. München : Quintessenz.
Frankl, V. E. (1968). Subjective and objective meaning. Viktor Frankl Institute Vienna: Videoclip Archives.
Frankl, V. E. (2000). Man’s search for Ultimate Meaning. New York, NY: Perseus.
Frankl, V. E. (2014). Man’s search for meaning. Boston, MA: Beacon Press.
Frankl, V. E. (2014b). The will to meaning. Foundations and Applications of Logotherapy. New York, NY: Penguin/Random House.
Frankl, V. E. (2019). Yes to life in spite of everything. Boston, MA: Beacon Press.
Frost, R. (1993). The road not taken and other poems. Dover Publications.
Lukas, E. (2000). Logotherapy textbook. Toronto: Liberty Press.
Lukas, E. & Schőnfeld, H. (2021). Meaning-centered Psychotherapy. Bamberg: Elisabeth Lukas Archives.
Marshall, M. & Marshall, E. (2022). Viktor E. Frankl’s Logotherapy and Existential Analysis: Theory and Practice. Ottawa: Ottawa Institute of Logotherapy. Peck, S. M. (2002). The road less traveled. New York, NY: Simon and Schuster.
Fear and trust are fundamental human phenomena that exist on a continuum of psychological and physiological states with existential aspects. The dimension of spirit offers a dimension in which fear and trust can dialogue and can be reconciled for harmonious living. Neuroplasticity, based on discernment and reflection, can aid to reinforce values that we want to live for and that are in harmony with universal values. Through the resources of the human spirit, fear can be tamed, and basic trust can be re-gained for a meaning-filled living to avoid despair. Meaning is associated with self-transcendence, resilience, and post-traumatic growth. Meaningful living is related to positive health and mental health outcomes. In the light of these considerations, the journey from fear to trust is that of hope and faith—a living project—that unfolds in the context of Frankl’s three-dimensional view of the person, inspired, and guided by the unconditional trust in ultimate meaning and unconditional faith in ultimate being.
Dr. Viktor E. Frankl, MD, PhD (1905-1997), was a neurologist, psychiatrist, and the founder of Logotherapy and Existential analysis, a meaning-oriented approach to psychotherapy. One his great contribution to medicine was the re-humanization of psychiatry and psychotherapy though a three-dimensional view of the person, in which the body and mind are vulnerable and instruments of the spirit, and where the spirit is a non-material dynamic, and the essence of the person and his or her indestructible core. The articles that are explored in this presentation inform us of the dynamics of the body and the mind as the instruments of the spirit. It is meaningful to understand the processes of our body (1) to be able to appreciate the marvel of creation, (2) to accept and understand how we can best manage our emotions, (3) to gain insight of our area of freedom and fate; and (4) to understand how we can best take care of ourselves to be able to accomplish our mission; and (4) to reach out to others with hope. Thus, our trajectory will cover elements of self-discovery, self-distancing, and self-transcendence.
Therefore, the premise of this exploration is that, although we are conditioned, we are not determined:
In “The Will to Meaning” Frankl asserted that “…human beings are not fully conditioned and determined but they determine themselves whether to give in to these conditions or stand up to them. In other words, human beings are ultimately self-determined” (Frankl, 2014b:122).
The objectives of this research are: (1) to explore the bio-psychological mechanisms underlying fear and trust, (2) examine existential phenomena related to fear and trust, and (3) consider the ways in which meaning-orientation can foster trust to avoid despair.
The sources of the present research are books of Prof. Viktor E. Frankl, MD, PhD. Additional resources were collected from books of logotherapists disseminating Frankl’s work, such as Prof. Elisabeth Lukas, PhD, and several other prominent experts in the field, books by the author on logotherapy and related topics, and research articles in the field of medicine, neurology, psychiatry, psychology, and counseling. The findings are examined in the context of a holistic view of the person as a body, mind, and spirit entity.
Fear is one of our fundamental emotions. Other emotions include anger, disgust, sadness, surprize, and happiness (Gu, et al., 2019).
According to neuroscientific findings, four basic emotions, happiness, fear, sadness, and anger are differentially associated with three core affects: reward (happiness); punishment (sadness); and stress (fear and anger): “…These core affects are analogous to three primary colors (red, yellow, and blue) in that that are combined in various proportions to result in more complex ‘higher order emotions,’ such as love and esthetic emotion” (Gu, et al., 2019).
Often, we tend to categorize these emotions into positives and negatives. We aim for happiness, and maybe even surprize, and wish to avoid fear, disgust, sadness, and anger. This is a natural inclination. However, in excessively doing so, we may overlook the evolutionary value of emotions that serve the preservation of our lives. Realistic fear serves to protect us from danger. Lack of reasonable fear would lead to hotheaded actions. Excessive fear is unproductive because it blocks us down. Thus, the right management of fear ensures that we can use the energy of fear for our advantage.
The Neuropsychology of Fear
Emotions are part of pour psychological processes, closely linked with our physiological functioning. Brain regions involved in the generation and modulation of the fear response are complex and involve the recognition of danger through the hippocampus (the parahyppocampal gyrus), and the activation of the cerebellum-amygdala-cortical pathway. Cortical and sub-cortical regions help to interpret, modulate, and process our perception of fear, and activate our physical response to it (Javanbankht, & Saab, 2017).
It is interesting to note that the perception of fear occurs first unconsciously and then consciously. Within 100 ms after a stimulus is presented, there is an unconscious registering of it, and in about 400 ms it is registered consciously. Processing may take a long time after the event occurred (Williams, 2004).
The sympathetic nervous system is activated in response to the threat (Le Doux and Pine, 2016). At the neuro-physical level, processing fearful stimuli is associated with enhanced skin conductance, increased eye blink frequency, increased pupil dilation, and accelerated heart rate which indicate autonomic arousal to prepare the body to deal with the impending events (Tao, et al. 2021).
Language allows to express the internal feeling to others. It allows us to communicate, to describe and to transmit the emotion after we become aware of it (Junto Institute, 2022). Self-awareness of feelings helps to identify internal experiences and tonalities in relation to thoughts and behaviors.
Figure 2: Junto Institute (2021). Wheeel of Emotions. A colorful illustratetion of nuances and intensities. A conceptual guide.
From neurophysiological studies we also know that intense emotions affect attention and memory. Optimal arousal levels and emotional involvement is associated with greater encoding and retention of information; however, intense stress is counterproductive to rational thinking, complex reasoning, decision making, and problem solving (Sandi & Pinelo-Nava, 2007).
According to the stress theory of Hans Selye, intense stress leads to the fight or flight response. Intense fear may also lead to being blocked and “paralyzed” in the body’s attempts to ward off the fear (Selye, 1973).
In the condition of prolonged toxic stress, that is unbuffered by mediating forces such as a source of safety, security and trust, the body’s resources become increasingly depleted and physical and emotional disorders can result from prolonged and intense states of arousal (Bucci, et al. 2016).
Unreasonable fear, and fear of fear, the anticipatory anxiety related to anxiety disorders has been described by several researchers (Kessler, et al., 2009).
Neuroplasticity and the brain’s remarkable ability to form new connections helps to mediate the effects of stress and fear in the nervous system (Cramer, et al., 2011).
According to a psychological definition, trust is an emotional brain state (Thagard, 2018). It has been described as (1) a complex neural process that binds diverse representations into a semantic pointer that includes emotions; (2) a feeling of confidence and security; (3) an abstract mental attitude toward the proposition that someone is dependable; (4) a belief in the probability that someone will behave a certain way (Thagard, 2018).
The Neuropsychology of Trust:
According to neuroscientific findings, the ventromedial prefrontal cortex and insula, and the amygdala, as well as the dorsomedial prefrontal cortex are involved in the mediation of trust. The structure of these brain regions has been found to be directly influenced by the grey matter volume and amygdala volume as a function of decision making and trust in others (Haas, et al. 2014).
Figure 3: Illustration of trust and distrust in the activation of brain regions involved.
According to the developmental theory of Erik Erikson, one of the main tasks of the early stages of life rom birth to 18 months of age is to develop a secure bond with a loving caregiver for the maintenance of trust. In the absence of a secure connection, there is a fear of abandonment. Erikson believed that children who learn to trust their caregivers in infancy are more likely to have a sense of safety and security in the world. They will form trusting relationships with others in their lives (Graves and Larkin, 2006).
Current research confirms that traumatic events reduce the amount of trust one experiences (Filkukova, et al., 2016, Dahlen, 2010, AFWI, 2019). However, one can learn to develop trust if one faces one’s fears (Hillebrand, 2021). Trust mediates the perception of threat. It alters people’s perception of themselves, and the world around them (Enjolras, et al, 2019; Filkukova, et al., 2016). From am individual to a global scale, reducing fear and enhancing trust has been described as the main precondition for enhancing social concern and peace-making (Wheeler and Booth, 2008).
It is important to note that trust can not be forced, commanded, or demanded because it is a choice to trust someone. One trusts someone with similar values easier than someone with dissimilar values. Here is an area were freedom where will, the ability to make decisions and choice are manifested. While tolerance toward others with dissimilar values is possible, and required for peaceful coexistence, value-impositions run contrary to harmony. Adopting values not in line with universal human values– such as the value of each life, or the dignity of the person–is not meaningful. Meaning is the objective reality of a value standing in relation to each person in their own unique situation that has to be discovered, and discerned through conscience (Frankl, 2014b). Conscience is a “meaning-organ” (Frankl, 2008) that helps to intuit and infer the meaning of the moment, the person, and situation specific meaning, that is related to what is the very best possible option represented by the actualization of a value in harmony with universal values culminating in “the value of values” –Ultimate Meaning (Frankl, 2000).
Fear and Trust in the context of Meaning
Originally, Maslow’s hierarchy of needs outlined five areas of human concern: (1) physiological needs, (2) safety needs, (3) love and belonging, (4) esteem needs, and (5) self-actualization. In 1960, following an exchange with Viktor Frankl, Maslow acknowledged that the main motivation of human behavior is the will to meaning and added it to his hierarchy of needs (Marshall & Marshall, 2022). Thus, while several concerns can be the object of our fear and confidence, it is within a higher and more encompassing dimension of the dimension of the human spirit where we can reconcile our fears and give space to trust.
When conceptualizing of a person as a three-dimensional entity of body, mind, and spirit, it is the spiritual domain where the search for meaning takes place and where there is a healthy tension between a person and the values that they wish to actualize. According to Frankl, body and mind are instruments of the human spirit, through which the spirit expresses itself.
The dimension of body is the reservoir of physical resources. It is a bio-physical organism that ensures our physical functioning and survival (Frankl, 2014b). The mind in Frankl’s theory is used to denote our psychological processes, such as perception, memory, cognition, thinking, and emotions (Frankl, 2014b).
The dimension of the spirit is conceptualized as dimension that is higher and more encompassing than the dimension of the body and mind, not a substance but dynamics, the seat of the will to meaning, the defiant power of the human spirit, conscience, and other healthy resources such as our capacity for self-distancing, self-transcendence, humor, love, gratitude, hope and faith (Marshall & Marshall, 2022). Psycho-physical parallel and psycho-noetic antagonism refers to the fact that while body and mind are vulnerable, spirit is a healthy resource that can not become ill (Frankl, 1994, Marshall & Marshall, 2020).
The implications of the nature of the body, mind and spirit led Frankl to conceptualize his first and second Creed. According to the Psychological Creed, the person can be disturbed but not destroyed; and (2) according to the Psychiatric Creed, behind the mask of disease, the spirit is still intact (Frankl, 1994:86, 96).
Emotions Point to Values:
The arousal of emotions, correlated with inner brain states and paralleled by physiological responses, is like an inner source of energy that informs us about our values, value-system, and value-hierarchy.
For example, we feel sadness about loosing a family member because we loved them. Grief and sadness follow from love and closeness, the experiential values and attitudinal values remain as a bond between us and our loved ones.
We may feel angry if we see someone tosses garbage in the park because we value taking care of nature and care about the good use of resources.
We feel disgusted and repulsed by the cowardly actions of a compulsive liar, because we value truth and justice.
Emotions are like inner signals that tell us when events and actions are in harmony with the values that we perceive through our conscience as what should be, could be, or ought to be.
From a holistic point of view, this inner signal system is something that we have rather than who we are, and it serves an important function to guide our lives, not like instincts and impulses, but as signals that we can choose to act on, we can choose to embrace, or choose our position in response to.
Any signal system is as good as effectively it functions, as much as we pay attention to it, and the way we interpret its meaning wisely. Similarly, to a traffic light, where red means stop, yellow means go and green means go, it would be foolish to ignore our “gut feeling” and speed up when we see the light turning from yellow to red.
From a logotherapeutic point of view, we are in the driver’s seat, not our impulses, emotions, or drives, and there is always a space between a stimulus, and a response. We have an area of inner freedom to decide how to respond to our circumstances: give in to fears or not; develop trust or choose not to develop it. Our mind and heart, the emotional and rational brain work together in discerning what is most meaningful in each situation.
Existential Aspects of Fear
There are phenomenological states that occur when the voice of conscience is ignored, repressed, or suppressed, the will to meaning is blocked, when one does not find meaning to fulfill, or when one’s usual ways of fulfilling meaning in life are no longer possible:
Existential vacuum- is the feeling of inner emptiness, boredom, that results when one does not see meaning is life (Frankl, 2014; 2014b).
Existential frustration-occurs when the will to meaning is blocked.
Existential distress- occurs upon long standing existential frustration and vacuum that can lead to depression and despair, noogenic neurosis (Frankl, 2004).
Existential struggle-occurs in the case of values transgressions (Marshall & Marshall, 2021).
The concept of “Existential Angst” has been widely used by the existentialists to describe a long-standing sense of lack of meaning in life.
The term “existential threat” has been used to refer to a feeling that one’s mere existence in jeopardy (used to refer to a fear of loss of values, loss of selfhood, or identity).
“Existential risk” is defined as “risks that threaten the destruction of humanity’s long-term potential” (Bostrom, 2002).
The Vicious Cycle of Fear of Fear Leading to Desperation
Frankl described that either avoiding or fighting fear increases fear and results in an anticipatory anxiety of fear of fear (Frankl, 2004). The same pattern can occur in groups and societies.
In the case of existential angst, the fear motivation can give rise to individual neurotic patterns: such as depression, aggression, and violence (Frankl, 2014b), especially when the will to meaning is frustrated, which further reinforces the existential angst.
In the case of existential threat, frustration of the will to meaning, can give rise to collective neurotic patterns, such as collectivistic thinking, fanaticism, reductionism, and nihilism, reinforcing the vicious cycle of existential threat and dread.
The common element between existential angst and existential threat is fear. How we respond to fear is therefore crucial in breaking the pattern blocking the will to meaning that leads to despair.
Figure 4: Maria Marshall (2022). Illustrates the vicious cycle of desolation and despair fuelled by fear.
Erik Erikson talked about a fundamental trust that develops in early childhood and which can be easily lost and when one encounters trauma (Cherry, 2019). Frankl’s notion of trust is “…basic trust that is ultimately a belief in life’s meaningfulness which we can choose to embrace. Among other things, it means the awareness of our uniqueness and irreplaceable singularity as well as our value for the world” (Schechner & Zürner, 2011: 151). Basic trust is based on a choice “that life is ultimately meaningful” as opposed to “meaningless.” The loss of this ultimate trust leads to over-dependence on success, happiness, power and feedback about one’s value and the seeking of approval from others, seeking experiences, expectations that create an insatiable uneasiness and restlessness—the existential angst.
The opposite of existential angst is basic trust (Schechner & Zürner, 2011). Basic trust brings about an inner recognition and change of heart and mind to be free from the approval of the world and of others and to be self-determined, free, and responsible in the pursuit of meaning. Basic trust is opposed to “anxiety motivation” and avoidance with “love motivation” and intention toward purposeful goals (Lukas, 2020). Embracing this basic trust implies that we are wanted in the world. We are loved and a precious and irreplaceable part of creation. Inherent to this viewpoint is to appreciate what is good, true, and beautiful and gratitude for the wonders of life and creation. Basic trust can be fostered by: (1) Opening our eyes to possibilities: the ability to do good; the invitation to experience something beautiful and the capacity to transform suffering into something meaningful; (2) By awakening to the wonder and gift of every moment; (3) Through gratitude and kindness; (4) Through formation and personal development; (5) Through nurturing healthy relationships (6) Though a willingness to be open to the wonders of the world and changes in ourselves through gaining new experiences and insights (Schechner & Zürner, 2011).
According to Frankl (2019), an affirmation of life’s meaningfulness, or the possibility of life’s meaningfulness points to the possibility of a world in which every person is awaited and wanted and every person in addressed by life. Thus, in a world in which every person has value and dignity. This trust is the wellspring of hope that is strong enough to attract the energy of fear to use it to boost a person’s determination to jump over his or her own shadows or overcome obstacles and to thus channel the energy of fear into a meaningful action. Fabry (2021) outlined six ways in which basic trust can be furthered through orientation to meaning. He termed them the “signposts to meaning:” (1) uniqueness; (2) choices; (3) self-distancing; (4) self-transcendence; (5) responsibility and (6) response-ability. Attentive Meaning Sensitivity is a competence that can be practiced and enhanced (Marshall & Marshall, 2016).
The Principled Model of the Freedom of Will
Within this framework, and consistent with a thorough review of the literature and neuroscience findings, the authors (Marshall & Marshall, 2017) put forth what they termed the Principled Model of the Freedom of Will (PMFW). This model shows that through a process of reflection, human beings can make decisions about which values to live for (slow process related to cortical brain activity associated with reasoning). These values are then stored in conceptual memory regulated by the cortico-limbo-diencephalic system to guide everyday decisions (fast process involving limbic structures associated with emotions).
Figure 5: Marshall, E. (2017). The Principled Model of the Freedom of Will.
Following the PMFW model, individuals can be helped to gain insight into their values as guiding principles. Individuals can affirm if they wish to live according to these values or choose other values in harmony with universal values.
“Freedom of the will is opposed to destiny. For what we call destiny is that which is essentially exempt from human freedom, that which lies neither within the scope of man’s power nor his responsibility. However, we must never forget that all human freedom is contingent upon destiny to the extent that it can unfold only within destiny and by working upon it” (Frankl, 1986:78).
Aside from many other factors, our brain physiology is part of our destiny because it is part of what has been given and made available to us. However, beyond mere brain functioning or destiny in life, or Providence, gifted each human being with a design that allows to creatively shape themselves to reach their ultimate destination.
Or, as Frankl stated, we may not be free from conditions, but we are free to bring something valuable into the world. Human beings can choose the values they wish to actualize and shape and mold themselves.
Self-Transcendence and Functional Brain Imaging:
A team of psychologists and experts in the field of mindfulness, Kristin Neff, Christopher Germer, Geshe Lobsang, Tenzin Negi, Christopher Willard, Jack Cornfield, Dennis Tirch, Susan Pollak, Paul Gilbert, Deborah Lee, and Laura Silberstein-Tirch with the National Institute for the Behavioral Application of Behavioral Medicine suggest that complementing traditional cognitive approaches with compassion practices is uniquely suited for addressing complex trauma (NICABM, 2019). The researchers differentiate between rumination “a repetitive thinking which focuses on negative internal states, self-perceptions and emotions” is associated with “increased levels of self-attention, personal distress, negative affect and poorer levels of autonomy and social and interpersonal functioning” (Sutton, 2016). They point out that reflection and meditation differ from rumination as their goal is to be open to a variety of experiences. They can involve observing the self-experience with the intention of gaining increased objectivity from different perspectives, angles, views, and contexts. They open access to bring unconscious resources to conscious awareness and open a pathway to strengths and resources. These researchers believe that, on a neurological level, people who engage in compassion are more likely to down regulate the arousal as it changes the tome of their setting from a simply cognitive exercise to being able to see an area of freedom where they can tale a stand toward themselves and events (NICABM, 2019). These psychologists have found that individuals who engage in compassion-oriented practices are able to better address early childhood issues than people who receive only traditional forms of therapy. By activating human compassion through action and relation to oneself and others, these individuals are more likely to experience fewer PTSD symptoms, score lower depression related measures, report lower levels of loneliness and sleep difficulties. They score higher on measures of happiness and sense of purpose. According to these psychologists, compassion is not just about being kind to your self and accepting yourself but being courageous and doing things differently. The core of it is to be able to do things for others. The most important aspect of compassion is the courage to do good to others (NICABM, 2019).
A large study by Yoona Kang and her colleagues (2018) was undertaken as a collaboration between schools of communication, departments of medicine, public health and neuroscience. The study explored whether affirmation and self-transcendent attitudes have the potential of affecting brain and eventually alter behaviour and health outcomes. Two hundred and twenty sedentary adults were randomly selected into two groups. Both group members received regular health programming and reminders about the benefits and advantages of healthy lifestyle, healthy nutrition and regular exercise. Participants in both groups were given a list of values to rank the order from highest to lowest personal significance. The control group was subsequently asked to engage in reflecting about those values which they deemed least significant to them along with everyday activities.
The other group participated in affirmation and compassion meditation. They were invited to reflect on the way they practice and experience their highest personally important values in their everyday lives. Subsequently, they practiced compassion meditation and well wishes in relation to these values and individuals. On the list the highest rated values included family members and connection with a transcendental entity.
Brain areas related to neural activity while performing these tasks were scanned and compared. Participants were also administered a battery of screening instruments related to their mood and health behaviours. Self-transcendence and compassion were found to significantly reduce the likelihood to evaluate the health messages as potentially threatening to the self esteem, even though beneficial (Kang et al, 2018). They predisposed participants for a tendency to openness, lowered defensiveness and valuing the health messages as “valuable to me.” Aside from message receptivity, there was an overall significant difference in mood and health behaviour. Self-directed, negative mood was less in the self-transcendence and compassion group than in the control group. Those who were affirmed showed greater increases in their average moderate/vigorous activity and decrease in sedentary behavior than those in the control group. Self-transcendent tasks stimulated the ventromedial prefrontal cortex associated with positive valuation and reward processing. During subsequent health message exposure, the same regions showed increased activity, indicating that affirmation, the reflection on values is interpreted as rewarding experience and coupled with self-transcendence, has the capacity to affect behavioural change (Kang et al, 2018).
These findings further support the idea that a positive, other focused mindset, characterised by kindness, compassion, gratitude and valuation may contribute to helping people see personally relevant information as valuable to them and they are more likely to engage in positive, healthy behaviours such as self care if they see a personal value and purpose attached to it. An interesting observation during this study was that even those who were asked to think about their values but reflected on lower ranked values showed some improvement in subsequent health related behaviours and showed pre-frontal activation, albeit not as much as the other group. This finding indicates that reflecting on one’s values, even if not followed by self-transcendent mindful and compassionate thinking, can have an affirmative effect (Kang, et al., 2018).
In fMRI images, Kang and her colleagues (2018) found frontal area activation during compassion and affirmation tasks related to self-transcendence and reflection of values that one wants to live for. The same frontal area activation was not found in the control group, who were asked to reflect on everyday activities.
Figure 6: (Kang et al., 2018.) Functional MRI images of the brain areas activated during affirmation, and compassion in comparison with the control group.
Brain Plasticity and Resilience:
Robust studies investigated the effects of early trauma on the developing brain and the effects of toxic stress on health and mental health outcomes in later adulthood (Harvard University, 2019). Brain-plasticity, the brain’s capacity to moderate the impact of trauma, develop new connections, has been observed during critical windows of development and during the life span. Toxic stress paired with a lack of supportive caregiving was linked with deficits in brain areas crucial to executive and control functioning in the social, cognitive, and emotional areas was noted (AFWI, 2019). Teaching internal self-regulation, problem solving, planning and organisation skills, cognitive flexibility, was found helpful to help override automatic responses and prevent reinforcing and transmitting adversity (Marshall & Marshall, 2021).
Miller Karas developed a Community Resiliency model that focuses on self-awareness and self-regulation to (1) track and understand bodily reactions, (2) access inner resources and learn how to evoke them and intensify them; (3) grounding, (4) understanding gestures and spontaneous movements; and (5) shift and stay, whereby one can intentionally recognize and down-regulate intense emotional states to reach an optimal level of physical and psychological arousal. This approach has been extensively used both nationally and internationally by the Trauma Resource Institute. It is appropriate for men, women, and children (Grabbe & Miller- Karas, 2017).
Building resilience skills and engaging in self-transcendent actions following trauma and complex PTSD was related to enhanced sense of meaning in life and post-traumatic growth in veterans. Engaging in meaningful community activities was perceived as qualities of “super-survivors” who not only overcame their trauma but helped others. Helping others, in return, was reported to have had a positive impact on the individual’s recovery following trauma (Southwick & Charney, 2018; Marshall & Marshall, 2021b).
Meaning in Life and Health Outcomes
A study with 1,546 individuals over the age of fifty found that in the presence of medium to severe pre-existing coronary heart disease at the baseline, purpose in life was associated with lower odds of having a myocardial infraction during a two-year follow up (Kim, 2015). A similar study with close to 7000 individuals found that those with higher purpose scores showed reduced likelihood of a cerebrovascular incident in the next four year-period (Kim, 2013). large study by Alimujaing and her colleagues (2019) in close to 7000 adults aged fifty years and over in the United States confirmed that stronger purpose in life was associated with lower all-cause mortality. These results were in line with findings by Koizumi, and his colleagues, according to which strong purpose was associated with 72 percent lower rate of death from stroke, a 44 percent reduction of the rate of chance of dying from a cardiovascular disease and overall 48 percent chance of dying from any cause of death in a population of men over the period of a thirteen year follow up, even if controlled for the effects of controlled stress and cardiovascular predisposing risk factors (Koizumi, et al., 2008).
The work of Patricia Boyle and her colleagues with 1151 elderly individuals at the Rush Alzheimer’s Disease Center (Boyle, et al., 2010) indicated that purpose in life was a protective factor against the development and progression of Alzheimer’s disease. Autopsy results obtained post-mortem confirmed that those individuals who had higher purpose scores have shown less cognitive decline despite the presence of high burdens of Alzheimer related protein accumulation, as measured in the amount of beta-amyloid and tau deposits associated with the disease (Boyle, et al., 2012).
A longitudinal study in the United States by Case and Deaton (2015) found that in a population of 100,000 white men who were followed between 2000 and 2020, there was a dramatic increase of deaths due to suicide, drug and alcohol poisoning, and chronic illness due to drug or alcohol use between 2005 and 2020. They termed these factors as “death due to despair.”
Chen et al. (2020) who investigated “death due to despair” in a sample of 100,000 health care workers in the US, (66,492) females (between 2001 and 2017), and 43,141 males (1988-2014), found that people who had a deep-seated spirituality and religiosity and attended religious service at least once a week had significantly lower rates of death related to suicide or addictions and overdose than those who did not have religious church attendance. Church attendance was positively correlated with psychosocial well-being outcomes, greater purpose in life and social integration.
A review of purpose and health-related studies was conducted by Dr. Adam Kaplin, chief psychiatric consultant to the Johns Hopkins Multiple Sclerosis and Transverse Myelitis centres and Laura Anzaldi (Kaplin & Anzaldi, 2015). Their observation is that research on the role of purpose is a new and upcoming movement in neuroscience. Considering the several side effects of pharmaco-therapy, especially in the areas of psychiatry and clinical neuroscience, these authors believe that “purpose in life should be promoted, as opposed to pill-pushing.” In other words, methods that enhance a sense of purpose and meaningfulness in life are desperately called for to complement current clinical practices.
Several recent studies shed further light on wishes for hastened death in people diagnosed with terminal cancer and the elderly. The following points summarize the findings:
Death wishes [in older adults] can not be explained by mental disorders (Van Wijngaarden, et al, 2021).
The mental health consequences of isolation are disconnection, meaninglessness, anxiety, panic, obsessive-compulsive symptoms, digestive problems, depressive problems, and post-traumatic stress (Rogers, et al., 2020; Pietrabissa & Simpson, 2020) and psychiatric symptoms (Brooks et al., 2020).
The trajectories of death wishes can be varied and fluctuate (Breitbart, 2017; Leigh, et al., 2017).
Active, outspoken, and expressed wishes can subside and vanish over the months or years (Van Wijngaarden, et al., 2021)
Wishes for hastened death are related to external factors such as health, activities, and relationships (Van Wijngaarden, et al, 2021).
Once the desires are firmly established, and in the absence of support, these wishes can be enduring (Wilson, et al., 2007).
Diminished wish for hastened death is linked with a regained sense of meaningfulness and forming connectedness (Breitbart, 2017; Southwick & Southwick, 2020; Van Wijngaarden, et al. 2021).
A ground-breaking study validated with randomised control trials at the Sloan Kettering Cancer Treatment Hospital in New York under the direction of William Breitbart outlined an eight session “Meaning-centered Group Psychotherapy Protocol; MCGP” (Breitbart, and Poppito, 2014a, Breitbart & Masterson, 2016; Breitbart, 2017). The sessions were intended to reduce anxiety, depression and suicidal ideation among patients who have been diagnosed with advanced stages of cancer and to increase their well being and quality of life by helping them find deeper meaning in the midst of battling their disease. They covered topics in eight consecutive sessions:
Concepts and Sources of Meaning.
Identity Before and After the Diagnosis of Cancer Diagnosis.
Historical Sources of Meaning: “Life as a Legacy” that one has been given.
Historical Sources of Meaning: “Life as Legacy” that one lives and will give.
Attitudinal Sources of Meaning: Encountering Life’s Limitations.
Creative Sources of Meaning: Creativity, Courage, and Responsibility.
Experiential Sources of Meaning: Connecting with Life through Love, Beauty, and Humor.
Transitions: Final Group Reflections and Hopes for the Future.
Those who completed the program showed lower scores on depressiveness, anxiety and wish for hastened death. Despite their cancer diagnosis, they reported higher levels of quality of life than people in the control group. The researchers noted that offering physical care is crucial in palliative medicine (Breitbart, 2017). Beyond that “…it is equally important to encourage the spirit by a constant show of love and compassion” (Kissane, and Poppito, 2006: 694), and enhance resilience though meaningful connections (Southwick & Southwick, 2020; Southwick & Charney, 2021).
In several studies, meaning was found to correlate with measures of self-transcendence, resilience, and post-traumatic growth, which are factors associated with psychological well being. Thus, meaning can be conceptualized as creating a bridge between protective factors in the face of adversity and directly contributes to psychological well-being (Russo-Netzer, & Ameli, 2021).
Based on current criteria for evidence-based research, Lewis (2014) summarized the findings of studies to date: (1) A positive correlation exists between meaning and measures of well-being and coping: (2) An inverse correlation exists between meaning and a diagnosis of mental illness; (3) When mental illness does occur, an inverse correlation exists between meaning and symptom severity. Other well-documented findings are: (1) an inverse correlation exists between reasons for living, or purpose in life, and suicidality; (2) an inverse correlation exists between meaning and a diagnosis of substance use disorders; (3) a positive correlation exists between meaning and health. Emerging findings include: (1) meaning in life is positively correlated with occupational functioning; (2) an inverse correlation exists between meaning and criminal or antisocial behavior; (3) meaning in life is positively correlated with social functioning (Lewis, 2014).
The present review of literature corroborates that neuroplasticity, based on discernment and reflection, can aid to reinforce values that we want to live for and that are in harmony with universal values. Through the resources of the human spirit, fear can be tamed, and basic trust can be re-gained for a meaning-filled living. Meaning is associated with self-transcendence, resilience, and post-traumatic growth. These factors are associated with positive health and mental health outcomes.
Viktor Frankl’s Logotherapy and Existential Analysis was formulated at a time when the search for meaning was a crucial preventive and protective factor against despair. It is a values-based approach to psychotherapy and counselling with principles and evidence-based methods (Russo-Netzer & Ameli, 2021; Marshall & Marshall, 2022).
Perhaps only a few people are aware that Frankl was afraid of heights (Marshall & Marshall, 2021). He challenged himself to rock climbing: “Who is stronger. Me or the fear in me?” he used to ask (Frankl, 2008). With the fear he climbed, and he advised is patients to do the same. In brief, to “Take the bull by the horns!” (Lukas, 2000:105) and “Hitch your wagon to a star!” (Lukas, 2011).
However, Frankl did not scale the rocks unaided. He used proper mountain gear and a rope. One of such ropes is exhibited at the Viktor Frankl Museum in Vienna (Marshall & Marshall, 2021). A rope is a symbol of our connectedness to others, to the world, to hope and security and trust. The rope is the symbol of our connection to our ultimate home.
When we learn about logotherapy, we not only learn to help ourselves, but we also learn about a skilful way of guiding people from less difficult to most difficult terrains. The most challenging heights are the ones where we must jump over our shadows and turn the energy of our emotions to propel us to new heights. These heights can not be conquered other than with courage, faith, and trust.
Dr. Frankl affirmed that anchored in Ultimate Trust, we can say “Yes” to life, despite everything. He ended his book, the “Will to Meaning” with what he said that he intended to be “the lesson to learn” from this book (Frankl, 2014b:121):
“…Out of an unconditional trust in ultimate meaning and unconditional faith in ultimate being, Habakkuk chanted this triumphant hymn: ‘Although the fig tree will not blossom, neither shall fruit be in the vines; the labor of the olive shall fail, and the fields shall yield no meat; the flock shall be cut off from the fold, and there shall be no herd in the stalls: Yet I will rejoice in the Lord, I will be joyful in the God of my salvation” (Frankl, 2014b:121).
As Dr. Frankl taught lessons about life by the way he lived his life, and the way he practiced, we must also live what we believe. The “unconditional trust in ultimate meaning and unconditional faith in ultimate being” (Frankl, 2014b:121) can be our motto, our inspiration and hope on our journey from fear to trust. – A living project.
Bostrom, N. (2002). Existential risks: Analyzing human extinction scenarios and related hazards” J of Evolution and Technology. 9 (1). http://www.nickbostrom.com
Boyle PA, Buchman AS, Barnes LL, Bennett DA (2010). Effect of purpose in life on risk of incident Alzheimer disease and mild cognitive impairment in community-dwelling older persons Arch Gen Psychiatry, 67(3), 304-310. https://doi.org/10.1001/archgenpsychiatry.2009.208
Boyle, P. A., Buchman, A.S., Wilson, S. R. (2012). Effect of purpose in life on the relation between Alzheimer Disease pathological changes on cognitive function in advanced age. Arch gen Psychiatry, 69(5):499-504. https://doi.org/10.1001/archgenpsychiatry.2011.1487.
Breitbart, W., and Masterson, M. (2016). “Meaning-centered psychotherapy in the oncological palliative care setting.” In: Clinical Perspectives on Meaning, P. Russo Netzer, S. Schulenberg and A. Batthyány (eds.). New York, NY: Springer International, 245-260. https://doi.org/ 10.1007/978-3-319-41397-6_12
Breitbart, W., and Poppito, S. (2014a). Individual meaning-centered psychotherapy for patients with advanced cancer. A treatment manual. New York, NY: Oxford University Press.
Breitbart, W. (2017). Meaning centered psychotherapy in the cancer setting. New York, NY: Oxford University Press.
Brooks, S. K., Webster, R. K., Smith, L. E., Woodland, L., Wessely, S., and Greenberg, N. (2020). The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet 395, 912–920. https://doi.org/10.1016/S0140-6736(20)30460-8.
Bucci, M., Marques, S. S., Oh, D., Harris, B. (2016). Toxic stress in children and adolescents. Advances in Pediatrics, 63 (1), 403-428.
Chen Y, Koh HK, Kawachi I, Botticelli M, VanderWeele TJ. Religious service attendance and deaths related to drugs, alcohol, and suicide among US health care professionals. JAMA Psychiatry. 2020;77(7):737–744. https://doi.org/10.1001/jamapsychiatry.2020.0175
Cramer, S. C., Sur, M., Dobkin, B. H., O’Brien, C., & Sanger, T. (2011). Harnessing neuroplasticity for clinical applications. Brain 134(6), 1591-1609.
Enjolras, B., Steen-Johnsen, K., Herreros, F., Bugge Solheim, O., Slagsvold Winsvold, M., Kushner Gadarian, M., and Oksanen. A. (2019) Does trust prevent fear in the aftermath of terrorist attacks? Perspectives on Terrorism 13, no. 4 (2019): 39–55 https://www.jstor.org/stable/26756702.
Fabry, J. (2021). Guideposts to meaning. Discovering what really matters. Charlottesville, VA: Purpose Research.
Filkukova, P., Hafsatd, G. S., & Jensen, T. K. (2016). Who can I trust? Extended fear during and after the Utøya terrorist attack. Psychological Trauma: Theory, Research, Practice, and Policy, Vol 8(4), Jul 2016, 512-519.
Frankl, V. E. (1986). The doctor and the soul. New York, NY: Random House.
Frankl, V. E. (1992). Psychotherapie fur den Alltag. Herder/Spektrum.
Frankl, V. E. (1994). Logotherapie und Existenzanayse. Texte aus sechs Jahrzehnten. München: Quintessenz.
Frankl, V. E. (2000). Man’s search for Ultimate Meaning. Cambridge, MA: Perseus.
Frankl, V. E. (2004). On the theory and therapy of mental disorders. Brunner/Routledge.
Frankl, V. E. (2008). Bergerlebnis und Sinnerfahrung. Innsbruck: Tyrolia.
Frankl, V. E. (2014). Man’s search for meaning. Boston, MA: Beacon Press
Frankl, V. E. (2014b). The will to meaning. New York, NY: Plume.
Frankl, V. E. (2019). Yes to life in spite of everything. Boston, MA: Beacon Press.
Grabbe, L.& Miller-Karas, E. (2017). The trauma resiliency model : A “bottom-up” intervention for trauma psychotherapy. J of the American Psychiatric Nurses Association., 24(1):76-84. https://doi.org/10.1177/1078390317745133.
Graves, S. B., & Larkin, E. (2006). Lessons from Erikson: A look at autonomy across the lifespan. J of Intergenerational Relationship 4(2). 61-71.
Gu, S., Wang, F., Patel, N. P., Burgeois, J. A., and Huang, J. (2019). A model for basic emotions using observations of behavior in drosophila. Front. Psychol., https://doi.org/10.3389/fpsyg.2019.00781,
Haas, B. W., Isjak, A., Anderson, I. W., Filkowski, M. M. (2015). The tendency to trust is reflected in human brain structure. NeuroImage. Volume, 107:175-181.
Hillebrand, K. (2021). The role of fear and trust when disclosing personal data to promote public health in a pandemic crisis. In: Ahlemann, F., Schütte, R., Stieglitz, S. (eds) Innovation Through Information Systems. WI 2021. Lecture Notes in Information Systems and Organisation, vol 46. Springer, Cham. https://doi.org/10.1007/978-3-030-86790-4_18.
Javanbankht, A. & Saab, L. (2017). What happens in the brain when we feel fear? Science. Smithsonian Magazine. www.smithsonian.com
Kang, Y., Cooper, N., Pandey, P., Scholz, C., O’Donnell, M. B., Lieberman, M. D., Taylor, S. E., Strecher, V. J., Cin, S. D., Konrath, S., Polk, T. A., Resnickow, K., An, L., Falk, E. B. (2018). Effects of self-transcendence on neural responses to persuasive messages and health behavior change. PNAS, 155, 40, 9974-9979. https://doi.org/10.1073/pnas.1805573115/-/DCSupplemental
Kaplin, A & Anzaldi L (2015). New movement in neuroscience: A purpose-driven life. Cerebrum, 7.
Kessler, R.C., Ruscio, A. M., Shear, K., & Wittchen, H-U. (2009). Epidemiology of Anxiety Disorders. Behavioral neurobiology of anxiety and its treatment, 21-35.
Kim, E. (2015). Purpose in life and cardiovascular health. Doctoral Dissertation. [Retrieved from: deepblue.lib.umich.edu].
Kissane DW, and Poppito S. (2006). “Death, Dying and Bereavement.” In: Blumenfield M., Strain JJ, (eds.) Psychosomatic medicine. Philadelphia, PA: Lippincott, Williams & Wilkins.
Koizumi M, Ito H, Kanko Y, Motohashi Y (2008). Effect of having a sense of purpose in life on the risk of death from cardiovascular diseases. J Epidemiol, 18(5), 191-196. https://doi.org/10.2188/jea.JE2007388
Lewis M (2014). The logotherapy evidence base: A practitioner’s review. www.academia.edu
LeDoux, J. E., & Pine, D. S. (2016). Using neuroscience to help understand fear and anxiety: a Two-system framework. Am J Psychiatry, 173 (2016), pp. 1083-1093.
Leigh-Hunt, N., Bagguley, D., Bash, K., Turner, V., Turnbull, S., Valtorta, N., et al. (2017). An overview of systematic reviews on the public health consequences of social isolation and loneliness. Public Health 152, 157–171. doi: 10.1016/j.puhe.2017.07.035.
Lukas, E. (2000). Logotherapy textbook. Toronto: Liberty Press.
Lukas, E. (2011). Binde deinen Karren an einen Stern. Was un sim Leben weiterbringt. Neue Stadt.
Lukas, E. (2020). Wie Leben Gelingen Kann. Interview with Michael Ragg. EWTN Television. Translated by Maria Marshall. Unpublished Manuscript.
Rogers, J. P., Chesney, E., Oliver, D., Pollak, T. A., McGuire, P., Fusar-Poli, P., et al. (2020). Psychiatric and neuropsychiatric presentations associated with severe coronavirus infections: a systematic review and meta-analysis with comparison to the COVID-19 pandemic. Lancet Psychiatry 7, 611–627. https://doi.org/10.1016/S2215-0366(20)30203-0
Russo-Netzer, P., and Ameli, M. (2021). Optimal sense-making and resilience in times of pandemic: integrating rationality and meaning in psychotherapy. Frontiers in Psychology, Review. https://doi.org/10.3389/fpsyg.2021.645926
Schechner, J. & Zürner, H. (2011). Krisen Bewältigen. Viktor E. Frankls 10 Thesen in der Praxis. Vienna, Autria: Braumuller.
Selye, H. (1973). The evolution of the stress concept: The originator of the concept traces its development from the discovery in 1936 of the alarm reaction to modern therapeutic applications. American Scientist 61(6), 692-699.
Southwick, S. M., Charney, D.S. (2018). Resilience: The science of mastering life’s great challenges (2nd Ed). New York, NY: Cambridge University Press.
Southwick, S. & Charney, D. (2021). Resilience for frontline health care workers: Evidence based recommendations. The American J of Medicine, 134(7), 829-830.
Southwick, S. M., Lowther, B. T., and Graber, A. (2016). “Relevance and Applications of Logotherapy to Stress and Trauma.” In: Logotherapy and Existential Analysis: Proceedings of the Viktor Frankl Institute Vienna, Vol. 1, A. Batthyány (ed.). Vienna: Springer International, 131-149.
Southwick, S. M. & Southwick, F. S. (2020). The loss of social connectedness as a major contributor to physician burnout. Applying organizational and teamwork principles for prevention and recovery. JAMA Psychiatry, E1-E2.
Sutton A (2016). Measuring the effects of self-awareness: construction of the self-awareness outcomes questionnaire. Eur J Psychol, 12(4), 645-658. Doi: 10.5964/ejop.v12i4.1178 [Retrieved from: ncbi.nlm.nih.gov].
Tao, D., He, Z., Lin, Y., Liu, C., and Tao, Q. (2021). Where does fear originate in the brain? A coordinate-based meta-analysis of explicit and implicit processing. Elsevier. Neuroimaging. http://www.elsevier.com/locate/neuroimage
Van Wijngaarden, E., Merzel, M., Van der Berg, V., Zomers, M., Hartog, I., & Leget, C. (2021). Still ready to give up on life? A longitudinal phenomenological study into wishes to die among older adults. Social Science and Medicine. Vol. 284, September 2021, 114180. https://doi.org/10.1016/j.socscimed.2021.114180
Wheeler, N., & Booth, K. (2008). The security dilemma: Fear, cooperation, and trust in world politics. Palgrave Macmillan.
Willliams, L. M., Liddell, B. J., Rathjen, J., Brown, K. J., Gray, J., Phillips, M. Young, A., Gordon, E. J. b.m., (2004). Mapping the time course of unconscious and conscious perception of fear: an integration of central and peripheral measures, 21, 64-74.
The current crisis in Ukraine is described as one of the greatest and fastest evolving humanitarian crises since the Second World War in Europe. It currently counts 1 million displaced persons who left Ukraine in matter of a few days. Most of these people are mothers and children. How can one help refugees?
The obvious answer is to make their path safe and provide for their immediate needs such as shelter, water, food, clothing, and sanitation. There are several aid agencies operating close to the borders. Financial aid to these agencies, through the Red Cross or the UN World Food Program, and others ensures that more people can receive the essentials they require in a timely manner. In addition to organizations, individual citizens have offered to help with their means. We have seen images of people in Poland and Hungary welcoming refugees at the border crossings and providing transportation and temporary accommodation. The European Union opened its door to refugees. Canada pledged to welcome any number of people fleeing from the war in Ukraine.
As the war drags on and the days are passing, more and more people are expected to cross the border and those receiving them have to be prepared to tend those who have been exposed to combat, wounded, and traumatized. Professionals with training in this field can access several guidelines for disaster mental health and many are accessible to anyone through the newly created depository of articles “For Each Other” at www.foreachother.at.
Here, I would like to mention a few considerations from personal experience that may be helpful for understanding the experience of being a “displaced person,” myself having had this experience thirty years ago. From now, on, I will refer to the fact of having to flee from a war situation or a conflict situation leaving behind one’s residence and seeking refuge elsewhere, usually in another country as a person who has been displaced and seeking refuge.
What do we need to keep in mind about a person who has been displaced? I will describe a few general considerations:
• Decisions had to be made at the spur of the moment or in very short time to leave
• The first consideration was to get children, the elderly and vulnerable individuals to a place of physical safety
• Minimal essential personal belongings were possible to carry from home
• The path was not exactly planned out and the details to the destination often unknown
• One counts on help from others and good luck to make it there
• The warmth of home is still in every piece of clothing, every piece of food or drop of water that one has
• One knows that going back is not an option, therefore the only way to advance is to look forward
* Many others join the same path. Crowds form and one is pressed. One hears the cries and laments of others. Sheds warm tears.
• Keep what is most essential in focus: a child. Every effort is worth saving this life.
• One discovers strength that one has not had before. Determination and courage flow to the person, as well as there is a flow of adrenaline. Heart palpitations, intense emotions are common.
• The future calls and one listens to one’s conscience. It nudges to not to give up. Keep going.
• One finds oneself in unfamiliar surroundings, surrounded by strangers. One implores that they are friendly.
• Even though one is in a new place, one has the feeling, one is still the same person.
• Nature is grounding. So is the pumping of the heart, the warmth, and the breath of a child.
• Memories are compressed, time seems altered.
• One’s heart clings to loved ones. In spirit, one is with them for brief moments at a time.
• Heartache. Warm tears running down the cheeks.
• Language that one des not speak. Words want to come but they do not surface. They are swallowed up by tears.
• Communication is any ways one can.
• One is still the same person. And one searches for the eyes of the other, notices their gestures, even tiniest forms of expression. One reads eyes, hands, and lips. Body language.
• One looks down. The pain in the eyes is hidden.
• One needs to ask. One needs to beg. One needs to explain.
• One needs to remain hopeful. Everything seems to be possible, yet the nothing can be taken for granted.
• Goodness has no boundaries.
• There are those willing to aid. There is a smile. A gentle encouragement. There is warm food. Water. A place to rest.
• A quick prayer is said.
• Thanking from the bottom of the heart. Gratitude and joy. Inside is restlessness and hesitancy. Outside it is words of thanks.
• The cell phone. The connections. The rest of the family. How can one reach them? Are they alive? Worries. Sleepless nights. Nightmares.
• A kiss for the child. It was all worth it. Find a soft toy. Give a hug. Caress the face.
• Tomorrow will be better. Life can be hard. Very hard. But it can make one stronger for the challenges ahead.
• For this young life. It is worth it. For a better life, its worth it.
* Keep going. Keep being you. Always keep going. Never give up.
I was told that once I am an immigrant, I will always be an immigrant. I did not understand these words at the time. Later, I learned that immigrants and refugees pass through several stages and phases in a process of “assimilation and accommodation,” as it was called in those days, and “adaptation” to their new host country. They pass from the ‘honeymoon stage” full of enthusiasm and hope to “disillusionment” and experiencing obstacles and hindrances. They may succumb to depression and despair as difficulties and challenges mount, and they do not have the means to effect change, to feel in control of their lives. They may then pass to a stage of gaining skills and abilities and eventually, come to be “well functioning” members of their society, considering themselves to be “experts” in both their original culture and their new environment.
I would like to complement this picture by adding what keeps displaced persons strong and resilient to withstand despair.
• Each time one sees a displaced person, one sees not a victim, but a survivor.
• A person of hope, who had strength to listen to their conscience and follow its dictates.
• A person who is not equal to hat they have, which may be very little. A person who is.
• A person with an indestructible spirit.
• A person capable of sacrifice.
• A person with emotions and feelings but not equal to emotions and feelings.
• A person with thoughts and convictions
• A person with a sense of values and justice
• A loving person whose heart reaches out to those left behind
• A caring person who found themselves in situations that many of their fellow men/women in the world may have never experienced and hopefully may never have to experience
• A professional, a mother, a father, a sister, a child, who is someone loved and awaited
• A person who seems to be alone but is never alone
• A person who may look forsaken but represents the wounds of humanity
• A person who may look deficient in expression, speech, language, writing, spelling and many other things, but has a heart in flames for the just cause
• A person who may be easy to reject, look down upon, distance oneself from, in order to escape from facing one’s own fears, but ignoring the most important: what is right and good and noble about being a displaced person
• A person with dignity that is often tested
• A person with dignity that is unconditional
* A person with hopes, skills, ideas, ideals and dreams
• A person who represents the hope of the world for peace.
Therefore, in treating a displaced person, the main thing is to do it with humility and sincerity, with humanness, simplicity, and honesty. The touch of humanity, such as a smile, a gentle touch or encouraging word can make the sunshine appear behind the clouds. Tears of pain can turn to tears of healing a hope. Yes, displaced persons will have deep emotions and many emotions. They will express a range of them if allowed. One does not need to be afraid of these emotions. They are not intended toward the helper, although at times they may seem like it. They are intended towards the wrongs, the injustices and the incorrectness that displaced persons are keenly aware of. Sometimes these emotions will subside over time, although they may be easily triggered by subsequent challenging events.
Symptoms of post traumatic stress, anxiety and depression may be experienced by those who have been exposed to violence and of curse this applies to those who have witnessed torture, loss of life, and cruelty. With insight into the body’s reactions to intense and prolonged toxic stress, one can build up one’s resources for coping. Beyond that, one can get in touch with one’s inner strength. With benevolence and support, the emotional wounds can be compassionately cared for. Self awareness and self compassion can gradually allow to reconnect with sources of hope and realistic optimism. One can at this point, be able to see beyond the concrete situation and connect oneself with universal values. There is, in a way, a space crated to consciously affirm what deep inside one always knew and what one was acting according to without it being explicitly stated.
Reinforcing what is good and positive, who one is beyond one’s means, goes beyond providing basic needs and reaffirms displaced persons in their sense of value and dignity. Finally, displaced persons can see themselves as not just a person who was forced to leave their home because their lives were in danger, but a person who was called by life to now become a citizen of the world and to rise above traditional ways of living, being, and doing things, to a new level of living, being and doing things, or better to say, a new dimension of living, being, and doing things, not just for the sake of the self, but for the sake of the world.
Therefore, it is important to reiterate and to make such persons to feel that they are of value, they are loved, they are good for something, they matter, and they are awaited in the world.
Walking in the streets of my new country I often had the feeling of de-realization in the first years. It felt as if I was walking somewhere in my body, and I could see myself from the outside. I had a sense that I was present in spirit. I kept telling myself that I was strong in my spirit, even if my spirit was invisible. I also told myself that a power much greater than myself is protecting me. Even though I could barely speak any English, was aware that my spirit was entirely healthy. My mind was, at that time, quickly running back and forth between attempting to retrieve the right English word for the one that came to mind in Hungarian. Later, the German and the English started to get mixed. Finally, I had some dreams in English, but most nightmares in Hungarian, my mother tongue.
Language is one form of expression. The language of the heart is another. It is the language of the heart that understands the other, without words needed to be said.
Therefore, for those who accept a refugee, or who aid a refugee, I would like to add a few more points:
• Your presence matters. It was saving and healing. This will never be forgotten.
• None of your good words, good deeds will go unnoticed.
• None of your good actions can be removed from this world.
• You are a person of courage.
• You do not need to be perfect. In your attempts to help, there will be challenges. There will be sorrows. There will be thigs you wish you could do more, different.
• You will feel the emotions of pain, grief, and sorrow if you are close to a person who suffers.
• Do not let this break you down. You are not the cause of the pain if you are there to genuinely offer your best.
• People who reveal to you their weakness trust that you are strong enough to handle it. They feel safe with you to share.
• Be clear on what you can offer and what is beyond your limits. This will help to problem solve.
• Be prepared that not everyone in your neighborhood may see you with good eyes or praise your actions. The indifference of others will hurt your heart to the core.
• Remain steadfast and entrust the person in your care with you to the Providence.
• Respect their choices and decisions.
* Trust their inner strength
• Accept that they may not be in the position even to thank you or show gratitude. Nevertheless, your reward is eternal.
• Be creative, flexible, and open to life.
• Be open to learning. Helping someone else builds you up as much as it can save the life of someone or make it more peaceful and dignified.
• Be grateful to life that you can be in this position.
• Offer grace for every way you can serve.
In conclusion, those who are helped and those who are helping are accomplishing a valuable mission together that without one or the other would not have been possible. As time passes, those who are helped and those who helped are both stronger, wiser, and better able to reach out to others who may tend a hand for help.
This is how a network of good deeds generates further good and makes our world a friendlier and more humane place to be. This is how, from a mustard seed, a huge tree can grow, and it can be tall enough so that all the birds of the sky can come and find rest on its branches, and shelter amongst its leaves. Love and care make it possible for such tree to grow.
In addition to crimes against humanity, the irreplaceable cost of the loss of countless lives, the displacement of millions of people, economic downturn, and sending shock waves through the entire human family, the current war in Ukraine rests on a fundamental error and faulty attitudes that lead to a vicious cycle of destruction and self-harm. While the implications of this harm to the self, in addition to others, may not immediately perceptible, its consequences are far reaching and deeper than physical wounds. These are the wounds of the soul. (6) The purpose of this article is to describe the nature attitudes that lead away from meaning and propose and to present possible meaning-centered interventions for altering course.
According to Viktor Frankl, MD, PhD, (1905-1997) an Austrian psychiatrist, a survivor of the Holocaust and the founder of Logotherapy and Existential Analysis, the Third Viennese School of Psychotherapy, the fundamental motivating force for human beings is not the will to pleasure, or the will to power, but the will to meaning. (4) His most well-known book, “Man’s Search for Meaning,” which sold millions of copies around the world, testifies to the endurance and resilience of a human being to find meaning under all circumstances, even the most miserable. LTEA is a meaning-centered and evidence-based approach to psychotherapy that rests on three fundamental assumptions: (1) The Freedom of Will; (2) The Will to Meaning; and (3) Meaning in Life. (1,8)
The first concept, the Freedom of Will, rests on Frankl’s three-dimensional conceptualization of the human being as a body, mind, and spirit entity. In the “Ten Theses on the Person,” Frankl, asserted that the dimension of the spirit is an indelible aspect of human existence that is not a substance but a dynamic.(2) The spirit is the source of the will to meaning, the human capacity for searching for and finding meaning, self-distancing, the capacity to distance oneself from the self and to observe oneself from the outside; self-transcendence, the capacity to reach out toward meaning, and other meta-physical phenomena such as love beyond the physical, gratitude, humor, kindness, forgiveness, hope, and faith. These capacities of the human spirit are, like an inner reservoir, the well spring of resilience, self-transcendence and growth that have a protective effect in crisis prevention and curative effect in crisis intervention. (3)
The first basic tent of logotherapy, Freedom of Will, asserts that humans are not fully subject to their conditions and the circumstances that surround them, but they can, within the limitations of those circumstances, and in view of being a fallible, vulnerable and finite human being, take a stand toward both internal conditions (such as one’s own biological and psychological state, instincts, drives, genetic makeup, thoughts, and emotions) and external circumstances (social factors, the past and what others decide to do). (1) The freedom to take a stand derives from the dimension of the spirit, which in Frankl’s holistic view of the person is conceptualized as the essentially human realm. The spirit is who we really are, over and above the dimension of the body and mind, of what we have. Body and mind are the instruments of the spirit. (1) As spiritual persons humans are infinitely more than reacting organisms, they can choose their stand toward their circumstances and shape themselves and their lives. (2)
The second concept, the Will to Meaning, asserts that, in addition to being free, human beings are free for something, they are free to reach their goals and accomplish purposes. (1) These goals and purposes are present in reaching out for meaning that is present in values that stand in relation to every person in each situation. Realizing meaning is seen as a fundamental motivating force of human behavior. (1) When the Will to Meaning can not reach its target, the feeling is experienced as a nagging feeling, followed by a sense of meaninglessness. (4) There are other forms of existential manifestations of the Will to Meaning being inhibited in its natural dynamics. The term “existential frustration” describes when values that used to be actualized, can no longer be actualized for some reason, and a person feels an inner sense of exasperation. (4) “Existential vacuum” is the feeling of inner emptiness that follows long-standing feelings of existential frustration. (4) “Existential struggle” results from not living up to one’s values or trespassing them. (7) “Existential distress” accompanies existential frustration and existential vacuum characterised by a feeling of despondency. (8) “Existential Angst” has been traditionally used by the existentialist to refer to a sense of meaninglessness (8). “Existential Threat” is used to refer to one’s existence and fundamental values being in jeopardy. The frustration of the will to meaning can lead to the pursuit of avenues that may mimic the effects of finding meaning, such as pleasure, success, or power seeking. (5) It can also result in aggression, addiction, depression, self-harming, and self-defeating behaviors as well as increase the severity of psychological and emotional distress. (1)
LTEA was specifically developed to help people become aware of and to tackle the obstacles that hinder the accomplishment of meaningful goals. (1,4) In LTEA, people are led to areas of freedom where meaning potentials can be found. However, they are not given or offered specific meaning contents because they need to discern and discover these for themselves with help from their conscience and will to meaning. The will to meaning is the strongest ally of the helper because it is that source of vitality and elan that is aimed at detecting realistic meaning possibilities that one can accomplish. (8)
The third principle, Meaning in Life, asserts the belief that life offers purposeful goals worth accomplishing in every situation. (1,4) Meaning is a thought of as a trans-subjective value standing in relation to the person. Thus, meaning is an objective reality that addresses the person, not an invention or figment of imagination or wishful thinking, arising from the soma or mind of the person. (1) Meaning is intuited through conscience and discerned in the dimension of spirit. (2) A person is invited to use their freedom of will and responsibility to make the best of a situation and of themselves. While ultimate meaning is abstract and impossible for humans to fully comprehend, as it is only with faith that one can approach its mystery, the meaning of the moment in harmony with ultimate meaning is a concrete possibility and task that is awaiting each person, linked to their specific circumstances and situation and in a state of change from moment to moment. (5) Thus, instead of finding a general meaning in life, one is invited to keep an open mind and remain flexible to accomplish the call of the moment, and thus shape oneself and one’s life moment to moment and day by day. (1)
There are three therapeutic techniques that form part of the non-specific tool kit of LTEA. These methods have been developed to deal with patterns, tendencies, and attitudes that can block the will to meaning and cause emotional and psychological suffering. Each of these techniques are evidence-based practices. (8)
Paradoxical intention has been used since the early 1930s in the treatment of obsessive and compulsive tendencies, and anxiety. (4, 5, 6) The basic premise of this method is that excessive avoidance of anxiety provoking stimuli can lead to excessive fear. Attempts to ward off this fear can be coupled with fear of fear. Fear of fear leads to a vicious cycle in which self-observation, hyper-vigilance, and hyper-attention, bring about the feared symptom. (4,8) Thus, excessive fighting against, leads to symptom amplification. The way to break the vicious cycle is to create a distance between the self and the fear, face the fear instead of running from it or warding off from it though safety behaviors, identify the trigger of fear, learn how to tolerate fear, and employ humorous formulations to exaggerate it to create even more distance between the spiritual self and the fear, which breaks the vicious cycle and symptom amplification. (1,8)
De-reflection has been used in the case of sleep disturbances, sexual dysfunctions, and anxiety disorders, where the root of symptom amplification had to do with anxious self-observation, anxious rumination, and hyper-intention. (1,5,6) The increased attention and intention, coupled with increased anxiety led to a vicious cycle of hyper-arousal that interfered with spontaneous functioning. Right passivity, though drawing attention away from the physical and emotional self toward areas of freedom and values allowed the spontaneity and natural flow to return. (8)
Modification of Attitudes is focused on identifying and altering attitudes and expectations that block meaning fulfillment. (1,8) Such patterns can be habit forming and alienate a person from being in touch with themselves, with their aspirations and meaning potentials in life, thus alienating them further and further and reinforcing maladaptive a poor choice that are causing suffering to themselves and others. Rather than value impositions, telling people what to do, ordering and commanding them how to alter their maladaptive patterns of behavior, therapists reach to the root of these behaviors in attitudes that are unrealistic, exaggerated, counterproductive, or self-defeating to help them gain new perspectives and outlook that may offer a fresh path to a productive and fulfilled life. The Socratic dialogue is used to challenge old and maladaptive assumptions and to bring up the possibility of re-thinking and re-committing oneself to new ways of seeing and doing that brings meaning into the world. The aim of the Socratic dialogue is to help to re-connect with universal values, and to re-connect with truth, beauty and goodness, aspects of meaning that one can bring into the world. (1,8)
The faulty assumptions underlying the idea of war can be seen in collectivistic thinking, reductionism, and fanaticism. (3) Collectivistic thinking requires to relinquish the individual agency and freedom of the individual to the thinking of the group. (3) In the case of an autocratic style of leadership, individual freedoms and responsibility is required to be relinquished to a central figure.
Reductionism is the idea that complex realities can be understood along lower levels. (3, 5) Such thinking denies the freedom of will of the individual.
Fanaticism is manifested in the elevation of a relative value to the absolute. (3) The danger of fanaticism is an “all or nothing thinking” in which the value on the of a pyramidal system is absolutized, idealised and quasi “worshipped.”
Three vicious cycles are created by the wrong attitudes: (1) “Existential threat,” the one’s values are in jeopardy, are exacerbated by a fanatic attitude in which one value is idealized and absolutized. Fanaticism evokes a feeling of “existential threat,” and the feeling of “Existential threat” reinforces the fanatic zeal to protect this value from being lost. (2) “Existential Angst,” a sense of meaninglessness fostered by reductionistic thinking provokes a fear of fear. The fear of fear reinforces the existential angst. (3) The perception of “existential threat” of the autocratic style evokes “existential angst” and the existential angst reinforces the perceived existential threat.
The will to meaning is temporarily blocked by these three obstacles. Existential frustration surfaces, but the voice of conscience is ignored and continually supressed. In the absence of meaning, the motivation may change to seeking pleasure and appreciation of utility instead of inherent value. Since this path des not lead to meaning, it is frustrated and leas to existential vacuum. In the vacuum aggression, violence, abuse, and harmful behaviors flourish.
In the continued absence of meaning, a will to power may predominate. It reinforces the fanatic zeal, but ultimately, fails to bring a sense of fulfillment and leads to frustration and despair. The consequence is existential despair.
From the perspective of LTEA, without restoring a healthy meaning-orientation, suffering amounts. Pain is inflicted in the self and on others. There are three points of intervention that can help to remove the obstacles from the path of the frustrated will to meaning: (1) breaking the fear of fear through paradoxical intention; (2) modifying the fanatic attitude through the method of modifying attitudes; and (3) re-instating a three-dimensional view of the person in one humanity by de-reflecting from self-interest and considering others. This will fully re-instate the dynamics of the will to meaning.
Paradoxical intention to break the pattern of existential angst and fear of fear can focus on being able to face fear and tolerate it without lashing out and hurting others. It is a normal phenomenon to experience fear of meaninglessness. The fear itself points to the significance of finding meaning. Excessive fear leads to a paralyzed sense of rigidity or attempts to fight the fear by frantic action and acting out. It is a human prerogative to take a distance from oneself, from one’s inner state. It is a human achievement to look fear straight in the face and deal with it, like the bull fighter tackles a bull by its horns. “Take the bull by the horns.” “You are in a unique position like no one else in the history of this world to effect change, and defeat fear by looking not its eyes and defeating it through your resolve to be stronger than it.”
Modification of attitudes can tackle the vicious cycle of fanaticism and the feeling of existential threat. Whenever we idealise a value, and place it on a pedestal, we place it in a position that if it is not possible to achieve, we are risking having no value because we put everything on the line, “we put all our eggs in the same basket.” An idealized value makes us loose sight of the fact that we are not the one wo assign values, but it is life. Rather than placing values, we need to live them. The Socratic Question helps us to reflect on: “Rather than us asking what we an expect from life, we need to ask, what is life asking from us in this moment?”
The third vicious cycle between existential threat and the existential angst that blocks the will to meaning can be alleviated through de-reflection. We think of the future beyond our self-interest. What is it that we want our legacy to remain in the world? According to Albert Einstein, if all the resources that are invested into the war could be put to a good use, the world could be a much better place to live in. Let us imagine and build such a world.
Frankl, a survivor of the Holocaust believed that when the basic need for meaning is ignored, disregarded, and shunned, then even success, power and fame will feel empty and futile. (5) In the absence of meaning, falls into the abyss of despair. In the presence of meaning, however, even a perceived failure can lead to a sense of fulfillment. (5)
He outlined three avenues through which life can be made meaningful. (1) Through creative values, to which category belong everything that we bring into the world through work, and creative activities. (2) Experiential values, though which we can find meaning in what we receive from the world, such as its beauty and the relationships we cultivate; and (3) through attitudinal values, the possibility of facing unavoidable suffering with courage. (4, 5) This latter in the highest form of human accomplishment because it offers the deepest possible meaning until the last breath. The attitudinal values are subdivided into another triad: meaningful attitudes to pain, guilt, and death. (5)
As human beings, we are fallible, vulnerable, and finite. However, our essence is not what is fallible, finite, and vulnerable, but that what is eternal—our essence. Surely, what we have done, cannot be undone. However, the attitude toward pain confronts us with the possibility of taking a stand toward fate. In the case of guilt, one has the chance to take a stand toward oneself. Because of our freedom of will, it is a human prerogative to become guilty of a wrongful act, and it is a human imperative to overcome this guilt, to have a change of heart. (5)
As for the third aspect of the tragic triad, life’s transitoriness, Frankl remarks that we usually see only the partial picture:
“Usually, man only sees the stubble fields of transitoriness and overlooks the full granaries of the past. In the past nothing is irrevocably lost but everything is irrevocably preserved and saved, safely delivered and deposited. Nothing and nobody can deprive us of what we have rescued into the past. What we have done can never be undone. This adds to man’s responsibleness. For in the face of transitoriness of his life, he is responsible for using the past opportunities to actualize potentialities, to realize values, whether creative, experiential, or attitudinal. In other words, man is responsible for what to do, whom to love, and how to suffer. Once has realized a value, he has fulfilled a meaning, he has fulfilled it once and forever” (5:52).
“Man’s Search for Meaning” expresses trust in the realistic optimism that change is possible. Through the freedom of will, a human being is uniquely in the position to shape and to mold him or herself.
“I speak of a tragic optimism, that is, optimism in the face of tragedy and in view of the human potential which at its best allows for: (1) turning suffering into a human achievement and accomplishment; (2) deriving from guilt the opportunity to change oneself for the better; and (3) deriving from life’s transitoriness an incentive to take responsible action” (4: 129-130).
An examination of existential angst and existential threat from an existential perspective reveals that the two dynamics intercept each other at the common point of anxiety. How one chooses to respond to anxiety can have implications for peace-making and healing.
“Existential angst” and “existential threat.” What do these concepts mean and why are they increasingly used in discourse? An understanding of these concepts may shed light on what existential issues we are facing, and what choices we have as we address these phenomena.
According to the dictionary definition, the feeling of “existential angst” is a feeling of dread, impending doom, and anxiety that reaches nearly the levels of panic; a term used by the existentialists related to the human experience of freedom and responsibility (7), and by extrapolation, related to finding and actualizing meaning, more precisely, it refers to the sense of meaninglessness and the apparent lack of meaning (8).
The concept of “Existential threat” has been used by people to refer to their basic needs not being met, a threat to their very existence, when their continued being is at stake or in danger (1). A perception of “threat” involves a sense of impending harm to their being and often involves anxiety and vigilance to ward off the harm.
Let us examine these concepts in further detail to highlight some of their existential implications and correlates.
There are many forms of anxiety. Some types of anxiety are reasonable and justified. Anxiety is state and an emotional reaction that is associated with feelings, thoughts, and physiological reactions, among which we can list, increased sympathetic nervous system activity, higher heart rate and blood pressure. Release of adrenalin to prepare the body for flight or fight. This is an evolutional response serving the purpose of survival. Psychological states associated with anxiety include vigilance, hyper-arousal, scanning, anxious rumination, catastrophic thinking. In the absence of real or imagined threat, the thoughts usually subside, the thoughts calm, mental clarity returns along with normalizing of bodily states. Homeostasis and a state of rest returns. Only, in the condition of prolonged toxic stress, that is unbuffered by the mediating factors such as a source of safety, security and trust, the body’s resources are increasingly depleted and in the case of lack of capacity to obtain rest physically and mentally, the body’s capacities to reinstate a state of rest will be jeopardized. Increased physical reactivity along with emotional hyper-arousal and vigilance will interfere with rational thinking and reasoning (5).
When one is talking about “existential anxiety,” we are talking about the existential dimension of the person, with their dimensions of body, mind, and spirit. Spirit is that dimension in which existential dynamics takes place. It is a dynamic that orients a person toward meaning, values and ideals that during the course of their actions one reaches toward to actualize. According to Frankl, meaning is the main motivating force of a human being, the reason of our existence (2,3). When our will to meaning is frustrated, we feel empty inside, thus the expression “existential vacuum” (3). Long-lasting existential frustration can lead to a dreaded sense of an apparent lack of meaning and despair (2, 8). Existential angst is a normal reaction to the sense of lack of meaning and indicates the significance of meaning in our lives. With guidance, one can help a person find areas in which meaning can be found to alleviate the existential angst and re-establish healthy tension between being and meaning and meaning-seeking, where meaning is the pacemaker and guide of our being (2).
Conceptualized from an existentialist point of view, a feeling of existential vacuum leads to a sense of emptiness in the absence of the perception of meaning and values to actualize. Existential distress is brought about by value conflicts. Existential frustration is the sense of loss of values (2). Existential struggle is related to the trespassing and disregarding of one’s deeply held values (6). In existentialist framework, existential threat can be conceptualized as a perception of the jeopardy of what one is, and what one stands for, such as a threat to one’s values.
When existential frustration and angst persist, people can attempt to find meaning in areas that do not lead to meaning but are shortcuts to a feeling that a sense of meaning would result in: they pursue pleasure or power (2). But since these do not result in a lasting fulfillment, the pursuit increases the level of their intention and their anxiety. Hyper-attention to oneself and hyper-reflection fuels fears that are now related to the intended and demanded results, in the absence of which the experience of “existential threat” intensifies. This threat is perceived whenever one’s needs for security, safety and basic needs are not met, or one’s values are in jeopardy, and is experienced as a threat through one’s functions of survival (notice: not functions of purpose and meaning, but functions of survival).
There are cases of course, when one’s basic needs such as food, shelter, clothing, esteem are not met. The existentiality of the person, the existential dimension in such instances would suggest that a person engages in problem solving, thinking, creative and cooperative values-based action. However, when a person’s entire existence is reduced to a capsule of an organism with body and mind and the spiritual aspirations have been denied or ignored, meeting needs may not proceed according to rational, reasonable, and reflective grounds. They will be pushed by instinct and drives, instead of pulled by what is meaningful to do to meet basic needs. A prolonger state of existential angst, whereby reflection on one’s actions and their consequences, reaching out to others and options, choices (self-transcendence and self-distancing) have been lost to an impulsive jerk response of stimulus and response. The existential angst that was there for a prolonged period, and ignored, has given space for a feeling of “existential threat” to sprout and to take over genuine existential concerns.
The existential threat will intensify when values are equated with what one has, rather than what one is. Furthermore, a sense of “jeopardy of values” will surface if one ignores one’s freedom of will choose to live one’s values in harmony with universal values, regardless of the conditions. Thus, without the realization that values can not be given or taken away from a person if they decide to remain true to them and live them in various circumstances, existential threat may become chronic and persistent.
Interaction between “Existential Angst” and “Existential Threat:”
In summary, “Existential threat” is an anxiety about the basic needs of a person not being met and beyond that, that their values are being in jeopardy, without reference to their existential self in search for meaning. When the “existential threat” is accompanied by angst, fear of fear produces a vicious cycle in which the more one attempts to fight the fear, the more intense it will become. Fear produces fear and the fear of fear keeps the person trapped in a highly emotionally charged state that interferes with rational problem solving, blocks the ability to listen access one’s inner resources and increases the frustration of the will to meaning, that remains unheard and unheeded. Blocking access to the freedom of will, ignoring one’s will to meaning, reducing oneself to the level of body and mind, desires, instincts and impulses, and emotions, feelings, and thoughts, leaves out the possibility to choose one’s values and responsibly live them, be guided by them. Therefore, a reductionistic and so called “value blind “ view of the self (and others) reinforces the existential threat and the existential angst.
How does one Break the Vicious Cycle of Anxiety?
How can one bear the grip of fear? One can no longer run from it; one needs to face it. Unless one does, the despair continues, and the vicious cycle pulls the person toward destruction. To face fears, one needs space. One needs to sit down with oneself and have a dialogue with oneself. If one cannot do it alone, one needs help. One needs to evaluate one’s actions. One needs to get in touch with one’s feelings, thoughts, and values. One needs to evaluate the consequences of the actions. One needs to be able to see oneself, as a being with body, mind, and spirit, between functions of survival and function of purpose. One needs to re-discover oneself as a person of worth, wit freedom and responsibility and the possibility to change oneself for the better. One needs to question the reality of one’s thinking when irrational and anxiety motivated, based on assumptions, past experiences or automatic conclusions that are exaggerated or overgeneralised, and result to increase suffering to the self and others. More so, one needs to re-connect with one’s inner self. The freedom of will, and the will to meaning, beyond the will to power and pleasure. One needs to assess and re-assess one’s values in light of universal human values. One needs to re-set oneself. One needs to accept one’s mistakes and assume responsibility for them. Effectuate change and growth. Mold oneself. Shape oneself. “Not to take every nonsense from oneself” (2). Discover the freedom and the responsibility to take a stand toward not only one’s circumstances, but one’s inner self: one’s fears and anxieties. Do not give into them. Do not let them be in control, Re-gain agency. Re-gain self-determination. Only the step in the “right” direction in the direction of meaning can bring about a gradual relief from the existential angst, reinforce a sense of trust and thus gradually ease the grip of existential threat.
Human relations involve body, mind, and spirit. Physical contact between people is often preceded by emotional connection, exchange of ideas though communication and an implicit or explicit dialogue about goals and values. One feels attracted to people with who one shares similar interests, can share ideas, or have similar goals. One shows open mind, benevolence, and tolerance toward diverse ideas. One shows respect for diversity of thought, ideas and perception of what others think what is meaningful to do in a situation. And this is rightly so, since meaning is always individually given, tailored to the situation and uniqueness of a person. But we know that meaning is not subjective. It is objective and it involves what is good for one and for the other (2). For such reason, one needs to rely on conscience to discern one’s course of action in accordance with values and universal values (2). “What is the best to do in a given situation?”
So, what happens is cases of conflict, where one person imposes on the other what they should do, how they should think, or live? There is a spectrum from mild to moderate to severe imposition, to the point that the other may feel that their will to meaning is not being heard or its dictates can not be fulfilled because of the amount of imposition. This will create tension. The tension can rise to the point of oppression. This can be manifested in words, gestures, and actions. In relationships, we call it abuse, and we recognize several forms of it: physical, psychological, sexual, emotional, spiritual, etc.
Abuse in all these cases presents the other party with suffering. The abuser suffers in their own way. However, instead of solving this suffering and choosing to respond to it by allowing oneself space, determining their response so that they do not harm the other, they may choose to impulsively lash out at the other, threaten the other, attack the other. In relationships, we call this to act aggressively.
What shall the other do? In partner relationships, one assesses the level and seriousness of the threat of aggression or the aggression once it occurred. One considers its history, its manifestation, its possible consequences. One tries to mediate, to negotiate, to find a common ground. However, with severe abuse in relationships, the one that cause the other serious emotional, mental, or spiritual pain, let alone physical pain, intervention is necessary. One does not counsel the abused party to return to the abuser. One does not counsel the abused party to physically fight back. One advises the abused partner to remove oneself from the situation until the other partner is committed to receiving help, accepts responsibility upon being confronted with their actions, and commits to change. Until the abuser learns how to tolerate their inner distress without lashing out, and how to resolve their issues about existential threat and angst within themselves, without harming someone else in the process, the distance needs to remain, lest to perpetuate the abusive cycle.
Concretely, when one witnesses abuse where one of the partners is beaten, and beaten to death, or likely to be beaten to death, one does not stand by. Moral duty and responsibility demand action. Vulnerable individuals need to be removed and protected. A safe space needs to be created between the abuser and the abused person and enforced so that the abuse does not go on. Sometimes, the police need to be alerted, the authorities need to get involved to restore justice and order need to be on the scene. This is the prerequisite of finding a space to re-build lives and achieve peace until the attacking party will assume responsibility, realize their freedom of will and responsibly mend their ways (if they decide to do that).
The same happens in conflict situations between nations. Each situation is different, and each nation has its own “face;” history, culture, and traditions. Mistakes can be made by individuals who bring an entire country into war against another one. We know that this is not a case of collective guilt (3). There are those who oppose to war but have no choice to live elsewhere and suffer the wrong actions of the leadership of their country. To the party that suffers the attack, we cannot say, “it’s your problem, we do not care.” We can not stand by passively because humanity is like a big family. What one does, affects everyone else.
We may say we want to work for peace, and we know how to get there. This ideal, the value of peace, needs to be upheld. However, when the conflict already happens, the fact is that peace has been disturbed. We need to be aware of this fact and face it. To bring peace, it is necessary to reflect and to think. Evaluate one’s values considering universal values. Re-align them if there is a misalignment and disharmony. Tolerate distress without lashing out, until meaning dawns.
It is necessary to have space to think. To create space between two warring parties until solutions can be worked out can be a part of building peace. This value is now actualized in a way that its optimally possible to live up to it, until the circumstances change, until there is a change of heart. It is a human pre-condition for gaining insights and to regain rational thinking to allow space to reflect.
We humans have a strong will. This will inherently helps to find meaning (functions of purpose) that ought to guide how we meet our needs (functions of survival). It can also be stronger than our will to power and will to pleasure to the point that we can accept sacrifices for the sake of the other, for the sake of living together in harmony.
Speaking of survival, survival would be meaningless if it was not for the sake of an ideal for which we are willing to lay down our lives and that is the source and purpose of our existence, the Reason of our being. When we find a strong reason to live, we can withstand frustrations, even if not all our needs are met. Or as Frankl quoted Nietzsche: “Whoever has a why can bear with nearly any how.” (3) It is this “why” and “what” is the most meaningful to do that is waiting for us to ponder in a crisis situation where space between stimulus and response allows to make a choice. This choice is meaningful only if it is the best option among those available, the best for us and for the others involved, since we are one human family.
Working for Peace:
A common goal, a common task– this is what will save humanity from extinction, and extinction not only because of needs not being met or values being in jeopardy but first, because of the self-destructive effect of rage and senseless and uncontrolled actions that follow from angst-motivation that follows from an un-reflected existence, where the will to meaning was not and cannot even be heard in the turmoil. “Existential angst” and “existential threat” require to be acknowledged and guided “toward” something and someone for whose sake we are willing to stop and think.
Peace requires to stop and think. To make space. Physical space away from the noise of battle. Mental and emotional, spiritual space for the voice of conscience (3). Space to listen, and space to discern. Space to heal. Space to get in touch with the inner strength to counter the “existential threat” and supplement it with answers to the existential angst. Search for what is meaningful (what is true, what spreads goodness and beauty), what builds up rather than destroys. Search for values in harmony with universal vales. The more a nation can have this space the more they can advance toward peace. –In a space as large as the heart.
The opposite of war as an aggressive act is a space in which value discernment can take place and where meaningful decisions can be made. When existential angst and existential threat are not equated with the person, but a distance can be gained from these states to find a response to them, without hurting or damaging another, victory has been won over dread. When a space is perceived between stimulus and response, the agency of the individual is can be called upon to decide in which direction they want to move. When the space is filled with meaning–the actualization of values in harmony with universal values–peace can freely flow.
Screaming “existential angst” and “existential threat” are sure signs that existential dynamics are at hand. To deny them and suppress them would deepen the cycle of anguish and despair. To face them and to respond to them squarely offers hope for a better life.
We can not deny the chance to the party needing inner space to let live, just like we cannot deny the right to life.
“Living itself means nothing than being questioned; our whole act of being is nothing more than responding to–and being responsible toward—life” (4)
“…O Lord, our Sovereign, how majestic is your name in all the earth!” (Psalm 8)
This is a busy time of the year, and two holidays almost coincide. In the Jewish tradition, Hannukah started at sundown on Sunday, December 2. It lasts eight days until December 5th. Hannukah is one of the most widely observed Jewish holidays, also called the Festival of Lights. It commemorates that in 165 BC, Judas Maccabee and his brothers won a victory over the invading Syrian army. On that occasion, they re-dedicated the Temple in Jerusalem. The oil lamp inside the temple had enough oil for only one day. But the light did not dim, and the oil lasted for eight days until new oil could be made. Hannukah is a joyous, cheerful celebration of re-dedicating oneself. Tikkun Olam means spreading good in the world and being the light of the world.
In the Christian tradition, Advent, the four weeks before Christmas is a time of waiting and preparation. We prepare our hearts and minds for welcoming the Christ Child. Jesus is the “Light of the World.”
In Frankl’s home both Christmas and Hannukah were observed (Klingberg, 2001).
Symbols and metaphors are commonly used in logotherapy to refer from the concrete to the abstract and to capture a meaning that goes beyond the mundane and the ordinary (Lukas, 2020).
In this presentation, we would like to consider some of the most frequent symbols associated with Hannukah and Christmas and illustrate logotherapeutic concepts or principles that can be pondered using these symbols. Symbols and metaphors are used in practice is for clarification and for encouraging the spirit. They usually occur in the context of an authentic “I and Thou” encounter, with the recognition that as therapists or patients, we are pilgrims in our journey of life (Marshall & Marshall, 2022). During the holidays, we profit from the time available for reflection and meditation to offer new insights and to allow meaning to unfold.
The symbols that we chose to reflect on today are those most frequently noticed in our surroundings at this time: (1) The candle, (2) the tree, (3) the presents, and (4) the star. Many of these items have rich symbolism and their existential significance can be explored.
Most of us have a candle in our homes. Whether we saved it from previous years, or we bought a new one for the holidays, our candles are ready to be lit.
The candle’s purpose, its function is to give light and warmth.
If we just kept candle hidden in the drawer, it would not fulfill its purpose.
So, let us take a closer look at our candle and observe what logotherapeutic thoughts may be associated with it. Some of the following ideas were described by Dr. Elisabeth Lukas’ “Candle Meditation,” found in her book, “Alles fugt Sich und erfullt sich,” published in 1994. She used these mediations in group settings:
The candle is composed of wax and has a structure.
Inside the wax is a tiny bit of wick that is visible on the top of the candle. The rest of the wick is invisible, but we know that it is inside.
The wick is the most important part of the candle, because without the wick, the candle would be of not much use. We could not light it, only burn it. (Maybe, that would not be such a good idea).
The candle represents our human reality. Our bodies and mind that are like the wax, fragile. We are fallible, vulnerable, and finite beings.
Much like the wick, our essence is not our bodies, or minds, but rather, what is “inside,” and most hidden from the eye, other than a little bit of what is visible of the wick at the top of the candle, what can be seen.
Spirit is the very essence of our being. Body and mind are only its instruments through which the spirit can express itself. This is similar, to how the wax provides structure and holding place for the wick so it can fulfill its function (Lukas, 1994). The spirit relies on its instruments to accomplish its purpose.
We can say, we have hands, feet, and eyes. With a stretch of the imagination, perhaps we can embrace the statement that we are the feet, the hands, and the eyes through which truth, beauty and goodness can be brought into the world.
St. Theresa of Avila was a Carmelite nun and a mystic. She wrote these beautiful verses so appropriate to the metaphor of the candle:
“Christ has no body but yours,
No hands, no feet on earth but yours,
Yours are the eyes with which he looks
Compassion on this world,
Yours are the feet with which he walks to do good
Yours are the hands with which he blesses the world.
Yours are the hands, yours are the feet,
Yours are the eyes, you are his body.
Christ has no body now but yours,
No hands, no feet on earth but yours,
Yours are the eyes with which he looks
Compassion on this world.
Christ has no body now on earth but yours.”
When we light the candle, it gives light and warmth. This is the purpose of human life. To be a beacon of hope and to shine in the world though one’s actions of caring and kindness.
In the moment we light the candle the candle is no longer wax and wick, it is transformed into purpose and function. The physical energy is transformed into light and heat energy that radiates into the world and that remains in the world.
It is interesting to ponder that the reality of the candle giving light is independent if someone else can see the candle or knows about it. Similarly, our actions of kindness and goodness do not pass away and are independent of who knows about it (Lukas, 1994).
The old candle, the broken candle, a damaged candle, the bruised candle can still be lit, and it can still give light and warmth.
As we contemplate our candle, we may recall Frankl’s words:
“What we radiate into the world, the waves that emanate from our being, that is what will remain of us when our being itself has long since passed away” (Frankl, 2019:45).
The Christmas Tree:
We may buy our tree or observe some that we can see around us on the streets, in the shop windows, or at the city square. A gorgeous, green tree may be erected and decorated in the mall or at the market.
What do we see?
The tree, a symbol of life, spirals toward the sky, ending in a high point symbolizing a climax or destination.
In may places, the branches of the tree bear rich decorations or tiny lights and ornaments. Every decoration is carefully placed. Sometimes, it takes some time to decide where one will place the larger ornaments, where one will place the smaller ones. Where one might hang a dented but highly prized piece, or where the most cherished ornaments will find their place. These decisions can represent the choices we make. The decorations are like the values that stand in relation to us. They shine brightly.
When we finish making our choices, and decide where we will place the ornaments, the lights, or the ribbons, we usually stand back and admire the tree. There it stands in all its glory. The decorations sparkle in the light, and they all rise, pointing up toward the top of the tree. Up high, closer to the tip, are the ornaments representing the higher values or universal values, such as the values of love, value of fidelity, the value of life, the dignity of a person, and so on. These values are under which the lower values are subsumed. The lower branches are closer to us. So are the decorations on them, which represent the values through which we actualize concrete meaning, the meaning of the moment that is within reach.
The tree is beautiful when all the decorations are in harmony with each other. From the concrete to the abstract, from the low to the high, from the meaning of the moment to ultimate meaning, the lights and special ornaments create a harmonious and appealing image of actions reflecting values just as decorations reflect our highest ideals, aspirations, and ideals.
Pierre Teilhard de Chardin, a French Jesuit and theologian once remarked: “…Remain true to yourself but move ever upward toward greater consciousness and greater love! At the summit your will find yourself united with all those who, from every direction, have made the same ascent. For everything that rises must converge.”
Frankl reminds us that our actions are meaningful if they are in harmony with universal values that point to ultimate value and to ultimate meaning (Frankl, 2014).
As we contemplate the beauty of the Christmas tree, we may take a moment to reflect on his words of wisdom:
“It is terrible to know that at every moment, I bear responsibility for the next: that every decision, from the smallest to the largest, is a decision for ‘all eternity;’ that in every moment I can actualize the possibility of the moment, of that particular moment or forfeit it. Every single moment contains thousands of possibilities—and I can only choose one of them to actualize it. But in making the choice, I have condemned all the others and sentenced them to ‘never being,’ and even this is for all eternity! But it is wonderful to know that the future—my own future and with it the future of the things and the people around me—is somehow, albeit to a very small extent, dependent on our decision in every moment. Everything I realize through them, or ‘bring into the world,’ as we have said, I save into reality thus protect from transience” (Frankl, 2014:106).
How do we decorate our tree, which values do we pace higher or lower? The choice is sometimes not easy to make. It may take some prayerful reflection to decide well.
Several ideas of presents that we want to buy, or wrap may be going through our minds. Those of us who are really organized, already have some items ready and hidden, somewhere were little eyes and hands can not touch them, so they are a surprise.
Presents represent our acts of kindness and good deeds, the warmth, and the love we share. Yet, while we have not given them, they are only possibilities. When we give them is the moment when they accomplish their purpose and bring smile to the face of someone.
As we contemplate presents, the ones we may give and those we may receive, we contemplate the gift of love and being loved.
Earlier, when we talked about the example of the candle, we talked about the uniqueness of each person and the value which is related to the community and serving the community, serving others. This is love that we give.
There is also a second path, says Frankl other than doing, and that exists in being, in being appreciated for who one is, which is a more passive way. This is lovethat we are given.
“This is a more or less passive path, without any stiving, without any doing—“without doing anything for it”—in being loved, what someone otherwise had to strive for in his activity or employment now seems to fall into his or her lap; on this path of being loved we achieve what we would normally have to fight for and though our performance, but without needing to earn them: indeed one cannot force love; love is not a reward but a blessing. On the path of love a person thus receives by “grace” the things that he or she would have to strive for to obtain through action: the realization of both his or her uniqueness and individuality. For it is the nature of love that makes us see our loved one in their uniqueness and individuality” (Frankl, 2019:75-76).
Thus, as we contemplate presents, the presents that may want to give and the presents we may receive, we can ponder love. The mystery oflove is that can not be demanded or commanded but it is an act of grace.
As the hustle and bustle of preparation is nearing, let us recall the greatest gifts that God gave. Let us prepare fitting gifts in our hearts:
“Lord make me an instrument of your peace.
Where there is hatred, let me sow love,
Where there is injury, pardon;
Where there is doubt, faith;
Where there is despair, hope;
Where there is darkness, light;
And where id sadness, joy.”
O Divine Master, grant that I may
Not so much seek
To be consoled as to console,
To be understood as to understand,
To be loved, as to love.
For it is in giving that we receive.
It is in pardoning that we are pardoned,
And it is in dying that we are born
To eternal life.” (Prayer reflecting the spirituality of St. Francis of Assisi)
The final symbol that I would like to ponder in relation to logotherapy is that of the Star of David and the Star of the Nativity. Christmas time in all traditions is a celebration of hope and good will. This hope and good will is fulfilled in our relationship with the Transcendent and the Divine who is not distant and far away but with us on our journey though the desert until we reach the Promised Land.
Perhaps these words are ever more significant today, during the suffering that we experience due to the COVID-19 pandemic than ever before.
Two millennia ago, in the small town of Bethlehem, Jesus was born. According to the Gospel of Luke 2:8-16:
“In that region there were shepherds living in the fields, keeping watch over their flock by night. Then an angel of the Lord stood before them, and the glory of the Lord shone around them, and they were terrified. But the angel said to them, ‘Do not be afraid; for see-I am bringing you good news of great joy for all the people” ‘to you is born this day in the city of David a Saviour, who is the Messiah, the Lord. This will be a sign for you: you will find a child wrapped in bands of cloth and lying in a manger. And suddenly there was with the angel a multitude of the heavenly Host, praising God and saying, Glory to God in the highest heaven, and on earth peace among those whom he favours!
When the angels had left them and gone into heaven, the shepherds said to one another: “Let us go now to Bethlehem and see this thing that has taken place, which the Lord has made known to us.”
So, they went with haste and found Mary and Joseph and the child lying in the manger.”
And at the time when Jesus was born, there was a star that marked the place of the manger, which led the wise men on their journey to Bethlehem:
“In the time of King Herod, after Jesus was born in Bethlehem, wise men from the East came to Jerusalem, asking, “Where is the child who has been born the King of the Jews?’ For we observed his star at its rising and we have come to pay him homage” (Matthew, 2:1-2).
And following the star they found the baby and thy paid homage to him.
The star of Bethlehem heralded his birth. The angels sang. And on this holy night, God, yet again, confirmed his never-ending covenant.
God is all mighty, God is all knowing, God is all powerful. In comparison, we are weak, vulnerable, time limited and fragile. Like a speck of dust on the face of the earth. But God does not abandon his people. He has chosen an appointed time in history to manifest himself in relation to us, in a way that we could possibly relate to him most in a personal way.
As we spoke of our finiteness, vulnerability, and fallibility, so we must also speak of suffering, and we must note the concept of the Tragic Triad of pain, guilt, and death that Frankl mentions in Man’s Search for Meaning (2014:129). Pain belongs to our vulnerability, death to our finality and mortality, and guilt to our fallibility.
Suffering uniquely colors our lives and represents an opportunity for expressing our individuality and uniqueness in not only how we experience it, but how we respond to it. Through creative, attitudinal, and experiential values, Frankl described the avenues through which suffering can be turned into a human achievement. The highest challenge, and the highest form of human achievement possible is to find meaning and to live meaning in suffering.
In Frankl’s words, “…In some ways suffering ceases to be suffering at the moment it finds a meaning, such as the meaning of a sacrifice” (Frankl, 2014).
Tragic optimism (and by optimum Frankl meant “the best”), humanity at its best, in the face of tragedy is manifested in the human potential that (1) allows for turning suffering into a human accomplishment; (2) deriving from guilt the opportunity to change oneself for the better; and (3) deriving from life’s transitoriness an incentive to take responsible action” (Frankl, 2019:130).
As we ponder the Star of David, composed of two inverted triangles juxtaposed one on the other, and the star of the Nativity, let us remember that as our suffering is unique although shared with all humanity, the meaning-call that lies in it is also unique that we leave with all humanity.
At Christmas time, let us open our ears, hearts and minds to a call that transcends time and space, and which resonates on our inner selves: “We are wonderfully designed, eternally loved, and awaited!”
To close with Frankl’s thoughts:
“It is only in the image and likeness of God that we understand ourselves (Frankl, 1951).
“It is only to the extent to which we transcend ourselves that we actualize meaning” (Frankl, 1972).
Frankl, V. E. (1951). Logos und Existenz. Vienna, Austria: Amandus Verlag.
Frankl, V. E. (1972). Der Wille zum Sinn. Vienna: Huber.
Frankl, V. E. (2014). Man’s search for meaning. Boston, MA: Beacon Press, Boston.
Frankl, V. E. (2019). Yes to life in spite of everything. Boston, MA: Beacon Press.
Lukas, E. (1994). Alles fught sich und erfullt sich. Stuttgart: Quell.
Lukas, E. (2020). Living Logotherapy. Logotherapy Principles and Methods. Bamberg: Elisabeth Lukas Archives.
Klingberg, H. Jr. (2001). When life calls out to us. The love and life of Viktor and Elly Frankl. New York, NY: Doubleday.
Marshall, M. & Marshall, E. (2012). Logotherapy Revisited. Ottawa, ON: Ottawa Institute of Logotherapy.
Marshall, M. & Marshall, E. (2022). Viktor E. Frankl’s Logotherapy and Existential Analysis. Currently in press. Ottawa, ON: Ottawa Institute of Logotherapy.
Bible references are based on the Holy Bible, NRSV (1989). Division of Christian Education of the National Council of Churches of Christ in the United States of America.
Quotations by Teilhard de Chardin, Theresa of Avila, and the poem attributed to St. Francis and are in the public domain.
*This presentation was prepared for the Christmas series of AMES, Alianza Mundial para Encuentros con Sentido, and presented virtually on December 2, 2021.
Notes from an Interview with Alexander Batthyany and Elisabeth Lukas.
On January 15, 2021, Professor Dr. Alexander Batthyany, Philosopher and University Professor at the Universities of Vienna and Budapest, Director of the Viktor Frankl Institute in Vienna, and Viktor Frankl Chair for Philosophy and Psychology at the University of Lichtenstein, and Professor Dr. Elisabeth Lukas, Clinical Psychologist, and former student of Dr. Viktor Frankl, were interviewed by Andreas Obrecht at the Austrian Radio [ORF] with the program title “Saying Yes to Life.” It aimed to provide an opportunity for Dr. Batthyany and Dr. Lukas to present their latest book with the title “Logotherapy and Existential Analysis Today: A Current Standpoint.” [Logotherapie und Exystenzanalyse Heute: Eine Standortbestimmung, 2020].
Dr. Batthyany studied logotherapy with Dr. Lukas over twenty years ago. These two prominent advocates of Viktor E. Frankl’s work collaborated in writing the book that explores the position of Viktor E. Frankl’s Logotherapy and Existential Analysis with respect to our complex reality today. The program provided an opportunity for listeners to express their views and ask questions.
Referring to the current pandemic, Andreas Obrecht explained that “Difficult questions arise in difficult times.” The interview aimed to explore some of the answers that logotherapy and existential analysis can provide in response to these questions. He prefaced the interview with the remark that “Logotherapy and existential Analysis, also known as the Third Viennese School of Psychotherapy, was founded by Dr. Viktor Frankl, an exceptional doctor, psychiatrist, neurologist, and philosopher.” He then chose one particular crucial point in Viktor Frankl’s life, 1941, when he held a valid visa in his hands that would have allowed him to immigrate to the United States. Since he was of Jewish origin, the visa was very significant for it would have allowed him to escape the horrors of the concentration camps. However, he decided to let it lapse because he wanted to protect his family. In 1942 his entire family was deported to the concentration camps where his wife, parents and his brother perished. He was liberated in 1945 by American troops.
From this brief window into the life of Dr. Frankl, Mr. Obrecht returns to the book in which Dr. Batthyany and Dr. Lukas state that it is hard to characterise Dr. Frankl since “his life was multi-faceted” and he was an exceptionally talented man. Dr. Lukas explains that “… One of the most remarkable qualities of Dr. Frankl was the coherence between his convictions, his teaching, and his life example which gave him a high level of credibility.” Namely, we can see that soon after the liberation when he found out that his loved ones perished, and he was struggling, he established to himself that there must be a ground and a reason for his suffering why he would be in a unique position to shoulder it and he held firm to the belief that a meaning that he can realise must be waiting for him in the face of it. Dr. Lukas explained, “…He had been granted a second life. This was a present. The first life ended in the camps. The second life was a gift of grace that he said he wanted to show himself worthy of it.” He wanted to use it well and so he lived in a way to help others. Another example of the congruence between his actions and words can be seen in the fact that “…he determined that he wanted to keep his heart free from hate and grudge.” Dr Lukas explained that “…hate and grudge dwell in the soul and weighs it down. The only way one can free oneself from both is by focusing on the present and how one’s life in the here and now can be filled with a meaningful content.”
The interviewer remarks how Frankl had written his book Man’s Search for Meaning very soon after his liberation and it become popular immediately after its publication. It is still a widely read book today, perhaps exactly because it offers an example for people on how to deal with suffering and even very intense suffering, such as Frankl experienced in the concentration camps. Dr. Lukas pointed out that Frankl dedicated himself to helping others as a doctor fully respecting each person. He did not ask his patients what their convictions were. His sole aim was “… to help people live a healthy life and this is what helped him to regain his own stability.”
The title of this new book is “Logotherapy and Existential Analysis Today: A Current Standpoint.” From the perspective of this historical vista, one can reflect on the contributions of this psychotherapeutic orientation today. Although the interview allows for only very brief remarks, Dr. Alexander Batthyany, notes that it is relevant to recall that the foundations of logotherapy have been laid before the second world war because this point is often missed or misunderstood. The roots and basic formulation of logotherapy were already laid by Frankl before the war and to think that he developed his theories in the camps or after his liberation emerged with this theory is of course not correct. What Frankl witnessed in the camps is that “…all the methods and therapeutic formulations that he gathered through his experiences earlier were applicable and held up in the camps and after.” Regarding the contribution of these principles today, Dr. Batthyany notes that he had been fortunate to hold presentations on logotherapy in different parts of the world, for example Japan or Africa, and he was always impressed by the realisation that the basic principles and the corresponding therapeutic methods are so to speak “trans-cultural” and timeless. “The basic factors, the basic principles remain, although the conditions may change with time and from place to place.” We live in some countries and on some continents in wealth but not on others and so the circumstances and the challenges may be different. However, the methods that have been applied across several cultures and have proven to be time-tested and effective. The principle what Frankl asserted is that fulfillment can be found “…not by intending that what feels good but discovering and doing what one is good for.” Thus, “…one can not aim for pleasurable activities to overcome hardships because there will be still hardships left but rather to think: how can I remain a human being in the good times and in the difficulties, through the ups and downs, and become a human being who leaves their own contribution to the world?”
One chapter in this book is entitled:” Happiness is what we are saved from.” This is a thought- provoking title. Dr. Lukas explained that it is easy to forget about life’s blessings: “What one experienced in the past is a wealth that was a gift. Each new day is a gift.” Looking carefully at the current situation, we realise that even what we take for granted, for example, our everyday lives, “…normalcy itself–is a present.” Dr. Lukas then asserted that “…even loss has an element of thankfulness about it that is easy to overlook.” Often it is only when we have lost something that we realise how precious it was. For example, if one loses a loved one. Or if one loses a job and realises how much one enjoyed work. These are values in life that we may temporarily overlook. She noted that it is relevant to become aware of the precious things that surround us. It is good to be mindful of everything that we value so that when we need to let go, we can think back with gratitude that we were blessed, and we were given these values as a present.
The first caller is a lady who has attended Dr. Lukas’ presentations and would like to point out another important contribution of Frankl that he summarized with the quotation “Whoever has a why can bear with nearly any how.” An experienced educator, she wondered how this idea could be presented to young people and if the formulation that if we have a reason, we can learn from our challenges could be explored in today’s classrooms. Dr. Lukas affirms her point by remarking that those who can see a task waiting for them can handle frustrations easier as they are searching for where they can responsibly contribute to making our society better.
Next, the interviewer invited Dr. Batthyany to summarize two main concepts in logotherapy: self-transcendence and self-distancing. Self-transcendence, said Dr. Batthyany, is the dynamics of reaching beyond oneself. “…It is an empirically demonstrated phenomenon. As human beings, we are capable of observing and reflecting on ourselves. Beyond self-awareness, we are able to reach beyond ourselves into the world and an area of possibilities in the world. These possibilities represent the area where our area of freedom lies. Not all of these possibilities are of equal value and this is where the element of responsibility enters. Some could be accomplished, some may be possible, and we need to aim for discerning the one task that is waiting for us to become actualised, that only we can bring into reality. This is our contribution. This is when we look not so much for what is good for me, but for what am I good for, what is meant for me to accomplish?”
Reflecting on Frankl’s remark that “responsibility is at the same time frightening and at the same time wonderful,” Dr. Battyany explained that it is a gift that we are able to act and that there are possibilities to choose from in our area of freedom where our values beckon. The realisation that without us acting none of these values can actualised, can fill us with a frightful sense of responsibility. Thus, “…we are all writers, and we write by the minute, the hour and the day our own stories. We decide what title we give to the chapters in our lives.”
Self-distancing, continued Dr. Batthyany, has to do with freedom. We have a physiological and psychological reality. For example, we have impulses and thoughts that may come and go. The question is if we are fully dependent on these psychological or physiological realities, “…do they have the last word, or can we gain some distance from them?” Here is where an area of freedom opens, at least in our attitudes. Dr. Lukas continues the explanation of this concept by referring to Dr. Frankl’s notion of the tragic triad of human existence: pain, guilt, and death. “No one is spared of pain, no one is free from guilt and we all have to face our finality.” In this relation to fate that which we do not have direct control over, or very little or no control over, we have little or no responsibility. We are not the ones who ask the question of why bad things happen to good people. Life does not answer these why questions. However, we are the ones who are being asked by life, what we are going to do in response to fate. “Until the last breath, we have a choice how we answer to life. We can answer with a yes or a no to life. That is what it means to be responsible.” Dr. Lukas explained that “…we can choose to be constructive, loving, or negative, bitter and cynical.”
The next caller asked why there is a strife between logotherapy and psychoanalysis. Dr. Battthyany explained that the roots of the differences go back to radical positivism. Historically, Frankl elaborated on the foundational principles of psychotherapy and the anthropological view of the human person to include the dimension of the spirit and unconscious spirituality along with the resources and capacities o the spirit which logotherapy mobilises. Thus, “…the are clear differences between psychoanalysis and logotherapy.” He goes on to say that “…If we omitted the changes that happened the evolution of psychoanalysis and we still considered it in its dogmatic origins with these principles at the forefront, then the differences would be very marked, indeed.” The differences would be even contradictions, for in logotherapy the therapist’s main concern is not the uncovering of hidden motives or drives. “Logotherapy rest on the recognition that we live in the world and our intentions are not ends in themselves; we are not primarily aimed at achieving homeostasis but that we are directed toward the world.” At the same time there are differences, there are instances in psychoanalytical thinking where we can see that “…the two orientations coincide”, noted Dr. Batthyany, and this is “…because ultimately, we are both talking about people in the world and the aim is the same: to help people. This is a common denominator. We want to understand people and support them. Thus, while there are some differences, there are some inherent similarities.”
The next caller expressed the view that through Frankl’s talks and presentations, one which he was fortunate to attend, there was always a thread of deep-seated trust and faith. Not necessarily in a religious sense, but the deep-seated trust of a believer, that was absent in Freud’s atheistic bent. He recalled the example mentioned at the start of this interview where Frankl shared that when the Vienna synagogue was destroyed , he found a marble piece with on the Ten Commandments engraved into it and it was the one: “Honor your mother and father so that you may do well in the land” and he acted accordingly. He based his decision on his faith and not on positivistic atheism.
The interviewer asked Dr. Lukas about the scientific basis of logotherapy following the findings of her dissertation . She explained that she measured two parameters. First: “To what extent people see their lives as meaningful?” She developed a test [Logotest] for measuring this first parameter. Second, the mental stability of her subjects. “The interesting finding was that with ninety nine percent certainty one could observe a correlation between mental health and seeing meaning possibilities in life.” Her findings offered one of the first empirical validation of Frankl’s work. This was an early study and since then, evidence for their validity has been mounting, with extensive research on the methods and the applications of logotherapy and existential analysis.
The question arose “What would Frankl say in response to the violence and aggression we see through the media today?” Dr. Lukas replied saying that each time has its negative trends. Frankl said that “…each time has its own illnesses and its own therapies.” Aside from reductionism, he identified fanaticism, fatalism, and collectivism. Nevertheless, there are several positive trends in today’s society as well, examples of kindness and altruism. Thus, we are confronted with the question “…whether to give in to these trends or to join those people who stand for hope and a better future.”
A caller requested to have some more information on the ways in which logotherapy can be applied in the case of treating emotional disorders. Dr. Lukas explained that logotherapy’s principles are applied with the intention to help the person in the present. “…We are not concerned so much with the past, and roots of the disorder but giving first aid in the present and exploring what possibilities the person has in the present.” In facing psychological difficulties and limitations “…we want to point to an area of freedom whereby one can develop a vision for the future.” Thus, logotherapy is primarily present and future oriented and helps to mobilise one’s inner resources in response to trauma or emotional challenges.
A caller who is currently a student of logotherapy and wishes to apply it in the future in his work with young people inquired about whether there is an international network of research and training insitutes in logotherapy? Dr. Batthyany replied that there are about 140 institutes in 40 countries. There are small institutes and larger institutes among them. [The list of these accredited institutes can be found on the website of the Viktor Frankl Institute: http://www.viktorfrankl.org]. There are innumerable publications of book and articles in many languages. However, the main point he wanted to emphasize is that “…the idea is always greater than the institutes.” What Frankl wrote and his students developed on the basis of his thoughts, ”… is wholesome and transculturally applicable.” The second point he made was that, as the saying goes: ‘the taller the tree, the deeper the roots,” and there is a lot of opportunities for an in-depth study of logotherapy and existential analysis.
A caller reported that he developed a program based on logotherapy and positive psychology with an emphasis on gratitude and mindfulness. He was wondering if happiness could be taught and learned? Dr. Batthyany lauded his efforts. However, about the question if to cultivate happiness can be made an intention, he offer this alternative: “…I think that aiming for a fulfilled life would be more realistic [than aiming for a happy life]. Happiness is only a small segment of life. There is also pain and grief. And if we focus too intensely on our own happiness it may cause us to be a bit blind to the suffering of others and the suffering where we could be helpful. …Engenderinghope and being helpful, acting with responsibility and accomplishing something worthwhile that is waiting for us to accomplish is what I think can be helpful.”
[Dr. Batthyany’s proposition stems from Dr. Frankl’ assertion that happiness is the by-product of a meaning-filled life, and it will ensue by itself, we do not need to intend it. It may come as a gift, or unexpected, as a surprise when we least expect it. Such as with the words of C. S. Lewis who said that “At the times of intense suffering we may still be surprised by joy.”]
A person sent in a comment wondering if lack of thankfulness is an overgeneralised statement. Alternatively, if we have the right to ask people in difficult situations to be grateful? Dr. Lukas answered these remarks with a personal example to illustrate that gratefulness does not need to disappear and it can be present especially in the most difficult situations. She related that her husband passed on after 44 years of happy marriage. It was a tragedy for her and “…the only thing that helped me was this great sense of thankfulness about having been happily married for so many years.” Illustrating the way in which gratefulness can be present and helpful, she explained: “…On my left side is thankfulness and on my right side is grief. Whenever grief on my right-side whispers into my ear: ‘You have lost something wonderful,’ gratitude in my left side whispers: ‘You had something wonderful.’ This is of great comfort.”
Another caller was wondering if logotherapy’s applications are too abstract and authoritarian. Dr. Lukas noted that it is one of the basic guiding principles of logotherapy that the therapist can not prescribe or command another person what to do or what should be meaningful to them. “…What we are attempting is to help people connect with their own inner resources, their own inner voice, one can name it one’s conscience or inner compass that orients them toward values and meaning that is inherent in the situation.” People need to discover for themselves best what it is that is a meaningful next step for them. “Therapy is successful when we can bring people into harmony with what they discern to be meaningful with their inner resources and we can help them gain awareness of it.”
The last caller asked if logotherapy can become a religion for a secularised society? Dr. Lukas’s answered this question with an empathetic “No.” “Logotherapy is a form of psychotherapy that is brief and effective. It is open to both religious and non-religious people.” Dr. Batthyany added that “…Frankl very clearly stated that logotherapy is for all people. It helps to intuitively discover meaning though being attuned to the inner voice of our conscience.”