beach during sunset

Trust, Basic Trust, Self-confidence, and trust in God

Interview with Elisabeth Lukas, PhD, by Stephan Baier (Grandios Magazine, Regensburg, February, 2022). Translated by Maria Marshall, PhD

  • How does the capacity to trust arise and grow?
  • In what ways does parenting affect trust?
  • Can one do well without a basic trust in life’s meaningfulness and a positive mage of the world?

These are the topics of the following interview that was conducted with Dr. Lukas by Stephan Baier at the GRANDIOS Magazine Studios in February 2022.

SB: Trust; what is this concept? The capacity to trust; are we born with it, or do we have to gradually learn it? And finally, is trust like a talent that one can be endowed with more of, or less with, or is it a decision to trust or not to trust. These are the topics that we are going to discuss with Dr. Elisabeth Lukas. Dr. Lukas is one of the most well-known psychotherapists in the German speaking world, and most certainly, the most prominent student of Dr. Viktor Frankl. Viktor Frankl was the father of logotherapy, also known as The Third Viennese School of Psychotherapy.

Dear Dr. Lukas, prior to this interview, you gifted me with this booklet (“Wolken vor der Sonne?” Lukas, 2021), that I would like to cite from, since I found something very interesting here that brings us right to our topic: You write that trusting people live not only longer lives, but they get along more harmoniously with others, and they can tolerate loneliness better than others. Why is this so?

EL: Yes, well, trusting people are of course more sympathetic because when it comes to communication and living together, one gets along easier with someone who is trusting than with someone who is skeptical, and when one meets others with a spark of trust, it is easier to get along right away then if one is met with suspicion. This trust that one grants in advance to the other, perhaps more than what they deserve, motivates the other to do something good in return, not to shatter the expectation. In this way one locks the other in trust that presupposes and expects that something good will happen. Of course, one sometimes pays a price for this, if one gives more trust than what was reasonable, one is going to be disappointed, but one needs to accept this. It is better to let oneself experience a bit of disappointment than to be stuck in a steady climate of skepticism and mistrust.

SL: But how do I become this trusting person?

EL: This question has to do with the basis of trust. You raised the question if one naturally has the tendency for trust, or one has to develop it? In principle, each newborn brings with them the capacity to trust, just as they take their first breath. Even babies are born with this innate tendency to expect help when they are helpless, and we know that human babies are more helpless than any baby animal. They are totally dependent on help. They have to trust that help will come. They only way they can signal if they need help is by crying and then help comes, maybe not right away, but it arrives. And this strengthens the experience that help comes when help is needed.

SL: But is there not a disappointment as well if the parent is not responsive? For example, if a mother responds late but does respond eventually, is it not a rhythmic change from disappointment to trust and from trust to disappointment, this rhythm of back and forth and back and forth between trust and disappointment?

EL: Human babies come into the world with a complex neural system that is incredibly adaptable. First, it makes the connection that help is on the way. That it comes. And learns to observe: Observe lights and shadows, observe movements. Also, to perceive those processes that are going to result in help. For example, they can hear the steps, or when spoken to. They learn to associate words with help. When they are spoken to, help will soon come, they will be comforted. When babies grasp the meaning of the events in the world around them through such associations, they can also wait. Here I would like to highlight a point that I think is important: Subjective sense of time. Subjective time is different from the objective amount of time that may have passed. Subjective perception of time changes in the course of life. For a younger person, the same time feels longer than for someone older. For a ten-year-old a year is a very long time. For a 16-year-old, a year passes in a blink. For a baby, an hour seems an eternity. When they cry the whole night or days go by before anyone responds to their cries of help, then for the child that affects their trust.

SL: When we experience pain or suffering, time seems to pass much slower than other times.

EL: You are exactly right. For a small child or for baby with a long time of no help and discomfort seems a very long time.  Most parents know this and they stay up most of the night and watch their baby and are attentive to their needs. I do not mean to say by this that parents need to be always one hundred percent available and run as soon as their child begins to fuss, there must be some learning on the part of the child as well, of a bit of toleration and waiting for the parent to help. When one has a good communication than one feels integrated in the milieu where one feels safe and protected in the home, one feels at home, and one trusts that help will arrive when it is needed even if it may take for some time to arrive.

SL: The older a child is, the greater the disappointments can get when they understand that the world does not operate according to their wishes. One needs to take this disappointment seriously and learn from it, that the world is not always the way we wish it to be. How can trust grow, despite the disappointments that children and youth need to experience?

EL: A child develops. However, from the beginning, they bring with them a sense of basic trust. This is so deeply engraved in people in all cultures in people from all walks of life and through all concepts and images of God, that there must be behind something or someone that we can trust. I’d like to point out that the fairy tales also do not paint us an ideal world, there are elves, and witches, and dragons, and all sorts of things that occur in them. Yet, what the fairy tales show to us is a clear world. Clear, since there is good and bad. In the stories the good always wins. It always has the final say. People can be saved, changed, and, at the end, the good comes through. This is what reinforces and re-states the notion of basic trust in children. When they grow, they understand of course that the reality is not always like that, the good characters are not always good, the bad characters are not always bad, and between good and bad there are all these ways of in-between, but by that time children have the capacity to distinguish and decide. They can differentiate between their external reality and their inner feeling of trust and security. In the external world, there may be a lot of things that do not match, that do not work, but in their inner reality, there can be something there that wins, that remains. It is otherwise when children from a very early age are subjected to abuse, violence, and aggression, and have experienced grave disappointments, and, as a consequence, they see the world as a hostile and dark world in which the good can not be taken for granted. The negative experiences in this case can stifle a sense of trust that remains hidden inside.

SL: We talked about the positive case, when children feel protected and well taken care of, and parents in such families can also do certain things right and maybe certain things wrong. What can they do to keep trust alive? You gave us one tip, to tell their children stories to reinforce basic trust. What else would you suggest doing?

E.L.:  With the example of the fairy tales, I just wanted to illustrate how in the folk tradition there is already a sense of basic trust. In the early years what fosters trust in consistency. This means rules so that children have a routine, and they can tell what is going to happen next. They learn that now it is bath-time, then we are walking for a walk, now it is time to sleep. This works well for the elderly as well; they function better when they have a structure that they are familiar with. Flexibility comes in-between. In the milieu of such structure, children learn to differentiate that certain people have different traits, different behaviors, reactions, but when their own reference person, a person who they trust, act inconsistently, that upsets children. Children can tolerate and learn very well how people have some different ways o reacting or doing things. However, strong emotional outbursts by the same person, or inconsistencies, and inconsistent reactions manifested by their main caregiver are troubling for children. This happens for example if mothers are over-exerted, under extreme stress, or under the influence of drugs and alcohol, where they show instability, lability, and there are outburst of emotion or temper. When the main caregivers have a loss of self-control emotionally, that confuses children because they learn that they can not trust someone if they are friendly because it is not for sure that this friendliness will last and for how long. It makes children fearful and anxious and loose trust.

SL: Caregivers model trust to their children themselves?

EL: There are no perfect families, but we can say that the intact family is the place of the highest feeling of security on earth. The reason of it is that in other places, one is judged according to one’s abilities and contribution. For example, if I have good recommendations as a speaker, I am being sought after. But if I shy away from people and remain in seclusion, no one will think that I am a good speaker. This is not the same in the family. In the family, when it is intact, one feels valued. Regardless of one’s appearance, even if one is unproductive, one is valued for who one is, whether one is young or old, smart, or not so smart, in the family, one is valued because one is part of the family. I know that this is an ideal, but the family is the place of this ideal. What is wanted to express is that in the family, one is valued for one’s personhood and for one’s inherent value. When children experience this, they develop a sense of self-worth, that helps them to face whatever may come their way.

SL: Is this not inherent in every person to want to be loved and accepted for who they are?

EL: Yes, although in the family it is also important to consider the other part of the question. Everyone wants to be loved but one needs to offer love as well to the others. One wants to be understood, but does one understand the other?  It must be a two-way process.

SL: When a child does not experience that, then what happens? For most children, they know that they are loved, valued, and accepted. They know that their parent loves them even when they are corrected or scolded. What happens to those who never experience such validation or acceptance? What do they then feel that they can give to the other when they have received little, and how can they then think that the world is still a good place?

EL: This is a fundamental question you are speaking about. One discusses this is psychotherapy a lot, and we need to reach back to one’s view of the human person. The view of the human person influences how one sees oneself and others. It is not true that a person is a “Tabula Rasa” and that everything that a person becomes is because of what their caregiver has written on this board. This is simply not the case. People come even genetically with a lot of influences; we know this thanks to modern research. One brings even psychological tendencies, both positives and negatives, strengths and weaknesses. On top of that one has the influences of the environment, the influence if the parents, influence of media, etc. At any rate, people are not merely the product of their genetic inheritance and the impact of their environment. Frankl always said, there is a third given, and this is the spirit of the person, which is an entire novum. Each person is unique, a new creation.

SL: And here lies our potential, right?

EL: Yes, here lies our potential in spirit, and thus a potential for molding and creating oneself. This is what I wish to emphasize. From the beginning, a young person reacts to their environment and to their circumstances in the way that they develop themselves and use their talents for self-discipline, and for self-development to bring the best out of what a person is capable of becoming. A person can take a stand toward their environment when they give their “yes,” or “no” or when they resist something. In other words, there is a capacity that one has for resistance. This is the case when one may be coming from a very miserable background and one had a misfortune of accumulating negative life experiences, this capacity to develop oneself and change oneself is still there and can be developed.  When one distances oneself from such negative influences, quite conscientiously decides to distance oneself from repeating what was mistaken, when one can distance oneself, and one decides “What I do not want” and “This is what I do not want to repeat” that is when Frankl speaks of the defiant power of the human spirit. “I will do it better, and I will do it differently.”

SL: This is a different message, right? If one came to you in psychotherapy and said to you, “I have been totally ruined in my childhood, and for that reason I am unable to go on with my life,” is it that you would have good news for them?

EL: It is a hypothesis that one is “ruined” and comes from being outspoken, but the spiritual person is never “ruined.” They have within themselves the capacity to make everything renewed and different. Also, from the experience of suffering one can develop an advantage of warning. “One knows what not to want, what will not work, and to be even stronger and determined to achieve it. In other words, the new generation does not need to repeat the mistakes of the old generation. They can grow through it and build something new and better. This old sadness may be there and come back at times, but one also has the defiant power of the human spirit through which it is possible to overcome the past and to build something new. 

SL: You were talking about basic trust that each person is born with. This can not be destroyed but it can be disturbed. So then if a person seeks your advice who trust has been shaken, what is your advice? How could one correct this?

EL: One question is how I could help someone, as you say, “correct this.” The other question is, how can one help oneself? Two different questions. How would I help a child, for example, shall we start with that?

SL: Yes.

EL: Children are by nature incredibly robust. Nature built them incredibly strong. When they come into contact with a person who has a positive influence of them, they can easily relax and open up. What one can offer, on the one hand, is caring conversations in which one points out connections. For example, a parent is under extreme stress, or ill. By this, what I mean to say, not to gloss over but to speak frankly and honestly, so they can process what happened. To illustrate connections and links, so that they can understand is helpful. When we understand things, we can process them better and is such way one fosters insight that is age appropriate and possible. The second point I wish the emphasize is the importance of building on children’s strengths. You see, children are capable of becoming very enthusiastic and when one notices and encourages their strengths and talents in the areas it may be in, technical, musical, sports, cooking, dance, arts and crafts, then these activities let them remain enthusiastic while their wounds are healing. They discover that they are good for something, they are good at something, and enjoy their activities, which reinforces the view that there are nice things in the world, not only the bad they experienced. Then they go on with life and grow with more elasticity and this is not an exaggeration, but a very helpful bandage for the wounds to grow with.

SL: For us to go on with our tasks, we need to believe that the world is good place, that for me personally, the world is good place, for me it is meaningful, that there is a meaning to discover. Do we need such a sentiment to be able to keep on living?

EL: I will start with the first part of your question, “do we need to know that the world is a good place” I would like to question this. Our world is not a very good place. It has good sides and bad sides. It is not about if the good in the world needs to outweigh the bad in the world. There is a lot of suffering it the world. There is a lot of grief. Frankl spoke about the tragic triad of grief, death, and pain. We all have sorrows, we all make mistakes, and we will die. Realistically, about whether the world is a good place, I do not know. About the other part of your question, if being has meaning, that is a different question. This has to do with a very deep search in people, a wish to find meaning in everything that there is. This is a quite deep search engraved in the human soul. The question is there is a last or ultimate meaning, despite all the grief and suffering. Basic trust is not at all the belief that at the end, everything will turn out fine. Basic trust is the conviction that there is a higher dimension, beyond our dimension, in which even our suffering can have meaning. It is the question if all the uncertainty of our life can culminate in a final harmony, even if we may not be able to grasp the individual pieces. Dr. Frankl, who was a survivor of the holocaust during the Second World War, explained that the prisoners walked to the gas chambers with their heads held high and a prayer on their lips. The prisoners did not think that God will appear and intervene and save them from the gas chambers. They knew that God will not intervene to stop this great injustice, but they entered the gas chambers with a prayer on their lips. This is basic trust. It remains a mystery why there is so much misery in the world and suffering. Frankl said we need to bow in front of this mystery. And we need to trust that in this higher dimension everything retains its meaning.

SL: Do you think it is easier for religious people to accept that there is such dimension? The reality of God in a higher dimension would be perhaps easier to grasp for someone who is religious.

EL: Frankl offered a very beautiful metaphor to illustrate this. Imagine a scale with two arms, an antique scale, with two wide arms. He said, take one side where one can place the idea that the whole entire reality is a nuisance with no meaning. Everything will be lost, the planets will disappear, the suns will get sucked into a dark hole, everything is nothing and leads to nothing. This is on one side of the scale. One the other side of the scale is the conviction that everything has meaning, beyond even human comprehension. This entails the belief that the reality of creation is more that what is available to us and that the whole of creation expresses the will of God. And Frankl said, with logic and reason one cannot decide for one side or for the other. The two sides weigh the same.

SL: Life would be nicer, if this side weighed more.

EL: Well, yes, but Frankl said that the only way to make one side weight more than the other is to place one’s entire existence on one side or the other. This side will, for this person, personally weigh more than the other. There are simply no statistics that will help with the decision. There are statistics of other kind, however. Two of them can be found in my book. One of them is by Stephen Covey who wrote a bestseller that you may be well familiar with, on the habits of highly effective people. These people who do very well in life, Covey found in his research, believe that there is such an ultimate meaning. They affirm the meaningfulness of life. The other research is by Leonard Sargon who followed a large group of people with longevity and found that many factors played a role, and among genetics and lifestyle, he established that a personal outlook on life also played a role. People who lived very long lives confirmed the meaningfulness of life. It appears that it is more helpful to believe that life is meaningful than it is to think that it offers no meaning, or nihilism.

SL: Can we establish then that those people who see a general meaning in life are more likely to experience their own lives as meaningful?

EL: When everything has meaning than of course every small part must have a meaning. Yes.

SL: When someone opts for the other arm of the scale, how do you help them? When everything seems absurd? Where does one reach then? One sinks into depression, or anxieties, or sadness?

EL: We need to know that everyone needs to make a decision for themselves. We can bring arguments, illustrations, and examples, but at the end the decision lies with every person. But every person can have time when they wrestle with the question. At these times it is very helpful what has been recognised in psychotherapy, a method, or the knowledge of the possibility of taking a “leap of faith.” How can one take a leap of faith? One has the capacity for self-distancing. What do we mean by self-distancing? One can step away from oneself and one can observe oneself from a distance in the present or in the past. One can also place oneself into the future and observe oneself there. One can look at oneself from the position that one is in right now and look in the future; my very best version of myself, for example in the future, and see what that would look like, and step by step advance towards that image that one wishes to become. This is the concept of the “leap of faith” [to advance toward something that is chosen and desirable out of one’s free will, to make that a reality when it is yet only in the future as an ideal].

For example, a person addicted to alcohol. How can she step out of tis habit? She must imagine, “One day, I will be sober, and I will stop drinking.” One can give help, but ultimately, people need to do it by themselves. This “one day” they need to live it as if they were already free. But it is not in the reality. They can set it into the reality step by step. The body is still dependent on alcohol but the “one day” can be already alcohol free. Maybe a day, maybe a week, maybe a month, maybe a year. One day, this can become reality. Or an overly anxious person. How can they break the disturbance? One can help them. But again, there is a point at which they need to do it themselves. They need to go into the depth of the deep of the anxiety and face it. Entering the situation and the moment one dares to face anxiety and realizes that one has strength and freedom that one did not know existed before. He or she may go with trembling knees, and perhaps the second time will be a bit easier than it was the first, and then one can elaborate it in the context of a story such as entering the lion’s den to find out that the “roaring lion” was a in fact a “pussy cat.” The courageous facing of anxiety allows this leap of faith. When I come back to your question about how one can help someone who is experiencing a lack of trust to re-gain that trust, we need to establish that there is nothing that one can do, because one can not force oneself to trust, one can only advise or challenge oneself to live as if one had trust. One leaps into a life of trust and lets oneself be surprised.

I often work with women who have difficulty trusting men because they had a bad experience in a relationship. They may have felt take advantage of, betrayed, used, you name it. Now they have a new man in their lives, and they do not trust this friend. They tell me they have pictures from the previous relationship come to their mind, they fear being taken advantage of, etc. So, I tell them, “But your new friend is of course entirely not guilty of your previous experiences.” The women conclude it themselves that “He does not deserve to be mistrusted,” and “I deserve to get to know a nicer side of life.” At this point then I advise them to take a leap of faith and proceed by being open to the other person with this self who is still experiencing suffering because of the repeating images in the mind, but the “I who I want to be, and can be” in the future. This often works. If there are no further disappointments, the relationship succeeds.

SL: Trust for adults it is a decision-making process then. An adult can decide in their freedom to want to trust and hold fast to this decision. Is this so?

EL: No. To want to trust is not the right word. But to decide to trust is the right word. Decision and trust belong together. This is a pair. When you decide, you must trust. When you trust, you must reach a decision. That is, you would not have to trust if you were always sure that something will work out fine. Thus, always in the uncertainty is that we need to have trust, and in the uncertainty the possibility of a decision is there. When you are applying for a job, you do not know yet if everything will work out fine; when you start a relationship and choose a partner, you do not know if everything will work out fine, and the relationship will be viable. At each point, you need to make a step into the uncertainty, and make a risk and a leap of faith; this is what is basic trust. Trust and decision work together just like uncertainty and taking a risk do. People who lack trust have a hard time deciding. Professor Frankl used a very beautiful expression about trust when he spoke to his American students: One has to act “half sure but who-hearted.” Maybe not sure, but with full trust.

About the subject of will, I like to mention that there are phenomena that cannot be intended. They can not be brought about by will. For example, one cannot intend to intend, one cannot “will” to love; one either loves or not. One cannot want to believe. One can not want to trust. These phenomena have prerequisites, from which they flow. For example, something valuable, brings forth valuing. Something loveable, brings forth to love it. Something believable brings it forth belief. Something trustworthy brings forth trust.  So, will is intended toward these prerequisites. This is what we can intend for, to want. We can look for something valuable in the world; something loveable; something credible; something trustworthy. This is what we can want to intend for. This is what we can “will.” We can look in the world to find them; we can seek them out. We can search and find. Whoever searches, finds.

There are a lot of things that are worthwhile in the world. When I find this what is worthwhile, beautiful, and trustworthy, it will automatically elicit my will, and elicit my trust.

SL: How is it with self-esteem?

EL: This is an exciting topic in psychotherapy. Psychotherapy has to do with a lot of people who suffer from their confidence being shaken. Self-confidence has to do with the evaluation of one’s own inner resources. Self-esteem can be too low or over-inflated and neither of these has a good outcome. Either one’s level of performance will be low because of low self-confidence, and one does not develop one’s potentials as much as one could, or one over-estimated one’s capacities and one needs to touch ground at some point. However, self-confidence has another aspect that I would like to address. When one accomplishes what one committed oneself to do, this correlates highly with inner satisfaction and well being. One can plan a lot and accomplish little of those plans. Or one can break one’s promises, change one’s decisions, sabotage oneself from accomplishing the tasks that one set out for oneself, and this will have a negative impact on self-confidence. Imagine the example that one orders some work being done and the handyman says he will be there at such and such time on such and such day. You wait the whole day, but they do not show up. You phone them, agree on a new date and time. The time, comes, and they do not show up, but give you all sorts of excuses. The following time, when they do not show up, you will not take any of the excuses but really get mad at them. This is how people who sabotage themselves or let themselves down feel about themselves. When people sabotage their own plans, the feeling is a sense of failure, or impotence, “I can’t do it,” “I can’t do well anything.” So, in therapy how this plays out is not that we have to persuade people who do not trust themselves to make a leap of faith and convince themselves to accomplish small tasks that they can feel good about. Rather, often we have to advise them to request from themselves as little as possible, and as less demanding as possible, but that little that they then really make a commitment to fulfill, regardless of their feelings, as much as possible, so they can develop a healthy stand.  

SL: For healthy self-confidence we have to have a realistic view of ourselves and know what we can do and what we are not so good at, right? For example, if I think that I am a great cook, but experience shows otherwise, I need to adjust the view of my abilities.   

EL: Yes, for those who over-value themselves, there can be a series of disappointments, and sometimes they need to learn the hard way. The question is how one can learn from experience and adapt self-experience. For example, it could be a learning process for someone who thought they were a great cook but found out that they are not such a great cook after all, to start with something small, a salad and a simple menu that they can pull off with no difficulty. So, it is important that one does not give up and says, “I can not cook at all,” but make it little by little, step by step, try out this and try out that, and end with the conclusion that “Well, not so bad after all.”  I think that the more one can learn from one’s experience about the difference between one’s self-confidence and the requirement of situations, the more one can use this knowledge to one’s advantage. In this sense, even negative experiences can be helpful because they can lead to development and growth.

SL: Do we need to be able to trust ourselves to be able to trust others?

EL: You pose very good questions.

SL: Do I need to have a firm anchor in myself to trust others?

EL: Well, maybe not if you take a leap of faith.

We can not say that only those people who have been loved can love. Maybe one is still able to give a positive attempt and make an effort to be positive towards others and, as a reward, receive self-confirmation. To come out of the difficulty does not require convenient circumstances. But to get back to your question, do we need to trust ourselves to trust others? That is a very good question. 

I have spent thousands of hours in therapy with patients and I noticed that the pictures that they formed had something in common. Those who had a more positive self-image, had more likely a more positive relationship with others and a more positive relationship with God. Those who had a negative self-image tended to have more unfavorable interpersonal relationships and an image of God as unforgiving and punishing. So, I could conceptualize it in this way: Imagine that in the course of the life of a person one could unroll a transparent film that is lighter or darker in color. All the experiences in life are projected onto this transparent film. The difficult experiences that get projected to a lighter part of this transparent film can still retain their sparkle. While even nice experiences that are projected onto a dark part of this film, loose from their sparkle somehow.

A man who takes a higher position and projects everything onto a dark film, will think of the downside of the new job: the mishandling, the rivalry, the incompetence, etc. But a man who loses his job, but this experience falls onto a bright film, that man may look at this experience as a good thing: “I will find a better job.” So, it has to do with this “the glass is half-full or half-empty mentality.” This is the background onto which the experience is projected that can differ and determines how it will be interpreted. So, self-confidence, confidence in others and in God can fall on a dark film or a bright film. This is what makes the difference.

SL: Very interesting. This far we have only talked about the positive side of trust. Now I would like to bring up its opposite side, naivity. There is an expression that goes with it, we say someone is “gullible.” Are some people gullible because they trust too easily and too much, and they fall for swindlers and robbers and you name it. How can gullibility be avoided and trust somehow trained?

EL: Even in the fairy tales there is a warning about not to trust everyone. Not to trust evil. But I think that today being overly trusting is not a virtue anymore. The internet is full of deceiving advertisement, the news full of fake news. One needs to learn caution and measure one’s trust. Whom to trust and not to trust, which was you question, and how to prepare for making good decisions, has to do with critical thinking. One needs to form opinions and informed choices based on credible sources. Such choices can be made in conversations, observing different options, perspectives, which is possible in democratic countries. Even in democratic systems there is one challenge with finding space and time to calmly consider options and alternatives. This happens when parents in a family are very stressed than perhaps there is little time for such earnest discussions of different sources and information. Honest discussions with others have great advantages.  For example, it has been shown that is schools, violence could be reduced through the introduction of a course on rhetoric. It is important to be able to express oneself and put into words one’s feelings; what one hopes for or what one is bothered by. Round-table discussions in politics can also lead to de-escalation. If one can express one’s inner self better, one gains trustworthiness because of the word. Words can be used for lying as well. One can see if one’s words are consistent with one’s actions and vice versa.

SL: Can we apply this in the society about people’s trust in institutions? It has been reported in sociological studies that the trust in major institutions such as the church, government institutions and agencies has dramatically decreased. Do you find this dangerous?

EL: I find this a pity. “Errare humanum est.” When one is human, one makes mistakes. As long as the responsible individuals are making an effort to correct the mistakes that have led to the decrease of trust, I think that is a good sign. I think in most instances there is a willingness to look critically at making good decisions. The understanding of a problem and capacity to solve it go together. Sometimes the attempt to solve certain problems can bring new problems that were not there before. For example, a new road can pose some inconvenience to the habitants. One arrives to the next problem. So, it is not that politicians, or church persons can not do anything at all well, rather they cannot do everything always well. I think it is these instances that need to be corrected because things have many perspectives. In addition, no one can have the capacity to foresee the future. Sometimes, in hindsight is easy to see and to make a judgement, but in foresight it is hard to always see the full consequences. When protesting, one should consider these facts and try not to just negate people in the position of power.

SL: Who I trust and whom I trust, is it then a personal decision?

EL: One can trust institutions, but not to forget that they are led by individuals. Certain individuals are corrupt.  Certain individuals are untrustworthy. To make generalisations and to say “all” politicians, or all theologians, etc. is not helpful because it does not correspond to the truth. One can seek out individuals and examine their credibility on the basis of what they say and what they do. I think that it is all right to let oneself get disappointed at times. We also may have at some point let someone down. It is not always that we may have kept the confidence that was invested in us. Wittingly or unwittingly, there are so many misunderstandings that can happen. It is better to look at individual cases because out of these individuals is that the system is made of. The individual influences the system and the institution is expressed in society that influences the institution.

SL: For the final question: Whom or what do you personally trust?

EL: I think that I am fortunate that my chosen film is bright. Therefore, my self-image, and my image of God, carry a rather bright tone. I have also no fear of disappointments. I think I can deal with them well because I am mild on people. In my profession I worked with thousands of people, and I have seen that we can all have weaknesses. A very nice saying comes to my mind, it was said by an author, whose name I now fail to recall, but it goes like this: We are all angels with one wing. One wing that represents all the good and the beautiful we can do. What makes us grand. We have another wing that is just a small stump, that is not well formed. There is something wrong with it. And so, the author continued, if the angels once decided that they embraced each other, then they could have two wings and they could fly. This is what I trust in: that if we embrace each other, and we are not too hard on each other, and we understand that the other also has a wing that is not perfect and has weaknesses, but if we hold on to each other, we have two healthy and strong wings, and, together, we can fly.

SL: Let’s keep flying together. Thank you very much!

“We are each of us angels with one wing, and we can only fly by embracing one another” (Luciano de Crescenzo, Italian writer 1928-2019).

Elisabeth Lukas, PhD, with Stephan Baier (2022)

From Fear to Trust: Approaching the Neuro-psychological and the Spiritual in the Context of a Three-Dimensional View of the Person

Maria Marshall, PhD, RP

“…If we wanted to build a bridge from person to person—and this also applies to a bridge of recognition and understanding–the bridgeheads must not be the heads, but the hearts” (Frankl, 1992:162).

Abstract:

Fear and trust are fundamental human phenomena that exist on a continuum of psychological and physiological states with existential aspects. The dimension of spirit offers a dimension in which fear and trust can dialogue and can be reconciled for harmonious living. Neuroplasticity, based on discernment and reflection, can aid to reinforce values that we want to live for and that are in harmony with universal values. Through the resources of the human spirit, fear can be tamed, and basic trust can be re-gained for a meaning-filled living to avoid despair. Meaning is associated with self-transcendence, resilience, and post-traumatic growth. Meaningful living is related to positive health and mental health outcomes. In the light of these considerations, the journey from fear to trust is that of hope and faith—a living project—that unfolds in the context of Frankl’s three-dimensional view of the person, inspired, and guided by the unconditional trust in ultimate meaning and unconditional faith in ultimate being.

Introduction:

Dr. Viktor E. Frankl, MD, PhD (1905-1997), was a neurologist, psychiatrist, and the founder of Logotherapy and Existential analysis, a meaning-oriented approach to psychotherapy. One his great contribution to medicine was the re-humanization of psychiatry and psychotherapy though a three-dimensional view of the person, in which the body and mind are vulnerable and instruments of the spirit, and where the spirit is a non-material dynamic, and the essence of the person and his or her indestructible core. The articles that are explored in this presentation inform us of the dynamics of the body and the mind as the instruments of the spirit. It is meaningful to understand the processes of our body (1) to be able to appreciate the marvel of creation, (2) to accept and understand how we can best manage our emotions, (3) to gain insight of our area of freedom and fate; and (4) to understand how we can best take care of ourselves to be able to accomplish our mission; and (4) to reach out to others with hope. Thus, our trajectory will cover elements of self-discovery, self-distancing, and self-transcendence.

Therefore, the premise of this exploration is that, although we are conditioned, we are not determined:

In “The Will to Meaning” Frankl asserted that “…human beings are not fully conditioned and determined but they determine themselves whether to give in to these conditions or stand up to them. In other words, human beings are ultimately self-determined” (Frankl, 2014b:122).

The objectives of this research are: (1) to explore the bio-psychological mechanisms underlying fear and trust, (2) examine existential phenomena related to fear and trust, and (3) consider the ways in which meaning-orientation can foster trust to avoid despair.

Sources:

The sources of the present research are books of Prof. Viktor E. Frankl, MD, PhD. Additional resources were collected from books of logotherapists disseminating Frankl’s work, such as Prof. Elisabeth Lukas, PhD, and several other prominent experts in the field, books by the author on logotherapy and related topics, and research articles in the field of medicine, neurology, psychiatry, psychology, and counseling. The findings are examined in the context of a holistic view of the person as a body, mind, and spirit entity.

Fear:

Fear is one of our fundamental emotions. Other emotions include anger, disgust, sadness, surprize, and happiness (Gu, et al., 2019).

According to neuroscientific findings, four basic emotions, happiness, fear, sadness, and anger are differentially associated with three core affects: reward (happiness); punishment (sadness); and stress (fear and anger): “…These core affects are analogous to three primary colors (red, yellow, and blue) in that that are combined in various proportions to result in more complex ‘higher order emotions,’ such as love and esthetic emotion” (Gu, et al., 2019).  

Often, we tend to categorize these emotions into positives and negatives. We aim for happiness, and maybe even surprize, and wish to avoid fear, disgust, sadness, and anger. This is a natural inclination. However, in excessively doing so, we may overlook the evolutionary value of emotions that serve the preservation of our lives. Realistic fear serves to protect us from danger. Lack of reasonable fear would lead to hotheaded actions. Excessive fear is unproductive because it blocks us down. Thus, the right management of fear ensures that we can use the energy of fear for our advantage.

The Neuropsychology of Fear

Emotions are part of pour psychological processes, closely linked with our physiological functioning. Brain regions involved in the generation and modulation of the fear response are complex and involve the recognition of danger through the hippocampus (the parahyppocampal gyrus), and the activation of the cerebellum-amygdala-cortical pathway. Cortical and sub-cortical regions help to interpret, modulate, and process our perception of fear, and activate our physical response to it (Javanbankht, & Saab, 2017).

It is interesting to note that the perception of fear occurs first unconsciously and then consciously. Within 100 ms after a stimulus is presented, there is an unconscious registering of it, and in about 400 ms it is registered consciously. Processing may take a long time after the event occurred (Williams, 2004).

The sympathetic nervous system is activated in response to the threat (Le Doux and Pine, 2016). At the neuro-physical level, processing fearful stimuli is associated with enhanced skin conductance, increased eye blink frequency, increased pupil dilation, and accelerated heart rate which indicate autonomic arousal to prepare the body to deal with the impending events (Tao, et al. 2021).

Figure 1: Routley, N. (2021). A Visual Guide to Emotion. https://www.visualcapitalist.com/a-visual-guide-to-human-emotion/

Language allows to express the internal feeling to others. It allows us to communicate, to describe and to transmit the emotion after we become aware of it (Junto Institute, 2022). Self-awareness of feelings helps to identify internal experiences and tonalities in relation to thoughts and behaviors.

Figure 2: Junto Institute (2021). Wheeel of Emotions. A colorful illustratetion of nuances and intensities. A conceptual guide.

From neurophysiological studies we also know that intense emotions affect attention and memory. Optimal arousal levels and emotional involvement is associated with greater encoding and retention of information; however, intense stress is counterproductive to rational thinking, complex reasoning, decision making, and problem solving (Sandi & Pinelo-Nava, 2007).

According to the stress theory of Hans Selye, intense stress leads to the fight or flight response. Intense fear may also lead to being blocked and “paralyzed” in the body’s attempts to ward off the fear (Selye, 1973).

In the condition of prolonged toxic stress, that is unbuffered by mediating forces such as a source of safety, security and trust, the body’s resources become increasingly depleted and physical and emotional disorders can result from prolonged and intense states of arousal (Bucci, et al. 2016).

Unreasonable fear, and fear of fear, the anticipatory anxiety related to anxiety disorders has been described by several researchers (Kessler, et al., 2009).

Neuroplasticity and the brain’s remarkable ability to form new connections helps to mediate the effects of stress and fear in the nervous system (Cramer, et al., 2011). 

Trust:

According to a psychological definition, trust is an emotional brain state (Thagard, 2018). It has been described as (1) a complex neural process that binds diverse representations into a semantic pointer that includes emotions; (2) a feeling of confidence and security; (3) an abstract mental attitude toward the proposition that someone is dependable; (4) a belief in the probability that someone will behave a certain way (Thagard, 2018).

The Neuropsychology of Trust:

According to neuroscientific findings, the ventromedial prefrontal cortex and insula, and the amygdala, as well as the dorsomedial prefrontal cortex are involved in the mediation of trust. The structure of these brain regions has been found to be directly influenced by the grey matter volume and amygdala volume as a function of decision making and trust in others (Haas, et al. 2014).

Figure 3: Illustration of trust and distrust in the activation of brain regions involved.

According to the developmental theory of Erik Erikson, one of the main tasks of the early stages of life rom birth to 18 months of age is to develop a secure bond with a loving caregiver for the maintenance of trust. In the absence of a secure connection, there is a fear of abandonment. Erikson believed that children who learn to trust their caregivers in infancy are more likely to have a sense of safety and security in the world. They will form trusting relationships with others in their lives (Graves and Larkin, 2006).

Current research confirms that traumatic events reduce the amount of trust one experiences (Filkukova, et al., 2016, Dahlen, 2010, AFWI, 2019). However, one can learn to develop trust if one faces one’s fears (Hillebrand, 2021). Trust mediates the perception of threat. It alters people’s perception of themselves, and the world around them (Enjolras, et al, 2019; Filkukova, et al., 2016). From am individual to a global scale, reducing fear and enhancing trust has been described as the main precondition for enhancing social concern and peace-making (Wheeler and Booth, 2008).

It is important to note that trust can not be forced, commanded, or demanded because it is a choice to trust someone. One trusts someone with similar values easier than someone with dissimilar values. Here is an area were freedom where will, the ability to make decisions and choice are manifested. While tolerance toward others with dissimilar values is possible, and required for peaceful coexistence, value-impositions run contrary to harmony. Adopting values not in line with universal human values– such as the value of each life, or the dignity of the person–is not meaningful. Meaning is the objective reality of a value standing in relation to each person in their own unique situation that has to be discovered, and discerned through conscience (Frankl, 2014b). Conscience is a “meaning-organ” (Frankl, 2008) that helps to intuit and infer the meaning of the moment, the person, and situation specific meaning, that is related to what is the very best possible option represented by the actualization of a value in harmony with universal values culminating in “the value of values” –Ultimate Meaning (Frankl, 2000).

Fear and Trust in the context of Meaning

Originally, Maslow’s hierarchy of needs outlined five areas of human concern: (1) physiological needs, (2) safety needs, (3) love and belonging, (4) esteem needs, and (5) self-actualization. In 1960, following an exchange with Viktor Frankl, Maslow acknowledged that the main motivation of human behavior is the will to meaning and added it to his hierarchy of needs (Marshall & Marshall, 2022). Thus, while several concerns can be the object of our fear and confidence, it is within a higher and more encompassing dimension of the dimension of the human spirit where we can reconcile our fears and give space to trust.   

When conceptualizing of a person as a three-dimensional entity of body, mind, and spirit, it is the spiritual domain where the search for meaning takes place and where there is a healthy tension between a person and the values that they wish to actualize. According to Frankl, body and mind are instruments of the human spirit, through which the spirit expresses itself.

The dimension of body is the reservoir of physical resources. It is a bio-physical organism that ensures our physical functioning and survival (Frankl, 2014b). The mind in Frankl’s theory is used to denote our psychological processes, such as perception, memory, cognition, thinking, and emotions (Frankl, 2014b).

The dimension of the spirit is conceptualized as dimension that is higher and more encompassing than the dimension of the body and mind, not a substance but dynamics, the seat of the will to meaning, the defiant power of the human spirit, conscience, and other healthy resources such as our capacity for self-distancing, self-transcendence, humor, love, gratitude, hope and faith (Marshall & Marshall, 2022). Psycho-physical parallel and psycho-noetic antagonism refers to the fact that while body and mind are vulnerable, spirit is a healthy resource that can not become ill (Frankl, 1994, Marshall & Marshall, 2020).

The implications of the nature of the body, mind and spirit led Frankl to conceptualize his first and second Creed. According to the Psychological Creed, the person can be disturbed but not destroyed; and (2) according to the Psychiatric Creed, behind the mask of disease, the spirit is still intact (Frankl, 1994:86, 96).

Emotions Point to Values:  

The arousal of emotions, correlated with inner brain states and paralleled by physiological responses, is like an inner source of energy that informs us about our values, value-system, and value-hierarchy.

For example, we feel sadness about loosing a family member because we loved them. Grief and sadness follow from love and closeness, the experiential values and attitudinal values remain as a bond between us and our loved ones. 

We may feel angry if we see someone tosses garbage in the park because we value taking care of nature and care about the good use of resources.

We feel disgusted and repulsed by the cowardly actions of a compulsive liar, because we value truth and justice.

Emotions are like inner signals that tell us when events and actions are in harmony with the values that we perceive through our conscience as what should be, could be, or ought to be.

From a holistic point of view, this inner signal system is something that we have rather than who we are, and it serves an important function to guide our lives, not like instincts and impulses, but as signals that we can choose to act on, we can choose to embrace, or choose our position in response to.

Any signal system is as good as effectively it functions, as much as we pay attention to it, and the way we interpret its meaning wisely. Similarly, to a traffic light, where red means stop, yellow means go and green means go, it would be foolish to ignore our “gut feeling” and speed up when we see the light turning from yellow to red.

From a logotherapeutic point of view, we are in the driver’s seat, not our impulses, emotions, or drives, and there is always a space between a stimulus, and a response. We have an area of inner freedom to decide how to respond to our circumstances: give in to fears or not; develop trust or choose not to develop it. Our mind and heart, the emotional and rational brain work together in discerning what is most meaningful in each situation.

Existential Aspects of Fear

There are phenomenological states that occur when the voice of conscience is ignored, repressed, or suppressed, the will to meaning is blocked, when one does not find meaning to fulfill, or when one’s usual ways of fulfilling meaning in life are no longer possible:

  • Existential vacuum- is the feeling of inner emptiness, boredom, that results when one does not see meaning is life (Frankl, 2014; 2014b).
  • Existential frustration-occurs when the will to meaning is blocked.
  • Existential distress- occurs upon long standing existential frustration and vacuum that can lead to depression and despair, noogenic neurosis (Frankl, 2004).
  • Existential struggle-occurs in the case of values transgressions (Marshall & Marshall, 2021).
  • The concept of “Existential Angst” has been widely used by the existentialists to describe a long-standing sense of lack of meaning in life.
  • The term “existential threat” has been used to refer to a feeling that one’s mere existence in jeopardy (used to refer to a fear of loss of values, loss of selfhood, or identity).
  • “Existential risk” is defined as “risks that threaten the destruction of humanity’s long-term potential” (Bostrom, 2002).

The Vicious Cycle of Fear of Fear Leading to Desperation

Frankl described that either avoiding or fighting fear increases fear and results in an anticipatory anxiety of fear of fear (Frankl, 2004). The same pattern can occur in groups and societies.

In the case of existential angst, the fear motivation can give rise to individual neurotic patterns: such as depression, aggression, and violence (Frankl, 2014b), especially when the will to meaning is frustrated, which further reinforces the existential angst.

In the case of existential threat, frustration of the will to meaning, can give rise to collective neurotic patterns, such as collectivistic thinking, fanaticism, reductionism, and nihilism, reinforcing the vicious cycle of existential threat and dread.

The common element between existential angst and existential threat is fear. How we respond to fear is therefore crucial in breaking the pattern blocking the will to meaning that leads to despair.

Figure 4: Maria Marshall (2022). Illustrates the vicious cycle of desolation and despair fuelled by fear.

Basic Trust

Erik Erikson talked about a fundamental trust that develops in early childhood and which can be easily lost and when one encounters trauma (Cherry, 2019). Frankl’s notion of trust is “…basic trust that is ultimately a belief in life’s meaningfulness which we can choose to embrace. Among other things, it means the awareness of our uniqueness and irreplaceable singularity as well as our value for the world” (Schechner & Zürner, 2011: 151). Basic trust is based on a choice “that life is ultimately meaningful” as opposed to “meaningless.” The loss of this ultimate trust leads to over-dependence on success, happiness, power and feedback about one’s value and the seeking of approval from others, seeking experiences, expectations that create an insatiable uneasiness and restlessness—the existential angst.

The opposite of existential angst is basic trust (Schechner & Zürner, 2011). Basic trust brings about an inner recognition and change of heart and mind to be free from the approval of the world and of others and to be self-determined, free, and responsible in the pursuit of meaning. Basic trust is opposed to “anxiety motivation” and avoidance with “love motivation” and intention toward purposeful goals (Lukas, 2020). Embracing this basic trust implies that we are wanted in the world. We are loved and a precious and irreplaceable part of creation. Inherent to this viewpoint is to appreciate what is good, true, and beautiful and gratitude for the wonders of life and creation. Basic trust can be fostered by: (1) Opening our eyes to possibilities: the ability to do good; the invitation to experience something beautiful and the capacity to transform suffering into something meaningful; (2) By awakening to the wonder and gift of every moment; (3) Through gratitude and kindness; (4) Through formation and personal development; (5) Through nurturing healthy relationships (6) Though a willingness to be open to the wonders of the world and changes in ourselves through gaining new experiences and insights (Schechner & Zürner, 2011).

According to Frankl (2019), an affirmation of life’s meaningfulness, or the possibility of life’s meaningfulness points to the possibility of a world in which every person is awaited and wanted and every person in addressed by life. Thus, in a world in which every person has value and dignity. This trust is the wellspring of hope that is strong enough to attract the energy of fear to use it to boost a person’s determination to jump over his or her own shadows or overcome obstacles and to thus channel the energy of fear into a meaningful action. Fabry (2021) outlined six ways in which basic trust can be furthered through orientation to meaning. He termed them the “signposts to meaning:” (1) uniqueness; (2) choices; (3) self-distancing; (4) self-transcendence; (5) responsibility and (6) response-ability. Attentive Meaning Sensitivity is a competence that can be practiced and enhanced (Marshall & Marshall, 2016).

The Principled Model of the Freedom of Will

Within this framework, and consistent with a thorough review of the literature and neuroscience findings, the authors (Marshall & Marshall, 2017) put forth what they termed the Principled Model of the Freedom of Will (PMFW). This model shows that through a process of reflection, human beings can make decisions about which values to live for (slow process related to cortical brain activity associated with reasoning). These values are then stored in conceptual memory regulated by the cortico-limbo-diencephalic system to guide everyday decisions (fast process involving limbic structures associated with emotions).

Figure 5: Marshall, E. (2017). The Principled Model of the Freedom of Will.

Following the PMFW model, individuals can be helped to gain insight into their values as guiding principles. Individuals can affirm if they wish to live according to these values or choose other values in harmony with universal values.

Freedom of the will is opposed to destiny. For what we call destiny is that which is essentially exempt from human freedom, that which lies neither within the scope of man’s power nor his responsibility. However, we must never forget that all human freedom is contingent upon destiny to the extent that it can unfold only within destiny and by working upon it” (Frankl, 1986:78).

Aside from many other factors, our brain physiology is part of our destiny because it is part of what has been given and made available to us. However, beyond mere brain functioning or destiny in life, or Providence, gifted each human being with a design that allows to creatively shape themselves to reach their ultimate destination.

Or, as Frankl stated, we may not be free from conditions, but we are free to bring something valuable into the world. Human beings can choose the values they wish to actualize and shape and mold themselves.

Self-Transcendence and Functional Brain Imaging:

A team of psychologists and experts in the field of mindfulness, Kristin Neff, Christopher Germer, Geshe Lobsang, Tenzin Negi, Christopher Willard, Jack Cornfield, Dennis Tirch, Susan Pollak, Paul Gilbert, Deborah Lee, and Laura Silberstein-Tirch with the National Institute for the Behavioral Application of Behavioral Medicine suggest that complementing traditional cognitive approaches with compassion practices is uniquely suited for addressing complex trauma (NICABM, 2019). The researchers differentiate between rumination “a repetitive thinking which focuses on negative internal states, self-perceptions and emotions” is associated with “increased levels of self-attention, personal distress, negative affect and poorer levels of autonomy and social and interpersonal functioning” (Sutton, 2016). They point out that reflection and meditation differ from rumination as their goal is to be open to a variety of experiences. They can involve observing the self-experience with the intention of gaining increased objectivity from different perspectives, angles, views, and contexts. They open access to bring unconscious resources to conscious awareness and open a pathway to strengths and resources. These researchers believe that, on a neurological level, people who engage in compassion are more likely to down regulate the arousal as it changes the tome of their setting from a simply cognitive exercise to being able to see an area of freedom where they can tale a stand toward themselves and events (NICABM, 2019). These psychologists have found that individuals who engage in compassion-oriented practices are able to better address early childhood issues than people who receive only traditional forms of therapy. By activating human compassion through action and relation to oneself and others, these individuals are more likely to experience fewer PTSD symptoms, score lower depression related measures, report lower levels of loneliness and sleep difficulties. They score higher on measures of happiness and sense of purpose. According to these psychologists, compassion is not just about being kind to your self and accepting yourself but being courageous and doing things differently. The core of it is to be able to do things for others. The most important aspect of compassion is the courage to do good to others (NICABM, 2019).

A large study by Yoona Kang and her colleagues (2018) was undertaken as a collaboration between schools of communication, departments of medicine, public health and neuroscience. The study explored whether affirmation and self-transcendent attitudes have the potential of affecting brain and eventually alter behaviour and health outcomes. Two hundred and twenty sedentary adults were randomly selected into two groups. Both group members received regular health programming and reminders about the benefits and advantages of healthy lifestyle, healthy nutrition and regular exercise. Participants in both groups were given a list of values to rank the order from highest to lowest personal significance. The control group was subsequently asked to engage in reflecting about those values which they deemed least significant to them along with everyday activities.

The other group participated in affirmation and compassion meditation. They were invited to reflect on the way they practice and experience their highest personally important values in their everyday lives. Subsequently, they practiced compassion meditation and well wishes in relation to these values and individuals. On the list the highest rated values included family members and connection with a transcendental entity.

Brain areas related to neural activity while performing these tasks were scanned and compared. Participants were also administered a battery of screening instruments related to their mood and health behaviours. Self-transcendence and compassion were found to significantly reduce the likelihood to evaluate the health messages as potentially threatening to the self esteem, even though beneficial (Kang et al, 2018). They predisposed participants for a tendency to openness, lowered defensiveness and valuing the health messages as “valuable to me.” Aside from message receptivity, there was an overall significant difference in mood and health behaviour. Self-directed, negative mood was less in the self-transcendence and compassion group than in the control group. Those who were affirmed showed greater increases in their average moderate/vigorous activity and decrease in sedentary behavior than those in the control group. Self-transcendent tasks stimulated the ventromedial prefrontal cortex associated with positive valuation and reward processing. During subsequent health message exposure, the same regions showed increased activity, indicating that affirmation, the reflection on values is interpreted as rewarding experience and coupled with self-transcendence, has the capacity to affect behavioural change (Kang et al, 2018).

These findings further support the idea that a positive, other focused mindset, characterised by kindness, compassion, gratitude and valuation may contribute to helping people see personally relevant information as valuable to them and they are more likely to engage in positive, healthy behaviours such as self care if they see a personal value and purpose attached to it. An interesting observation during this study was that even those who were asked to think about their values but reflected on lower ranked values showed some improvement in subsequent health related behaviours and showed pre-frontal activation, albeit not as much as the other group. This finding indicates that reflecting on one’s values, even if not followed by self-transcendent mindful and compassionate thinking, can have an affirmative effect (Kang, et al., 2018).

In fMRI images, Kang and her colleagues (2018) found frontal area activation during compassion and affirmation tasks related to self-transcendence and reflection of values that one wants to live for. The same frontal area activation was not found in the control group, who were asked to reflect on everyday activities.

Figure 6: (Kang et al., 2018.) Functional MRI images of the brain areas activated during affirmation, and compassion in comparison with the control group.

Brain Plasticity and Resilience:

Robust studies investigated the effects of early trauma on the developing brain and the effects of toxic stress on health and mental health outcomes in later adulthood (Harvard University, 2019). Brain-plasticity, the brain’s capacity to moderate the impact of trauma, develop new connections, has been observed during critical windows of development and during the life span. Toxic stress paired with a lack of supportive caregiving was linked with deficits in brain areas crucial to executive and control functioning in the social, cognitive, and emotional areas was noted (AFWI, 2019). Teaching internal self-regulation, problem solving, planning and organisation skills, cognitive flexibility, was found helpful to help override automatic responses and prevent reinforcing and transmitting adversity (Marshall & Marshall, 2021).

Miller Karas developed a Community Resiliency model that focuses on self-awareness and self-regulation to (1) track and understand bodily reactions, (2) access inner resources and learn how to evoke them and intensify them; (3) grounding, (4) understanding gestures and spontaneous movements; and (5) shift and stay, whereby one can intentionally recognize and down-regulate intense emotional states to reach an optimal level of physical and psychological arousal. This approach has been extensively used both nationally and internationally by the Trauma Resource Institute. It is appropriate for men, women, and children (Grabbe & Miller- Karas, 2017).

Building resilience skills and engaging in self-transcendent actions following trauma and complex PTSD was related to enhanced sense of meaning in life and post-traumatic growth in veterans. Engaging in meaningful community activities was perceived as qualities of “super-survivors” who not only overcame their trauma but helped others. Helping others, in return, was reported to have had a positive impact on the individual’s recovery following trauma (Southwick & Charney, 2018; Marshall & Marshall, 2021b).

Meaning in Life and Health Outcomes

A study with 1,546 individuals over the age of fifty found that in the presence of medium to severe pre-existing coronary heart disease at the baseline, purpose in life was associated with lower odds of having a myocardial infraction during a two-year follow up (Kim, 2015). A similar study with close to 7000 individuals found that those with higher purpose scores showed reduced likelihood of a cerebrovascular incident in the next four year-period (Kim, 2013). large study by Alimujaing and her colleagues (2019) in close to 7000 adults aged fifty years and over in the United States confirmed that stronger purpose in life was associated with lower all-cause mortality. These results were in line with findings by Koizumi, and his colleagues, according to which strong purpose was associated with 72 percent lower rate of death from stroke, a 44 percent reduction of the rate of chance of dying from a cardiovascular disease and overall 48 percent chance of dying from any cause of death in a population of men over the period of a thirteen year follow up, even if controlled for the effects of controlled stress and cardiovascular predisposing risk factors (Koizumi, et al., 2008).  

The work of Patricia Boyle and her colleagues with 1151 elderly individuals at the Rush Alzheimer’s Disease Center (Boyle, et al., 2010) indicated that purpose in life was a protective factor against the development and progression of Alzheimer’s disease. Autopsy results obtained post-mortem confirmed that those individuals who had higher purpose scores have shown less cognitive decline despite the presence of high burdens of Alzheimer related protein accumulation, as measured in the amount of beta-amyloid and tau deposits associated with the disease (Boyle, et al., 2012).

A longitudinal study in the United States by Case and Deaton (2015) found that in a population of 100,000 white men who were followed between 2000 and 2020, there was a dramatic increase of deaths due to suicide, drug and alcohol poisoning, and chronic illness due to drug or alcohol use between 2005 and 2020. They termed these factors as “death due to despair.”

Chen et al. (2020) who investigated “death due to despair” in a sample of 100,000 health care workers in the US, (66,492) females (between 2001 and 2017), and 43,141 males (1988-2014), found that people who had a deep-seated spirituality and religiosity and attended religious service at least once a week had significantly lower rates of death related to suicide or addictions and overdose than those who did not have religious church attendance. Church attendance was positively correlated with psychosocial well-being outcomes, greater purpose in life and social integration.

A review of purpose and health-related studies was conducted by Dr. Adam Kaplin, chief psychiatric consultant to the Johns Hopkins Multiple Sclerosis and Transverse Myelitis centres and Laura Anzaldi (Kaplin & Anzaldi, 2015). Their observation is that research on the role of purpose is a new and upcoming movement in neuroscience. Considering the several side effects of pharmaco-therapy, especially in the areas of psychiatry and clinical neuroscience, these authors believe that “purpose in life should be promoted, as opposed to pill-pushing.” In other words, methods that enhance a sense of purpose and meaningfulness in life are desperately called for to complement current clinical practices.

Several recent studies shed further light on wishes for hastened death in people diagnosed with terminal cancer and the elderly. The following points summarize the findings:

  • Death wishes [in older adults] can not be explained by mental disorders (Van Wijngaarden, et al, 2021).
  • The mental health consequences of isolation are disconnection, meaninglessness, anxiety, panic, obsessive-compulsive symptoms, digestive problems, depressive problems, and post-traumatic stress (Rogers, et al., 2020; Pietrabissa & Simpson, 2020) and psychiatric symptoms (Brooks et al., 2020).
  • The trajectories of death wishes can be varied and fluctuate (Breitbart, 2017; Leigh, et al., 2017).
  • Active, outspoken, and expressed wishes can subside and vanish over the months or years (Van Wijngaarden, et al., 2021)
  • Wishes for hastened death are related to external factors such as health, activities, and relationships (Van Wijngaarden, et al, 2021).
  • Once the desires are firmly established, and in the absence of support, these wishes can be enduring (Wilson, et al., 2007).
  • Diminished wish for hastened death is linked with a regained sense of meaningfulness and forming connectedness (Breitbart, 2017; Southwick & Southwick, 2020; Van Wijngaarden, et al. 2021).

A ground-breaking study validated with randomised control trials at the Sloan Kettering Cancer Treatment Hospital in New York under the direction of William Breitbart outlined an eight session “Meaning-centered Group Psychotherapy Protocol; MCGP” (Breitbart, and Poppito, 2014a, Breitbart & Masterson, 2016; Breitbart, 2017). The sessions were intended to reduce anxiety, depression and suicidal ideation among patients who have been diagnosed with advanced stages of cancer and to increase their well being and quality of life by helping them find deeper meaning in the midst of battling their disease. They covered topics in eight consecutive sessions:

  • Concepts and Sources of Meaning.
  • Identity Before and After the Diagnosis of Cancer Diagnosis.
  • Historical Sources of Meaning: “Life as a Legacy” that one has been given.
  • Historical Sources of Meaning: “Life as Legacy” that one lives and will give.
  • Attitudinal Sources of Meaning: Encountering Life’s Limitations.
  • Creative Sources of Meaning: Creativity, Courage, and Responsibility.
  • Experiential Sources of Meaning: Connecting with Life through Love, Beauty, and Humor.
  • Transitions: Final Group Reflections and Hopes for the Future.

Those who completed the program showed lower scores on depressiveness, anxiety and wish for hastened death. Despite their cancer diagnosis, they reported higher levels of quality of life than people in the control group. The researchers noted that offering physical care is crucial in palliative medicine (Breitbart, 2017). Beyond that “…it is equally important to encourage the spirit by a constant show of love and compassion” (Kissane, and Poppito, 2006: 694), and enhance resilience though meaningful connections (Southwick & Southwick, 2020; Southwick & Charney, 2021).

In several studies, meaning was found to correlate with measures of self-transcendence, resilience, and post-traumatic growth, which are factors associated with psychological well being. Thus, meaning can be conceptualized as creating a bridge between protective factors in the face of adversity and directly contributes to psychological well-being (Russo-Netzer, & Ameli, 2021).

Based on current criteria for evidence-based research, Lewis (2014) summarized the findings of studies to date: (1) A positive correlation exists between meaning and measures of well-being and coping: (2) An inverse correlation exists between meaning and a diagnosis of mental illness; (3) When mental illness does occur, an inverse correlation exists between meaning and symptom severity. Other well-documented findings are: (1) an inverse correlation exists between reasons for living, or purpose in life, and suicidality; (2) an inverse correlation exists between meaning and a diagnosis of substance use disorders; (3) a positive correlation exists between meaning and health. Emerging findings include: (1) meaning in life is positively correlated with occupational functioning; (2) an inverse correlation exists between meaning and criminal or antisocial behavior; (3) meaning in life is positively correlated with social functioning (Lewis, 2014).

Conclusion:

The present review of literature corroborates that neuroplasticity, based on discernment and reflection, can aid to reinforce values that we want to live for and that are in harmony with universal values. Through the resources of the human spirit, fear can be tamed, and basic trust can be re-gained for a meaning-filled living.  Meaning is associated with self-transcendence, resilience, and post-traumatic growth. These factors are associated with positive health and mental health outcomes.

Viktor Frankl’s Logotherapy and Existential Analysis was formulated at a time when the search for meaning was a crucial preventive and protective factor against despair. It is a values-based approach to psychotherapy and counselling with principles and evidence-based methods (Russo-Netzer & Ameli, 2021; Marshall & Marshall, 2022).

Perhaps only a few people are aware that Frankl was afraid of heights (Marshall & Marshall, 2021). He challenged himself to rock climbing: “Who is stronger. Me or the fear in me?” he used to ask (Frankl, 2008). With the fear he climbed, and he advised is patients to do the same. In brief, to “Take the bull by the horns!” (Lukas, 2000:105) and “Hitch your wagon to a star!” (Lukas, 2011).

However, Frankl did not scale the rocks unaided. He used proper mountain gear and a rope. One of such ropes is exhibited at the Viktor Frankl Museum in Vienna (Marshall & Marshall, 2021). A rope is a symbol of our connectedness to others, to the world, to hope and security and trust. The rope is the symbol of our connection to our ultimate home.

When we learn about logotherapy, we not only learn to help ourselves, but we also learn about a skilful way of guiding people from less difficult to most difficult terrains. The most challenging heights are the ones where we must jump over our shadows and turn the energy of our emotions to propel us to new heights. These heights can not be conquered other than with courage, faith, and trust.

Dr. Frankl affirmed that anchored in Ultimate Trust, we can say “Yes” to life, despite everything. He ended his book, the “Will to Meaning” with what he said that he intended to be “the lesson to learn” from this book (Frankl, 2014b:121):

“…Out of an unconditional trust in ultimate meaning and unconditional faith in ultimate being, Habakkuk chanted this triumphant hymn: ‘Although the fig tree will not blossom, neither shall fruit be in the vines; the labor of the olive shall fail, and the fields shall yield no meat; the flock shall be cut off from the fold, and there shall be no herd in the stalls: Yet I will rejoice in the Lord, I will be joyful in the God of my salvation” (Frankl, 2014b:121).

As Dr. Frankl taught lessons about life by the way he lived his life, and the way he practiced, we must also live what we believe. The “unconditional trust in ultimate meaning and unconditional faith in ultimate being” (Frankl, 2014b:121) can be our motto, our inspiration and hope on our journey from fear to trust. – A living project.

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