SOURCE_DOCUMENTS/journal_006_1.txt

Volume 6, Number 1 Spring/Summer 1983 
CONTENTS 
Counseling Tactics and Personality Structure 
Elisabeth Lukas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 A Child, Paradoxical Intention, and Consciousness James D. Yoder .............................................19 Paradise Lost? Betwixt and Between Christopher R. Stones ........................................22 Treatment of Snake Phobia George Sargent ..............................................28 "There's Something About That Name" William L. Hanks, Jr.........................................31 Logotherapy in Prison Michael F. Whiddon .........................................34 Treatment of Existential Frustration Vlastimil Siroky .............................................40 A Well Beside the Crossroad Ginta Palubinkas ............................................42 A Creation Myth of Meaning Jeffrey Mitchell .............................................44 Alcoholic Recovery by Videotape James C. Crumbaugh ........................................47 Takashima's Noo-Psychosomatic Medicine Paul Naitoh ................................................50 PIL Test on Cancer Patients Rosemary Henrion ...........................................55 Book Reviews ...................................................60 
© Institute of Logotherapy 
The International Forum for 
LOGOTHERAPY 
JOURNAL OF SEARCH FOR MEANING 
Volume 6, Number 1 Spring/Summer 1983 
CONTENTS 
Counseling Tactics and Personality Structure 
Elisabeth Lukas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 A Child, Paradoxical Intention, and Consciousness James D. Yoder .............................................19 Paradise Lost? Betwixt and Between Christopher R. Stones ........................................22 Treatment of Snake Phobia George Sargent ..............................................28 "There's Something About That Name" William L. Hanks, Jr.........................................31 Logotherapy in Prison Michael F. Whiddon .........................................34 Treatment of Existential Frustration Vlastimil Siroky .............................................40 A Well Beside the Crossroad Ginta Palubinkas ............................................42 A Creation Myth of Meaning Jeffrey Mitchell .............................................44 Alcoholic Recovery by Videotape James C. Crumbaugh ........................................47 Takashima's Noo-Psychosomatic Medicine Paul Naitoh ................................................50 PIL Test on Cancer Patients Rosemary Henrion ...........................................55 Book Reviews ...................................................60 
© Institute of Logotherapy 
Logotherapy in Israel 
Mignon Eisenberg 
I spent the Winter/ Spring semester in Israel, as guest lecturer in Logotherapy at Tel Aviv University. My students were undergraduates and graduates of the School of Social Work. My second semester course was a logot herapeutic group for professionals. In addition, I conducted six intensive three-day training workshops for people in the helping professions at the Tel Aviv, Haifa and Jerusalem universities, and at university branches in outlying parts of the country, with kibbutz members, doctors, therapists, teachers, counselors and social workers. 
This was my second guest semester in Israel. Since my last visit, two more books, in addition to Man's Search for Meaning had been translated into Hebrew: Frankl's Unheard Cry for Meaning and Fabry's Pursuit ofMeaning. I had used the English editions of these books as text books in my teachings in Israel. 
One of my last year's students, who works for the Department of Criminology at Bar Ilan University, is engaged in a research project on a possible correlation between the existential vacuum and crime. Another former student is working on a paper about suicide among juvenile offenders; one student is doing her dissertation about therapy with cancer patients; a participant in one oflast year's workshops is working on a paper about therapy with schizophrenics; a young woman therapist recently inaugurated a counseling center for women and issues concerning women. 
In spite of the chaos of senseless terror and dying, with the old and especially the young ever ready for the maximum sacrifice to guarantee the survival ofthe State, with inflation and economic decline galloping at a maddening pace, with a growing sense ofimpotence at becoming a pawn in the manipulative chess game of international politics and the traumatic memories of the holocaust still throbbing in every citizen's heartbeat, there is felt in Israel a consuming passion for living and loving, a poignant, all pervasive search and wrestling for meaning and self-renewal, an all-encompassing urge for an inner religiosity, embedded in the sobering discipline of secularism. It seems that the entire country is a live laboratory mercilessly testing and stretching the human capacity for selfdebasement and self-scrutiny, with people exposing themselves to the entire scale of human emotions: from complete apathy and indifference, over the sadistic and masochistic, the hedonistic and nihilistic, to the saintly and sublime, attesting to the human capacity for self-transcendence and the glorious freedom to make personal choices, to take a stand. 
I found a hunger for becoming more human, an unparalleled thirst for logotherapy as a compass for compassion and conduct, as a legitimation to pursue ideals, as an answer to the threat and challenge ofthe "Fourth World" of moral and ethical underdevelopment, that threatens to erase all mankind in a cosmic cataclysm, aided by a global climate where the norms have become a mad and persistent drive for mutual and self-destruction. 
It is fascinating to be a part of the incessant ongoing dialectic struggle for a new, a greater horizon. In Israel, the tenets oflogotherapy are being expanded, if not in finding answers, then in posing penetrating and probing questions for the certainty of conscience ( Gewissheit des Gewissens). This was demonstrated in the recent investigation into the war in Lebanon, initiated not by any conqueror, but by a nationwide, collective need to quantify the unquantifiable, to assess moral and ethical responsibility, not for any act of commission, but for the possibility of omission. Not even for what was thought, but for what could or should have transpired in the gray matter of the human mind. What was produced was a historical and philosophical document, an expression of moral thought, a truly humanistic credo, a setting of broad boundaries of responseability and the definition of humanness by what the ideal individual might be expected of becoming, by using a yardstick of the human removed by only a wing-beat from the angels: height psychology at its apex. As a blue-print for personal morals and ethics the conclusions of the committee sound like a modern commentary to the 2000-year-old injunction of Rabbi Hillel: Don't do unto others, what you don't want others to do unto you. Added to this are the four virtues of Theodor Herzl, fathered by human despair: Courage, moderation, justice and self-sacrifice. 
The feedback of the students and the general interest in the topic exceeded all my expectations. Students who in this era of mass-confusion find themselves attracted by many irresponsible cults, turned to logotherapy as a key to themselves, their ideas and ideals. The students were particularly gratified to become aware that they were not victims, but capable of turning into captains of their fates, thanks to the defiant power of their spirit. 
Students were given three assignments in writing: At the beginning of the course, a personal profile, exploring intra-personal, inter-personal and community-related attitudes; an in-depth life history of a person removed from the student by at least one generation, and a final essay "Logotherapy and I" reflecting any learning and growth over the semester months. The harvest is overwhelming in its abundance and high quality. I shall permit myself to utilize the remaining space for quotations from some of the students' writings. 
The Reality of Fear 
"I suddenly grasped that all the things I fear: parting, leaving, death of close ones, illness, wars -all these things do exist and are part of our reality, so that fear thereof is rational and realistic. I learned accepting these fears as part of myself, perhaps even as an immunization against the tragic triad. I regard these fears no longer as negative, but as an adaptive process and healthy. This view enables me to value the good around me. It also helps me to know I can always choose my own reaction. Professionally, I was also aided. I work in deprived areas of poverty. Since my personal feelings changed, I can better point out alternatives and give hope to my clients. Logotherapy shortens my way, bringing me today's views and conclusions which I would perhaps reach on my own, but only after years of struggle and experimentation ..." 
The Death of a Friend 
"My struggle with finding meaning in suffering dates back several years. At the height of the Yorn Kippur war, my best friend David was killed. These were the hardest moments of my life. My entire world collapsed. I sat and wept and kept asking myself whether we had a right to live. He died for us. All my thoughts were focused on him; my base had been taken from under my feet and there was no sense in living. I was even angry at God, and this filled me with guilt feelings. I realized how helpless we were in the most important matters like life and death. I felt so lonely. In this darkness, I discerned no light. After months of mourning, I began to see David more clearly and to understand that he would have wanted to see me strong, building my life anew. At that moment I understood for the first time that there must be some meaning in this suffering. I knew I would never stop grieving and hurting, but I also understood that pain and suffering could not be my life's meaning and that there was something beyond that. If David sacrificed his life in the war, there was a purpose. In his death he ordered us to live. I detected that David left a world behind, a world for which he died, and that this obligated me to continue his path. Imprisoning ourselves with the pain was the opposite of what he would have wanted. I found that my life had acquired a new sense. New life goals and meanings were added, to perpetuate the memory of David in a way he would have appreciated, actualizing his dreams. It was my task to transmit to those who did not know him, his way of life, his uniqueness. In this I saw the meaning of my suffering. Today, I also realize that the crisis was a further stage in my development and acted as a catalyst. It caused me to detect resources in myself whose existence I had doubted. It became clear to me that if I could find meaning in David's death, I could confront the most difficult situations. It was the beginning of setting goals that suited my talents and permitted me to develop as a human being. Today, I am establishing better contact and communication with others who are searching for meaning. It is a mutual cross fertilization ..." 
"The uncertainty of knowing whether our conscience is right leads us to more tolerance, because we cannot be certain that the conscience of others in the same situation, who drew different conclusions may not be right. This makes for tolerance and acceptance of those around me as human beings. It really matters not that much what meaning they found. The very fact of their being human endows them with the right to opinions which I don't have to approve, but I can accept their right to think differently. I derive happiness by giving of myself, sharing with others, fulfilling my duty to society. One of my life's aims: To contribute to society and fulfill its expectations of me ... This is the first time such a high emotional investment was demanded of me in writing a paper. It constituted a consciousness-raising for me ..." 
Pain is Part of Life 
"I read Man's Search about six times in different periods of my life, at different developmental stages. In adolescence, the message seemed more theoretical, but later, more from an experiential viewpoint, it gave me a sense of coming in touch with my spiritual dimension. Often, in times of suffering and crisis, I questioned the meaning of life, not knowing how to express myself. I kept hoping for better days and could not see a compromise between good and evil. In the last years, I did find a synthesis, especially in my awareness that the world does not have to be closed and limiting. I began to see myself as an active being, in the process of becoming. I sensed the human pre-eminence over the beast. 
'The turning point came during a crisis when I was confronted with the meaning of my life and that of my family. It happened at New Year. My father, suffering from a serious heart ailment, was hospitalized for the 24th time. My mother deteriorated emotionally and I felt a terrible anger over the why and the meaning of this unbearable pain we were subjected to. 
"It was then that I experienced the paragraph in Frankl's book: 'No one can deprive a person ofthe last human liberty, to choose an attitude.' In light ofthese words, I could see life as a big prison devoid of meaning if we were not aware of our spiritual freedom. I began to understand the words: 'Pain is an indispensable part of life, even in the form of fate and death. No one can escape it ...' I recall the dramatic moment last year when dad woke up from unconsciousness and began to improve visibly. The doctor came to his bedside and exclaimed, 'Mr. K., you are stronger than life!' Father answered, 'I am alive and must live for the sake of my family.' When the doctor turned to mother and told her to be strong, she said, 'I shall be strong because it is my task to help my husband to continue living with us.' My parents, I realize now, answered the doctor in logotherapeutic coin. They expressed to him the meaning of their pain, an unavoidable suffering they could not change. 
"This memory helps me today to find meaning in all my past suffering, the terrible suffering with the slow and continuous loss of the person dearest to me, my dad. I sense that our deepening closeness lends meaning to the memory that will stay with me. My being with him in this difficult period, seizing the opportunity to enrich him, constitutes my meaning." 
Countering Despair 
"Logotherapy cannot prevent suffering, but it can counter despair, a situation when life seems meaningless. I would like to share the most severe crisis of my life and growth through suffering. 
"It happened about ten years ago -my mother's illness and death. We were a family of five, parents and three children, two teenage daughters and a younger son. One sister was enlisted in the army and I attended high school. Two years before her death mother became ill with cancer. Her condition worsened steadily, especially in the second year. She was only 46 years old when she fell ill, a very active woman, working hard keeping house and also holding a job to help feed the family. During her illness, I took care of the house in addition to my other duties, as a student, mem her of a youth organization, dancer in a group, and other activities. I felt especially desperate, since on the one hand I was a helpless witness to the deterioration of my mother's condition, and on the other hand I wanted to continue everyday life and not let strangers know our tragedy. 
"The first meaning I found in suffering was not to let it affect other spheres of my life. This gave me strength to go on. Yet often I almost collapsed under the weight of my helplessness, thinking: If she really had to die, so young and in full bloom, what is the meaning of this devastating suffering? I saw her pain and silence and kept thinking of the mother I used to know. The situation demanded an explanation, so I could muster the strength to continue to nurse her, and not to transmit to her my frustration. I wanted her to spend her last weeks with a smile on her lips and a good feeling in the heart. I decided, since I could not help her stay alive, at least to care for her with all my heart, so that her 'memory' oflifc would be the best. Today, I cannot understand where I took the strength. I decided to give, give, give, so she would know how much I loved her and wanted her, and also so that I would know later that I had done all I could for her. Today, ten years later, when I ask myself, would I do it differently, the answer is 'no.' It was my choice out of responsibility. The greatest gift she left me, was when father told me that mother said to him, 'You know, Lillian cares for me not like a daughter, but like a mother.' 
"In spite ofthe terrible pain I sensed with her death, I felt I did the best while I could and that there were other tasks to be approached and that I had to find meaning in continuing life. This was hard. I felt angry at the whole world and a powerless pain. Even in my imagination I could not visualize life without mother. The void she left was so painful; I thought I would not be able to fill a part. Yet slowly, the truth dawned upon me: If I will not take myself into my hands and start reorganizing, nobody would do it for me, and I felt it my duty to save myself and rise from the ruins. I chose full responsibility for selfrehabilitation and decided not to succumb to the threatening depression, not to lean on others, not to delve into self-pity. Thanks to logotherapy, I lived through the realization that responsibility is the result ofinner discipline. We are free, not because we were coerced, but because we decide it. 
"After a mourning period of several months, I decided to prove to myself, to mother, and the entire world, that in spite ofthe fact that she was no longer with us, and in spite of the acute pain and suffering, I would try to actualize my potential and to tell the other family members to do the same. This way, mother's death would not cause further decline. Before mother fell ill, it was clear that we were all going to attend college. This thought stood like a light next to me, in all my actions, and gave me strength to continue and develop, to slowly raise my head from the ground, to walk erect on the street, without inferiority feelings or lowered self-esteem due to being an orphan. Quite the opposite, I felt pride that in spite of it, we were developing well, the house was still warm and a center for the family. Another achievement: Even father recovered, thanks to us, and returned to his former activities, even improving his status, bettered himself when he had to be both father and mother to us, a new task. Today, my sister is married, and mother to two children. She is ,studying for her doctorate in biology. My brother is in the regular army and studying for a M.A. in math. I hope soon to have my B.A. in social work. 
"Sometimes, daydreaming, I see mother visit us briefly, pleased with what she sees. We continued her dream and made it reality. Both during military service and my years at the university for the first and now for the second degree, it was important to me to excel and at the same time continue with my other responsibilities. I experienced, how out of a situation of terrible suffering, I built myself and grew, helping myself constantly through the meaning and sense I found in suffering. 
"Writing this, I feel I reached another rung in self-understanding: The candor I developed, the self-confidence that began emerging and the awareness that decision and choice were mine. These were the foundations I laid for myself and which permitted me to establish a relationship with the man I met, and to sense the wonderful thing called love. We talked a lot and were happy and surprised to find in Frankl's book things we had felt and discussed. 
"I feel that I am moving toward becoming the person I would like to be ..." 
Practical Applications 
"When I sat down to write this essay, thinking what did this course give me, I realized that in addition to learning new things about myself as a human being and my world view, I learned new things which will help me in my function as a social worker, skills, techniques, and a philosophy which will aid me greatly with my clients. I have already begun to put this theory into practice in my field work this semester. May I give three examples from my work at the hospital: 
"a) A 24 year old girl, ill with diabetes since the age of six months, married at 17, became pregnant and gave birth to a girl. The birth and neglect worsened her condition. Today she suffers from serious kidney illness, needs dialysis and suffers from blood vessels problems. The medical prognosis is bad, with a maximum of six years to live. She lives separated from her husband and daughter, three years old, lives with her father. When the case was assigned to me, I found a desperate patient, hopeless, crying all day, wishing for death. In my work with her, we tried to find new meaning for her life and she did find this meaning in her daughter, and actually began to live anew. Her life is very difficult: Three times a week she has to be in the hospital, she is undergoing frequent surgery, is in great pain, yet she has found a reason for her suffering -for her child, for the one day in the week when they meet. She wants to be a good mother and pleasant for the sake of her daughter. About a month after her discharge from the hospital, I ran into her. She wore make-up, her hair was combed, dressed fashionably. I did not recognize her at once, but when I did, I realized that she did find meaning, and I firmly believe that this will extend the medical prognosis given to her. 
"b) A 50 year old male who lost his eye sight. For weeks I could not make any progress with him. He was embittered, drowning in his problems and blindness, full ofself-pity and disheartened by the fact that he was dependent on others. All my attempts to show him alternatives were in vain and I almost lost hope that I could help. His despair remained unchanged, he felt helpless. 
"The change occurred after our class discussion about paradoxical intention. When I met Z. after this class and he again told me how miserable he was and how dependent on others, I reacted: 'Yes, true, you are miserable and unhappy, you cannot do a thing, you are entirely dependent on others, not being able to do the smallest thing yourself.' I sensed some discomfort expressed in his face at my words. At the end of the session I told him he should think of how unfortunate he was all the time and to let everybody around him know that he could not function without their help. He asked me. 'You really think I am miserable and dependent on others?' I replied clearly, 'Yes,' and added, 'Each time you have to get out of bed, go to the toilet, to the dining room or for treatment, or just for a walk, ask the nurses for assistance.' This was the end of our session. Prior to the next meeting, the nurses and staff gave me the surprising news that Z. refuses any help, wants to do everything by himself, and succeeded generally. When we met I was stunned. He recognized me by the sound ofmy steps and told me with a victorious voice: 'I am miserable? I depend on others? I want you to know that I am doing everything on my own.' 
"c) Here I want to relate about one session only, when I utilized an exercise from the course in a family therapy case of nine members, parents and seven children. At each session, I found myself struggling against the morbid mood of the entire family. They were deeply enmeshed in their many problems, unable to extricate and liberate themselves, not even for one brief hour. It was impossible to talk to them or to solicit their attention, so deeply were they engrossed in their blues. 
"Coming from class that day, I decided to try the 'Happy List.' I had nothing to lose, nothing else had helped. I asked each of the family members to write down things they like or enjoy doing, and then to rank the five favorite items, to read them aloud and discuss them. I watched them while they wrote and noticed the change in their expressions. Then, each read his list and clarified. They began to listen to each other, to tell stories and jokes connected with what they had put in writing. It was extremely interesting to me to note how their mood had changed, each one of them. It was a successful session thanks to the logotherapeutic approach ..." 
MIGNON EISENBERG. Ph.D. is a certified logotherapist in Chicago and Regional Director ofthe Midwest Region ofthe Institute of Logotherapy. 
Practical Steps in Logoanalysis 
Robert R. Hutzell 
This article outlines the specific procedures of the logotherapy technique I have employed during the past six years. A report of the results ofthis procedure will be published in the next issue of the Forum. 
It has been applied to 150 geriatric, neuropsychiatric patients, more than 200 inpatient alcohol-treatment patients, a number ofgraduate students in training, medical center staff members, younger patients hospitalized for psychosis, and individuals seen in an independent practice. Modification ofthe procedure has been presented, among others, as a marathon at alcohol-rehabilitation and university settings, as a values clarification group for inpatient alcoholics, and as a "burn-out" workshop for mental health professionals. 
Crumbaugh I developed Logoanalysis as a practical step-by-step application of the principles of Frankl's Iogotherapy (p. 62) that uses objective activities to stimulate perception of a new meaning and purpose in one's life (p. 189). Crumbaugh4 notes that he chose the term "analysis" rather than "therapy" to indicate that the person using the method is not necessarily mentally ill in the classical sense (p. 125) and further to indicate Crumbaugh's particular method of doing logotherapy, i.e., a series of rather formalized exercises (p. 126). He notes that his particular methods are largely technique-oriented, seeking to offer a concrete, step-by-step procedure for progressing along the journey in searching for life meaning (p. 126). 
A typical Logoanalysis as presented to inpatient alcoholics is outlined below. The group takes approximately 20 hours to complete with persons who are not severely debilitated. Most often, the group is conducted for one hour, five days per week, for two weeks, with approximately one hour's "homework" assigned for each hour of meeting time. With more debilitated patients such as the geriatric inpatients the group must be much more concrete and directive, with 15 to 20 hours of meeting time and much less homework. 
Group exercises and homework assignments are offered I) to help the participant clarify the creative, experiential and attitudinal values that are particularly meaningful to the participant's life; 2) to identify positive and negative aspects of both personality and circumstance that will either help or hinder the participant's attempts to reach future goals; 3) to set immediate and intermediate long-term goals; 4) to analyze for consonance and dissonance the relationship between the participant's goals and the participant's values; and 5) to set reasonable, practical plans by which the participant's goals might be attained. 
I. Session I: Introduction. 
A. Definitions: Logotherapy, Logoanalysis, Existential Vacuum. Relevance of Logotherapy for the particular group's participants. 
I. Analogy: Road map --Life, like travel, can best get you to a satisfying place if you know where you are headed and see various routes that will take you there. 
2. Visual analogy: Jigsaw puzzle (or drawing). 
a. 
Life, like a jigsaw puzzle (and like the Logoanalysis sessions) is constructed of many interlocking pieces (show several pieces) whose meaning may not he clear separately but becomes clear when enough pieces are noted and fitted together. (Fit together several pieces eventually forming a picture of a rabbit.) 

b. 
Often a seemingly minor piece can flood the picture with a whole new meaning. (Add a decorated egg to the rabbit picture.) 

B. 
Discussion: Questions regarding Logoanalysis. 

C. 
Administration, scoring, and discussion: Life Purpose Questionnaire, Minnesota Multiphasic Personality Inventory (MMPI) Existential Depression Scale, or other simple assessment of Existential Vacuum. 

D. 
Explanation: Two-step format to be applied for the upcoming Values Clarification exercises. 

I. 
Expanding Conscious Awareness (ECA) --looking at our lives from many perspectives in addition to those from which we typically view our lives. 


2. Stimulating Creative Imagination (SCI) -identifying the particular meanings associated with each perspective. 
E. Group exercise: What I wanted to be. 
1. 
ECA -Participants, in turn, relate their earliest responses to the question "What do you want to be?" 

2. 
SCI -What particular reason or value or meaning probably underlaid your response and made it particularly meaningful to your life? 


F. Homework. 
I. Purpose-In-Life (PIL) Test. 3 
2. Seeking-Of-Noctic-Goals (SONG) Test.2 
II. Session 2: Values Clarification -Creative Values. 
A. Scoring and discussion: PIL and SONG. 
B. Distribution and explanation: Values Summary Sheet. 
I. Every time you clarify a value in group or homework exercises, list the value on this sheet even ifyou have listed it on the sheet previously. 
2. 
Also list those values noted during the group exercises by other participants whenever you find yourself inwardly exclaiming "That's me, too!" 

3. 
Later in the analysis we will study any patterns of the same or similar values listed more than one time on your Values Summary Sheet ~-values that show definite patterns to he particularly meaningful to you. 


C. Group exercise: My vocation. 
I. ECA ·-Relate the vocation you have held longest. 
2. SCI -What particular aspect or values of this job are most meaningful to you? 
D. Group exercise: Alternate vocations. 
1. 
ECA -List several alternative vocations you might like to have had. 

2. 
SCI -What are the most pleasant aspects or values each job holds for you? 


E. Homework exercise: Hohhies. 
I. ECA -List five hobbies you have or you think you might like to have. 
2. SCI -After each hobby list the most positive aspects (meanings) the hobby holds for you. 
F. Homework exercise: Meaning-In-Life-Evaluation (MILE) scale4 (pp. 105-I08). 
III. 
Session 3: Values Clarification -Experiential Values. 

A. 
Group discussion: Homework -Hohbies and MILE scale. 

I. 
Rank order MI LE Scale values according to your ratings (the value with the most marks is ranked number one, second most ranked number two. etc.). 


2. 
What values surprised you the most hecause they ranked much higher than you would have guessed given your past behaviors and thoughts'? 

3. 
What values surprised you in how low they ranked on the MILE scale? 

4. 
Copy the eight highest ranked values onto your Values Summary Sheet. 


MEANING IN LIFE EVALlJA TION (MILE) 
Wealth Fame Friendship Physical heauty Sex Intellect A good name To have new experiences 
To be remembered favorably Happiness Romantic love Understanding the mystery of life Be a leader of people Religion Health Peace of mind To be a hero (heroine) Social acceptance and hclonging 
Be of service to people Personal identity 
B. Group exercise: Recent events. 
I. ECA -Relate a recent event that you attended out of personal interest rather than because of some requirement (the event might be an organized event such as a sports activity, movie, concert, or a non-organized event such as a vacation, a visit, a walk). 
2. SCI -What are the experiences (values) you wanted to gain in attending the event? 
C. Explanation: Need To Be Needed -point out the many values clarified thus far that are impossible without involvement with other persons. 
D. Homework exercise: Five senses. 
1. 
ECA -List one of your favorite experiences for each of the five senses. 

2. 
SCI -Describe the underlying values you associate with each of the experiences. 


E. Homework exercise: Satisfying experiences. 
I. ECA -List 12 of the most satisfying experiences you have had in your life. 
2. SCI -Describe the most significant value that made each experience worthwhile to you. 
IV. Session 4: Values Clarification -Attitudinal Values. 
A. Group discussion: Homework results. 
B. Review: Values Summary Sheet instructions -Participants should have a minimum of 30 to 50 entries (including repeats) from the group and homework exercises at this time. 
C. Group exercise: Oft-repeated saying. 
1. 
ECA -Relate a saying, comment, or quote which you use frequently. 

2. 
SCI -What attitude or value are you expressing through this statement? 


D. Group exercise: Family commandments. 
I. ECA -Share a family saying heard over and over during your childhood (e.g., children should be seen and not heard, clean up your plate, etc.). 
2. 
SCI -What attitude or value was your family trying to instill in you? 

3. 
SCI --Have you accepted the value as a meaningful aspect of your life? (Add the accepted value to your Values Summary Sheet.) 


E. Homework exercise: Epitaph on tombstone. 
1. 
ECA -Place your name on your tombstone while imagining that you will do your best to live out the rest of your life with attitudes and attributes that are important to you. 

2. 
SCI -Write your epitaph using five words that each separately describe your life as you hope it can be described after your death. 


F. Homeimrk exercise: Qualities from significant others. 
I. ECA -Name IO persons who have had a significant effect upon your life and note whether the sum of each person's effect on your life was more positive than negative(+) or more negative than positive (-). 
2. SCI --After each(+) note the quality of that person which you admired the most and after each ( ) note the opposite of the disliked quality of that person. 
V. Session 5: Current Status Analysis -Personality. 
A. Group discussion: Homework results. 
B. Distribution and explanation: Logoanalysis Summary Sheet (a paper with separate headings for listing clarified values, results of current status analysis, projected goals, and plans to reach goals. 
I. All of the work done throughout the analysis will eventually be summarized on this Logoanalysis Summary Sheet. 
2. 
Exercises conducted during Session 5 will be listed in the Current Status Analysis section of the sheet. 

3. 
Homework assigned at the end of Session 5 will result in completion of the Values section of the sheet. 

4. 
Information for the Goals section and for the Plans section of the sheet will result from upcoming group sessions and will be tied to both the Values section and the Current Status Analysis section. 


C. Group exercise: Positive and negative aspects of personality. 
I. Each participant, in turn, becomes the Target Member and describes a positive aspect of his or her personality ( one that the person feels will help in reaching whatever goals that person sets), a positive aspect that the participant feels other members of the group may have already observed. 
2. 
Each participant, in turn, describes a negative aspect of his or her personality ( one that can get in the participant's way as the participant attempts to reach goals), one that other members of the group may have already observed. 

3. 
Each participant describes a positive aspect of his or her personality that the participant feels have been hidden from the other group members. 

4. 
Each participant describes a negative aspect of his or her personality that the participant has hidden from the other group members. 

5. 
The group as a whole chooses an additional aspect of each Target Member's personality that the group feels will be most helpful in that member's attempts to reach goals. 

6. 
The group as a whole chooses an additional aspect of each Target Member's personality that the group feels is most likely to get in that member's way when trying to reach goals -pointing out that it is helpful to the Target Member to 


know that he or she is being perceived negatively in one particular way or another. 
D. Group discussion: It is important to know our negatives as well as our positives because once we are aware of them we can decide to make the choice to change, to not change, to fine hone, or to even magnify that aspect of ourselves. 
E. Discussion and demonstration: Most positives can be changed easily to negative (e.g., leadership can become ambition, energy can become manic behavior, strong will can become inflexibility or stubbornness), hut also the opposite is true in that it may not be difficult to alter a negative into a positive. 
F. Homework exercise: Describe yourself. 
I. List IO words or phrases that you think accurately describe yourself. 
2. 
Mark a(+) after each one that is positive, a(-) after each one that is negative and a (0) after each one that is neither helpful nor harmful to your meeting your goals. 

3. 
Add five additional words or phrases that you think people who know you might say about you hut that are not included in your list about yourself. 

4. 
Place a(+),(-), or (0) after each of the five. 


G. Homework assignment: Values patterns. 
I. Look for patterns of the same or functionally similar values on your Values Summary Sheet. 
2. Transcribe onto your Logoanalysis Summary Sheet only those values that show definite patterns (i.e., the same or similar values noted two or more times). 
VI. Session 6: Current Status Analysis -Circumstances. 
A. Group discussion: Feelings about last session's exercise entitled "Positive and negative aspects of personality." 
B. Group discussion: Results of "Describe yourself' homework exercise. 
C. Group exercise: Positive and negative aspects of circumstance. 
I. Describe one of the most positive circumstances or situations that you have going for yourself that might help you reach your goals (e.g., supportive family, education, job security). 
2. Describe a negative circumstance or situation that is going against you and might hinder your attempts to reach goals (e.g., legal charges, large mortgage). 
D. Homework exercise: Describe your circumstances. 
I. List the top 5 circumstances you have going for you. 
2. 
List the top 5 circumstances you have going against you. 

3. 
List two additional circumstances that persons who know you well would say you have going for you and that might help you reach your goals. 

4. 
List two additional circumstances that persons who know you well would say might hinder you in your attempts to reach your goals. 


E. Home-,rnrk assignment: Transcribe all of the Current Analysis results onto the Logoanalysis Summary Sheet. 
F. Homework assignment: For the next session be prepared to share several of your goals. 
G. Homework assignment: For the next session be prepared to share the Values Patterns from your Logoanalysis Summary Sheet. 
VII. Session 7: Analyzing goals for consonance with values. 
A. Group discussion: Discuss homework exercise entitled "Describe your circumstances." 
B. Demonstration: Analyzing goals. 
1. 
Ask a volunteer to share goals. 

2. 
List the values from that volunteer's Logoanalysis Summary Sheet. 

3. 
Review each value, asking if the value is in any way dissonant with the goal. If there is any dissonance (e.g., values include creativity and flexibility in the job while a goal is to become a production line worker) the appropriateness of the goal should be questioned. (Note: this rarely happens.) 

4. 
Re-review each value, check-marking each value that is consonant with the goal and is sufficiently experienced to be temporarily satisfied when the goal is met (e.g., the value "family relationships" would be marked for a goal like "taking a family fishing trip" while values such as "listening to classical music" or "rigid structure in vocation," would not be marked for the family fishing trip goal). 

5. 
Note values remaining unmarked. 


C. Repeat demonstration: Analyzing goals (if time permits, repeat the demonstration with another volunteer). 
D. Explanation: Comment upon the desirability of experiencing all of one's values somewhere within the totality of one's goals and tasks. (Note here that a specific method for setting goals to experience any values not marked will be demonstrated during the next session.) 
E. Explanation: Comment that it is desirable to experience one's values relatively often, and note that one's goals should include immediate, intermediate, and long-term goals or tasks. 
F. Homework assignment: Analyze a variety of your goals by the method discussed during this current session and, for the next session, be prepared to share any left over (unmarked) values for immediate tasks (within 24 hours) and for intermediate tasks (several weeks to months) as well as for long-term tasks (within years). 
VIII. Session 8: Establishing new goals consonant with values. 
A. Group discussion: Homework results and insights. 
B. Demonstration: Setting new goals. 
I. Ask volunteer to share leftover values for immediate or intermediate or long-term goals. 
2. Have group "brainstorm" goals that might allow the participant to experience those leftover values. 
a. 
Each participant, in rotation, offers one possible goal or task. 

b. 
At this point, quantity of ideas rather than quality is emphasized and therefore there is no discussion or critiquing of the individual goals/tasks. 

c. 
Goal/task ideas are offered until there is one complete rotation through the participants without any new ideas stated (if you pass during one round of offerings, you are not obligated to pass again if the brainstorming round gets back to you again). 


3. 
Have the volunteer subjectively assess the various ideas in order to pick out one goal/task that the volunteer would like to set as a personal goal. 

4. 
Use the first half of the demonstration entitled "Analyzing goals" (Session 7, B, I, 2, 3) to assure that the new goal is not dissonant with other values of the volunteer. 


C. Discussion: Ideas related to the setting of new goals. 
I. Comment upon the fact that the results of the brainstorming session can be expanded by the participant alone or preferably with the help of friends and/ or family. 
2. 
Comment upon the fact that it is frequently beneficial to set new goals from the values on the Logoanalysis Summary Sheet in addition to those set from just the "leftover"values. It may be helpful to arbitrarily (e.g., random groups of7 values) or systematically (e.g., groups of naturally related values, such as out-of-doors, nature, wholesomeness) break up the total list of values into several more manageable lists for brainstorming. 

3. 
Comment upon the fact that the specific procedure outlined here leaves the participant with a ready list ofsecond and third choices, should the first choice need to be altered or discontinued. 


D. Demonstration: Goals from Current Status Analysis. 
I. Using the Current Status Analysis section of a volunteer's Logoanalysis Summary Sheet, demonstrate that appropriate goals often can be found in setting a goal to change a specific "negative" into a "neutral" or "positive." 
2. Discuss example goals/ tasks and use the first half of the "Analyzing goals" method (Session 7, B, 1, 2, 3) to demonstrate that the new goals are not dissonant with the participant's values. 
E. Homework assignment: Using one of the methods described in this session, set one new immediate goal, one new intermediate goal. and one new long-term goal, and write these on the Logoanalysis Summary Sheet. 
IX. Session 9: Setting Plans and Getting Started. 
A. Group discussion: Each participant shares one immediate, intermediate and long-term goal/ task (these can be taken directly from the homework assignments given during sessions 6 and 8). 
B. Demonstration: Establishing plans to reach goals. 
1. 
Discussion may indicate that a particular goal is unrealistic and that perhaps an alternate and more likely attainable goal which will allow experiencing the same values should be set. 

2. 
Ask a volunteer to share one goal. 

3. 
Determine "major steps" or "mileposts" that will collectively lead to successful attainment of the goal/task. 

a. 
Each major step should be clearly stated. 

b. 
Each major step should be measurable (so that the participant can know when it has been completed). 

c. 
The major steps then should be prioritized (some steps must precede others while some steps can be worked on simultaneously). 

d. 
Set a reasonable time frame for each major step. 



4. 
Fill in the "detail steps" that will lead up to fulfillment ofeach "major step." 

5. 
Examine the positives from the participant's Current Status Analysis and determine how these can be used to enhance progress of the detail steps and the major steps (i.e., maximize assets). 

6. 
Examine the negatives from the Current Status Analysis and determine how they can be dealt with to be neutralized, or to be circumvented, or even to be used as pluses while making progress through the steps toward the goal (i.e., minimize deficits). 


C. Discussion: Motivation to get started (include Old Saying "A trip of a thousand miles starts with the first step"). 
D. Motivational exercise: Ruler of the world. 
I. Choose what you would do first for people if you were ruler of the world. 
2. 
Point out that even the ruler would not totally be able to complete most of the tasks. 

3. 
Suggest that participants, while not rulers of the world, can "get started" and "make some difference" in the task (which is indeed all that the ruler could do anyway). 

4. 
Discuss examples of how participants might personally do a part of what they felt they would do if they were ruler. 

5. 
Discuss examples of what each participant could do today to start work on the task. 


E. Homework assignment: Spend some time on that task identified by the "Ruler of the world" exercise and be prepared to share your progress next session. 
F. Homework assignment: On the back ofthe Logoanalysis Summary Sheet, following the "Establishing plans to reach goals" method (Session 9, B), establish plans to meet the new goals that resulted from the homework assignment of Session 8. 
X. Session 10: Summary and Critique. 
A. Group discussion: 
I. Review progress of homework regarding "Ruler ofthe world" results. 
2. Review the plans associated with the homework assignment on setting plans. 
B. Summarization: What the course of the group has been; any comments about the group. 
C. Group discussion: Any changes participants see in themselves as a result of attending the analysis -usually participants have some new goals plus increased motivation to complete prior goals. 
D. Group exercise: Chinese proverb -"Happiness is something to do, someone to love, and something to hope for." 
1. 
State proverb and note how in many ways it summarizes the analysis. 

2. 
Question if participants have goals related to each of the three areas noted in the proverb -point out where individual participants may need to place some greater attention. 


E. Readministration, scoring, and discussion: Life Purpose Questionnaire, M MPI Existential Depression Scale or other. 
F. Distribution: Reading lists and any other take-home material. G Group critique ofanalysis: 
I. Three best (most useful, most liked) components of the analysis. 
2. 
Three worst (least useful, difficult to understand) components of the analysis. 

3. 
Three suggestions for changes that could improve the analysis. 


H. End analysis. ROBERT R. HUTZELL is senior level clinical psychologist at the Veterans Administration Medical Center, Knoxville, Iowa. 
REFERENCES 
I. Crumbaugh, James C. Everything to Gain: A Guide to Self-Fulfillment Through Logoanalvsis. Chicago, Nelson-Hall, 1973. 
2. 
___ The Seeking of Noetic Goals Test, Psychometric Affiliates, P.O. Box 3167, Munster, Indiana 46321, I 977. 

3. 
___and Leonard T. Maholick. The Purpose in Life Test, Psychometric Affiliates, P.O. Box 3167, Munster, Indiana 46321, 1969. 

4. 
___ W. M. Wood, and W. C. Wood. Logotherapy: New Help for Problem Drinkers. Chicago, Nelson-Hall, 1980. 


The Viktor E. Frankl Scholarship 1983 
Stephen S. Kalmar 
Again we are publishing the winning essay in the Viktor E. Frankl Scholarship Contest sponsored by the Institute of Logotherapy. In 1983, 72 essays were submitted, coming from 36 high schools in 31 cities and towns. This year the judges found it even harder than last year to select a winner. The quality of the essays was of a higher standard. We leave it to the readers to decide whether the winning essay equals or surpasses last year's winner. 
We are aware that the participants do not represent a true cross section of the total Californian youths of the I980's, nor of all the high school graduates of 1983. Our contest appeals to students inclined to analyze their life, their past experiences, and their hopes for the future. This was so last year and is so this year. Still, there are remarkable differences in the composition and views of this year's participants. Perhaps these differences are significant for the whole student population. 
Many more women participated in 1983 than did in 1982, 49 out of the total 
72. All three top essays (chosen blindly) came from women. Many female students stated how much easier it was now for women to choose professional careers which previously were not open to them, and how they were looking forward to making use of these new opportunities. But an equal number stated that they wished to marry early and start a family, and were counting on the new attitude of men to help with household chores, and that they would postpone a professional career for a few years. 
More participants than last year expressed concern about economic difficulties their families are encountering -unemployment hitting their families and friends, the length and severity of the recession, and the importance of choosing a career that would provide them with financial security. Many said that finding a "good" profession offering a steady and secure income is the main foundation for a meaningful future for them. In the same vein, many others accepted the new advances in technology and spoke of"robotniks," computers, and space explorations as facts of their life. They did not consider these developments as frightening as many essayists did last year; rather, they spoke of them with great expectations. Technology has meaning for their future life. 
More of the participants than last year see the nuclear threat as a real danger for their future -not a theoretical possibility, but something that is apt to happen, especially through an unforeseen accident, causing a nuclear holocaust. 
More also seem to have previous knowledge of the teachings of Viktor Frankl, apparently because more high schools are introducing his theories in the school curriculum. 
Fewer essayists showed political interest or social criticism, or expressed disagreement with or distrust of the government. Last year some still spoke nostalgically about the great fervor and purpose of the I 960's, the exciting years of their older brothers and sisters. The memories and the spirit of the '60's seem to be dying. 
Fewer participants than last year based their essays on deep personal experiences and what they had learned from them for their future direction, values, and pursuit of meaning. 
Fewer showed a sense of humor, they seemed to be earnest, very realistic, and ambitious. If this is a true sign of our times it provides a sad commentary. 
The contestants were equally divided among those who believed that today's youth have it harder than former generations, those who said they have it easier, and those who didn't think there was any difference. 
The winning essays do more than show that the contestants have understood Frankl's ideas and approve of them. To motivate them to go beyond paraphrasing Frankl's writings, it would perhaps be advisable to change the contest theme from "The Pursuit of Meaning for the Youth ofthe I 980's" to deal with the question of "What are the problems of today's youth, their hopes and chances to achieve a meaningful life?" In this way contestants will be encouraged to write essays based on their own thinking, personal analysis, their own experiences, and conclusions therefrom. 
STEPHENS. KALMAR is a member ofthe Board ofDirectors ofthe Institute of Logotherapy and was one ofthe judges in the contest. 
Winning essay, Viktor E. Frankl Scholarship Award 1983: 
The Pursuit of Meaning for Youth in the 1980's 
Wendy L. Pohlers 
Children are starving in India. There is Communist rule in the Soviet Union. America is in a recession. The unemployment rate is high. With what may seem to be a futile existence with no security, we find meaning for our lives. Just as the Joad family in The Grapes of Wrath migrated to find their place, we, the youth of this world, must also find our niche in society. But where do we find this meaning? It would be foolish to try to find meaning in the material things of this world. These may be destroyed with a single fire, flood, earthquake, or tornado. These material possessions can be taken away by just one hoodlum, criminal, or drunkard. The person who finds meaning in these material things will be destroyed, crushed by the emptiness of his or her life. We must find our meaning in the only thing we can be sure we will have all our lives, ourselves. Our meaning must be found within ourselves. Is it necessary that we find meaning for our lives? Dr. Viktor Frankl states in his book, Man's Searchfor Meaning: 
... man's search for meaning and values may arouse inner tension rather than inner equilibrium. However ... there is nothing in the world ... that would so effectively help one to survive even the worst conditions, as the knowledge that there is a meaning in one's life. 
The youth of today, as a whole, seem to be very misguided. They are so busy trying to "do their own thing" that they forget why they're doing it. Their only reason seems to be "everyone else is doing it too." Fortunately, not all oftoday's youth feel this way. I, for one, don't. I feel that one's life has to have some deeper meaning than "just for the hell of it," although when one is buried in an endless supply of homework, and has a schedule stricter than that ofa drill sergeant, one tends to forget that there is meaning for it all (if one has time to forget). But in order to find contentment in our lives, we must search for meaning. 
But where does this meaning come from? Meaning comes from our innerworkings, our mind, our thoughts, our values. These "inner-workings" come from our upbringing. Our values are first instilled during our childhood. Parents teach their children the values they themselves were taught, but our final set of values is made by ourselves. We modify and change the values to suit our own way ofthinking. For example, a child can be taken to church every Sunday, with the hope that he will adopt the values of the church. When the child is old enough to make up his own mind he can either adopt the parents' values or break away and develop his own. 
The youth of today seem to be more willing to "break away" from the values they were brought up with. The youth think these values are old fashioned and much too conservative for today's liberal society. As much as parents try to bend the rules to give their children some leeway, the rebellious youth still try to "break away." I, personally, have never been one to take the easy way out of anything. I am the "child"who adopted the ways of the "church," the rest of my family and friends chose to "break away." It may seem like the noble thing to do, but being different is not easy. But these are the sacrifices one must be willing to endure in order to do what we think is right. And one becomes a better person for it in the end (or so somebody said). 
Meaning for one's life can also be found in one's sufferings. The youth of today try to slide by, taking the easy way out (or at least what they think is the easy way out). But suffering is a part of life. The sufferings endured during our youth help us to better cope with our problems we will face in later life. A poem by Robert Frost states: 
Two roads diverged in a yellow wood And sorry I could not travel both .... 
Each person must decide which road to take, for there is no turning back. The decisions that we make during our youth will stay with us for our entire life. Either we can "ease on down the road" or we can take "the long and winding road." Ifwe take the first road, it might start out easy, but when we get to the end we will find that the "wizard wasn't really a wizard at all." If we take the second road, it will take a long time, it will take a lot of work and determination. There will be much pain and suffering, but when we get to the end of the road, we will find that it will "lead to the door" of contentment and inner satisfaction. 
One can also find meaning for life in love. As Viktor Frankl states in Man '.s Search/or Meaning: 
Love is the only way to grasp another human being in the innermost core of 
his personality. No one can become fully aware of the very essence of 
another human being unless he loves him ... 
We can only love someone if we see him as another human being. In Martin Buber's essay "I-Thou versus I-It," Buber states: 
... this is the exalted melancholy of our fate, that every Thou in our world 
must become an It. It does not matter how exclusively present the Thou was 
in direct relation. As soon as the relation has been worked out or has been 
permeated with a means, the Thou becomes an object among objects 
perhaps the chief, but still one of them, fixed in its size and its limits. 
We must accept people as equals before we are able to love. Love is instrumental in a person's meaning. For example: when Dr. Frankl was in the concentration camps, he found meaning for his life from the love he had for his wife. Love for others gives us meaning for our lives. Love is uplifting and sustaining. It keeps one going when all else is gone. Although we may think that loving is a risk, that the person whom we love may die or be taken away from us, we must remember that the love is within ourselves and that love cannot be taken away. 
I am finding meaning in my life through all three of the previously mentioned aspects: through my accomplishments, suffering, and love. I compare my life with that of a tree. Each year the tree becomes older and gains a new ring. My "rings" are my accomplishments in life. I have set goals for myself. I challenge myselfto achieve more than I ever thought possible. As I attain these goals, I add "rings" to my life. These "rings" enable me to determine my outlook I have on myself. From these "rings" I am able to distinguish my strengths and weaknesses, my abilities and limitations. Although I try very hard, I cannot always win. Sometimes I must accept coming in second place. As Charles Haddon Spurgeon said: 
It takes more skill than I can tell To play second fiddle well. 
I heard someone once say: "Winning isn't everything, but losing isn't anything." This statement might seem pretty accurate, but in reality it isn't. Although coming in second place seems like the worst place to be, I have grown from these expenences. 
The tree spends its whole life trying to grow bigger and stronger, and then one day someone cuts offall the branches it worked so hard to grow. At times, I, too, feel that I have been "pruned." I work and strive to achieve something and then it is taken away from me. Of course I don't realize until much later that that "pruning" I received helped me to grow and flourish, as it does also enable the tree to grow and flourish. 
But this tree cannot grow without the sun and water. And I, too, need the warmth of love in order to grow. Love helps me to add new "rings"to my life and it also enables me to withstand "pruning." For love is the food that enables us to grow. Just as the tree needs the sun and water to grow, I, too need this nourishment. This "nourishment" cannot be taken without giving something in return. In exchange for the sun and water, the tree gives back to the world fruit and wood. So in order for me to get love, I must give some in return. As the love others give me helps me to grow, the love I give to others enables them to grow. There would be no use for the sun and the water without the tree, nor would there be a purpose for the tree without the sun and water. 
With the diverse lifestyles taken by the youth of today, it is impossible to determine what their pursuit of meaning is. It is up to each of us to discover for ourselves what our meaning in life is. One thing is certain, the search for meaning is well worth the effort. It gives our lives a focus. It gives each person a perspective which is so vital in this unpredictable, ever-changing world. 
WENDY L. POHLERS is a graduate from the Fontana High School, Fontana, California, and a freshman at the Skadron Business School in San Bernardino, California. 
Logotherapy and "Drawing Anxiety" 
Frederic H. Jones 
Logotherapy or perhaps "logoeducation" can be useful for a classroom teacher of art as well as other creative fields. The philosophy of growth and the responsibility for "becoming" whatever one's potential permits provides a natural grounding for many curriculum and classroom problems that occur daily in art education. Of course, the Socratic dialogue is applicable to teaching in general but by eliciting learning experiences through any number of pedagogical techniques, from questioning to assigned studio experiences, it is most appropriate for art and design teaching. 
A specific logotherapeutic concept that has proved useful in my own teaching of drawing and design to college design students is the technique ofdereflection combined with a dialogue about meaning and meaningful living to reinforce positive inherent abilities in the students both on an individual basis and in the classroom setting. I would like to share a case study of this particular kind of application. 
One day after a drawing class at the Academy of Art College, Kay (a 36-year-old interior design major), came up to me in tears. "Mr. Jones, I think I'm going to drop out ofschool. 111 never learn to draw!" This confession amazed me because Kay was one of my better students and was making consistently high grades. I invited her to discuss the problem and she told me that only "talented" people could draw, that they started when they were young, not after 30 like Kay had done, and were "naturals." She also explained that every time she attempted a drawing, she was so filled with anxiety that the tension and distraction was damaging her relationship with her husband. I reviewed her portfolio and discovered that there was a tightness to her formal drawings that was not present in her informal sketches. I pointed that out to her, and she was dismayed that I considered the 15-minute exercises better than the drawings on which she had spent hours. I suggested that the problem might be "performance anxiety," very much like sexual dysfunction. We discussed the concept of dereflection and I suggested that she change the room and general environment in which she did her drawing homework. I also suggested that she might watch television or listen to music while drawing to relax her and take her mind off her anxiety. Her standards were much higher than the class requirements. I therefore suggested that she study the work of her classmates and professionals in the field so that she would discover that her own work was quite comparable. I also suggested that she set immediate goals more in line with her level of training and expect more advanced work in the future. She was expecting her work to be equal to professional work before she had had the experience or training. I then modified her assignments to include more sketching for several weeks in the hope that the success with the informal work would increase her self-confidence. We also talked about paradoxial intention and I suggested that she try to draw as badly as she possibly could at the beginning of each homework session, even to the point of scribbling unrecognizably. This might make use of her sense of humor as well as loosen up her physical anxiety. 
Kay and I held several private evaluations of her progress during the balance of the semester during which we discussed realistic goal setting, taking responsibility for her own feelings, the broader aspects of perfection and her own goals, expectations and "meaning in life." Kay's work in both informal and formal presentations continued to improve, as did her own self-image and her home relationship. She completed the course with an "A" grade. 
"Drawing phobia" is rather common among design students. Phobias are even more prevalent in students outside the arts. 1equate this kind of thinking with "math anxiety" and the mistaken idea that only "talented" people can sing or play a musical instrument, or that only a few people are "creative." Somewhere along the way children are indoctrinated in a cultural tradition that supports these false notions. 
My own teaching experience reinforces the opinion that anyone with normal perception and motor skill can draw. No one would suggest that everybody who tackles the arts will become a Van Gogh, but the basic skills are available to anyone. This positive assertion ofdrawing ability should carry through into the classroom setting. It is important for the instructor to create a classroom environment as conducive as possible to success, and to reinforce the success as often as possible. It is also useful to give lecturettes as well as tell stories illustrating the possibility of drawing success and to relate the successes and new skills to a broadening of meaning potential in the student's global experience. Success at drawing and its establishment of perception can be broadened by analogy to strengthen creativity, problem-solving skills, and self-motivation. It can also be used as a center of meaningfulness in the student's life. "Drawing anxiety" is part of a "creativity anxiety," or the idea that creativity is in some way special to certain people and not accessible to ordinary people. The fact is that creativity is an inherent quality of all human beings and can and must be developed more fully in today's world. 
As Geraldine Brian Siks says: 
"For a child to exist, to be alive, is a mystery in itself, but it is his ability to create and express himself that sets him apart from all other living creatures. Creativeness is the fundamental purpose for which human beings were put on this earth. Growth is the purpose of all human existence. In order to realize himself, an individual must develop his mind, his body, his imaginative faculties in whatever direction they may turn. "2 
The creative imagination must be encouraged and developed. Siks further points out that "the greatest number of children throughout the country need constant encouragement to keep alive and develop their imaginative faculties." This same need for creativity and for engendering and supporting it permeates our entire society. 
Frankl says: 
"Today education cannot afford to proceed along the lines of tradition, hut must elicit the ability to make independent and authentic decisions. In an age in which the Ten Commandments seem to lose their unconditional validity, man must learn more than ever to listen to the ten-thousand commandments arising from the ten-thousand unique situations of which his life consists. 
"1 
In other words, we must live a life of creative intentionality. 
The central element of existential psychology and logotherapy is the concept that one must take responsibility for making decisions about those things that are within our power. Our responsibility is to live an intentional and creative life to exercise our potential fully even in the face of adversity. 
Creativity is the synthesis of ordinary elements into an extraordinary new element, unique for the creator. Creativity is the foundation of human life and society: the creativity of love, of procreation, of relationships, of taste, of art, of literature and music. Even the most seminal of human thinking and speech requires basic creativity. Creativity, however, without intentionality leads nowhere except to aimless novelty and dissipation. 
Perhaps one ofthe most important applications for logotherapy, as a therapy, is to use its principles to unblock the creativity of our adults and aid them in coping with the complexities of a society that no longer can count on tradition to direct them. Logotherapy, as a philosophy, undergirds the education ofchildren to a society that will require decision and adaptation that we can only dimly 1mag111e. 
FREDERICH. JONES, Ph.D., is academic dean of Western Design Institute, San Francisco, and teaches logotherapy at J. F. Kennedi· University, Orinda, California. 
REFERENCES 
I. Frankl, Viktor E. Man '.s Search/or Meaning: An Introduction to Logotherap_r. Boston: Beacon Press. 1959. Paperback edition, New York: Pocket Books, 1977. 
2. Siks, Geraldine Brain. Crea1ive Dramatics: An Art/or Children. New York: Harper and Hros., Publishers. 1958. 
Logotherapeutic Treatment of Neurotic Sleep Disturbances 
Heinz Gall 
In serious cases of insomnia actively directed therapy is helpful. The following example demonstrates the process using methods of Viktor Frankl: 
The woman, age 44, has suffered for years from difficulties falling asleep. In 
the early stages she had not been seriously ill organically. All her tests were 
negative. Even now, doing her work as a secretary, she feels quite well. As a 
youth she would have liked to go to the University, but was held back by the 
needs of a younger sister. As the big sister, it was up to her to go out and earn 
a living right after the war. At 19 she married. Her husband is a teacher. It is 
a somewhat dissonant marriage. On the one hand she appreciates her 
husband; on the other, she cannot understand nor excuse his having drink
ing spells every once in a while and spending such evenings out with his 
friends. These spells do not occur often but they always get her down. Often 
she could not fall asleep waiting for her husband. As time went on the 
problem of sleeping grew worse even when he was home. Their intimate 
relationship is not disturbed and they enjoy their two children. The relation
ship with her own parents is somewhat cool. They Jive in a comfortable 
home. 
The patient is asked to describe how she prepares for sleep. She says: "I try to be calm, turn off all thoughts, but it doesn't work." 
The counter argument goes like this: "Don't fool yourself. You aren't really calm. You cannot force sleep. If you wait for sleep, it will not come. Sleep is automatic and independent ofyour will. Take this example: A child goes to bed, not wanting to fall asleep right away. It wants this and that. You leave the child and suddenly it has fallen asleep. Healthy and happy persons, too, do not 'want' to fall asleep, they lie down, and everything else happens by itself." 
With these "nervous problems" things often happen in contradiction to what one expects, a paradox. The more I go after my goal the more it escapes me, and the contrary happens. IfI check my heart anxiously, it is likely to act up all the more. If a stutterer decides to speak especially clearly he will find himself stuttering all the more. 
The mechanism of the patient's neurosis is now outlined: In the beginning, falling asleep has been a problem during a critical episode of one's life. This is followed by the worry that one would not be strong enough the next day. Anxiously one awaits the next night. From this small starting point a pattern of suffering develops. The patient confirms that she understands this all very well, but how can she help herself? 
The answer: You must consciously turn your usual way of thinking around. This will restore the natural balance. For a while there will be a compromise between you and your sleep-disturbance, a kind of "peaceful co-existence." No more insisting on sleep at any price, and instead a greater trust in life. Sleep is independent of will. If thoughts come, pay attention to them and turn them into friends. Length of sleep is not nearly as important as inner calm and rest. In your thinking about your sleeping problem you could even see something beneficial in not-being-able-to-sleep right away. After all, we want more from life than just to sleep it away. 
The basic idea is to accept the disturbing symptom and make friends with it, then to gradually trick it and begin to play it down. 
The patient was willing to try this approach but was afraid to omit her sleeping tablets -she had taken one to two Faustan pills every night -which helped her function and hold her job. 
The method then suggested was to take her tablets regularly every other day. On the alternate days she was to take the chance. After six weeks it might be possible to reduce the intake to twice a week. 
As a further method, autogenic training became part of the support system. 
The patient wanted to know why all her long walks at night did not help even though she went to bed very tired from the exercise. My answer: As with all these "tricks," the main thing is the motivation. If you take a walk for the joy of walking, that is fine. But if you undertake the walk only because you want to sleep well, then there is a hidden fear behind it and the opposite happens. It is actually a "bribe" offered to nature -if I take a walk, you will give me sleep in return. 
Having discussed the disturbing problem of sleeplessness, we talked about the origin of illness in more detail. The cause must lie in some dissatisfaction, the essential conflict of the patient is her ambivalence toward her marriage. It is up to her to find her way. Whatever she decides to do must be done wholeheartedly. If she wants to stay with her husband, she has to take him with all his good and bad points. If her love cannot accept him, then the choice is separation, but again, with all its advantages and disadvantages. A positive third way would be to find things to do that will serve as a vent, an outlet, for the things that remain unsatisfactory. This can be a compromise. A negative third way is flight into illness. Though this "negative" method has some small payoffs, it is a slim substitute for fulfillment. 
The decision is up to the patient. But in making the decision she is to remain, as much as possible, free of prejudices. Because the patient still has a real attachment to her husband she can try to find some understanding for his occasional parties with his associates. After all, she takes Faustan and he his alcohol, they both must have reasons. For him it may be not so much the alcohol as the occasional atmosphere ofcomradeship with his friends. She probably also has some little weakness. Why does she have to have her husband all to herself? 
The first conversation with the patient ended after three-quarters of an hour, in good understanding. At the second consultation three weeks later she definitely felt better and brought up her own insights to the session. She attended ten autogenic training sessions and was able to learn that method. Now, after three years. the patient is well and able to sleep normally without medication. The marriage has become more solid. One session with her husband had also taken place. 
Discussion 
In this case two forms of Frankl's methods come into play: paradoxical intention and dereflection. 
This case is one of many where similar methods bring results. Frankl's methods have been a decisive factor in psychotherapeutic treatment of our department for 13 years. It is applied in various neuroses depending on the individual case. We do not discuss Frankl's mystical speculations about the "Super-Meaning" because this is not needed for application, being merely an attempt at justifying his own philosophy of life. 
The two methods, paradoxical intention and dereflection, are easy to understand and readily find confirmation in our personal experience. They open to patients a new way of thinking which gets them out of old thought patterns. By thesis and antithesis a balance is eventually reached. 
We heartily agree with Frankl's emphasis on every human being's search for the meaning of his or her life -as seen through the influences of character, upbringing, and society. Thus, "logo"therapy. To find meaning is also the concern of those who are in a crisis situation when they seem to have lost all goals and purposes. But they must direct their will to meaning not toward themselves and their fate, but rather toward the outside world and their joy of living. 
It is difficult to present objective success statistics in psychotherapy. But it is certain that Frankl's methods achieve as many improvements or cures as other psychotherapies that are applied with concern. Their great advantage lies in the relatively short time needed to see positive results, usually after as few as three to five sessions. The methods can be applied in ambulatory practice, mostly in individual counseling, but also in group therapy. 
Logotherapy is beneficial to phobic, compulsive, and depressive neuroses, and to a lesser degree in hysterical or neurasthenic forms. Then too, neuroses in advanced age will respond less readily because new goals arc less available in old age. 
A combination oflogotherapy with other psychotherapies is always possible: suitable are autogcnic training, psychodrama, some behaviorist techniques. For heavy neuroses where analytical therapy is necessary, Frankl's methods can form the foundation. In closing, an anecdote as an example for both his methods: A young couple takes a room at a hotel and the wife says, "I won't stay alone in this room, I'm afraid and always imagine there are mice all around." The husband advises, "Then imagine also that cats are around, too." 
HEINZ GALL, M.D., is on the staffof the Clinic/or Psychiatry, Neurology, and Ambulatory Psychotherapy at the Medical Center, Greifswa/d, German Democratic Republic (DDR). 
I Remember Edith 
James D. Yoder 
Dr. Weisskopf-Joelsun (right) with Board president Will Finck and Board memher frmpe/1 Douglass. 
Today, July 19, 1983, I picked up my office mail. Puzzled, I glanced at the letter bearing my return address and a yellow label with the words "Deceased: Return to Sender. From Athens, Georgia." 
It was my letter to Dr. Edith Weisskopf-Joelson, written a few days after returning from the Third World Congress of Logotherapy and the Logotour. I did not open my letter. I was stunned and deeply saddened. 
For years I had taken note of Dr. Joelson's scholarly journal articles. I shared them with my graduate students. Just last week I had referred a graduate student to her article "The Crisis in Consciousness and Psychotherapy." Since our return from the Logotour in Europe I had re-read her International Forum article "The Place of Logotherapy in the World Today." Now my letter to her, drawing together our plans for our Kansas City Chapter's Fall Festival of Meaning, returned, labeled "Deceased." Dr. Joelson was looking forward to coming to Kansas City as a featured presenter, narrating from her latest manuscript Father, Have I Kept My Promise? She planned to relate her personal story to important logotherapy and existential themes. 
I first met Dr. Joelson at the Second World Congress of Logotherapy in Hartford, Connecticut in April of 1982. But I had known her "spiritually" for years. 
She had been the presenter at our Spring Logotherapy In Action conference. Her wonderful presentation, "Logotherapy In a Wider Perspective," had received a standing ovation. She was first on our list ofpresenters to return to us in September, 1983. Now this letter, "Deceased," and only a few days ago the joys and tears shared on the Logotour in Europe together. Edith was one ofthe oldest members of the tour group, but she was the youngest in heart -endowed with a spiritual presence. Her lovely Viennese diction -firm, well-enunciated words coming from deep within her consciousness gave evidence of her certain spiritual grounding. Both Lona and I counted it a special privilege to travel and share with her from Regensberg, where she offered to loan me her green Tyrolean hat, to Vienna, where we sat together as she shared her deeply moving encounter of"homecoming." Edith, tears in her eyes, told us of her return to her "home in Vienna." 
"I rode in the same elevator that had the very same mirrors where I checked my gowns when I was eighteen and leaving for a date." Her eyes bright, her spirit transcendent -tears on her cheeks. "I saw my bedroom I'd so loved when I was young. I looked out of the window in silence. The view over the Vienna parks was beautiful. I'd forgotten how beautiful they were when I had to leave in the dark shadows of Hitler and Nazism." 
She faltered a moment and brushed her eyes. "The saddest part: I took a walk around the circle where we shopped when I was a girl. All the little Jewish stores -names on the windows." Again, a moment of silence, then her courageous voice continued as she looked directly at me, saying firmly: "Then it hit me, not a single one remained." 
But Edith had transcended Nazi shadows and terrors. Those on the Logotour who accompanied Edith to Hitler's Eagle's Nest, high on a Bavarian mountaintop will not forget her exclamation, "Hitler, you're dead, and I'm still alive!" 
Yes, she lived among us and we have the blessing of being richer because of her. She, that tiny, gentle woman with the twinkling eyes who could conquer shadows and hate by her love and forgiveness. There was no room in her heart for rancor or bitterness. 
She taught me how to say "Georgia" as they say it around Athens. With her pixie haircut and bright eyes and smile she said, "It's pronounced this way -as you spell J-A-W-J-A-W, there: JAW-JAW!" (Georgia). 
She had shared with us, on our "free day" in Vienna, her "homecoming," and how she would weave it in as a finish in her book. 
I count it a privilege to have known her. We mourn her death. We experience the loss to us, to her community, her students, the logotherapy community and the world who so needs her words and voice and undaunted spirit. 
I'll miss you, gentle Viennese-southern Georgia woman, scholar-poet-priest and citizen of the universe. Thanks for your courage and for your belief in me and for your love. I'm glad we could walk together, hold hands for awhile. 
JAMES D. YODER is a certified logotherapist and Regional Director ofthe Kansas City area. 
Because of Dr. Weisskopf-Joelson's love for young people and her efforts to help her students lead a meaningful life, the Institute of Logotherapy has established an EDITH WEISSKOPF-JOELSON SCHOLARSHIP FUND to enable gifted high school seniors to enter the university of their choice. Donations marked "Edith Weisskopf-Joelson Scholarship Fund" are being accepted by the Institute. 
Edith Weisskopf-Joelson 
Edith Weisskopf-Joelson was born in Vienna, Austria in 1910. She obtained her Ph.D. in Psychology at the University of Vienna in 1937 under the direction of Else Frenkel-Brunswik and studied with such notables as Egon Brunswik, Karl and Charlotte Buehler. She was able to escape the Nazis, and came to the United States. She taught briefly at Briarcliff College, then went to the University of Indiana, to Purdue University, and since 1966 to her retirement in I 978, she taught at the University of Georgia in Athens. She continued active teaching of an occasional course both at Athens and at West Georgia College's graduate program in humanistic/transpersonal psychology. 
She played an active role in the development oflogotherapy. Like so many of the survivors of the Nazi holocaust, she had seen the value of the existentialist, phenomenological, and humanistic orientations. Like Frankl, she sought meaning in the sufferings of so many lest we become merely the victims listed in the statistics. 
"Since suffering is unavoidable, it seems much wiser to adopt a philosophy of life which accepts a certain amount of suffering or even gives it a positive value. Our current mental-hygiene philosophy, on the contrary, stresses the idea that people ought to be happy, that unhappiness is a symptom of maladjustment. Such a value system might he responsible for the fact that the burden of unavoidable unhappiness is increased by unhappiness about being unhappy. "I 
Dr. Weisskopf-Joelson published at least 46 articles and co-publications ranging from technical experiments on projective tests to profound philosophical considerations. Her writings were meant to be read and experienced, not just listed. A book in dialogue form was mostly finished and in the hands of her editor before her most recent trip to Germany. She participated vigorously in logotherapy, even after retirement. At the Second World Congress of Logotherapy in Hartford, Connecticut, I 982, she was asked to substitute in part for Frankl, who could not attend because of a recent illness. She presented three speeches in English and German to the Third World Congress of Logotherapy in Re gens burg, Germany in June, 1983. She was given a standing ovation. She then travelled to Dachau and to her former home in Vienna, before returning to Athens, Georgia. She was home but two days when she died, July 3, after a series of cardiac arrests. 
James B. Klee, Ph.D. 
REFERENCE: 
I. Weisskopf-Joelson. Some Comments on a Viennese School of Psychiatry. Journal ofAhnormal Soda/ Psychology, 1955, 51, 701-703. 
Remarks from a Free-Floating Spirit 
Edith Weisskopf-Joelson 
The following passages are taken from remarks by Edith WeisskopfJoelson made at a symposium at the Third World Congress ofLogotherapy in June 1983. 
I was in awe when I read the title ofthis symposium, "Collective Responsibility for and Response to Individual Pain and Despair." This is a formidable title for a finite mind like my own. Therefore I should like to bite off a small portion ofthe topic. I shall assume that pain and despair are caused by lack of meaning. There are of course many other causes but, in the spirit ofthis Congress, I should like to focus on this one cause and ask myself the question: what are some reasons why contemporary people in the Western world have considerable difficulties finding their life's meaning? One is that our time inspires scant enthusiasm. Let us compare the countries of the Western world with underdeveloped countries in the Third World. People in underdeveloped countries have a common ideal: With the help of technology they hope to build a real homeland for themselves and put an end to poverty, hunger, disease, infant mortality, and ignorance. "Some day, maybe, our country will be rich and powerful like the United States" -this might be the dream ofsome Third World people who now live barely above maintenance level. Thus, in these countries meaning is easily found, easily shared, and easily converted into action by a common effort. Now I would feel very uncomfortable about what I have said if I could not add the following: The point I want to make is somewhat weakened by the fact that self-improvement in underdeveloped countries is usually attained by the help of a powerful nation whereby the price of such help paid in emotional currency is often excessively high. 
What hopes does youth in the Western world have regarding a shared vision of a better life in the future? Can we hope that our children will have a better life than we had, and that our grandchildren will have a better life than our children have had in any respect other than technological and medical progress? Our youth is doubtful that this is the case. There are few inspiring visions in the air, and meaning has to be found individually and laboriously. The fragmentation of work brought about by the industrial revolution has put further roadblocks in the path of meaning. The work of a carpenter who worked in his own shop used to be an eminently meaningful task. To receive an order from a customer, to make a chest of drawers from scratch was a highly creative enterprise. It took much daydreaming about the finished product and much wonderment about the gradual change ofraw wood into a beautiful piece offurniture. Work ofthis kind supplied a reason for living. Work on an assembly line cannot do that. Attempts are being made by Japanese industrialists to replace lost individual creativity by warm human relationships in the factory. 
This consideration takes us to another block on our path toward meaning. Human relationships are the most flowering potential source of meaning, but many observers have noticed that men and women ofthe 20th century have lost much closeness and warmth when relating to each other. Many factors have been blamed for the resulting estrangement. Competition is one of them. An anthropologist, Robert Lifton, described the following scene taking place in a United States grade school. 
The teacher called a pupil named Boris to the blackboard and asked him to reduce the fraction 24 over 16 to the lowest possible terms. Boris came up with 6 over 4 and could not proceed further in spite of the teacher's encouragement. Then the teacher turned to the class and said, "Mary, can you show Boris how to finish the reduction?" Mary walked out to the front of the classroom with great assurance and victoriously put the correct solution 3 over 2 on the board. The anthropologist Lifton comments that had a member of a primitive tribe observed this scene, he or she would have come to the conclusion that children in the United States are tortured beyond endurance. Another factor which blocks intimate relationship becomes apparent in a document I found in a business magazine, a coolly detached guide for newly promoted executives and their wives. It advises that the executive gradually break with old friends and subordinates in order to minimize the resentment. He is told to find logical excuses for not joining the group at coffee breaks or lunch. Similarly, he is advised to miss department or card sessions, occasionally at first, then more frequently. Invitations to the home ofa subordinate may be accepted but not reciprocated except 
. in the form of an invitation to a whole group of subordinates at once. After a while, all such interactions should cease. And now I want to read something of which I am very proud; namely, that wives are a special problem in this respect. This is so, we are informed, because they don't understand the protocol ofoffice organization. Good for them! The successful man is advised to be patient with his wife who may adhere to old relationships longer than he does but, as one executive puts it, a wife can be downright dangerous if she insists on keeping close friendships with the wives of her husband's subordinates. Her friendships will rub off on him, color his judgment about the people under him, jeopardize his job. Moreover, one personnel man points out, when parents drift away from former friends, kids go too. This does not need any elaboration. It is obvious to what terrible estrangement such a policy would lead. Now as I go on talking to you, I become more and more uncomfortable. I am a logophilosopher and my life has been guided by logotherapy applied to myself by myself. Then why do I whine about the roads to meaning being blocked? Do not these blocks themselves represent meaning? Do they not say "remove us"? Thus I must change my initial statement that our time inspires scant enthusiasm. No, our time inspires great enthusiasm. Our time is one united cry, help! help! help! Need I say more? 
It is difficult for me to introduce the fundamentals of logotherapy. This is the case because I have assimilated logotherapy so much into my life and into my personality that I take it for granted. It reminds me of a situation which happened in 1938 when I was a refugee from Hitler's Germany and was in Norway in a woman's college and had to teach English and German. It was easy for me to teach English because I had learned it in high school and I taught it as I had learned it. But it was immensely difficult for me to teach German. The girls would ask me questions such as "Why do you say der Hund and die Katze?" "Why is dog masculine and cat feminine?" I wanted to say, well, that's obvious, but I didn't say that. In the same way many of the teachings of Frankl have become Edith, and it is not for me to analyze them out of myself. 
What I just said is expressed in what I wrote in Frankl's guest book when I visited him in Vienna in I 977. I wrote "My life is guided by logotherapy." In a way that's true in a very undramatic sense. Logotherapy is a response to the type of patients who come to see therapists. Several decades ago such patients would have been compared with a person who had a broken leg and the therapist had to fix the leg. Modern patients can sometimes be compared with a person with two healthy legs who doesn't know where to go. Now if you don't know where to go, you usually go where the money is. And where the money is, there is also pleasure and power. 
I am not about to give you a sermon about the corruptive influence of materialistic values, because this is done, sometimes very expertly, by many other people, especially on Sundays. But I would like to tell you about my own life, where this really proved to be true. My family was rather wealthy and I was only moderately happy. Then came Hitler and we had to give him all our money. I left Nazi Germany with three dollars. I found a job teaching at Briarsmith College, and I had the most fantastic experience that I could support myself. I always thought next month no paycheck would come but it always came, and I was rather happy. Then I got married to a man of moderate means and we had a very nice and simple and private life. These years were among the most meaningful ones in my life. 
In some way, humanistic psychology is self-centered. Jungian psychology is rather interesting when we consider self-centeredness versus other-centeredness. Jung says he enjoys that; he thinks it's great progress when his patients become selfish because then they can engage in individuation. But then, he says, after that they find out how important other people are. Well, I'm not a psychologist and not a psychiatrist, but you have to categorize me in some way. I want to get paid by universities, they don't tolerate free-floating spirits. I am a free floating spirit. Yet, you must go under some roof so I went under the roof "clinical psychologist," but what I would like to call myself is a "relevantist." I find out what field at the moment could help us solve our problems and then I study this field, which annoys my colleagues tremendously. I have come to believe that the humanistic psychologists are not interested in therapy, they are not interested in sick people, they are more interested in the self-actualized, unusual people. 
I believe when Dr. Vlahos spoke about youth in the sixties and seventies, he spoke about counter-culture and, incidentally, counter-culture students were my favorite students, and I had my most beautiful time teaching them because I didn't teach, I learned. Some of them officially became Zen Buddhists ~ I correspond with one of them who lives in a Zen Buddhist monastery in Los Angeles; others became anonymous Zen Buddhists -they thought that way but they did not label themselves. I gathered them around me and we met every week and talked. I was careful to watch these people because I was wondering what was going to happen when the clinical psychology and psychological professions and the psychiatric profession got in touch with these people and start to diagnose. Now what might the diagnosis have been? It might have been schizoid borderline or even schizophrenic, and therefore it is for me a strong and important thought that some of our clinical entities by which we label people as sick are actually not at all clinical entities -that they only describe differences in ways oflooking at the world. I have an article in press which I called "Schizophrenics as a Minority Group," and in this article there is the statement that trying to heal schizophrenics is like trying to baptize Jews or to bleach Blacks in order to make them socially acceptable. 
EDITH WEISSKOPF-JOELSON, Ph.D., was a professor of psychology, emerita, University of Georgia. 
Love and Work In Frankl's View of Human Nature 
Elisabeth Lukas 
Ever since human beings began to think, they have raised such questions as "What am I?'' "Who am I?" "Where do I come from?" "Where am I going?" And since time immemorial they have found answers to these questions~ religious, philosophical, medical, and in the 20th century, also psychological answers. 
Yet, in spite of the great diversity of psychological schools, the young science of psychology has so far come up with only two basic views of human nature: The first originated with Sigmund Freud and has been accepted by almost all subsequent schools including behaviorism although it is based on different premises. The other view was conceived by Viktor Frankl and its greatest impact perhaps still lies in the future. The two views seem incompatible. Although they look like a thesis and an antithesis, they seem not suited for a synthesis. For the time heing, at least, every theoretical or practicing psychologist must select the view of human nature he prefers. Once he has made his choice, he is bound to follow it in his practice, his research and interpretation to remain consistent with his own view of human nature. 
Monads 
Because work and love are intrinsically linked to our fundamental view of human nature, I should like to roughly outline these two views before discussing Frankl's view more closely as it relates to work and love. What principally separates the two views can best be described by the term "monad" versus the term "self-transcendence," the one a condition of being closed versus the other being open toward the world. Traditional psychological theories, regardless of whether they originate in psychoanalysis or behaviorism, consider human beings as monads. They are seen as a closed system. Within that system there is a multitude of influences: drives, our will, feelings, cognition, conditioning, automatic responses, creativity, spontaneity, the conscious and the unconscious, influences from within and without with the many reactions to all of these. Many theories exist about the various layers ofthe person and about the degree of maturity that provides a balance within the system or upsets that balance, thus causing psychological disturbances. Much material has been gathered about the impact of our needs and their fulfillment upon our normal functioning, while stress, shocks and frustrations appear threatening to us. 
This view considers normality as equal to inner equilibrium, and psychological stability is defined as preservation of the monad. A person is healthy if he is able to satisfactorily abreact his drives, adequately meet his needs and wishes, not repress his traumas, adjust his conditioning mechanisms to his requirements, and self-actualize himself. Neurosis and psychopathology arc seen as a con seq ucnce when our natural desires for happiness, success, and caring cannot be met because the monad is disturbed, drives are repressed, irrational behavior is caused by complexes from the unconscious, the inner development of the ego is stifled by psychological damage from the outside world, or our self-confidence is undermined by wrong conditioning. The closed view of human nature centers around the ego and, in perhaps oversimplified terms, can he expressed hy the phraseology: "Good is what is good.for me," or "I remain healthy if I can get what is good fur me," and ''I'll fall sick if I cannot get what is good for me." 
In considering work, it follows the same pattern. Within this psychological premise, work is "good" work if it is good for me; that is, not boring, not too stressful, not ovcrdcmanding, if it brings in money and recognition and allows me enough freedom. 
Love, too, is considered in positive terms if it brings advantages to me: human closeness, a partner to talk to, an opportunity to relate and find safety, security and fulfillment of drives and pleasures. 
I don't deny that the "monadic concept" of human nature also includes interrelationships with the outside world. Obviously it is necessary to invest something in our work and love relationships, or there would be no gain. But the interrelationship is just as much dominated by the doctrine of our wishfulfillment as are all our other actions and emotions which aim, at their deepest motivation level, at maintaining our inner equilibrium. This view of human nature appears insightful and reasonable, yet leaves us with a certain uneasiness when it answers the old question, "What are we?" with the admission that we are "beings in pursuit of happiness," and, to be specific, "our own happiness." 
The Open Model 
A fundamentally different approach, that of Viktor Frankl, starts from the premise that human beings are not monads, not enclosed systems. Viktor Frankl considers human beings -in contrast to other living creatures -open to the world, open through the exclusively human dimension ofthe spirit. He does not deny the various energy potentials found in the model of the monad (such as drives, emotions, cognition and automatic reactions); they have heen proven to exist. They are complemented, however, hy motivational forces which are not on the same level as the drives, wishes, and needs of the psyche because they transcend the ego -we reach beyond ourselves. Viktor Frankl calls this motivational force the "will to meaning." 
Forces of the will are of course also part of the traditional view of human nature. What is new in this concept of "the will to meaning," a bursting open of the monad, is that meaning is not a meaning oriented toward the self. Meaning is seen as the actual meaning of a situation. Meaning contains an objective component which can be perceived subjectively. Meaning is the connecting link between the human being and the world. Meaning, therefore, is never just a "meaning for me," but always is also a "meaning as such." The self-transcending opening of a person toward the world is so great that for the sake of a desirable meaning goal we may forego, ifneed be, personal happiness. The question as to what we human beings are is no longer answered by "a creature in pursuit of happiness," but "a creature in pursuit of meaning," that is "a meaning to be found in the world." 
Let us look at this expanded concept ofthe human being as it relates to work and love. If we consider the human capacity for self-transcendence, then "good work" is identified with "meaningful work" which is work that changes something existing in the world for the better, in short, which leads toward wholeness. 
Normally, meaningful work also is pleasurable, more so than work that is merely "not overdemanding" or "profitable." But in extreme life situations it is possible that meaningful work is very hard, laborious, thus does not bring immediate pleasure but is considered important and valuable and for this reason is bravely carried out. The criterion of self-advantage is valid only as far as the monad goes; beyond that the important thing is the meaning of the cause. 
Similar considerations arc valid for the phenomenon of love. Frankl views love as something far beyond the satisfying of an elementary or sublimated sex drive. Again the element of meaning is considered to go out beyond the self -to the beloved person. Just as work worthy of a human being includes the value of the work to be done, so love worthy of a human being includes the value of a beloved partner whose well-being and happiness are considered. It is true that the devotion to another person is reflected back into one's own heart, but there are situations which demand that we transcend our self-interest for the sake of genuine love. 
The Child in the Circle 
An example of the contrast of these two views is offered in Bert Brecht's "The Caucasian Chalk Circle." He describes two women fighting for a child. One of them is the biological mother who undoubtedly has a right to her child; the other woman is a maid who has raised the child under difficult conditions and loves it like her own. The functioning ofa monad is demonstrated by the conduct ofthe biological mother: she feels her right is threatened, her self-esteem is thrown off balance, and in order to reestablish it, she must insist on her right. The judge places the child in the center of a chalk circle and the two women to the left and right of it, with the instruction that the true mother will be able to pull the child to her. The biological mother pulls as hard as she can, hut the maid who had raised the child mobilizes her capacity to self-transcendence and lets it go because she thinks, "To prevent the child from being torn apart, I'd rather relinquish it." In the play, it is not difficult for the judge to decide which one of the women has a right to the child. 
The psychologically trained observer, too, will not find it too difficult to foretell which one of the two women would have ultimately been happier if the judge had decided according to the original plan: the biological mother with her triumph over the rival at the expense of the child, or the maid with her painful voluntary sacrifice for the sake of the child. We can safely assume that the latter was full of inner satisfaction even if her self-esteem had been lowered compared to that of her opponent. 
The story is an extreme example but clearly shows what is meant by "opening ourselves toward the world." The biological mother did not open herself; she remained closed in herself. She was busy working through her trauma -the loss of the child -abreacting her aggression toward her rival, defending her own interests, restoring her inner equilibrium -and those worries about herselfand her problems leave her no time to see the world beyond. In the last analysis. she does not even see her child although she fights for it. But basically, she does not fight for her child. She fights for her own satisfaction or happiness. She is typical of a person in pursuit of happiness. 
The maid, on the other hand, is open to the world. She, too, has a trauma; she has given up her boy friend because of the child., She, too, has aggressive feelings against the mother who had abandoned her child and now comes to claim it. Her inner equilibrium is at least as off balance and her stakes are at least as high as those of the other woman. But in spite of her own problems she is able to see the world beyond -the innocent child which is being made to suffer. A suffering that is not meaningful. Her "will to meaning" rebels and gives her the strength to leave the monad behind, and with it, to forget all her own problems. An objective meaning is elucidated: the well-being of the child must be preserved! And she finds this meaning in self-transcendence. She acts according to the dictum of the person seeking and finding a meaning. 
If we believe that our spiritual dimension enables us to find some meaning in the world beyond our narrow needs and which might even oppose them, then we have to restore two concepts to psychology that have been lost. The concepts of freedom and responsibleness. Neither exist in the closed system where we are determined by unconscious forces and learning patterns. Where people are shaped beforehand by inner and outer forces, there is no sense of guilt. 
In an open system things are more complex: the impulses from the outside, perceived as meaningful or meaningless, touch our existential longing for a meaningful life and challenge the energies of our spirit that cannot be shaped beforehand. These energies are freely chosen and require our ability to respond, our response-ability. 
The Reporter of the Devil 
Let us illustrate this with an example that deals, not so much with love, but with work. 
A few years ago a film was shown called "The Reporter of the Devil." This film, based on a true event, told the story of a miner who was buried in a mine and had to be dug out. Experts said there were two ways: a relatively quick way by drilling a hole, or another, lasting somewhat longer, by digging a tunnel. It was estimated that the miner could survive either but of course those were guesses, because a direct communication with him was not possible. The accident attracted many onlookers, among them a reporter well-known for his magnificent storytelling. This reporter strongly supported the digging of the tunnel because the longer stretch of time for the rescue would give him the opportunity for a longer series of articles which would keep his readers in suspense for several days. The merchants of the village also favored the longer rescue action because they gained some income from the many spectators who had come to watch. Thus, it was decided to dig the tunnel. When they reached the miner, he was dead. 
The film presents a reporter who does his work expertly and is eminently successful. Yet, one has to admit that he went too far. The life ofa human being should have had preference over the best series of articles. From the psychological angle two views emerge: the one that limits the human being to the model of the monad, and the other that is open to the human capacity for self-transcendence. 
The model of the monad excludes guilt. The action of the reporter can be completely explained as an expression of his personality. One might suspect an inferiority complex originating from his childhood and requiring professional successes as compensation; or one might suspect a lack of caring because of faulty learning experiences. Some might also blame societal conditions which support the egotistic behavior of the reporter, and the pressure from his readership. 
As Viktor Frankl sees human nature, these arguments are only partly valid, because they show only one side of the picture: the fluctuation of input and output in the psyche of the reporter. The other side shows the meaning of the situation~ the rescue ofthe miner. We must distinguish between the psychological influences from the outside, such as social pressure, and the objective meaning gestalt which has no influence on the person and can be perceived only through the dimension of the spirit. The situation of the miner and the meaning of his rescue are elements of the outside world. Although they have a certain demand quality, they do not influence the psychological stability or stress ofthe reporter. Up to here the two views agree, but now comes the claim in which the Frankl view transcends the other: the claim that our capacity for selftranscendence enables us to decide rather independent of psychological stability factors or stress as soon as we perceive a meaning in the outside world, by either fulfilling it or not. 
This is the responsible freedom of the human being which has been reintroduced into psychology since Frankl. It is a freedom notfrom the influences of emotions, learning, or psycho-social factors, but a freedom to the fulfillment of a meaningful task despite such influences. Self-transcendence is the capacity to take a stand against ourselves, to grow beyond ourselves, beyond the limits of the monad, to respond out into a world which is full of meaning even though it may often be only vaguely perceived. We have our conscience that can perceive the meaning of any given moment, and the freedom and the responsiveness to act according to what we have perceived. Guilt is defined as "saying no" to the question of meaning, a No that was said by the reporter of the quoted case. 
Challenges 
This second example also is not an everyday event. Nevertheless, we will find our lives full of such challenges, though not as grave in their consequences, if we only look out for them. They usually deal with the phenomena of love and work. Some mothers force their children to top achievements so they can pride themselves, while others provide the best education for their children to give them a good start in life. The difference lies in the self-transcendence ofthe latter. 
Some wives complain about their frigidity because their husbands do not help them to achieve a climax, and others are affectionate even if they do not find complete satisfaction in every sex act. Again, the difference lies in selftranscendence. If we really love someone, a child, a partner, we cannot simply chase after our own happiness and misuse the other person as a means of satisfying our wishes. 
The same is true for work. Some authors write books to make the bestseller list, and others write to make a gift to their readers. Some doctors build up a profitable practice, and others primarily want to conquer diseases. Some factory workers work overtime to get a higher standard ofliving, and others to feed their large family. Again, the difference is self-transcendence, the inclusion of the objective meaning from the outside world into our own motivation. As a psychologist, I am not concerned with morality nor am I concerned with what people should do, but with what they can do. Can a person include into all personal decisions the well-being of others or the meaning of a planned work? Sigmund Freud says "no." Viktor Frankl says "yes." This "yes," as I have said before, is not merely a simple negation of the "no" but a new definition of the human being. Frankl himself defined his thesis as based on the fact that the human being reaches out beyond himself for something that is not himself -for something or someone: for a meaning to fulfill, or for another human being to lovingly encounter. Human beings find fulfillment for the sake of a cause or another person. The more they merge with their task, the more they become themselves. 
Frankl is not satisfied with the revolutionary claim that we can think and act self-transcendingly, regardless of drives and learning. He goes a large step further in his claim that we are truly human only when we look and grow beyond ourselves. Happiness, which other schools of psychology regard as the highest goal of human striving, is for Frankl no goal at all: it is the automatic byproduct of a meaningful life which finds satisfaction by forgetting oneself. 
I should like to conclude this essay with two brief reports from my psychological practice which illustrate Frankl's view of love and work. 
Spider Phobia 
The first report is diagnostically interesting. It concerns a case of spider phobia. A young girl became hysterical and had fainting spells whenever she saw a spider. Anamnesically there had been a number ofevents in her childhood that could have caused her phobia -mainly the fact that she had grown up in an old farmhouse full of spiders which often hid in her bed, and second, her parents often had sent her to bed during the day when she had misbehaved. Later, the parents moved to a clean house and they no longer punished her, but the fear of spiders remained to the extent that even a picture ofa spider in a book caused the attacks. 
Since in my anamnesic explorations I look not only for the dominant problem and its origin but also for positive events. I asked the girl whether she had ever had experiences with spiders that had not been frightening, and to my surprise she said yes. One single time had she been able to pick up a small spider with her handkerchief without panicking, without running out of the room or calling for help. Of course, I wanted to know how a person who from childhood on had had an abhorrence of spiders and had developed a severe spider phobia could have simply picked up a spider and put it out of the window. What had happened? 
As one might suspect, self-transcendence played a part, or the monad would not have opened. A close childhood friend had visited her while being in poor health. She had just been released from the hospital, felt weak, and lay down on the girl's bed. While they chatted, the friend fell asleep. When the girl was leaving the friend's bedside she saw a spider on the windowsill. She had the choice to flee screaming from the room and wake up her friend and frighten her, or quietly to put the spider out. She decided on the latter. Consideration for the friend was stronger than the power of fear. This example teaches us something about psychological diagnosis, namely that we must not classify a human being according to a hard and fast pattern of behavior. Each of us can react atypically if we have a deep reason. That is why it is dangerous to base the diagnosis exclusively on negative connections between the patient's past and present as this tends to assume that the present inexorably depends on past behavior, and this is not necessarily so. Sometimes love for another person, love in the widest sense, is enough to give the present moment a new and unexpected chance. 
Obesity 
My second short report is therapeutically interesting. It concerns a case of over-eating. This case deals with a patient confined to a wheelchair who could not exercise normally and was suffering from the consequences: constipation and stomach cramps which could not be relieved even with strong laxatives. 
His overweight had been diagnosed to be of psychological origin and the hypothesis of ersatz-gratification fitted well, because a man in a wheelchair has to do without many things. But all attempts at therapy had Jed nowhere and there seemed to be little hope for improvement. I, too, could see few possibilities to overcome his addiction for food, and I focused my attention on a new direction. The man was burdened by his handicap and suffered from digestive troubles, but there must be something in his life which would make it worth living -in spite of everything. 
We started an "existential analysis" to explore his interests and abilities which might bring meaning into his monotonous life. Our Socratic dialogue uncovered past years when the patient had spent several years in a prisoner-of-war camp and because of his bitter experiences the man was concerned about people innocently imprisoned all over the world. He became upset about stories of torture or inhuman conditions in prisons and repeatedly mentioned how much he would like to help those people. 
Our conversation unavoidably turned to Amnesty International, and suddenly the man perceived a meaning gestalt that offered itself to him. Even from a wheelchair he could support an organization like Amnesty International. He telephoned, made contacts, organized a branch office in his apartment, indexed articles and drafted letters -in short, he became an important helper of Amnesty International. I invited the man to a follow-up session but he didn't come, he had no time. Weeks later I wrote him a few lines which remained unanswered. Somehow I regarded his silence positively because I felt that the meaning potentials that enriched his life were more important than the best psychotherapy. Yet I was surprised when he dropped in on my counseling center a few months later. He happened to be nearby and wanted to tell me about his various activities. I could hardly concentrate on his words but looked at his slim figure. "How did you get rid of your excess weight?" I asked him. He laughed. "I don't know," he answered. "I only know that when Amnesty International needs me, I forget about food." 
How can we interpret this case history psychologically? We could assume that the patient simply changed his ersatz-gratification from overeating to working for Amnesty International. Or we could assume that he was overcompensating for all that he missed in his childhood. But I believe we would do a gross injustice not only to him but also to the value content of his new task were we to declare his devotion as an expression of a neurosis and his help for political prisoners a coming to grips with psychological complexes. In every human contribution, be it ever so small, if it improves conditions in the world, there lies an objective meaning, reaching far beyond the subjective plane of complexes and compensations. 
It is not a disgrace to admit that meaningful work can make therapy superfluous because wherever meaning is found, so much energy from self-transcendence is released that the neurosis has no chance. However, psychotherapists may be needed to lead the patient to seek and find something meaningful in life, and it is this function that Frankl has formulated for his students: to see the human heing beyond self-interest, who is "in search for meaning," who asks help not only for his psychological disturbance but for his exclusively human suffering. Love and work may trigger, in an important way, psychological events. These may originate in drives and impulses, but they are aimed at an outer world in which human existence strives to fulfill itself meaningfully. Only to the extent that this happens is existence truly human. 
ELISABETH LUKAS, Ph.D., is a licensed logotherapist and head ofa Counseling Center in Munich, West Germany. 
Patients' Perceptions of the Meaning of Suffering 
Patricia L. Starck 
This article describes a study recently completed in Alabama using a newly developed instrument, The Meaning in Suffering Test (MIST, Starck, c. 1982). The study involved 99 patients in six different hospitals. 
The Problem 
Suffering is a common, natural experience and is an ineradicable part of life. Responses to suffering are highly individualistic, although there may be a typology of coping styles. The nursing staff who has 24-hour a day, 7 days a week duty is likely to assume major responsibility for assisting patients to cope with suffering, whether acute and temporary, or chronic and permanent, when they are hospitalized. 
There is a paucity of research on suffering and on effective nursing strategies to promote adjustment to suffering experiences. Frankl postulated that experiences of unavoidable suffering can become opportunities for human growth in a positive direction. A synthesis of Frankl's idea and theory has been adapted and given the title of "Meaning Psychology" by this author, and utilized in application to nursing care. "Suffering," in this report, is understood to mean "unavoidable suffering." 
Purpose 
A research project was designed for the following purposes: (a) to describe characteristics of suffering experiences as perceived by patients, (b) to describe typologies of suffering behaviors, and (c) to define effective strategies that help patients get through suffering experiences. 
Research Questions 
The study posed seven research questions: 
I. What characteristics do clients ascribe to suffering? 
2 Can patterns of suffering behaviors be identified as personal responses in clients who experience chronic and/ or repetitive suffering? 
3. 
Can typologies ofsuffering behaviors be identified as personal responses in clients who are experiencing suffering? 

4. 
Do clients find meaning in suffering experiences which enhance their understanding of life and furnish opportunities for self-actualization and/or self-transcendence? 

5. 
What cultural values and beliefs do clients hold to explain the suffering experiences of their lives? 

6. 
What responses do clients use in coping with the burdens of suffering? 

7. 
What strategies of nursing care help clients get through their suffering experiences? 


Assumptions 
The following assumptions were made based on Frankl's theory of Meaning Psychology: 
1. 
One's beliefs about suffering affect ability to cope and influence adaptation in a positive or negative direction. 

2. 
Suffering can offer opportunities to achieve higher levels of understanding about life. 

3. 
Meaning can be found in suffering experiences by the individual undergoing the experience. 

4. 
The role of the nurse includes assisting patients to cope with suffering expenences. 


Study Procedure 
After approval by an institutional human rights board, a staff of nurse researchers ( 17) undertook the study. Training sessions for data collectors were held on informed consent procedures, interviewing techniques, and data recording. The sample consisted of hospitalized clients who had a medical diagnosis describing some type and degree of pathology, whether physical or emotional. Criteria for participation in the study included being mentally clear and able to communicate, currently undergoing a suffering experience as perceived by the client (either acute or chronic), and of age majority according to Alabama law. 
Three instruments were used to collect data. The Demographic Profile, and my own tests, MIST. Part I and Part 2, and the Nurse-Client Interaction Evaluation. Validity and reliability information is available by request. MIST, Part I, consisted of a 20-item instrument which reported the client's perception of the frequency of feelings toward suffering on a seven-point Lickert scale (see Figure I). The purpose of MIST is to ascertain the clients' perception of the extent to which they found meaning in suffering experiences. 
MIST, Part 2, asked for client verbalization to describe the suffering experience, coping mechanism, and experiences of others known to the client (see Figure 2). 
The third instrument, the Nurse-Client Interaction Evaluation (see Figure 3) asked for the client's like or dislike for discussing personal suffering experiences with a nurse on a nine-point Lickert scale. 
Findings 
Demographic Profile. Demographic analysis revealed that the ages of the clients ranged from 26 to 86 years; the mean was 58.86 years. The largest percentage (66.3 per cent) was males; however, it should be noted that two hospitals where data were collected were veterans hospitals where males predominate. The percentage of black clients was 31.9 per cent contrasted with the state population of 26.6 per cent blacks ( 1980 census). Most of the clients were married (52.1 per cent) and most listed their religious preference as "Protestant" 
(87. 9 per cent). Consistent with state norms, the level of education for most of the clients was nine to twelve grades. Most of the clients lived in rural or semi-urban areas (70.2 per cent); most were "non-working" (74.5 per cent); and most earned $12,000 or less per year (68.8 per cent). (Other details of demographic data are available in the full report.) 
The three most frequent diagnoses were: (a) psychiatric (21.5 per cent), 
(b) cardiovascular-medical ( 11.8 per cent), and (c) gastrointestinal ( 10.8 per cent). Within specific categories, it was found that clients with cancer seemed to be more optimistic, while those with medical breathing problems responded as suffering greatly. The clients whose perception ofsuffering without meaning was greatest were those with psychiatric problems; whereas surgical clients (in particular, coronary by-pass surgery) perceived suffering to be most meaningful. 
MIST I 
In analyzing the results of MIST I, it was found that the mean score was 101.48; the standard deviation, 16.72; and the range was from 61 to 140. Statements of beliefs about suffering were rank ordered by strength of belief. The strongest belief was "I believe everyone has a purpose in life; a reason for being on earth." The weakest belief and the only response with a mean on the negative end of the scale was "I believe suffering limits a person's opportunities for true fulfillment." 
The most ambiguous responses were received for Item No. 12 "I believe suffering is a punishment for sin." To this item, 43 responded negatively, 33 responded positively, and 13 were in the neutral category. This item also had the greatest standard deviation. 
The data were also analyzed by subscales of: (a) subjective characteristics of suffering, (b) personal responses to suffering, and (c) meaning of suffering. The findings indicate that individuals do perceive suffering differently. Some of the differences can be attributed to ethnic background, sex, marital status, number of hospitalizations, and chronicity of the medical problem. 
The majority of the subjects interviewed stated that suffering was more indicative ofthe human condition than a punishment for sin. The majority ofthe subjects responded that they believed unavoidable suffering was beneficial. More specifically, they believed that such suffering helped them understand life better. They also thought that individuals varied in the amount of suffering that each could tolerate. 
The majority of individuals interviewed believed that suffering had meaning. Few were willing to admit that they were victims offate. Most subjects believed that some good things came from their suffering and they had learned valuable lessons. 
MIST II 
The first question in MIST II asked the client to choose a number I to 10 which best represented the degree of his/her suffering (I =minimum, 10 = 
maximum). The mean response was 6.4 indicating a high degree of suffering. This finding substantiates Frankl's view that suffering is like gas in a chamber; no matter how great or small, suffering tends to completely fill the human soul. 
The responses to MIST II, Questions 2 through 16 were transferred to a master sheet and reviewed for patterns. Answers were categori1ed according to Frankl's three ways of experiencing meaning in life events: (a) task or missions values, (b) experiential values, and (c) attitudinal values. Findings for one question are summarized as follows: 
What do you generally do when you experience suffering in order to cope with it? 
Task 
Talk to relatives/friends; Pray, attend church, read Bible, praise the Lord, ask for strength from Lord to overcome it; Go to hospital; Call doctor; Seek help from nurses; Take medicine; Watch TV; Read; Sleep/walk/rock; Drink beer; Grunt/ cry/ fuss; Stay busy mentally & physically; Sew; Dress-up; Get away; Get in bed or on sofa; Do something exciting; Do something for someone else; Try everything. 
Experience 
Try to bear it-suffer with it; Talk to Lord; Listen to music; Get still/quiet/withdraw; Get weak and do nothing; Fantasize about tomorrow; Understand God is real and near and will help me; Remain calm and alone; Take it easy, don't he pressured; Wait it out; Try to relax; Sit down & compose self. 
Attitude 
Try to see good in it; Try to reach within self; Think and pray; Think about blessings; Talk to self to encourage; Look on positive side; Mind over body practice; Remember that it will be short lived & that other people have pain; Take an interest in others; Pray the Lord's will be done; "Grin & hear it"; Concentrate on something else; Try & control self; Think about past; Think of suicide. 
(Responses to all questions may be found in the full report.) 
Nurse-Client Interaction 
Clients were asked to anonymously complete a one-page questionnaire in order to evaluate to what extent the client enjoyed or was upset by discussing personal suffering experiences. The findings validate that clients had a positive or favorable reaction to discussing the suffering experiences in their lives and did not feel that their privacy was being invaded. This finding should help to dispel the myth that discussing suffering with a client will surely trigger a depression response, a fear that prevents many nurses in traditional practice from meeting the needs of clients who are suffering. 
Conclusions 
The findings of this study suggest a need to continue exploring ways for helping professionals to dialog with clients about their suffering experiences. A recommendation is made for further research to refine and improve the knowledge base ofsuffering within a conceptual framework ofcaring and compassion. 
PATRICIA L. STARCK, R.N., D.S.N, is Dean and Professor of Nursing, Troy State University, Troy, Alahama 36082. Afu/1 copy (~lthe report, including M /ST I and M /ST II, is availahlefor $6.00. Checks should he made out to Troy State Universitr. 
Figure 1: MIST (Meaning in Suffering Test) Part 1 
Instructions: Please choose a number which best represents thefrequency of your feelings about each of the following statements. Try to avoid neutral (4) by choosing either a 3 or 5 whenever possible. Before you begin this test, fix in your mind the suffering which you believe you have experienced and how you feel about it at this time.* 
I. I believe I have the spiritual help (not necessarily religious) to overcome the burdens of my suffering. 
2 3 4 5 6 7 Never Rarely Occasionally Sometimes Often Very Often Constantly 
2. 
I believe suffering causes a person to find new and more worthwhile life goals. 

3. 
I believe I understand life better because ofthe suffering I have experienced. 

4. 
I believe success in dealing with suffering depends upon a person's attitude about the situation. 

5. 
I believe suffering limits a person's opportunities for true fulfillment. 

6. 
I believe everyone has a purpose in life; a reason for being on earth. 

7. 
I believe life has been unfair to me because I am a victim of fate. 

8. 
I believe there is always hope in suffering. 

9. 
I believe suffering can teach valuable lessons about life. 


IO. I believe my suffering experiences have a pattern which recurs despite my efforts to change my life. 
11. 
I believe my suffering is part ofa grand design even though I may not always understand it. 

12. 
I believe suffering is a punishment for sin. 

13. 
I believe my suffering experience has given me a chance to complete my mission in life. 

14. 
I believe some good things have occurred as a result of my suffering. I5. I believe people differ in the amount of suffering that they can bear. 


16. 
I believe people are not given more suffering than they can bear. 

17. 
I believe my suffering has given my loved ones a chance to become more fulfilled. 

18. 
I believe suffering occurs if a person is unlucky and fate has been unkind. 

19. 
I believe suffering is part of the human condition and comes to everyone sooner or later. 

20. 
I believe suffering tests the strength of a person's character. 


Add each answer choice for all 20 questions for a TOTAL SCORE:____ 
Divide total score by 20 for a MEAN SCORE:____ 
*The following scoring scale ( 1-7) is used for each question. but is shown here only once. 
Figure 2: MIST (Meaning in Suffering Test) Part 2 
I. On a scale from 1-10, how would you rate your suffering experiences? (I-minimum suffering, I0-maximum suffering). 
2. 
What do you think suffering teaches, if anything? (Name 3 if possible) 

3. 
What do you generally do when you experience suffering in order to cope with it? 

4. 
What, if anything, helps you get through the suffering? (Name at least 3 things) 

5. 
What "good" or positive aspects resulted from your suffering? (Name 3 if possible) 

6. 
What "bad" or negative aspects resulted from your suffering? (Name 3 if possible) 

7. 
How has your suffering affected your body, mind, and spirit? (Name 3 ways, if possible) 

8. 
Name 3 people who you think have suffered and describe the suffering experience 

9. 
What characteristics would you ascribe to suffering? (Give 3 words to describe how you feel when you are suffering) 

10. 
What are your values and beliefs regarding suffering? (Name at least 3 mottos such as (a) eat, drink, and be merry, (b) and this too shall pass, (c) into each life a little rain must fall, etc.) 

11. 
What resources do you use to cope with your suffering? (Name at least 3, such as family, friends, drugs, activities) 

12. 
What action by the nurse or other helping professional helps when you are suffering? (Name at least 3 actions) 

13. 
Please describe what you feel to be your purpose in life. 

14. 
Does this suffering experience affect your ability to complete your purpose in life? 

15. 
Are you able to do worthwhile deeds for others even though you are suffering? (If yes, name at least 3) 

16. 
What is your behavior like when you are undergoing suffering? (Name at least 3) 

17. 
Religious preference ( optional): __Catholic _protestant ___________None Other, please specify _____________________ 


Copyright pendinf!,, Swrck, 1981 
Figure 3: Nurse-Client Interaction Evaluation 
Please indicate the extent to which you agree or disagree with each of the following statements by circling the correct number. The purpose ofthis form is to help the nurse improve care for patients who have suffering experiences. Your frank and candid responses will be appreciated. 
KEY:* 
I agree very strongly 6 disagree slightly 2 agree strongly 7 disagree somewhat 3 agree somewhat 8 disagree strongly 4 agree slightly 9 disagree very strongly 5 neither agree nor disagree 
I. I have enjoyed the experience of discussing the suffering experiences in my life. 
2 3 4 5 6 7 8 9 
2. 
It has been upsetting to me to discuss the suffering experiences in my life. 

3. 
I have felt a sense of personal involvement between myself and the nurse who questioned me about my suffering. 

4. 
I have felt that the nurse was invading my private life in a way that made me uncomfortable when talking about my suffering. 

5. 
I believe that my condition gives me opportunity to find new meaning and purpose in life. 

6. 
Talking to the nurse about my suffering has caused me to re-experience grief. 

7. 
I am glad to participate in this research project in order to help others. 


To be completed by Nurse Researcher Total Score__ Mean Score__ 
*The scoring scale ( 1-9) is used for each question. but is shown here only once. 
A College Test of Logotherapeutic Concepts 
Ernest J. Nackord, Jr. as told to Joseph Fabry 
Four concepts developed by Viktor Frankl were tested in the City College of San Francisco whose student body as a whole represents a microcosm of San Francisco in ethnic composition, religions, and economic status. 
The tests compared two groups ofstudents. Group A came from a graduating class ofstudents in the registered-nursing program, all high scholastic achievers, many ofthem honor students. Group B was taken from a low-performance class of students who were given remedial assistance. 
The two groups had the following composition: 
Group A (high achievers): Total number 43: 8 males (19%) and 35 females (81 %). Racial composition: 65% white, 35% non-white. Median age for males: 27 years, ranging from 25 to 39. Median age for females: 28 years, ranging from 24 to 42. 
Group B (low achievers): Total number 52: 22 males (42%) and 30 females (58%). Racial composition: essentially non-white. Median age for males: 19 years, ranging from 18 to 24. Median age for females: 19 years, ranging from 18 to 36. 
PIL Test 
The first test investigated Frankl's contention that there is a correlation between scholastic performance and meaning orientation. As an instrument to measure meaning orientation the Purpose in Life (PIL) test by Crumbaugh and Maholick2 was used. The PIL questionnaire consists of 20 items to be rated on a seven-point scale. In each item, position four is designated as "neutral," and different descriptive terms are given for positions one and seven. Position one indicates a low purpose in life, position seven a high one. Subjects are asked to mark one position for each item, and add the score. The 20 items arc as follows: 
I. I am usually: (I) completely bored (7) exuberant, enthusiastic 
2. 
Life to me seems: ( I) completely routine (7) always exciting 

3. 
In life I have: ( I) no goals or aims at all (7) very clear goals and aims 

4. 
My personal existence is: ( I) utterly meaningless. without (7) very purposeful and purpose meaningful 

5. 
Every day is: (I) exactly the same (7) constantly new and different 

6. 
If I could choose, I would: (I) prefer never to have been (7) like nine more lives just like born this one 


7. After retiring. I would:  (I) loaf completely the rest of  (7) do some of the exciting  
my life  things I've always wanted to  
8. In achieYing life goals I  (I) made no progress  (7) progressed to complete  
haYe:  fulfillment  
9. My life is:  (I) empty. filled only with  (7) running over with exciting  
despair  good things  
10. If I sh,rnld die today. I  (I) completely worthless  (7) very worthwhile  
would feel that my life has  
been:  
11. In thinking of my life I:  ( I) often wonder why I exist  (7) always see a reason for my  
being here  
12. As I view the world in  (I) completely confuses me  (7) fits meaningfully with my  
relation to my life. the  life  
world:  
13.Iama:  (I) very irresponsible person  (7) very responsible person  
14. Concerning man's freedom  (I) completely bound by limi (7) absolutely free to make all  
to make his own choices,  tations of heredity and  life choices  
I believe man is:  environment  
15. With regard to death, I am:  (I) unprepared and frightened  (7) prepared and unafraid  
16. With regard to suicide. I  ( I) thought of it seriously as a  (7) never given it a second  
have:  way out  thought  
17. I regard my ability to find  (I) practically none  (7) very great  
a meaning, a purpose, or  
mission in life as:  
18. My life is:  (I) out of my hands and con (7) in my hands and I am in  
trolled by external factors  control of it  
I9. Facing my daily tasks is:  ( I) a painful and boring  (7) a source of pleasure and  
experience  satisfaction  
20. I have discovered:  (I) no mission or purpose in  (7) clear-cut goals and a satis 
lifc  tying life purpose  

Crumbaugh's testing of 1,151 cases showed a mean score of 102 (out of a possible 140), with a percentile of 49-5 I. He established that a score of 92 and below indicated a lack of purpose and meaning; 92-112 an indecisive range; and 112 and above a definite purpose and meaning. 
The high-achievement group scored above average (5 or higher) on all 20 items, while the low achievers scored below average (3 and below) on all 20 items. The average score for the high achievers was 124.4, more than 12 points higher than the score indicating a definite purpose and meaning in life. This works out to an 88 percentile. On the other hand, the average score for the low achievers was 74.9, or 17 points below the score indicating a lack of purpose and meaning. The percentile was 7. 
These results -that 88% of the high achievers, and only 7% of the low achievers, had found meaning and purpose in life --confirmed Frankl\ contention ofa correlation between meaning orientation and scholastic achievement. It also seems to support Frankl's advice that "in an age of the existential vacuum, the foremost task of education, instead of being satisfied with transmitting tradition and knowledge, is to define our capacity which allows man to find unique meaning. "4 The importance of logotherapy's role in education induced the Second World Congress of Logotherapy, in April 1982, to select "Education for Responsibility" as its theme. Yet, a survey of 1500 American universities and colleges revealed that only 57 used logotherapy in some form.7 
The greatest differentials between the high-and the low-achieving groups concerned responsibleness, future-orientation, a personal feeling of meaning (PIL questions 13, 7, and 4). In rating themselves as responsible or irresponsible persons, the high achievers assessed themselves 4.6 points (out of a possible 7 points) higher in responsibility than the low-achievers. Almost as high (4.5 points) was the difference in their projection into the future -looking forward to loafing as against doing exciting things. Also high (4.1 points) was the variance in their views on whether their personal existence was meaningful or meaningless. 
These results seem to indicate that students who see themselves as irresponsible, have little to look forward to, and see no personal meaning, are also poor scholastic achievers. This does not necessarily mean that their lack of responsibility, future orientation, and meaning is a cause of their poor performance, or vice versa, but they seem to be caught in a vicious circle that needs to be broken, and the means toward breaking it would be an "education for responsibility," and an emphasis on goals and meanings. 
The smallest variance between the two groups was scored for items 15, 12, and 
11. Although here, too, the high achievers scored above average, and the low achievers below average, the differential was only two points or less. This seems to allow a cautious optimism that the circle can be broken. The young people are not too concerned with death (item 15) nor even with suicide (item 16), where the difference was just above 2 points. Although they see little personal meaning at the present time, they are more optimistic about their reason for being here and their place in the world. The logotherapeutic approach would be to build on their feeling of general meaningfulness to help them see meanings in their own lives. 
Checking "Collective Neurosis" 
The second logotherapeutic concept tested at the City College of San Francisco was that of collective neuroses, or pseudoneuroses, which tend to undermine the search for meaning. Frankl describes the four symptoms as follows: 3 
1. 
A planless, day-by-day attitude which says there is no point in wasting our life searching for meaning because we have to die anyway, and perhaps soon in an atomic holocaust. 

2. 
A fatalistic attitude that maintains it is impossible to find meaning because we are completely determined by such forces as fate, genes, unconscious drives, our past environment, or economic conditions. 

3. 
Collective thinking which prevents us from looking for personal meanings and prompts us to accept the values of our society. 

4. 
Fanaticism which forces meanings on us. 


The following table lists the questions asked of the two groups, and their answers. 
1. Do you consider it worthwhile to act since, after all, we shall be killed by the atom bomb one day? 
YES(%) NO(%) YES(%) NO(%) 
High achievers 90 IO Low achievers 78 22 
2. 
Do you believe we are playthings of outer and inner forces and powers and have no control over our destiny? 

3. 
Do you think it is best to usually make oneself inconspicuous? 


High achievers 29 71 Low achievers 40 60 
YES(o/c) NO(%) YES(o/c) NO(o/c) High achievers 29 71 Low achievers 34 66 
4. Do you believe that someone who has the best of intentions toward others is justified in using whatever means he considers appropriate to achieve his particular 
aim? 
High achievers 12 88 Low achievers 42 58 
The results of this test contradict Frankl's finding6 that the vast majority of college students today have at least two of the four collective neuroses. Although there was some difference between high and low achievers, neither group showed a majority vote on a meaning-killing day-by-day attitude, fatalism, conformity, or fanaticism. The difference in the findings of Frankl in Europe and those in San Francisco may be cultural: America's young people may have retained something of the indomitable frontier spirit of their forebears who believed in overcoming obstacles by their own efforts, and also retained their distaste for conformity and fanaticism. There was little difference between the two groups on conformity. The greatest variance showed up in the attitude of planless, day-by-day living. Compared to the low achievers, the high achievers rejected planlessness by more than 2 to I. 
Meanings and Values 
The last two tests compared the reaction to two of Frankl's main concepts: the motivating force of the will to meaning, as contrasted with the will to pleasure and the will to power; and a comparison in importance of the three values -creative, experiential, and attitudinal. 
The participants were asked to list their first, second, and third choices of what they considered to be their strongest "will to" in life. The results were as follows: 
The will to have a life of pleasure (Will to pleasure) 
Choices(%) 
First Second Third 
High achievers 17 66 17 
Low achievers 31 51 18 
The will to have a life of power or status (Will to power) 
High achievers 2 27 71 
Low achievers II 21 68 
The will to have a life of meaning and purpose (Will to meaning) 
High achievers 83 7 IO Low achievers 64 28 8 
Although both groups rated their will to meaning highest, the high achieving group scored meaning as the motivating force four times as high as the will to pleasure and power combined, while for the low achiever the will to meaning was only 50% more motivating than the other two combined. For both groups the will to power was lowest, hut for the high achievers it was almost nonexistent. This at least was the judgment of the graduating nursing students who, as part of the helping professions, are not looking for power and status but for meaningful activity. This aspect was also brought out in the fourth test which compared the preferences ofthe two groups for Frankl's three values -creative, experiential, and attitudinal. 
Again the participants were asked to rate, as first, second, and third choices, the values which they considered of foremost importance in their own personal lives. Here are the results: 
How do you rate the importance ofyour job, vocation, hobbies. etc., in other words, what you do for or give to the world'' (Creative values) 
Choices(%} 
First Second Third High achievers 46 44 10 Low achievers 45 38 17 
How do you rate the importance ofenjoying a movie, going for a walk. music, sports, etc.. in other words, what the world gives you? (Experiential values) 
High achievers 23 45 32 Low achievers 31 40 29 
How do you rate the importance of your freedom to choose your attitude, your response toward whatever fate life hands you: this includes pain. suffering, guilt, etc. (Attitudinal values) 
High achievers 31 12 57 Los achievers 23 23 54 
There was no significant difference between the two groups, especially if one combines the first and second choices, and compares them with the third choice: 
Creative values: 90: IO for high achievers, 83: 17 for low achievers. Experiential values: 68:32 for high achievers, 71 :29 for low achievers. Attitudinal values: 43:57 for high achievers, 46:54 for low achievers. 
The greatest difference occurs in the creative values. This class of graduating registered nurses was highly motivated to find their meaning in their profession: 83% placed the will to meaning as a first choice, and 90% made creative values (their work) first or second choice. This may explain the high rate of burnout I have noted among nursing graduates. They often come back to the college to study for another career. They complain about having been restricted in their nursing career to regulated duties and routine activities that leave them no time for self-transcending patient care on a human level. Often the most sensitive individuals drop out of the nursing profession because of meaning frustration and inappropriate attitudinal values. 
Two lessons can be drawn from the figures in our survey: one lesson, for the nurses themselves, would be not to put all their hopes for meaning in their work, but to give attention to the meaning possibilities of experiential, and especially attitudinal values. Thus, they will have something to fall back on when their work turns out to be not as meaningful as they expected. The second lesson is for the administrators of hospitals and nursing homes. Time should be left for personal consolation of patients, for a human sharing and caring that often is discouraged in the busy day of hospital work. In either case the application of logotherapeutic principles can be useful. 
Our figures show that what is true for the nursing profession is also true, to a slightly lesser degree, of all students. In the remedial group, too, creative values scored high and attitudinal values low. Most students leave college and join the work force with high expectations to find meaning in their work, and sooner or later are disappointed. The problem ofjob burnout is widespread and could be alleviated by Frankl's demand that education help students to expand their capacity for finding their own unique and personal meanings. The problem could also be alleviated by a new approach by management that stresses values and meaning in the work situation. 1• x. 9-10 
In my work as school counselor I have found Viktor Frankl's books valuable tools for helping students gain new perspectives in their lives, focusing their attention on goals, meanings, and responsibleness. I also found that his books are not easy to read, especially the most useful ones, The Doctor and the Sou/3 and The Unconscious God. 5 I have made 20-page notes from these books, and also three-page outlines of my notes. I first give the short outline to those students I think will benefit from learning about logotherapeutic principles. When they respond favorably I give them the 20-page notes, and eventually, if they are interested, I recommend that they read the book itself. I believe that the results of our tests indicate that exposure to logotherapeutic ideas will improve student performance in the college and also later in life. 
ERNESTJ. NA CKORD, Jr., Ph.D., is a counselor at the City College ofSan Francisco and a psychologist in private practice. 
REFERENCES 
I. Biickmann. Walter. Sinn-orientierte Leistungsmutivatiun uncl Mitarheite1juhrung. Stuttgart. Enke Verlag, 1980. 
2. 
Crumbaugh. James C. and Leonard T. Maholick. The Purpose in Life Test. Psychometric Affiliates. Box 3167, Munster. IN 46321. 

3. 
Frankl. Viktor E. The Doctor and the Soul. New York, Vintage Books. 1977, p. XVI. 


4. 
___ The Will to Meaning. New York. New American Library. 1976. p. 64. 

5. 
___ The Unconscious God. New York. Simon and Schuster, 1978. 


6. 
___ Aychotherapy and Exisrentialism. New York, Touchstone paperback, 1975. pp. 120-121. 

7. 
Hirsch. B. and V. Lieban Kalmar. "Logotherapy in U.S. Universities: A Survey" in The /nterna1ional Forum for /.ogotherapr. 5 (2), !03-105. 


8. Humberger, Frank E. "The Executive in an Age of Alienation," in The International Forum for Lugotherapy, 4 (I). 35-44. 
9. Phillips. Oliver A. "New Course in Management," in Logotherapr in Action, Fabry et al., eds. New York, Jason Aronson, 1979. Distributed through the Institute of Logotherapy. 2000 Dwight Way. Berkeley, CA 94704. 
IO. Sargent, George A. 'The Work Situation," in Logutherap1· in Action. Fabry et al.. eds. New York, Jason Aronson, 1979. Distributed through the Institute of Logotherapy, 2000 Dwight Way, Berkeley, CA 94704. 
The International Forum for 
LOGOTHERAPY 
JOURNAL OF SEARCH FOR MEANING