Woods, Sunshine, Spirituality

The World is not Well, but it can be Healed

[PASSIONSWEGE] “Stations of the Passion” Radio Talk

Veronika Bonelli’s Interview with Alexander Batthyány

February 21, 2024

Translated and summarized by Maria Marshall

Key points: 

VB: “The World is not Well, but it can be Healed” is the title of Alexander Batthyány and Elisabeth Lukas’s book with the subtitle: “Mastering Difficult Life Situations.”

VB: “Stations of the Passion” [PASSIONSWEGE] seeks to accompany suffering individuals when spiritual resources are relevant to overcoming crises. 

AB: Most people see suffering in negative terms as something that must be accepted because it’s unavoidable and not possible to alter. What consumer society misses is that suffering always occurs in the context of being connected with others. We human beings are interrelated. In suffering we can recognize something that is yet not fulfilled and not complete, waiting for our answer. In being there for something and for being there for someone, we can respond to suffering. There are examples of kindness, mercy, generosity, and goodness that can be actualized even while there is suffering.

VB: Frankl quotes Nietzsche in stating that “Those who have a why can bear with nearly any how.”  He found this statement to be true even in the most extreme situations. How did you come to know logotherapy?

AB: I was always interested in questions of meaning in life. When I was in high school, I came across an audio cassette that Frankl recorded when he was eighty years old. He spoke to the younger generation and the essence of his message was that a more important question than how to live to live well and to have it good in life, is the question of how to live so that we do well in life, and that we live so that we are good for something. In how we live, we have to find our own answer to the question of why I am here and what I am good for.  This message was condensed in 19 minutes and really influenced the rest of my life. Later, I heard that Frankl lived and taught in Vienna and when I moved there, I was able to attend one of his lectures. What impressed me most about Frankl was his trustworthiness and the conviction with which he spoke. He spoke with great enthusiasm. Even though he must have presented the same topic over a hundred times, he talked with the same enthusiasm as if he spoke for the first time, or for the last time. Later, I wrote a letter to him in which I told him that I knew that learning from him would have a significant influence on the rest of my life. In reply, I received a letter in which he told me to go to an optician and to present myself there and say, “Dr. Frankl has sent me.” So, I went to this place, and I said that Dr. Frankl had sent me and there were three or four books waiting for me, beautifully signed and dedicated. 

VB: Dr. Lukas is one of the most well-known students of Dr. Frankl.

AB: Dr. Frankl and Dr. Lukas are two very different personalities. It was very reassuring for me to see this in the view that most schools of psychotherapy die with the death of their founder. However, in the case of Dr. Lukas and Dr. Frankl I could see that the same techniques and methods worked with the same effectiveness, regardless of who it was who used them. Dr. Lukas has an incredible goodwill toward people. She has an amazing capacity to see the good in them. I think this has to do with a basic attitude that one adopts and chooses. She had this wonderful healing strength emanating from her, which I would not describe as charisma, but rather an act of will and a basic trust to see the good in others and to seek what is for their good. This is what she lived, and what she taught her students to do. I have been in touch with her for the past 23 years. This latest book that we wrote was written in response to first the corona virus and then the war in Ukraine, where we reflected on the questions of how to respond to these crises. We noted that everything can be lost very easily. However, what is meaningful, remains. Responsibility remains. The question is, “What are we responsible for?” and “What is asked from us in such situations?” There is an area that we do not control, and that is not where our responsibility lies. Next to that area of fate, there is an area that is still open and available, with possibilities in it. Therein is where our area of responsibility lies. The key to happiness in this case is in our hands. We have to choose the key that brings happiness not only to us but to others. 

AB: The first step is to acknowledge the reality of suffering. Not to look away from it, not to run away from it. We have to avoid toxic positivity because with it the demand for happiness can be so ingrained that one cannot express the feeling when things are not going well. So, the first step is to acknowledge suffering. Not with the words, “Do not worry,” but rather, with the words, “I can see that this is a great challenge for you.” Thus, bring awareness and acknowledge what lies in the area of fate. 

AB: Second step in logotherapy is to look for possibilities in the area of freedom. Frankl said this in one of the presentations that I attended that we have many possibilities, but we should not actualize every one of them. In fact, some possibilities are better if they never become reality. Meaningful is only something from which something good can come into the world. Something that would be a pity not to actualize.

AB: In one of his last lessons, Frankl remarked that young people have a lot of possibilities still in front of them. Old people have realities behind them.

AB: The economy of love does not follow the same rules as financial laws—the more I give away, the poorer I become.  On the contrary, with kindness, the more I give away the more I will have. With kindness I do not have to wait for others, I do not have to say, “I cannot give what I do not receive.” I can take the first step and make a change that will make a difference in my life.  Despite suffering, I do not have to be the victim of my fate. Life does not need to happen in the future, somewhere and somehow. It happens now. Life is not answered in the when and where, but here and now. We make many plans about our trips, or future, but what is meaningful, what is waiting for us is not abstract and hidden but happens right now in our everyday life, or nowhere. 

AB: I would like to mention that suffering does not always have a nice face. Sometimes it is not attractive, and not convenient. Nevertheless, one needs to see and go at times where one would rather not have gone. We need to remember that self-actualization is not the goal. We are not to seek to help others so that we may have it good. The intention is the good of the other.

AB: Heidegger visited Frankl when Frankl had just returned from Australia and held a boomerang in his hand. He gave it to Heidegger as a present with the explanation that the boomerang is a hunting tool. It comes back to the hunter only if it misses its target. The same with kindness toward others. It intends the other, not the self. The same can be seen in the work of a psychotherapist. It is offered for the good of the other.  Likewise, a sacrifice is offered for the sake of something or someone else. Dostoevsky said that “to love the other means to see them as God intended them to be.”

VB: Finally, to quote from your book, old age is the time of saying goodbyes. Time of looking back at what was accomplished. Gratitude for everything that was possible to save into eternity, for what remains. In the words of Francis Bacon: “It’s not the happy people who are grateful. It’s the grateful people who are happy.”                     

photo of boats during dawn

The Meaning of Logotherapy in Psychiatry and Psychotherapy

Presented by: Dr. Cvijeta Pahljina (1943 – 2022), Psychiatrist, at The Future of Logotherapy Congress, Vienna, 2016.

Translated by: Maria Marshall, Ottawa Institute of Logotherapy, 2023.

Recorded by: Yulianna Sagdieva, Director of the Institute for Logotherapy in Central Asia, 2016.

Published with permission from: Barbara Pahljina (daughter of the presenter).

In 1982, the Croatian translation of “Yes to Life In Spite of Everything” was published. In this book, Frankl expressed the view that the essence of a human being is spirit. Frankl stated that human beings always “stand on the ground with their forehead raised toward the sky.” This means that we are oriented toward values.  In this book, he gives a poignant illustration of the human potential for choosing between what is good and what is evil. As a psychiatrist and philosopher, he acknowledged the givens of life. His idea is that the spiritual dimension is an active and dynamic resource that finds expression through our being.

In this presentation, I would like to address the topic of what logotherapy means to the psychiatrist and the psychotherapist and what it means concretely, in my life. As a therapist, I want to work with to build trust and mobilize people’s inner strength with a vision to counteract despair and to break the chain of aggression. I want to work toward mobilizing the community in a sense of the ethos that “the world is not healthy, but healable” (Frankl) and that with small steps we can reach our goals and make progress. In this quest, everything is related and intertwined: values, conscience, freedom, responsibility, meaning, what we hold as worthwhile. I want to illustrate how I translate this into practice.

First, I want to talk about the question of who comes into psychiatric practice, and what kind of people I would be likely to meet? It is people with anxieties, people with psychoses, somatic complaints, addictions, dementia, or people who show symptoms of the ills of society. The emphasis here and the key point is that they are not patients, but people. I use individual or group psychotherapy with a logotherapy orientation to treat them.

The most important guideline is that we heal not only with medications and psychotherapeutic methods, but most importantly, with our own person. In the first place, psychiatrists and psychotherapists should love the people who come to seek their help. They should make them feel welcome. When one feels this love, one radiates it. Everything else that I feel or think should be put away, while I am ready to listen to the clients when they come. Clients expect that whatever they bring to me can be handled. Ideally, that we can handle everything together. One needs emotional stability for this kind of work. Inner calm. Trust that there is a solution. That client already has an intuition for the solution.

What we can offer is our time, care, and the best of ourselves. They entrust us their burdens and we seek to understand these from their position and as we look for solutions. We must be able to grasp life from their point of view, and live life with them.

People are not chemical test tubes in which many elements can be mixed and the wanted results will crystallize. They are not animals on which experiments can be done. There are biological causes that can be influenced with psychopharmacology. There are disturbances in the neurotransmitters of the nervous system. There are psychological causes that are exogenic and can be influenced by psychotherapy. But the person as a spiritual being needs the presence of another person who can understand their pain and look for meaningful solutions. Someone who believes in them that they can find a meaningful solution. Someone who helps them and believes in them. Someone who can differentiate fate from the area of freedom and in the free area acknowledge accomplishments. People develop trust in psychiatrists who welcome them, want to help them, and support them.  Trust is essential for further advancement.

As I mentioned earlier, in psychiatric practice, we face a whole palette of difficulties. What can one expect from logotherapy in all these cases. What meaning does the logotherapeutic approach bring? What is specific about it?

We are familiar with the imago hominis [image of the human being] of Frankl, the schema of freedom or fate. This applies to all the cases. As do the concepts of meaning, self-distancing and self-transcendence. Methods, such as modification of attitudes, de-reflection and paradoxical intention can be used. What is always different is the uniqueness of the person and the uniqueness of their situation. The Psychiatric creed: The person never loses their dignity. This is very specific to logotherapy and differentiates it from other psychotherapeutic orientations.

Individual Intervention

First example: A 45-year-old man, locksmith, married, father or two children, ages 14 and 7 years old. The dilemma is whether to orient him toward reality and to insist on it or not. Diagnosis: schizophrenia. First dialogue after he is discharged home, using the Socratic Dialogue.

Psychiatrist: “You say you have seen the Virgin Mary in the middle of the night?”

He: “Yes, she stood over a burning bush in my garden and said to me that I need to run to a priest who lives 25 kilometers away from my house and there I will receive a rosary. I ran, the priest received me, and he gave me a rosary.”

Me: “How did you end up in psychiatric care?”

He: “I did not want to go home, and I was scared because people were following me for a week on the street and photographed me. I don’t know why. Then, the priest had the idea to phone 911 and an ambulance was sent out, so they took me to the hospital.”

Me: “So, If the priest had not phoned 911, would that have been better or not?”

He: “I am grateful to the priest because at that time he saved me from this horrible anxiety.”

Me: “You were in the hospital for three months and you have been at home now 14 days. What is happening with the anxiety?”

He: “Everything is quiet now and no one is following me.”

Me: “What do you think now, were these real people who were following you, or it was part of the illness?”

He: “In the hospital the doctors explained to me that the hallucinations were psychotic, and I had paranoid delusions, and they gave me medication after which the thoughts went away.”

Me: “Can you accept that these thoughts were part of an illness?”

He: “Yes.”

Me: “How about the Virgin Mary and the rosary?”

He: “I did not see her after that. She was so kind and compassionate. I will never forget that. I think that it was the real Virgin Mary and not my illness.”

At home he had specific antipsychotic medications and in two years he had two additional episodes with paranoid delusions and hallucinations. He regained a good stability in his relationship and regularly came to appointments once a month. Since the illness affected his cognitive functioning, he couldn’t continue to work. Currently, he lives at home, and his wife works. They have a family with two children. This works out well with the children. They have a small farm where he is active. His father-in-law also had schizophrenia and he is making sure that he takes his medications as he should. A few years later, I had another Socratic dialogue with him to shed more light on his values that are his guiding principles.

Me: “How do you think about your life, are you satisfied with it, or would you have wanted it to be something different?”

He: “Thanks God, I am healthy. I have a good family. Despite the diagnosis I feel good, I would not want to change anything.”

Me: […There is an affirmation of his life as worthwhile despite the illness. This is an example of the defiant power of the human spirit. He is thankful for his life despite the illness.]

Me: “You received treatment. Looking back, could this treatment have some meaning?”

He: “I could not help the anxieties I was experiencing. That was beyond me. But after the treatment I am at home, my wife is working, and I can help my family more than before.”

Me: […He understands the difference between fate and freedom. I noticed that he developed mild Parkinson’s symptoms because of the medications. However, he insisted that despite the hospitalization, the medications, the Parkinson’s symptoms, his life was worthwhile and good as it was. He said this out of love for his wife, for his children, for his father-in-law whom he is helping. And he was grateful. Even a client with schizophrenia is capable of self-transcendence. He could experience meaning despite his illness.]

Question for the practitioner:

Should a psychiatrist question the client’s beliefs?

Here psychiatrists are questioned in their humanity. The client was convinced that the apparition of the Virgin Mary was real. The main point for psychiatrists to consider is that every person is more than their illness and they are capable of self-transcendence despite difficulties.

Second example: A 28-year-old hairdresser, a lady who was brought to see me by her mother after having been hospitalized at a psychiatric hospital. They were shocked when they the diagnosis of hebephrenic schizophrenia was communicated to them.  Her mother was a director of a bank. She was diagnosed with terminal cancer, and she was given only a few months to live. She wanted me to follow-up the treatment of her daughter. The daughter was beset by anxieties, she showed disorganized speech and abnormal speech content. She experienced hallucinations with depressive and manic mood. The father died in an accident when she was 3 years old. The older sister was a doctor who worked nearby. The mother wanted to leave the house to the daughter after her death. She hoped that with some psychiatric help, her functioning could improve to the point that the eldest daughter could care for her. After the death the mother, the client came to my office, and in a suspiring clear voice she said: “When I was a little girl, I asked Jesus to send me an illness so I can save the world. I have been in the hospital for a long time.” She begged me to say the “Our Father” together. We joined hands and we prayed the “Our Father” together. It was unexpected. Then, she sank into her confused speech. Sometime later, she met someone at the hospital who had schizophrenia for ten years. He lived with his parents. They went for walks together. Two times a week they baked pancakes together. He loved her despite her illness.

Questions for the practitioner:

What are the boundaries between mystical and spiritual experiences and psychotic illness? Was the early experience with Jesus an early childhood symptom of schizophrenia that was not diagnosed at that time? How should a psychiatrist react in such a situation?

Although the psychiatrist may not want to question something that the client holds so dear, the psychiatrist must ask about the implications of the experience because it is clearly something very significant. She showed the willingness to “save the world” through her illness. That was her attitude towards her illness. At that point one can stop questioning this religious experience any further.

Third example: A 45-year-old woman, divorced, who has a daughter and two grandchildren 5 and 7-years-old. She lives alone in an apartment in a  small city. Her diagnose was Schizoaffective psychosis. [This is a mixed psychoses with manic-depressive episodes and schizophrenia.] She was a policewoman. When she was 27, she saw the opportunity to steal money, which she reportedly did. There were internal investigations. The whole year of investigations left her very exhausted. She was married with a policeman from the same police station, and they had a 2-year-old daughter. The man had an affair with another woman and left her. She decided to move with her daughter to another town where she continued to work as a police officer. She had an emotional and financial crisis. A short time after, she started to experience obsessional ideas that she was being followed. She imagined that the police were going to storm her house and that she would end up in prison. In remission when she felt better, we had this conversation.

Me: “If you had the chance now, would you steal or not?”

She: “Of course not.”

Me: “What can you do now to get out of this problem?

She: “I am still in a financial crisis, I cannot acknowledge the investigation, I could not live with the ridicule of my colleagues.”

Me: “What else can you do then? This is in the area of fate now because it happened in the past. What can you do now to make this good again? When you cannot make it up to the right person, can one make it up to someone else? Can you think of something?”

She: “I am thinking about visiting an old man who lives alone and helping him.” 

After her release, she visited this old man and took care of him. She readily assumed this task out of her free will. With time, they became good friends and he sometimes helped to watch her daughter while she had some other work to do. She got a new job in a new place, working as saleslady at a kiosk. For seven years she was in good remission. Then, the old man died, and her grief precipitated a depressive episode. Although medications and psychotherapy helped, she had to be admitted to the hospital because of the depression. She wanted to commit suicide and took an overdose. Her 15-year-old daughter was there with her. In the next couple of years, she had depressive and manic episodes, and she was between lighter depression and suicides attempts and lighter manic episodes. She saw me regularly. Five years ago, her mother passed away. Her father developed Alzheimer’s disease died in a nursing home. Her sister developed depression and committed suicide. She lived through these difficult experiences. She grieved for her sister. Currently, she is in a stable condition, and she lives in her home. Next door to her lives her daughter. She is divorced and has two children. She goes for walks with them from time to time and she has a cat that she loves. She reads the newspaper, she writes cards, and writes poems. The symptoms of depression are the hardest. The suicidal thoughts ease up when she thinks about her grandchildren and her cat.

Questions for the practitioner: 

How can the client deal with the responsibility of a past crime?

One needs to evaluate what it is that she was doing at that time and how her actions are different now from those actions, since she is doing something good for the community. She developed a new attitude toward life because of her grandchildren and this change was not easy to make because of her health condition. It was a self-transcendental choice. She could find meaning and she found the steps to make life livable.

Can it be that guilt feelings are still leading to conflicts?

In this case one should find ways to restore her balance. For a practicing Catholic, seeking out spiritual guidance, reconciliation, and making amends can be considered. From the psychiatric point of view, it is important to emphasize connections with people, such as social workers, family, organizations, to remain active in society. The key is to do something from the heart and to live for someone. “Often it is through the ruins, that one can see the stars” (Frankl).

These were three different people with seemingly similar diagnosis, but as we said, unique persons in unique situations.

Group Intervention

In psychiatric treatment, we need to take into consideration the manifestations of dysfunctions in society. As we mentioned earlier, the premise is that “society is not healthy, but healable” (Frankl). For example, in Croatia, a significant proportion of young people live alone and avoid making commitments. This stems from not being mature enough to face adult responsibilities and seeking refuge in isolation from society. Then at the age of forty, realizing that opportunities have been missed and the time for establishing a family is faint, they develop depression and require mental health care. We can treat these people in de-reflection groups where everyone shares the same problem. There is a similarity between the experience of these people and the fairy-tale of the “Sleeping Beauty.” We can use this story to animate a discussion where everyone plays a role.

[For those of you who are not familiar with this fairy tale, it is about a 15-year-old girl who lives sheltered in her parents’ castle until one day wanders into a remote room of the castle where she accidentally pricks her finger and falls to asleep for one hundred years. A thick bush of thorns surrounds the castle. A young prince hears about the story of a princess asleep there and cuts though the bushes that turn into roses. She kisses the princess who wakes up from her sleep and the two live happily ever after.]

The knight who saves the princess comes through the thorns of the bushes surrounding the castle and all the bushes turn into roses. This illustrates that with hard work and goal orientation, the obstacles in life can fall away.

It is difficult to change society but when we do not shy away from our freedom and responsibility, we can creatively use our resources and the results can be very interesting: Volunteering, reading, hikes. The psychiatrist can lead these groups and help individuals in the groups to set meaningful goals.

In conclusion, “What is the meaning of logotherapy for the practitioner?”  We can answer this question by recognizing the spiritual dimension of the person and their unconditional dignity. It is a privilege in life to be able to help to someone.

calm body of lake between mountains

Logotherapy and Existential Analysis for Burnout and Moral Injury

Viktor Frankl’s Logotherapy and Existential Analysis (LTEA) can be helpful to prevent burnout as well as to manage the effects of moral injury. Burnout and moral injury are two different entities. Burnout refers to exhaustion from excessive work. Moral injury is the consequence of values transgressions.

Ottawa Institute of Logotherapy, 2020

Burnout is a phenomenon that occurs at the workplace. LTEA, with its focus on the search for meaning, can be useful in its prevention. When people have a sense of meaning and purpose, they can take care of themselves better, and participate in meaningful activities where they actualize values in their lives.

Logotherapy and Existential Analysis for Moral Injury
Ottawa Institute of Logotherapy, 2021

Moral injury refers to values transgressions. It can occur in the process of work, or everyday life, when there is a betrayal of one’s personal values by someone else or through one’s own failures. To come to terms with values transgressions it is important that a person recognizes their values and how they are in search of meaning.

In LTEA, search for meaning refers to the actualization of personal values. Values are guiding principles, but if they are not lived, one cannot find meaning in life. Therefore, it is important to recognize what are our personal values and if they are in alignment with universal values.  Examples of universal values are human rights and the dignity of the person. When one actualizes values in harmony with universal values as their guiding principles, one finds meaning in life. In the case of moral injury, there is a sense of meaninglessness. The sense of meaninglessness can lead to symptoms such as disappointment, anxiety, and distress. These symptoms are the manifestation that the person is experiencing a lack of such values. The symptoms in themselves are not pathological, but if not managed, they can lead to serious consequences, such as depression, or posttraumatic stress disorder.

LTEA, in the first place, looks at areas of freedom and how a person can respond to a situation. It explores emotions related to values. After identifying the values, a person can decide, out of their freedom of will, what is the best course of action. In certain situations, it is to reaffirm those values, those personal and universal values that a person has, and lives accordingly, or choose a different path, or acknowledge that someone else has trespassed those values. In this way, LTEA can be a helpful complement to other therapeutic modalities like cognitive behavior therapy (CBT). The issue with CBT is that we try to reappraise cognitions or look at reality from different perspectives, but in the case of moral injury, the reality is that there has been a values transgression.  As we acknowledge this reality, we recognize the emotions in relation to our values and in doing so, we search for meaning in suffering.

On the other hand, with burnout, what we are trying to do is to increase the resiliency of the person. Resiliency means that people can face life’s challenges and they don’t become broken or sick in the face of those challenges.  They can step back through self-distancing from the situation and respond according to their values. In many cases, when there is exhaustion from work, it is important that the person takes care of themselves, that they replenish their energies so they can be effective in their work.  In other situations, they can analyze what kind of work they are doing and if it is meaningful to them. Sometimes there are repetitive tasks, or monotonous work that is not meaningful, and the person loses their own sense of humanity. When we reconnect with our values, we start to see possibilities within that work environment where we can live our values: In connecting with coworkers, contributing to society, or how we face different challenges.

Burnout and moral injury if left untreated can lead to mental health problems. LTEA offers an approach that can improve life satisfaction and resiliency.

On March 23-24, 2023, Professor Edward Marshall is offering a two-day workshop at the Royal Ottawa Mental Health Centre that will focus specifically on the methods and applications of Viktor Frankl’s Logotherapy and Existential Analysis. This event is tailored toward health professionals and students who would like to deepen their knowledge and understanding of the uses of this modality in their clinical practice. Registration Page.

gray and black galaxy wallpaper

Logotherapy and Existential Analysis for Moral Injury validated by Science

The December 2022 issue of the Scientific American features an article by Elisabeth Svoboda on Moral Injury: “Moral Injury is an Invisible Epidemic that Affects Millions.” The article defines Moral Injury as a “specific trauma that arises when people face situations that deeply violate their conscience or threaten their core values.” It presents recent examples from the health care setting, where ethically challenging dilemmas are part of the everyday scenario.

Scientific American, December 2022

The article reviews literature that first identified Moral Injury in the military setting, to its working definition for everyday life and clinical practice. It provides several examples that require a therapeutic approach that goes beyond traditional cognitive behavioral therapy (CBT), since the distress is genuine and not the product of distorted thinking. The article asserts that Moral Injury is different from Post Traumatic Stress Disorder (PTSD). It does not respond well to conventional trauma treatments, and it requires a more “spiritual approach” that considers the whole of the person.

Proposed models for the treatment of Moral Injury share the emphasis on the search for meaning to overcome its effects. The article reflects on the role of Viktor Frankl’s Logotherapy and Existential Analysis (LTEA) for the management of Moral Injury. This approach “bolsters a clients’ sense of purpose.” It validates the reality of values transgressions, and helps to find meaning in line with core values as guiding principles. LTEA can be applied alone, or as a complement to other treatment modalities currently employed in the treatment of Moral Injury.

The book, “Logotherapy and Existential Analysis for the Management of Moral Injury,” by Edward Marshall and Maria Marshall, published through the Ottawa Institute of Logotherapy in 2021, reviews the history of the conceptualization of Moral Injury, the development of tools for its assessment, and a review of the treatment modalities proposed for its management. In developing the case for the application of LTEA, the book reviews the evidence base of LTEA, and provides practically relevant principles and methods based on LTEA that can be useful for clinicians when treating individuals affected by Moral Injury.

Logotherapy and Existential Analysis for Moral Injury
Ottawa Institute of Logotherapy, 2021

On March 31, 2022, Professor Edward Marshall offered a workshop with over 120 participants on the application of Logotherapy and Existential Analysis for the management of Moral Injury at the Royal Ottawa Mental Health Centre, Canadian Centre of Excellence on PTSD.

Awareness of Moral Injury is increasing as examples locally, and globally amount. Validation for the use of LTEA as an evidence-based method for addressing the symptoms arising from moral injury is a welcome sign that the scientific community embraces LTEA to offer a purposeful and meaningful contribution to the treatment of moral injury, one that puts humanity at the forefront of responding to suffering arising from values transgressions. 

On March 23-24, 2023, Professor Edward Marshall is offering a two-day workshop at the Royal Ottawa Mental Health Centre that will focus specifically on the methods and applications of Viktor Frankl’s Logotherapy and Existential Analysis. This event is tailored toward health professionals and students who would like to deepen their knowledge and understanding of the uses of this modality in their clinical practice. Registration Page.

photo of pathway surrounded by fir trees

The Road Less Traveled: Reflection on the Dictum that One Becomes the Value that one Actualizes; One Becomes the Cause that one Makes One’s Own

Maria Marshall, PhD, RP

“Two roads diverged in the wood, and I-I took the one less traveled by, and that has made all the difference”

(Robert Frost)

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).

References:

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.

gray soil pathway between grass

How can we support refugees and displaced persons?

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.

• Caution.

• 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.

yellow petal flowers

Choosing the Path of Meaning: Breaking the Chains of Violence and the Aggression of War

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).

It is possible to follow a path that does not lead to meaning. It is possible to recognize that that path is dead-end, and at any moment, it is possible to choose another path that leads to life. A human being can become aware of meaning and has the capacity to defy inner or outside obstacles to fulfill the meaning of the moment, if they maintain their vitality, and exercise their spiritual muscles.   

Sources:

(1) Batthyány, A. (2022). Logotherapy and Existential Analysis. Open document available from: The Viktor Frankl Institute, Vienna. https://www.viktorfrankl.org/logotherapy.html

(2) Frankl, V. E. (1950). Logos und Existenze. Vienna: Amandus Verlag.

(3) Frankl, V. E. (2010). The Feeling of Meaninglessness. A Challenge to Psychotherapy and Philosophy. Edited by: A. Batthyány. Milwaukee, WI: Marquette Press.

(4) Frankl, V. E. (2014). Man’s Search for Meaning. Boston. MA: Beacon Press.

(5) Frankl, V. E. (2014b). The Will to Meaning. New York, NY: Plume.

(6) Frankl, V. E. (2019). The Doctor and the Soul. From Psychotherapy to Logotherapy. New York, NY: Vintage Books.

(7) Marshall, E. & Marshall, M. (2021). Logotherapy for the Management of Moral Injury. Ottawa, Canada: Ottawa Institute of Logotherapy.

(8) Marshall, M. & Marshall, E. (2022). Viktor E. Frankl’s Logotherapy and Existential Analysis: Theory and Practice. Ottawa, Canada: Ottawa Institute of Logotherapy.

man standing on a rock

The Art of Living

Walking Tour of a Living Exhibition

Commemorating the 100th anniversary of the birth of Dr. Viktor Frankl, the Viktor Frankl Museum in Vienna first opened its doors to the public on the 19th of March 1995. Its was an initiative of the Viktor Frankl Center in Vienna, aiming to preserve the life and legacy of Viktor Frankl, MD, PhD, who lived and worked at this location from 1945 until his death in 1997. The Art of Living program of the Austrian Radio Station [ORF] aired on January 10, 2021, produced by Ms. Brigitte Krautgartner, explored the themes that come alive as we enter the doors of this unique exhibition, offering a view into the timeless wisdom and timely message of logotherapy. Ms Maria Harmer accompanies Ms. Elisabeth Gruber, Director of the Viktor Frankl Museum Vienna, who shows us around the exhibition hall and leads us through some of its interactive features (Viktor Frank Museum Vienna, 2021).

The following are reflective notes that summarize the interview:

  1. From Life and Work to a Museum / From Museum to a Living Exhibition:

Ms. Harmer opened this interview by reminding her listeners that an awareness of meaning in life is most helpful in difficult times since it helps to overcome external difficulties and inner challenges. We can learn a lot from Viktor E. Frankl, the founder of Logotherapy and Existential Analysis, who was of Jewish origin, and “…one of the greatest teachers when it comes to affirming life.”

We know from Frankl’s biography (Frankl, 2000) that during the second world war, he survived several concentration camps. Due to tragic circumstances, he lost his young wife, their unborn child, his mother, father, and brother. From 1945 to 1997 the year of his death, the world-renowned psychiatrist lived in his apartment in Mariannengasse 1, in the IX district of Vienna. His second wife who is now 95 years old still lives there. Part of the apartment has been transformed into a museum.

Because of the coronavirus, the museum was closed for some time, and currently it operates with limited opening hours. Ms. Gruber unlocks the door stating: “When we first came through these doors and decided to set up the museum, we asked ourselves: ‘Viktor Frankl is world renown; If we do not do it, who will? If we do not do it, when will it be done?’ –so, we did it.” This is how the museum came into being.  

Ms. Harmer remarks that the words of Rabbi Hillel: “If I do not do it, who will do it? If I do not do it, when shall I do it? And If I do it only for myself, who am I?” –are words Viktor Frankl often quoted. The quote offers a fitting appeal to explore our area of freedom with our possibilities and opportunities. Which one of these, as of yet unfulfilled potentials, depend upon our courage and determination to be fulfilled?

  • Scaling the Mountain Cliff: 

In the entrance, we are greeted by a large photo of Dr. Frankl scaling a mountain cliff. Ms. Gruber stops to explain the significance of this photo: “This is a very fascinating image because Frankl suffered from fear of heights, but he did not want to let this deter him. So, he said to himself, who is stronger ‘I or me,’ ‘Is it my anxiety or is it me as a person?’ ‘And he said to himself, I will go climbing with my anxiety and despite my anxiety!’” Frankl took the advice that he often gave to his patients: “Do not take every nonsense from yourself” and he prescribed the same medication for himself as he would prescribe to his patients: “Take a bull by its horns” and as you do so, the anxiety will loosen its grip. We are stronger than our emotions and physical reactions. We can do things that we never thought we would dare to do if we see a strong meaning that beckons us. Frankl wanted to live what he preached. As early as in 1928 and 1929 when he first took up maintain climbing (Viktor Frankl Institute Vienna, 2021), we see that he was ready to challenge himself and to “take his own medicine.”

  • A Thread Running through the History of our Lives:   

The Director of the museum leads us through the museum past historical boards showing how Frankl was first influenced by Freud and then Adler, and he founded the “Third Viennese School of Psychotherapy.” She stops at this point, reflecting on the metaphor of a “thread.” She explains that a thread that runs through our lives connecting us with it. At each step, we can grow beyond ourselves as this rope holds us up. “…And this means that we have a connection with the ultimate Thou—who is concerned about us and watches over us and extends a hand to us so that we can master life’s challenges”—this is the reason why we are invited to say ‘yes’ to life.

Ms. Harmer reminds us that in his book, “Say Yes to Life, a Psychologist Experiences the Concentration Camps” [which was translated as “Man’s Search for Meaning” in English and first published in 1959; Viktor Frankl Institute Vienna, 2021], Viktor Frankl detailed his experiences “…not to elicit sympathy or to complain but to help others gain strength.” This book moved millions of people around the world. Its main thesis, which Viktor Frankl never tired repeating, is that meaning is available in every life situation.

  • Every Situation is Unique and Every Moment in Precious:

Continuing the tour, we hear an excerpt from one of Frankl’s presentations [quoting Nietzsche]: “Who has a why in life can bear with nearly any how.” And another excerpt that explains this statement: “This is to say that whoever has a goal and a task, whoever can perceive that there is a mission that only he or she can fulfill, who, in other words, sees meaning in life, is capable of enduring suffering…for the sake of this meaning…for the sake of a loved one.” Ms. Gruber pauses to emphasize that his is one of the main points. And the other is to emphasise how precious each moment is. When we come face to face with death, we become aware of the limitations of life, and our vulnerabilities. That is why we can say “…death is the engine of life.” When we can see that every moment is unique, unrepeatable, and irreplaceable and no moment comes again in life—this is what death brings into awareness—that each moment is precious. As Frankl stated, “…Faced with life’s transitoriness, it is meaningful to act.” If there were no such limitations, each action and decision could be procrastinated indefinitely.   

These words remind bring us back to the present. Certainly, these times of the coronavirus pandemic remind us of the unique and unrepeatable moments we live in. On several occasions, it was remarked that this present crisis confronted us with our own vulnerabilities and finiteness.

  • “Seeing Through” Means Appreciating the Healthy Core of the Person:

Next, we arrive to a glass case housing the glasses of the psychiatrist. Ms. Gruber explains that “…the glasses for him were the symbol of seeing through.” To see through in a situation would mean that we are aware that the anxiety and stress affects us physically, psychologically, and emotionally. However, what we do not want to miss and what we really want to keep in front of our eyes is that “…wee have a healthy core that is the indestructible part of our being—of every human being.”

This unconditional belief in the meaningfulness of life is what Viktor Frankl wants to call our attention to, explains Ms. Gruber, as she points to several questions illustrated on boards. “What is the point of life?” “What is worth living for?” “Will death destroy all what we achieved?” –These are philosophical questions that philosophers have grappled with for centuries. Through the lenses of a three-dimensional view of the human person, we can see people not only as they are but as they can be. We can appreciate that the core of the person is the spirit, a healthy core, that is inherently dynamic and oriented toward meaning.

  • Inherent to human existence is a Will to Meaning:

Above, through the speaker we hear Dr. Frankl repeat the phrase which he repeated innumerable times during his lifetime: “Fundamental to a human being is his or her will to meaning.” Thus, the question of meaning is timeless. For, it is an age-old question that was with humanity since its creation. According to Dr. Frankl, “In the last analysis, a human being can not exist without meaning.” And when he is ill, or close to death, is when the question of meaning is most likely to surface in his or her depth…that is when he is confronted with the question of meaning, for “…people do not question meaning when everything is going well, but when they suffer.” That is the point when they need something desperately to hold on to. “A man who suffers and sinks into hopelessness and despair unless he can decisively hold on to meaning.”

  • Reaching to the Infinite:

Ms. Gruber explains that, after 1945, Frankl had not much left in terms of material possessions. Great was the weight of the death of his loved ones. He still held on to the belief that life holds meaning and that is in a unique position to fulfill this meaning. In his Jewish family home, he experienced protection and unconditional trust.  Yet, he wanted to reach beyond his Jewish roots to a point that connects us all as human beings and ties us all into one human family. He pointed to something that transcends all denominations and addresses the heights to which we can aspire. “Whenever someone spoke of God, he related it to a notion of ‘God as the most intimate partner of our soliloquies.’” This means that “…whenever we are talking to ourselves in honesty and in solitude, we can say that we are talking with God.”

“His advice is indeed rewarding in our times,” remarked Ms. Harmer, who chose to end this program with melodies of trust and safety from Wolfgang Amadeus Mozart’s Missa Brevis in C-Dur, K. 220.

Indeed, the Viktor Frankl Museum Vienna is a living exhibition that invites its visitors to participate in life fully and take up courage to scale every mountain that may lie ahead.

References:

Frankl, V. E. (2000). Recollections. Cambridge, MA: Perseus.

Krautgartner, B. (2020). Viktor Frankl neu gelesen. [Re-reading Viktor Frankl]. Broadcasted 10 January 2021. Retrieved on January 11, 2021 from: https://radiothek.orf.at/oe1/20210110/624571/1610261069190

Viktor Frankl Institute Vienna. Website. Biography. [Retrieved on January 11, 2021 from: https://www.viktorfrankl.org/biography.html

Viktor Frankl Museum Vienna. [Retrieved on January 11, 2021 from: https://www.franklzentrum.org/english/viktor-frankl-museum-vienna.html

Carried by the Spirit

“Carried by the Spirit: Our Hearts Sing”

Discerning Meaning during the COVID-19 Pandemic

Edited by Maria Marshall and Edward Marshall

Published through the Ottawa Institute of Logotherapy

New book available on Amazon

September 2, 2020 Paperback; September 3, 2020 Kindle

Contributors from around the world recorded their experiential observations and reflections on how the principles of Viktor E. Frankl’s Logotherapy and Existential Analysis (LTEA), a meaning-centered psychotherapy, can activate the resources of the human spirit to increase resilience and alleviate existential suffering while facing the consequences of the COVID-19 pandemic.

The writing process blossomed into an expression of selfless giving and self transcendence. Words of wisdom, courage and solace emerged in response to suffering. Healing words sprang forth in response to the wounds of humanity. A circle of care from person to person overarched our world to respond to the COVID-19 pandemic with care and compassion.

The book includes an original article from 1935, authored by Dr. Viktor E. Frankl (1905-1997), which is published for the first time in the English translation with permission from the Viktor Frankl Archives in Vienna. This edifying instance offers a unique insight into Dr. Frankl’s work. His humanity and closeness to his patients offers a legacy that enriches our understanding of what it means to be a loving human being.

The editors gratefully acknowledge the support of Prof. Dr. Franz Vesely and Dr. Gabrielle Vesely-Frankl at the Viktor Frankl Archives and the Viktor Frankl Estate, Vienna, who granted permission to include an original article written by Prof. Dr. Viktor Emil Frankl in 1935. We are thankful for their acquaintance and friendship.

We wish to thank all our colleagues for the gift of their presence and caring. Especially our contributors: Dr. Teria Shantall, Rabbi Dr. Reuven P. Bulka, C. M., Dr. Tamas Ungar, Valquiria Gonҫalves de Oliveira and Dr. Eugenio Ferri, Dr. Meba Alphonse Kanda, Prof. Dr. Rachel B. Asagba, Matti Ameli, Mar Ortiz, Prof. Dr. Daniele Bruzzone, Dr. José Martínez-Romero Gandos, Prof. Rev. Andrzej Jastrzebski, Prof. Rev. Wladimir Porreca, Dr. Adriana Sosa Terradas, Dr. Robert Hutzell and Vicki Hutzell, Sharon Jones, Dr. Cynthia Wimberly, Dr. Willem Maas, Prof. Dr. Svetlana Shtukareva, Panayiota Ryall, Erika Dunkelberg, Rev. Zoltán Nyúl, David E. White, Sladjana Milošević, Mónica Montes de Solares, Elena Osipova, Sabine Indinger, Blanca Ramirez Gonzales, Prof. Dr. Vladimira Velički, and Miro Raguž.

This book was written in solidarity with those who suffer from the global impact of the COVID-19 pandemic.

All proceeds from the sale of this book will be donated to a United Nations fund aiding refugees and displaced persons.

Meaning is a need or meaning as a need?

Meaning is not a “need” in the sense of basic needs that are ends to themselves and their aim is rest and homeostasis upon fulfillment until the next need arises-as is the process in the dimensions of the body and mind (i.e. Frankl, Existential Dynamics in the Will to Meaning). In the dimension of spirit, existential dynamics is fundamentally reaching beyond oneself toward meaning. There is a tension between being and meaning. Between what is and what could be, should be, ought to be. That is why Dr. Frankl spoke of a “will to meaning” instead of a “need” to meaning.

In relationships, one can have different ways of relating: physical, emotional, psychological, and spiritual. The depth and height of this bond can evolve, mature and “grow” to mutual transcendence toward meaning–love as a spiritual act, free and responsible dedication and commitment. In such relationship a physical-emotional bond reflects and corresponds to the the highest form of valuing and spiritual communion (i.e. Frankl on the Meaning of Love in the Doctor and the Soul).

Do we “need” meaning? Do we need meaning in relationships?

Let Dr. Frankl answer:

“But let us come back to the issue of meaning: I hope I could show you that man’s basic concern is neither the will to power, nor a will to pleasure, but a will to meaning, his search for meaning-precisely that which is so much being frustrated today! But man needs not only meaning but also something else: he needs the example and model of people who have fulfilled the meaning of their lives, or at least are on the way to do so. And this is precisely the moment at which the issue of the family comes in. For I regard the family as a lifelong opportunity to watch and witness what it means to fulfill meaning in life by living for others, nay, by living for each other: the family, indeed, is an arena where mutual self-transcendence is enacted!” (Frankl, 2010, The Feeling of Meaninglessness. Milwaukee, WI: Marquette Press p. 205).

In our spirit, we can take a stand toward what our physical, social or psychological circumstances may be. Our social connections can be a source of meaning. Our connections to other people can encompass different dimensions.Spiritual connectivity can transcend the dimension of human.

How much we long for meaningful relationships in our human family today….

“Maslow’s distinction between higher and lower needs does not take into account that when lower needs are not satisfied, a higher need, such as the will to meaning, may become most urgent” (Frankl, The Unheard Cry for Meaning, 1978; p. 33).