SOURCE_DOCUMENTS/journal_014_1.txt

Volume 14, Number 1 Spring 1991 
CONTENTS 
Logotherapy on Hysteria ....................................................... 6 Elisabeth Lukas 
Multiple Personality Disorder and Logotherapy ...... 11 R.R.Hutzell, T. Gonzalez-Forestier, and M. Eggert Jerkins 
Meaning in Women's Lives ................................................. 2 2 Mary Alice Nicholson Logotherapy and the Disabled......................................... 2 6 Martha K. Stavros Social Conscience in Logotherapy ................................. 3 2 Robert F. Massey Alcoholics Anonymous as Group Therapy ................. 3 6 Robert M. Holmes "Stress Management" for Teachers ............................... 4 2 Bianca Z. Hirsch Lessons from Two Children ............................................. 4 6 Harald Mori Self-Transcendence in Marital Therapy ..................... 5 0 Jim Lantz and Karen Harper Assisting Caregivers of Alzheimer's Victims ........ 5 3 Joseph Graca and Dale Archer 
Index ........................................................................................... 5 8 
Book Review ............................................................................ 6 2 
Meaning-Centered Family Therapy 
Elisabeth Lukas 
How logotherapy Works 
Logotherapy is meaning-oriented psychotherapy. Its basic idea is that meaning fulfillment in life is the best protection against emotional instability and the best guarantee for psychological health. 
Meaning is transsubjective. That means, we cannot decide arbitrarily what is meaningful to us in a given situation. We only can discover the meaning inherent in a situation. We are like archeologists studying hieroglyphs, deciphering, decoding, discovering. Logotherapy is a discovering, not an uncovering psychotherapy. 
The best means for this discovery is our conscience whose antenna is directed toward meaning as a Geiger counter is directed toward radiation. Logotherapy tries to strengthen personal conscience (which is not identical with the superego or traditional morality) and to motivate people to listen to, and follow, this inner, intuitive voice. 
In therapy, the patient wants to reach a state of health but there is an obstacle (depression, fear, psychosomatic illness, and others). Traditional psychotherapy focuses on the obstacle, tries to understand its causes, and reduce it to size. Logotherapy focuses on a meaningful goal (logos) beyond the obstacle, and motivates the patient to jump over it in pursuit of meaningful goals. 

•Let's look at the jump (overcoming the obstacle to reach a meaningful goal): Patients face the obstacle like a person standing on a diving board afraid to jump. Such people have three choices they can wait until the fear goes away-this is hopeless. They can climb down, capitulate, and flee -this results in illness. Or they can jump in spite of their fear, using the defiant power of their human spirit. and get well. 
When they choose to jump, they do not receive an immediate reward and relief. Instead, exactly what they feared happens: they go down to the bottom of the water. Only then do they experience something wonderful: they are buoyed up again! They are lifted up, the water is carrying them. The jump has freed them to become healthy. 
The same often happens in life· we decide to do something meaningful despite obstacles of fear, pessimism, despair, or anger. We jump over the obstacles to reach a goal or. to change the metaphor, we enter a tunnel until we see light again. We go through addiction, anxiety neuroses, suffering, family crises. But in the end the light bums brighter than ever before. 
•Let's 
look at the aim of the Jump (the "what for"): Not every aim is meaningful. A jump from firm ground into the unknown can be fatal. We have to read the signs: we cannot determine meaningful aims arbitrarily. In family crises a meaningful goal is not what is of advantage of one member but what serves the whole family. The meaningful goal for each member is what decreases suffering and increases hope for the entire family. 

•Let's 
look at the human being: Within systemic family therapy the individual is seen as a function of the system. Within logotherapy, the individual is seen as a unique person who acts, not merely reacts or acts out The person is tree to act, even if a certain way of acting is difficult or not pleasurable. The action can be chosen willingly; what cannot be chosen willingly is the meaningfulness of the action. The family member is able to decide to jump or not to jump. If the family system is bad (unhealthy models. reinforcement of notjumping, no assistance) the jump is difficult but the person still has the freedom to dare it 


Logotherapy's message to the human being is twofold: It shows the freedom to act which It helps to find the meaningexists under all circumstances ful goal of a certain action 
The "I could" The "I should" 
The "I could" and the "I should" add up to the person's responsibility to act in a meaningful way. Logotherapy, in this manner, strengthens the person's voice of the conscience. 

You are free to jump despite This meaningful goal needs your all obstacles, fears, diffulties jump, is calling you, is important 
Logotherapists keep patients from brooding about obstacles by helping them dereflect from their difficulties and by showing them their inner power and abilities. At the same time, logotherapists show patients the importance and necessity of devoting their power to something valuable in the world. 
;The (hidden) ability of / \trhe (hidden) value of somettiingl' 
!the subject (the patient) ~ ti transsubjective {the JogosL __ _ 
This produces an arc of tension between the patient and the logos (meaning), and this tension serves as additional motivation to jump into meaningful actions (go through the tunnel and arrive in the light). 
Model for Couples Counseling 
A couple describes a conflict situation they have gone through without solution. Both partners are sad or angry about the event, and deeply hurt. 
Example: They had a serious quarrel one evening last week and have not spoken to each other since. 
Step I 
The counselor asks the man: "What do you think was the actual element that upset your wife? What bothered her, what made her sad?" 
The man: "I think she didn't like me coming home later than she had expected. She hates waiting for me." 
The counselor asks the woman: "What do you think was the actual element that upset your husband? What made him so angry, what hurt him in his innermost being?" 
The woman: "I don't know. He suddenly shouted at me." 
The counselor insists on an answer: "Look, what we do is like a guessing game. Try to guess what the essential problem was for your husband in this conflict." 
The woman: "During the quarrel I said that he was never punctual and reliable, not even when he was young, and 
that something was wrong with his character. Perhaps this 
offended him because he once did a silly thing in his early days 
and doesn't want to be reminded of it again and again." 
The counselor asks a check-question of both: "Is it correct what your partner presupposed? Did he or she guess the element of your pain?" 
If one or both fail to agree, they can correct the presumption which is an important piece of information for the other. 
Example: The man agrees but the woman says: "My problem was not really that my husband came home later than promised. I understand that he sometimes cannot stop his work and leave it unfinished for the next day. What upsets me is the way he comes home. When he is tired, it is like I am not even there. He doesn't notice me. He mumbles a short greeting and hides in his room. I am a nobody to him." 
After correction, or if both agree, Step II is initiated. 
Step II 
The counselor asks the man: ~,n a similar situation, do you see any possibiliy to prevent your wife from getting so upset? Can you imagine any little change in your behavior that would help your wife endure the situation better?" 
The man: "Well, before going to my room I could sit down with her for a few minutes and explain why I was late and what has gone on in the office." 
The counselor asks the woman: "Do you see any possibility to prevent your husband from becoming so upset in a similar situation? Do you have any idea what, if you change, would make it easier for him to get through the situation without such strong negative emotionsr 
The woman: "The only thing l can do is to let the past be past and avoid accusations about former times. If I blame him, it should be for present reasons without connections to old stories and his faults of yesteryears." 
The counseior asks the check•question of both: "Would the change of behavior your partner rnent1oned really alleviate your conflict and bring relief to you? Would it indeed help you in similar critical situations?" 
If one or both fail to agree. they can describe what instead would help them, but they are not allowed to make greater demands. 
The woman may say "For me, it's not so important that my husband explains, with a lot of excuses, why he is late. A little sign of tenderness, a kiss of the cheek after arriving at home. would be enough." (This is a true correction.) 
The man may say: ''She should not only let my past be 
past but also not attack my parents for bringing me up badly." (These are greater demands.) 
The counselor stops him: "We are speaking now about the possibility of your wife no longer bringing up your past problems. The question was: If she would stop doing it, would this be a relief for you in a present crisis?" 
The man: "Of course it would." 
After correction, or if both agree, Step Ill is initiated. 
Step Ill 
The counselor asks the man: "Are you ready to actualize the possibility you mentioned (or have recognized in our dialogue) and change your behavior in a similar situation? Are you ready to do this regardless of what your wife does, whether she changes or not, whether she thanks you for it or not? Are you ready to do this for the sake of your family? To do it as a contribution to increase hope in your family?" 
The man can say Yes or No. 
Example tor a Yes reply: "All right, if it means so much to her, I shall try to be more attentive and tender after coming home, even if I am tired and my thoughts are still at the office. She is, after all, my wife and deserve my affection." 
Counselor: "And if she again brings up stories of the past, will you then give up your tenderness and attention, or stick with your new line?" 
The man: "That's difficult to say, but I shall try to keep my word. This is no business deal, it's my marriage that is in danger. Yes, I shall try." 
The counselor asks the woman: "Are you also ready to undertake what you offered? Are you also prepared to try in the future what would make life easier for your husband?" 
The woman can say Yes or No. 
Example of a Yes reply: "Deep in my heart I have known tor a long time that nothing is gained by dragging up old mistakes again and again. I do it only when I am angry. But, okay, I won't do it in the future, even when I am angry." 
Counselor: "And in case you are very angry because you feel you're being ignored by your husband, will you then punish him by falling back onto your old habit, or will you stick to your new ways?" 
Woman: "I don't want to promise anything but I shall try my best. I don't want it to be my fault If our home breaks up." 
It both say No during Step 111, the couple counseling has to be given up because there no longer exists a true willingness to save the partnership.But in my many years of practicing this type of meaning-oriented family therapy, this has never happened. It is unlikely that two persons who seek the help of a professional to restore their marriage will refuse every cooperation. Normally, at this point both agree in some way. And if only one says Yes, this may suffice as an impulse toward a healing evolution of the pertnership. 
The counselor asks the check-question of both: "Are you happy about the readiness of your partner to change a little bit? Can you accept the change as genuine, can you trust in this readiness? Are you prepared to be surprised positively by your partner's change in behavior without having to demand it?" 
If one of the partners has problems with answering the check-question, the counselor should not discuss these problems but just respect them and repeat the importance of the fact that every change of the self can be realized without preconditions, whether the partner believes in it or not or whether the partner reinforces the change. 1f the change occurs under these conditions it is a gift, never an act of calculation; it is a small sign of love, no more or less -and that's a lot! 
After the answers to the check-question it is time to end the session and let the couple leave together, making a new appointment within a few weeks. 
The counselor may say: "I congratulate you because you have discovered meaningful goals for you both to develop further, and I wish you success in your endeavor. And don't forget: there won't be immediate positive results. First comes a tunnel to go through, and later, when you have succeeded in passing through this tunnel of bad habits, and old wounds are still bleeding, then perhaps the sun will shine again in your family, and the wounds will close forever." 
Observations from Experience 
My experiences with this questioning scheme have been encouraging. These observations are worth noting: 
•Most 
partners know exactly what the element is that upsets the other, or what changes would make the other one happy. They seldom guess wrong. The problem of marriage conflicts is mostly not lack of information, but of good will. 

•Meaning-centered 
family therapy strengthens in each partner the ability to self-transcend. The family member is not asked what hurts him or her but what hurts the other. The partner Is directed to see the wounds of the other, and at this moment pity and compassion naturally arise. This supports the renewal of good will (the "will to meaning") and the readiness to take action. If instead the family member is asked what hurts him or her, focused is directed on their own wounds. This 


blocks the renewal of good will and the readiness to do something for the other. 
•Often 
the partner's offer of good will is regarded as too small, and more is demanded. The counselor should not give in at this point. At the center of meaning-oriented family therapy are not the demands on the other but the vision of improved behavior demanded from oneself -demands for no other purpose but to save the partnership, which is a high value. 

•Even 
if only one partner changes behavior in a meaningful way, the hope for the whole family increases. I have had cases when one partner was not ready to change for the sake of the other, but the other was ready to do so. When both came to the next therapy session, however, both had changed. The good will of one shamed the other who, in the end, didn't remain as unmoved as originally stated. We must keep in mind that all work done on oneself to make living together a bit easier for the other is an expression of still-existing love. The moment you receive an expression of love, it touches the heart -and who of us is unreceptive of love? 


As mentioned before, logotherapists help people overcome their inner obstacles by helping them discover meaningful goals and tasks waiting beyond the obstacles. They confront patients with the "I should" and the "I could" to evoke their feeling of responsibility. Guided by the questioning scheme described here, patients discover what their "I should" is within the present family situation, and they are motivated to say Yes to the "I could" and to jump over the inner obstacle. 
As symbolized by the metaphor of the diving board, the first jump is hard. Expressing good will is one thing, but acting upon it without expecting immediate feedback is another. After each jump, a long fall occurs. Patients must be prepared for this. But without jumping into self-responsibility and without some period of uncertainty and loneliness, no new beginning in a partnership is attainable. 
It may happen that one partner jumps, and the other doesn't. It is possible that the partnership cannot be maintained because one partner refuses to contribute at this final stage. It can happen that despite therapeutic assistance separation and divorce are unavoidable. But even then, the one who jumped to rescue the partnership is the one who will emotionally better survive its breakdown. Because once one has jumped (which means, developed further), one will be able to do so again, to overcome new obstacles and, if need be, master life alone. 
Goethe wrote: "Also from stones thrown onto your path something magnificent can be built." Obstacles inside and outside of us are also material to build a monument of dignity. 
Questioning Scheme for Couple Counselong 
Step I 
The couple describes a conflict situation which they have gone through without solution. Counselor: "What do you think was the actual element that upset your partner?" 
Both answer. 
Counselor: "Is it correct what your partner presupposed?" 
If one or both fail to agree, they can correct the presumption. 
Step II 
Counselor: "If a similar situation occurs again, do you see any possibility to prevent your partner from getting so upset?" Both answer. Counselor: "Would this change of behavior your partner mentioned really help you in similar critical situations?" 
If one or both fail to agree, they can describe what instead would help them, but they are not allowed to make greater demands. 
Step Ill 
Counselor: "Are you ready to realize the possibility you mentioned and change your behavior -regardless of what your partner does?" 
Both say Yes or No. 
If only one says Yes, this may be enough to increase hope for the family. 
Counselor: "Are you happy about the readiness of your partner to change him or herself a little bit? Can you accept it as genuine?" 
No discussions anvmore, end of sessions. 
ELISABETH LUKAS, Ph.D., is director of the South German Institute of Logotherapy, FOrstenfeldbruck, Germany. The above article is based on her address at the University of Santa Clara, California, during the Eighth World Congress of Logotherapy. 
If Freud Could Talk With Frankl 
Joseph Fabry 
It has been my good fortune to know personally two giants of this century's psychology: Sigmund Freud, the founder of psychoanalysis, and Viktor Frankl, the founder of the existential school of logotherapy. Although I was never trained in psychology, it is ironic that I had more personal contact with Freud than his fellow psychotherapist Frankl had with Freud. 
Frankl met Freud only once when, as a student, he ran into the famous professor in the streets of Vienna and mustered the courage to address him. Frankl had written letters to Freud and even sent him an article which Freud printed in his journal, but never met him in person. As Frankl tells the story, when they met on the street and Frankl introduced himself, Freud remembered his name and even his address. 
My acquaintance with Freud was of a different nature. He was the uncle of a schoolmate, Harry Freud, who took me occasionally to his aunt's home to have hot chocolate and cake. These visits started when we were 13, and I only knew that Freud was some kind of medical doctor. He was in his late sixties at the time, and sometimes made a brief appearance to have his coffee with the family. He participated in the family chitchat, told jokes (I didn't know he had written a book on the psychology of humor), and struck me as a gentle and polite old man. After a while he would fold his napkin, rise from his chair, bowed slightly toward Harry and me, and say something like, "If the young gentlemen will excuse me, I have some work to do," and disappear through a small door into his consultation room where his famous couch stood. I saw the couch only once, when Freud had his weekly tarock card game with friends (all pioneer analysts, I learned later) and Harry and I chased through the apartment in search of his chow Jopie. 
My first inkling of Freud's importance was when Harry told me that one of his uncle's clients was the King of Rumania (or was it Yugoslavia? Greece?). By that time I knew that Freud was a psychoanalyst but I had only a vague idea what that was, something about straightening out crazy people. My interest was the theater and literature. I was amused, though, that our psychology high-school teacher seemed nervous about having Sigmund Freud's nephew in the class, although Harry didn't know much more about psychology than I. 
I last encountered Professor Freud in London when I helped Harry move furniture in the home his uncle occupied during the last year of his life. Freud made a brief appearance to thank us with a smile -the cancer in his jaw made speaking too painful. 
Viktor Frankl never had Freud as a professor at the university, but was interested in psychoanalysis, became active in Alfred Adler's individual psychology, and eventually founded his own school, logotherapy, which has been called "the third school of Viennese psychotherapy." 
Logotherapy maintains that mental health and stability depend on seeing a meaning in one's life. When I first came across Frankl's book Man's Search for Meaning in 1963, I had been trying for 25 years to make sense of the events of 1938. Frankl's findings confirmed what I had been groping for. Things happen to us, undeserved, unexplainable, unavoidable. There is no point in torturing ourselves trying to find meanings in these meaningless happenings. Meaning can be found through healthy attitudes we take toward these unavoidable events, awareness of what we can learn from them, and how we grow through them. In my case, the cruel blows of Hitlerism, meaningless in themselves, made a man out of a boy, forced me to take charge of my life, accept responsibilities, develop potentials, be more sensitive toward the suffering of others, establish a new family, become bilingual. 
Frankl's emphasis on meaning was useful in a society that was becoming increasingly pleasure-oriented, where people felt frustrated when pleasure escaped them. Frankl maintained that life does not owe us pleasures, it offers us meanings. 
This view of life seemed to contradict Freud's. Freud stressed the "pleasure principle," which considered finding pleasure, including sexual pleasure, our main motivation for living and acting. If repressed, he said, we become neurotic. Frankl spoke of a "will to meaning" as our main motivation. If repressed or ignored, we feel empty, frustrated, in despair. 
The two views seemed to be on a collision course. Frankl himself never expressed the dichotomy this way. Although he had been expelled from Adler's school who previously had been expelled from Freud's school, Frankl always gave Adler and Freud credit for laying the foundation of psychotherapy. Frankl justified his broader outlook by saying modestly that a dwarf standing on the shoulders of giants could see farther than the giants themselves. 
Frankl's followers, however, were less gracious. They saw Frankl's and Freud's views of human nature as contradictory. Freud was a depth psychologist, digging into the deep past of patients to find the causes of their disturbances. Frankl was called a "height" psychologist helping patients reach for meanings and goals, less concerned about deep-rooted causes than about overcoming symptoms. 
Freud died in 1939 when Frankl was working out his meaning-oriented therapy that was to be tested so cruelly in three years of meaningless suffering in German concentration camps. I often pondered what the two men would have to say to each other now. I hoped they would find some common ground. My speculations are influenced by my memory of Freud as the kindly uncle and by my schoomate Harry's comment when I sent him my book on logotherapy and asked him not to consider it an attack on his uncle. "My uncle," he wrote me, "if he were alive today, would not be an orthodox Freudian." 
"Of course I am an orthodox Freudian," Freud says, stirring his coffee with a spoon, as he always did. "But I'm not a fanatic." 
"I list fanaticism as one of the mind states that prevents people from finding meaning." Frankl puts his hands around his cup of coffee. The love of strong coffee is one thing these two Viennese psychiatrists have in common. "Fanatics don't have opinions, the opinions have them. They think of themselves as helpless victims of their opinions. Of course, you are not a fanatic, Professor Freud." 
"Thank you, Professor Frankl." Freud makes one of his tiny, ironic bows toward Frankl. "You say, they think of themselves as helpless victims. Don't you believe that they are? Don't you believe there are forces in us that compel us to do things over which we have no control?" 
"There are these forces, yes," Frankl agrees. "Psychological drives do make us victims, but not helpless victims. We have what I call the defiant power of the human spirit. It is to your credit to have discovered that sickness can originate in the psyche as well as in the body. I have added a third dimension where sickness can originate the human spirit. And this is also the dimension where cures -and prevention -of sicknesses can originate. The spirit is quite different from the psyche. The forces of the psyche drive us to do things, they make us victims. In the dimension of our spirit we are the drivers, we decide whether to be helpless victims, or to rise above our instinctual drives." 
"Psychoanalysis knows we can overcome unconscious forces," Freud nods. "Otherwise, what would be the point of trying to cure a patient? We cure by making conscious what troubles patients in their unconscious. We do not need any spirit to do that. You know I have called religion an illusion." 
That's the cue Frankl responds to quickly. He has made this point many times . "The spirit is not a religious concept," he explains. "Every human being has a spirit, even atheists. It distinguishes us from other animals. It's the essence of our humanness. Other animals also have bodies and drives, but only we have a spirit." 
"And where is this spirit located?" Freud challenges. 
"Where is the psyche located?" Frankl counters. 
"In the unconscious," Freud explains. 
"Well," Frankl speculates, "then perhaps the spirit is located in the conscious. Only humans are conscious of their unconscious. And of their future, including their own death. They're conscious of goals, meanings." 
"Ah, meanings," Freud says. "A hazy concept. Not very scientific. What is meaningful to one person is meaningless to another." 
"Yes," Frankl agrees. "We're all unique. Meanings are not measurable in labs. They cannot be repeated in controlled experiments. They can only be apprehended statistically. You can ask a thousand people, and find that such and such a percentage finds meanings in a certain action or a certain experience. Statistics deal with averages. Our human spirit allows us to go against averages and statistics." 
"Then what is meaning?" Freud insists. 
"A right way to respond to a situation. As I see it, meaning is hidden in every situation we face," says Frankl. "But each person may respond to it in a different way." 
"A baseless assumption," Freud objects. 
"Call it hypothesis if you want to use a scientific term. Even the natural sciences are based on hypotheses." "But they can be checked and proved," Freud points out. "The existence of meaning," says Frankl, "can be proved in the 
living. Logotherapy is an existential psychology. Try to live as if there were no meaning in the universe, no order, as if everything were chance, and see how neurotic you get." 
Freud pulls out a cigar and takes his time lighting it. A thin smile curls his lips as it always did when he thought of a joke. "Neurotic," he muses. "How crazy is a neurotic? This reminds me of the story of the inmate in an insane asylum who walks in the garden and asks the gardener what he's growing. 'Strawberries, ' the gardener says. 'And what are you putting on them?' the inmate inquires. 'Horse manure,' the gardener tells him. 'Funny,' says the inmate. 'I always put whipped cream on my strawberries. But then -I am crazy.'" 
Freud draws heavlly on his cigar when he adds: "I've never had a patient who got neurotic because he was worrying about meaning." 
Frankl looks uncomfortable. "If you will excuse my pointing this out, Professor Freud," he ventures. "When you lived in Vienna, meaning was no problem. People lived In a closed society, everybody had his place, meaning was given from above. Father knew best, and all those father figures -teachers, priests, kings -knew best, too. They had rules, commandments, and laws to tell people what was meaningful. No problem there. The problem was sex. It was repressed and caused neuroses. Today, two generations later, sex is not repressed. Meaning is repressed. Or ignored. Or doubted. We live in an open society, an affluent society. We seek pleasure, riches, power, prestige. Nobody tells us what meaning is. We have many choices and have to find the meaningful choices ourselves. " 
"And how do we do this?" "It's difficult," Frankl admits. "In the last analysis, we have no other way but to listen to our conscience. " "Conscience?" Freud raises an eyebrow. "Another unprovable assumption." "Hypothesis," Frankl corrects. "Of course. you were right, our conscious is greatly determined by societal influences. " 
"The superego," Freud nods. 
"Yes, what you call the superego," Frankl agrees. "We do find meaningful what father figures have found meaningful tor thousands of years. And it mostly still works. But I would maintain that we also have a personal voice within us that enables us to take a stand against the voice of the superego. " 
"But in order to work, we have to make this voice conscious, " Freud points out. "To rescue it from the unconscious." 
"I'm so glad to hear you say this," Frankl responds with enthusiasm. "The unconscious is not merely a hiding place for repressed traumas. You are the discoverer of the unconscious. But, Professor Freud, it I may say so, it always seemed to me your unconscious was a bit narrow. It was full of all the disagreeable things your patients did not want to face consciously. But what I found in my patients was that the unconscious was often more inclusive. It was also a storehouse of agreeable things they had repressed, or neglected, such as their goals and meanings, and also their conscience. " 
Freud looks down at the cigar in his hand. "The unconscious, as I see it," he says thoughtfully, "contains all sorts of repressed memories, good and bad. But I never thought of them in terms of meaning." 
"As I said, Professor Freud, meaning was not a problem in the Vienna of your time. It became a problem in the late thirties. Your student and my teacher, Alfred Adler, excluded me from his society because of my insistence on meaning in therapy. Later he himself wrote a book on the Meaning of Ute." 
"You know," Freud picks up Frankl's thoughts, "it occurs to me that you see human nature in terms of the positive, and I more in terms of problems. The reason, perhaps, Is that I started my observations with very sick patients, severe hysterics." 
"And I started my observations with the unemployed in Vienna, and with high-school students In tear of their final examination. You 
remember: to fail this exam was a serious threat to their career, and too often ended in suicide." "I generalized my view of human nature, drawing conclusions from the sick to the healthy," Freud contemplated. "And many of them suffered childhood abuses they repressed," Frankl agrees. "But that isn't necessarily true for everybody." 
"And you expanded your view of human nature from the hopeless to the general public," Freud continues. "You stressed meaning and hope. That isn't necessarily true for everybody either." 
"I found it to be true even in the most meaningless situation, in the death camps . There I found confirmation for another one of my hypotheses -unprovable assumptions, as you call them -our capacity to take a stand. You lived for 14 years with cancer and pain -isn't that proof of the defiant power of the human spirit?" 
"I suffered pain, yes," nods Freud. "My body suffered. So did my psyche. And I lived with it. But I didn't need any specifically human spirit to endure it. Animals suffer, too." 
"Isn't that a rather reductionistic view of human nature?" Frankl challenges. "Isn't there something more in us than in other animals?" 
"Obviously." Freud is irritated. "Consciousness. Intelligence. Language. Mind. Logical thinking. Awareness of the future. Oh, you know. A whole slew of things." 
"Enough to make room for them in a specifically human dimension. The word "spiritual" Is perhaps unfortunate, especially in English where the term has religious connotations. The German geistig points more toward mind and Intelligence. This may be more acceptable to you. I sometimes call this specifically human dimension the •noetlc," from the Greek word noos, mind. But to my way of thinking, it's more than mind, it includes meaning." 
"Perhaps," shrugs Freud. "But to look for meaning in concentration camps still seems to me a rationalization. And what was the meaning of my cancer?" 
"The cancer had no meaning," Frankl admits. "The meaning was the attitude you took toward It." Frankl also likes to illustrate his points with jokes. "You know the story of the man who went to his rabbi complaining that he was so poor he had to live with his wife and six children in one little room. Eight people in one room! The rabbi told him to take the goat out of the stable and put it into the room with the family, and see him again in a week. In a week the man is desperate. The goat, the crowding, the smell! The rabbi tells him to put the goat back Into the stable and see him again in a week. The man comes back and the rabbi asks him how things are. "Heavenly!" the man beams, "Only we eight people in the room!" 
Freud nods patiently like someone who heard the story before. 
Frankl continues his arguments. "The meaning was in the ways you lived with your pain. You continued living and working, in spite of it. Your life had a purpose, far beyond yourself. You're one of the giants of our time. The world has changed because of your insights. Psychology is now considered one of the great human sciences, as you always wanted it to be. You have changed everything from sexual relations to education and politics. And, if I may say so, you have enabled me to develop my logotherapy. " 
"Oh my," sighs Freud. "But have I made the world healthier? Have you made it more hopeful?" 
"We have helped people a little bit to see the world more as it really is, not the way our fathers and kings and priests told us it should be. We have taken a step toward truth." 
"I hope you're right, Professor Frankl," says Freud. "Helping people see the Truth, with a capital T, is the goal of science." 
"The meaning of science," Frankl corrects, with one of his mischievous winks. 
The two men smile at each other. 
JOSEPH FABRY is founder of the Institute of Logotherapy in Berkeley. author of The Pursuit of Meaning and Guideposts to Meaning, and coeditor of the International Forum for Logotherapy. 
Logotherapy's Place for the Ritually Abused 
Jennifer Ladd 
I am a survivor of ritual abuse, the severe sexual and physical abuse by a cult, usually in the form of ritualistic ceremony. The tortures are so bizarre that non-survivors, including therapists, often disbelieve what ritual abuse survivors tell them. Ironically, this disbelief protects these cults; since survivors are not taken seriously, few people investigate into these odious groups. Also, survivors are usually too scared, due to brainwashing and threats made by cult members, to speak out. 
My parents joined a "branch" of the Satanic cult in New York when I was eight. By the time I left home to go to college, I had completely repressed what had been done to me during my childhood years. I was plagued by low self-esteem, withdrawn, depressed, and suicidal. Consequently, I looked for help in counseling. 
My first breakthrough occurred in my sophomore year with Laurie, a former intern at UCLA's psychological services center. One day, feeling suicidal as usual during that time, I told Laurie that before our session I had been waiting by one of the fountains on campus. I must have spoken affectionately about that fountain because she pointed out that I had a deep ability to appreciate things. No one had ever told me that. When Laurie made me aware of my ability to appreciate I clung to that, literally with my life. I realized that even during the roughest times I could search for something to appreciate and hang onto. Giving attention to the positive in the midst of a negative wasteland would later lead me to see the possible place of logotherapy in the treatment of abused survivors. 
Later the same year I recovered my first memories of incest, though memories of the ritual abuse had not yet surfaced. The memory was triggered on a hot summer day in New York when several men on the street made sexual remarks to and about me. Terrified beyond what the incident merited, I ran home, sat on the floor and wept as for the first time I remembered my father fondling me. My world was caving in; everything seemed chaotic. My next memory came when I was receiving massage therapy from a friend. Being touched around the hips brought back the feeling that my father had done more than fondling. 
The summer before graduation I spent three weeks in Paris. The moment I arrived I felt a freedom I had never experienced in the States. I was starting life over again, ~xperiencing freedom from parents for the first time, speaking a new language, joining a different culture, acquiring both new friends and a sense of my strength. I decided to return to the States, finish my studies, then head back to Paris. 
I stayed in Paris for four years, earning my living with computer work and a French radio show. I found a counselor who helped me remember and work through the incest. I studied flamenco dance, wrote poetry in English and French, and began drawing. I became more and more daring, giving poetry readings and dance performances. I also began to date men and had my first intimate relationship. 
I felt that I had come to terms with the incestual aspects of my childhood, but sensed that there still was something ominous to be uncovered. I returned to the States to do graduate work in psychology at J. F. Kennedy University in Orinda, California. Within a few months I recovered memories of sexual abuse by my mother, brother, and maternal grandparents. But the biggest shock came during an art therapy class where we students were instructed to do our own drawings, sculptures, and sand-tray work. At one particular meeting, I watched in horror and amazement as my hand drew a series of devil's heads. Bit by bit, drawing by drawing, I recovered important information about the ritual abuse. 
Over the next years I regained memories of increasingly painful events. My role in the cult had been that of "breeder." At thirteen, as part of a ceremony, I was raped repeatedly by a man dressed as the devil. The goal was for me to give birth to a child that later actually was sacrificed in the name of Satan. Between the ages of eight and thirteen I had been the victim of various group rapes by men and women in the cult, including my father, mother, and brother. These rapes resulted in my having to undergo two abortions which were performed within the cult. Also, other children and I were forced to hurt each other with whips and lances as cult members watched with delight. After that, my function in the cult was over, but occasional incest by my father continued. 
I sought therapy with a variety of counselors. Some didn't believe me. Most had preconceived notions about what my difficulties "must" be, including that I "must" have a multiple personality because many survivors of ritual abuse do. Still others insisted on my returning again and again to the past to dig into wounds that had already begun healing. 
Logotherapy's Place 
1 first heard about logotherapy through a friend who lent me Viktor Frankl's book Man's Search for Meaning. Frankl's emphasis on life goals and tasks had a huge impact on me, especially since it's easy to lose sight of one's life goals if therapy sessions caver only a person's pain. Frankl wrote of a mother who was about to commit suicide, and how he motivated her to live because her child would need her. Frankl convinced another suicidal person not to give up, because he was the only one who could finish a specialized science book. While not all potential suicides are parents or brilliant scientists, the principle remains the same: to focus on goals, or what I like to think of as "our mission on earth." 
My exposure to logotherapy through books and counseling confirmed and strengthened my will to follow and enjoy my life goaJs. I became aware that some paths to my recovery were based on logophilosophy. Among them are: 
•Emphasizing 
the positive achievements, large or small, and tragedies turned into triumphs. 

•Working 
in the present as well as the past 

•Distinguishing 
between events that cannot be changed and areas where we still have choices. Past abuses clearly cannot be undone -they are events without meaning; but meaningful attitudes can be found toward those cruel and meaningless traumas. We can free ourselves from the areas where we are helpless by giving attention to those we can master. 

•Finding 
meaning not only in changed attitudes toward past events (having learned from my experiences, grown from them, gained insights and understandings) but also in meaningful activities and experiences. Meaningful activities include self-transcending acts, for example using my past traumas to help other ritual abuse survivors. Meaningful experiences include creative activities, awareness of the wonders of nature, and relationships. 

•Finding 
the resources of the human spirit: unique personal meanings and goals, the defiant power of the spirit, and the ability to listen to and follow our innate inner wisdom -all of these help to defeat behavior patterns ingrained by the cult. 


Although many memories of the ritual abuse still elude me and will need to be worked through when they surface, I lead a full and joyous life. 
Marian 
Last year I worked at a halfway house in Oakland with Marian, a ritual abuse survivor only a few years older than I. She spoke incessantly of the tortures to which she had been subjected. The exasperated counselors couldn't handle details of these horrors, which included cannibalism. They frequently told Marian to stop lying. She had a history of temper tantrums, and these were aggravated by the counselors' behavior; the more they told Marian to stop acting out, the more she became infantile and domineering toward other residents. 
The first time I saw Marian, she immediately began to talk about the horrors of her childhood. She was amazed that I listened to her and acknowledged what she had been through. From then on Marian seemed relieved to see me and would give me a hug. She was always calm when we spoke. After several sessions she took me to her room to show me her drawings. She had stunning talent! I told her that she could almost certainly sell her work and encouraged her to continue. When I mentioned her drawings to the other counselors, it became apparent that they knew nothing about them. I realized that I had been privileged to see Marian's art. 
Once. Marian showed me a collage she had made from newspaper clippings. She had included a lot of "evil" things: shocking headlines, photos of dead bodies, words and pictures that had a demonic quality. But with the instinct of a true survivor, she had also added beautiful things, such as flowers, picturesque images, and life•inspiring phrases. Survivors, and perhaps humans in general, have an innate sense of balance. The worse the horrors we go through, the stronger and more beautiful are the images we choose to counteract these horrors. I've seen this over and over. It confirms the incredible ability of the human spirit to overcome the ills done to us. Looking at Marian's collage, I was careful to acknowledge each image of evil. This was to counteract the disbelief to which she was so frequently exposed. My stance was the same as the American dictum of being innocent unless proven guilty. I had no reason not to believe what Marian told me. On the contrary, my experiences had shown me that certain people are capable of any act. 
Marian and I discussed each positive aspect, too, of her collage. She seemed grateful. Over time, I continued to confirm Marian's experiences while focussing on her positive activities and goals. 
I have since stopped working at this halfway house to devote more time to my studies and to take on related part-time 
I have since stopped working at this halfway house to devote more time to my studies and to take on related part-time work. Several months ago I happened to run into Marian. She told me she had moved back into the community, was taking art classes, and lived independently. She seemed in good health and good spirits. 
Ritual abuse is actually fairly frequent. In one Oakland meeting for survivors I have seen 30 participants. A friend who is also a survivor knows of 70 others in the San Francisco East Bay alone. This is not counting ongoing meetings in San Francisco itself. 
JENNIFER LADD, an assumed name, is a graduate student getting her Master's Degree at J. F. Kennedy University, Orinda. She has advised more than 200 therapists on how to work with ritual abuse survivors and continues to consult and counsel survivors of cults. She can be reached for questions and comments at P. 0. Box 4575, Berkeley, CA 94704.. 

Variations on this flower appear over and over In my artwork. It is the physical form of my inner healer. With beauty, grace, and a long root to keep me grounded, this flower signifies clarity and strength which survive trauma. 
Conscience in East Germany 
Wolfgang Grassier 
During the past forty years, citizens of the former East German state often felt conflicts of conscience between their beliefs and the enforced ideology. Many ignored or repressed such conflicts, others succumbed to the manipulation of their consciences. Any ideology tries to manipulate conscience. 
The word "conscience" was not often used in East Germany. The government used it occasionally when speaking of ''true fatherland," "true socialism," or the "true country of workers and peasants." The Church, too, used the word. The confessed Christian followed the call of conscience. And physicians, of course, took the Hypocratic oath. 
The state was the future, everyone had to serve its dictates, it dominated personal conscience. Some Marxist-philosophical papers dealt with conscience, very few with ethics. And those followed the party line. 
East German psychology and psychotherapy did not mention conscience -with few exceptions, as in my own practice. But whether or not one spoke about conscience, its reality and conflicts existed. One may try to repress reality, but it cannot be eliminated. 
The teacher's dilemma 
One example from my neurological practice before the revolt in 1989: Mr. A, an educator of strong Christian faith, was hired to teach biology and history to tenth-graders. He loved teaching but the subject of history was strongly interwoven with Marxist-Leninist ideology which had to be passed on to the students. This resulted in a conflict of conscience in Mr. A, with phobia and depression. Hospitalization, out-patient treatments, medication, and group therapy did not bring relief. 
Soon a second conflict made its appearance: On the one hand Mr. A dreaded confronting himself in school and with his students, feeling that he failed in his beloved profession. He even considered a change of work. On the other hand, he felt responsible toward his students and the prescribed curriculum ("in spite of my Christian conviction cannot believe that everything in Socialism is harmful, I won't give up that easily."). Another consideration was that the goverment did not automatically accept the resignation of teachers. A change of profession, such as quitting teaching, was possible only when supported by a statement from a physician, often a neurologist. This procedure was complex and often humiliating but, if successful, allowed additional payments in the new profession for a limited time. 
Here Mr. A experienced a third confict of conscience : "I would like to resign and start new as agricultural economist -but I don't want to be stigmatized as 'incapable of work' and get some form of pension." In Socratic dialogues Mr. A was helped to find the meaning behind possible decisions. What did he see as more meaningful: To do his 'duty' and pass on to his students a worldview he did not share, leading to ever new conflicts with students and fellow teachers -or quit teaching, even if labeled as "incapable" of teaching and receiving some temporary pension? 
Mr. A chose the second alternative. The main reason was the solution of the first, existential conflict about his worldview. Two years later in his new profession, all symptoms had significantly improved. The first and second conflicts of conscience were solved, the third seemed to be repressed: he liked his work as agricultural economist, the additional payments were regarded negatively but, after all, were needed. 
In the third year a new conflict threatened, imposed by the state: Mr. A was faced with the alternative of remaining an agricultural economist without the additional payments, or returning to teaching with higher pay. The old symptoms returned. The conflict: Teaching a worldview he detested, or lower pay. 
We went through several hours of Socratic dialogue raising Frankl's basic questions of freedom of choice, responsibility for others and to one's own conscience. What had priority: the material and financial, or the call of conscience, self-transcendence, and practice of religious beliefs? Mr. A decided to sacrifice his beloved teaching career and the higher pay. He now is free from symptoms. 
Bibliotherapy 
Mr. B, a lecturer in an engineering college, was highly gifted in his field, talented in many areas, smart, a bit complex and a stickler for principles. He also had studied church leadership. The state did not grant benefits for such studies but rather presented obstacles. Mr. B was convinced that clergymen were especially needed at that time, and therefore did volunteer work in his church. 
In his field as engineering lecturer he was highly appreciated and was even entrusted with special tasks. He was asked to become a member of the Communist party; at the same time the college learned about his church work. Soon his formerly appreciated position became an inferno. The administration subjected him to many petty chicaneries, his mail was controlled, he was frequently called to justify his actions, his professional advancement was blocked, and his colleagues shunned him. Others may have broken under such pressure but his worldview, his family, and his self-confidence sustained him. The salary was not bad but advancement was cut off. 
He developed depressive moods and several vegetative symptoms. He refused psychotherapy in a clinic, convinced it would not help. At that time the district church office asked him to become the pastor of a church. This started the real conflict of conscience. 
He had volunteered in churches before and considered it his task to help with congregational problems, in spite of the difficulties. He had combined his job as engineering teacher with his church work. This was no longer possible. He wanted to help the congregation but saw quitting his position as lecturer as capitulation. 
Mr. B consulted me at a time when I had become familiar with Frankl literature. I was not yet a trained logotherapist. I gave Mr. B several of Frankl's (German) books in which the concept of conscience was thoroughly discussed. Four weeks later he returned the books. He had found the answer to his personal problem for his specific situation. His family understood and supported his decision. He gave up his position as a lecturer, his good state salary, and his pension. He saw the position as pastor in a village that had no pastor as his new life task, although the salary of 800 GOA mark was far below his pay as lecturer, necessitating lowering his living standard drastically. He had heard his conscience call for an "honorable capitulation" and for his new task. He soon became one of the most asked for and busiest pastors in a medium-sized city of East Germany. Understanding Frankl's concept of the essence of humans had significantly helped his decision. It was a cure by Kbibliotherapy." 
The New Germany 
The events of 1989 brought the collapse of the MarxistLeninist ideology, and with it the control and tutelage of the state and its dictatorship. The planned economy was mistrusted and a freemarket economy became a goal. Democratic thoughts and attitudes were to follow quickly. The past few months have demonstrated that this development was to be a slow process. In addition to economic difficulties, many people have problems adjusting themselves to the political turnabout. Insecurity and inner emptiness still prevail.In this situation logotherapy can help people reach out for meanings . 
The power of money and material stability should not be underestimated. Monetary union and German unification, desirable as they were, caused much worry. East Germany wants to achieve Western affluence as quickly as possible. This acceleration proved an illusion. Both Germanys had developed in different directions.The West Germans fear that they will have to contribute too much to the underdeveloped East, and will have to sacrifice their own affluence. But these are merely extraneous considerations. 
East and West Germans will have to meet each other on an "inner'' level. For this to happen, they need conscience, as a "meaning organ," to help people find their true existential values. A simplistic distinction between 'Easterners' and 'Westerners' is not useful. The greater burden will have to be borne by the East Germans who face unpredictable changes in personal and professional conditions. Fears and anxieties of an uncertain future have to be worked through. 
The Question "What For?" 
A case example for the new conditions: Dr. C worked on the staff of a hospital He was married and had three children. The family suffered through all the difficulties of former East Germany. In spite of the stumbling blocks the state placed in the way of all those who strayed from the party line, Dr; C had been admitted to college and received good grades. After graduation, at age 22, he got caught in the gear of East German justice, and barely escaped a prison sentence beause of "student activities Inimical to the state." Immediately afterwards his mother, to whom he was devoted, died. His father had been killed in the war. Now it was up to him to manage his parental home which steadily deteriorated under the conditions of Socialism (low rents, high taxes, little possibility to invest, enforced renting to paroled prisoners, several larcenies). 
His wife worked as economic adviser in a government car company. She carried a twofold burden, at home and at work. The three children had to be guided through the ideologies of the socialistic school system. The family felt like an island in the midst of Socialism. They went their way, didn't care for the ideology, accepted the severe limitations of freedom, and struggled through. A few years ago, Dr. C was forced, because of high taxes and repair bills, to turn over the parental home to the state, without reimbursement. This was an inner as well as a financial burden. 
In 1989 came the turnabout and new enthusiasm. The power of the East Gennan state was broken, Gennany was reunited, democracy and a market economy were in the wings. 
Now new kinds of problems turned up. The hospital where Dr. C worked, was closed because of inefficient management by the former government. He had to open his own practice, at age 48, and borrow money at high interest rates. His wife faced discharge and unemployment as all state-owned companies collapsed. The training place where their oldest daughter studied pharmacy was about to be closed. Another problem: Dr. C wanted to reclaim his parental home in which he still lived and paid rent to the state. From the income of this house, invested in the free market, he intended to pay his debts. But the process of returning the property dragged on, entangled in red tape. Interests on his debts increased steeply. 
Dr. C, who had mastered the difficulties under the previous regime, felt an inner existential distress caused by these external worries. Often he was overwhelmed by thoughts of suicide never before entertained. 
In several Socratic dialogues we discussed Frankl's concept of conscience. Conscience was seen as a "meaning organ" with the task to sniff out the concrete meanings of a concrete situation, here and now. It became evident to Dr. C that his conscience now had a special function: to discover the meanings of the moment in these times of upheaval, challenging him to see meanings behind the new tasks facing him. He came to see conscience as the channel for selftranscendence, and the new situation, with all its burdens, as a challenge to find new creative, experiential, and especially attitudinal values. The voice of conscience, self-transcending, said: "t exist not only for myself, but above all for my family, profession, patients. I share my life with them. Suicide is no solution. As Frankl says, it is not I who asks questions of life, but life asks questions of me and gives me tasks. Therefore my existence cannot be ruined because the new situation gives me new meanings and new tasks to fulfill." These logotherapeutic reflections and an awareness of the suprahuman dimension helped. The external difficulties still existed but the inner person found its anchor. Dr. C discovered personal harmony and stability by trying to find answers to the question of the "what to "live for" in the midst of new challenges and difficulties. 
The Spirit of the New Germany 
The problems of healing the German partition and establishing real unity are to be solved in the dimension of the spirit. Selfinterest and fear provide no basis for freedom. Responsible persons in both parts of Germany will have to help in the renewal process, and the political revolution of East Germany must be worked out by both. 
We know now what dictatorships have done to personal conscience. But democracies and free-market economies also shape the conscience of their people. Excessive rationalism, individualism, and hedoism in the West heavily influence the forming of a great part of our conscience. But behind these parts, shaped by outside influences, lies the "core1' of personal conscience, and it is logotherapy's task to help people find this core and act in accordance with it. 
The future is open, and the developing common German history will not be without problems. The old ideology of East Germany has collapsed, and it will be beneficial if logotherapeutic ideas, with its future-oriented outlook, will enter the vacuum. 
WOLFGANG GRASSLER, M.D., is in private practice in Frankenberg, Saxonia, and vice president of the East German Society of Logotherapy. 
Coping Strategies in Death Camps 
Solveig Cronstrom-Beskow 
People go through "concentration camp" experiences, forced to live under terrifying circumstances without reason or fault. They survive, and even grow in strength, from learning the coping experiences of survivors of Nazi camps. 
Viktor Frankl testifies that, in the death camp, he was able to look at the inner picture of his wife when he needed extra strength. 1 This was decisive for him, together with the hope he always carried that he would somehow be able to meet her again. He had searched for and found a meaning in his life as a prisoner in a death camp. 
To keep up physical and mental strength, he noted something else: the ability to find values in life enabled him to survive despite an inalterable situation. 
The Hungarian-born professor Georg Klein writes about his escape from a train that was to take him and many others to a most likely death: "The most incredible has happened: I have survived. I no longer have to be executed just because I exist I Where are all the others, where is my old and new world, where are my friends, my girlfriend ? Who has survived, when and how can real life begin?"2 
Klein also writes about those who were less lucky. One of them was the head of the Jewish Council in Budapest who had been tortured. "I rushed to him and found him a totally different man. Gone was his will power and his posture ... I urged him. Come with me ... But he didn't have the strength. His strongest argument against my idea was: after what I have been through and what I have seen, I no longer want to live."2 He had lost hope. Others felt the same hopeless apathy. "Life? It wasn't worth a shrug of the shoulders anymore." 
Love, hope, and faith were the basis for survivor strategies. Jean-Frarn;:ois Steiner provides additional illustrations. He managed to escape the concentration camp Treblinka. Afterwards he observed: "These were the kinds of men who died but did not give up on life. While they were being killed they wrote plays for the theater, for themselves, for nothing, to live. Because life, any kind of life, has to be lived, and to live is not to just survive but to laugh, to think, to write. It's not strength that runs out, it's the wish to live."3 
The Wish to Live 
One prisoner is surprised: "He could not understand this irrepressible desire to survive, but he did, against his own will, he felt touched by it as if if had been a force he was not able to master. "3 
Steiner notes what happened in a group of Jewish prisoners: "Morally broken by the preparations they had gone through in the ghetto, they were prepared to do anything for a chance to live. But this wish to live was something more than an instinct of self-preservation . . . for a Jew, to live is more than an expression of the wish to live, it is a duty." 3 The duty contains a meaning. Steiner adds: "A mysterious force made them determined to try to survive to the bitter end." Frankl calls it the defiant power of the human spirit. 
Pass on the Truth 
Those who thought they had not the strength to wait for release, ordered others to survive, to tell their story, or to carry the family name further, to take care of the ones left at home, to live a life in freedom that they themselves would never experience. 
A father told his son: "You shall live and go to our land, the land of Israel. You shall marry there and foster children, my children, the children of my father and grandfather. You shall teach them our religion and to fear God. You shall also tell them how we died so that the world will never forget." 
"God does not exist." the child murmured. 
"Of course, my son," the father answered, his voice filled with love, "but we don't understand Him. Our sins have shut our ears and eyes."3 
The body of this man was not strong enough to survive but his trust never failed. He was confident there was meaning to everything, even if we are not always able to see it. 
The Task to Witness 
The wish to testify to what happened made it possible for Steiner to write the book about Treblinka, to witness what he had experienced. 
Many prisoners felt they were sharing a collective fate. They lived as individuals as well as parts of a unity, an undivided whole that had a specific task -the task of a witness. 
The book about Treblinka gives examples of the difficulties many witnesses had in being believed, even by those they wished to warn. The need to deny that such things could ever happen was strong among those who had not yet seen with their own eyes what was going on. 
Georg Klein was one who did believe. Thanks to a report smuggled to Budapest, he was able to understand the real meaning of the railway transports and where the train was going to take him. 
Many winesses were called liars. If they insisted, they were often shut out from the solidarity of the group. The belief in the good of human beings and the protecting hand of God was so strong that the stories were not taken seriously. 
That their secure life was breaking up was for many unthinkable, particularly for those responsible for children. The rumors about torture and liquidation had no meaning to them. Fulfilling their task at home seemed much more meaningful, so they remained where they were, faithfully trusting in humanity and God until they were collected in one of the daily transports. 
Religion 
Another source from which prisoners got their strength to survive was a firm religious conviction. Steiner tells of an inmate whose "belief was so strong that he saw his experiences as proof of God's interest in His human creatures. The man decided to live, to detect the inner and secret content of this holocaust."3 Religious beliefs took many forms. "According to the mysterious philosophy of life characteristic of some Jews, the real enemy was not Hitler ... it was Death, despair at Life." And, "During the Nazi time, the deed of faith was no longer to die for His sacred name but to honor the first gift He gave us: Life."3 
Just as Frankl was able to visualize the face of his wife so vividly that he gained strength and faith from the inner picture, other prisoners found purpose and meaning through different representations and values, religious or secular. Being right had such a survival value. "My whole idea of politics could be justified only as long as I was right," says Jacob Gemms, president of the Jewish council in Vilna, Lithuania. "Today I am aware of my mistake, and my life no longer has meaning...3 
Helping Others 
Helping others was for some a reason to stay alive. Steiner quotes a prisoner who rejected a suggestion to flee: " I came here with my wife and my children. I will never leave 
Treblinka. There is no place on earth for a person like me. The only way I can give my life a meaning is to help others. "3 
This confirms Frankl's belief that self-transcendence is a strong motivation for discovering meaning in a situation. He defines self-transcendence as reaching out beyond the self to others or to a cause· 1 
Steiner also found reasons to survive on the other end of the spectrum: the wish to get revenge for the injustice done to them or to avenge the death and silence of people they knew. 
Dialogue with Nature 
Being close to nature was a source of support and consolation. "The clock is striking six. The appeal begins. Kalman Tajgman cannot withdraw his eyes from the two old trees where the SS-men are standing, impatiently stamping their feet. .. Speechless witnesses to many tragedies, the trees stretch out their knotty, indifferent and friendly branches... Already long ago Tajgman started an impossible dialogue with them. Initiated into his distress, they always listened with the same majestic gentleness that they still do . . . During the winter they stood there like arrogant, deprived farm foremen, but since spring they seemed to have gained weight and strength, and even got color, a beautiful, dark and deep green. Touched, Tajgman bids them respectfully: 'Farewell, my dear companions, farewell my silent friends, my witnesses who had only eyes to see but no mouths to tell'."3 
Humor and Self-Distancing 
Humor, as well as its more bizarre variant, gallows humor, was an important part of camp life that served survival and kept up courage. Steiner tells us that "a certain kind of humor, a mixture of fantasy and tragic-comic selfirony played an important role." Frankl sees humor as the product of the human capacity of self-distancing, seeing oneself from the outside. In his lectures he often tells of the times when he marched through the mud to a place of forced labor. At this low pont of his life he saw himself lecturing in a well-lit convention hall, filled with people, telling them of the conditions he currently experienced. This self-distancing made his present miserable condition bearable. 1 
Symbols 
In order to grasp something of the concentration camp situation I visited one of these camps, now a museum. Its name is Stutthof, near Gdansk in Poland where many kinds of persons were imprisoned: homosexuals, criminals, Jews, and those who had been conspiring against Hitler. 
In an exhibition case I found items that had been made in secrecy. Hazarding their life, the imprisoned men and women found ways to produce manifestations of bonds which linked them to their past lives. 
For one of them the meaning of life was represented by a pair of children's shoes, recreated in miniature about two centimeters long, made from the straw of her sleeping mattress. Someone was waiting at home! Someone for whose sake it was necessary to survive. 
Another symbol: a hand-drawn card with the Polish eagle proudly bearing its crown the Nazis had stripped off at the beginning of the war, together with a red heart of love. The eagle and the heart break their way through the barbed wire which constitutes the dividing line between those longed for on the outside and themselves on the inside, between freedom and lack of freedom, between life and death. Above, heaven is pale blue and bright. 
Perhaps the strongest is the most religious symbol Christians know: the cross. Alongside a line of crosses: two rosaries made of small pieces of bread, worn and polished by someone's loving hands. 
At the ultimate border of chaos and despair there was faith. Faith in humanity and in God -and Life. There was meaning in staying alive, a meaning to rise above the insulting situation, and find inner pictures, to live -one moment, one day at a time. 
SOLVEIG CRONSTROM-BESKOW is a licensed clinical psychologistlphychotherapist, occupational therapist, active in the field of /ogotherapy in Sweden. She is the author of five books on existential questions, bereavement, and youth in search of identity. She currently lectures and does research on coping strategies. 
REFERENCES 
1. Frankl, Viktor. Man's Search for Meaning. New York, Pocket Books, 1985. 
2. Klein, Georg. I stallet for hem/and (Instead of a homeland), Stockholm, Bonniers, 1984. 
3. Steiner, Jean-Fram;ois. Treblinka. Stockholm, Bonniers, 
1966. 
The Dynamic of Meaning 
Jana Preble 
Logotherapists pass on a boundless gift, a legacy of hope. They help clients see the dynamic of meaning that lives in them regardless of age or circumstances, and invites them to fuller wholeness and new responses to life. 
Why Johnny Can't Read 
Johnny was a third-grade boy who was being passed along in the school system from grade to grade even though he had not learned to read even the simplest words. He was tiny, wiry, excitable, and considered himself impossible. 
My first effort was to get to know him: Who was Johnny? What was important to him? What did he like to do? School was a miserable experience because he could not do well. 
"I'm hopeless," he announced. 
"No way!" I responded with more bravado than I felt. How could I instill hope? I suspected there was really nothing wrong with Johnny that couldn't be cured if he could only be met on his own terms. None of the traditional means had worked. So I asked Johnny to tell me a story about himself in which he did the most exciting things he could think of. 
He made up a spellbinder in which he took his BB gun and set off across the high desert. When he came to the interstate and wanted to get to the other side, he crawled through a culvert underneath the multi-lane highway in hot pursuit of a desert jackrabbit. I carefully wrote out the story for him in his own words. 
He was obviously interested, and I asked him to illustrate the story for me in the manner of children's beginning readers -a picture for every sentence or two. At this point he was involved; that itself showed promise. After the story was illustrated, I invited Johnny to read it to me. He looked at me dumbfounded and announced that I was pretty stupid because I knew he couldn't read. 
"I want to hear this story again," I said, "just the way you told it." 
"I can't remember exactly," he said. 
"Let's work on it together. I'll help if you get stuck." 
The tension and energy in him was incredible. I put my hand on his shoulder and pulled my chair closer, and he began to relax a little. He faltered; I helped; he began. Together, word by word, we went through the story, full of words not found in elementary readers. 
When we finished he gave an enormous sigh of satisfaction. I don't think he'd ever sat still for so long. We went back to the beginning. We looked for words that recurred in his story and made a word chart. He began to recognize words out of context. Almost immediately he could read his whole story without an error. The test, I knew, would come if he could recognize and read the words in another story. 
"I hope I can read another story," he volunteered. We tried and he could. 
I was not an elementary school teacher. I simply hit on the meaning of this child's life, without judging his meanings (guns, children playing near dangerous highways, the potential killing of wild animals for fun). It was his meaning and, for the moment at least, I would content myself with that. My meaning was to show this child he could master reading. We'd worry about more constructive activities later. 
Entering Johnny's world of meaning had been the key to school education for him -there was no other way. Once that way was discovered there was no stopping him. He learned to read once instruction was oriented to his own personal meaning. 
A Shift in Values 
Logotherapy is consistent as a philosophy and a viable therapy. There is no need for manipulation, no forcing a client to fit a treatment, or a treatment to fit a client. All that is occasionally required is a shift in perception, a new way of seeing that expands persons rather than limits them. 
Mark was a busy, stressed professional who often found much of his "important" work meaningless. It required long hours, meetings, and individual appointments. He was exhausted and suffering from burnout. His entire life centered around his work and what he thought was required to maintain his image as a junior executive on his way to the top. Even his "recreation" was geared to his work -racquet ball with other managers, golf with clients, tennis at conventions. Even his dates were arranged with an eye to the impact his partner would have on his work. 
Mark was oblivious to all that until we began to examine the various aspects of his life. He admitted he didn't even particularly like his work. He was uncomfortable with the basic philosophy of his organization; he was bored at many of the meetings; and he realized that he was tired of spending all his time trying to prove himself. 
We explored the possibility that he change work but he chose for the time to remain. In the course of this exploration Mark discovered that his own values conflicted with the way he lived his life. He also saw that his work did not really demand a life so conflict-ridden. What was motivating him were not the requirements of his work but his own fears of not succeeding. 
In the course of clarifying his values and value conflicts we explored activities that held meaning for him in the past. It was apparent that Mark had lost touch with something of the essence of himself in his effort to measure up to what he perceived as his corporate image. 
Mark had many friends in high school and college but also enjoyed time alone, such as long walks in the woods, and listening to music. He also had volunteered in a refugee resettlement project. At graduate school, his class schedule and part-time jobs offered him little time other than what was needed for study. At that point he had started to think in new, career-oriented terms. Upon graduation he began the climb of promotions and never resumed the friendships and activities he formerly enjoyed. 
We discussed what he missed in substituting his present "recreation" for former leisure activities. We evaluated the importance of his present lifestyle for career goals, and Mark discovered that he was pressuring himself -that no one in his company was really demanding that he perform on the golf course or on the party circuit. Nor that he work nonstop. He was afraid his work quality was not adequate. In reality, his neglect of his own interests and his deep need for time for reflection was hindering his work performance. 
Mark re-established priorities for his use of time. In the midst of a round of meetings he found a few minutes to spend sitting on the banks of a river watching the winter ice float by, observing the migrating birds, and listening to the sound of the water slapping the shore and the wind in the trees. Rather than calling the office for messages that could be dealt with in the few minutes between meetings, Mark used the time to rediscover some meaningful experiences. 
He regained energy and a sense of satisfaction in life outside his work. His work took on new meaning as well, as he performed more creatively on the job. His concern for corporate ethics resulted in the establishment of a management ethics committee. All this emerged directly from his shift from living out of fear to living from the center of his own unique meaning. 
This had implications for Mark's quality of life and had an impact on his corporation and on its community social structure. 
A Response to Love 
The key to a positive response to suffering is love. 1 Although we may be powerless to change our circumstances, we always retain the power to choose a loving, meaningful direction. Spiritual freedom allows us to cultivate an attitude of trust and hope in ultimate meaning, even in the midst of suffering. 
Louise suffered an incapacitating stroke which left her paralyzed and without speech. She lay in the hospital for months in intensive therapy, wondering -as she was able to slowly and painfully articulate later -why she was afraid to die. She had lived alone, following the death of her husband, daughter, and grandchild in a car accident, and because there was no one to give care at home, she was sent to an extended care facility. 
She had reached a plateau in her recovery, confined to bed and wheelchair, unable to feed herself, and struggling to express the simplest thought in words. One day, when I stopped in, a television set was on in her room. Music was playing, and Louise's eyes showed a glow of life I had not seen before. I knew nothing about Louise and her interests before her stroke except her family tragedy. The staff had been unable to provide information. Her effort to respond to the music was a clue to meaning. 
The care facility had an independent living center where a group often gathered to sing. I asked if they would come to Louise's room to sing hymns and folk songs. When they did, the expression in Louise's eyes changed just as they had when the music was playing on television. I asked the group to keep singing, and I joined in. Before long we were not singing for Louise but to Louise; the singing ceased to be a performance and became our effort to speak to her. All at once Louise seemed to be singing, too. Her lips were moving along with ours, mouthing the words of the familiar songs. 
Music was a key to meaning for Louise, and became a vehicle for her to recover some ability to speak. Eventually she was able to convey to me that she was afraid to die. Actually, death was not impending. Though severely handicapped, medically she was doing well. Knowing that fear of death is often tied to the suspicion that one has not lived life responsibly, i.e. in response to one's own meaning, I began to explore the potential unlived meaning in Louise's life. 
With loss as severe as Louise's -loss of husband and family in sudden death, loss of mobility and verbal facility in stroke -it seemed almost impossible to look at potentials. Yet all paradoxes of life have a place in logotherapy. Each person's uniqueness is cause for both pain and celebration. Louise had to come to terms with unlived meaning and accept that she would never be able to live what once might have been posible. We discussed her regrets over unfulfilled responsibilities and unrealized potentials. (I use the term 'discussed' figuratively. Louise never regained full speech capacity but she was able to convey thoughts to my interpretation which she then either confirmed or denied.) 
While she was afraid to die, she saw no point in going on living in her condition. She saw no meaning ahead. Confronted with the idea that dwelling on meaninglessness would only perpetuate the grief over unlived meaning, Louise agreed to explore potentials. Music figured prominently again, and she joined the independent-living singing group. The more she sang , the more her speech improved, but was never fully regained. 
Louise learned to type as she regained some mobility in one hand and arm. She wrote notes to other patients and she wrote thoughts to me. One day I received this note: "not important who what you are. projects important working with others benefit their work with you is meaning. health big improving now new life." The nurse told me it took Louise three days with periodic help in spelling to type her note. Louise expressed in her simple way that working with others on mutually beneficial projects brings meaning and fulfillment, and that her health was much improved since she was living that way. She said that love was her meaning. She was no longer afraid to die. 
Frankl remains always in touch with reality, yet does not deny the mysteries of life -the mysteries of suffering, creativity, relationships, and the mystery behind all mysteries: the mystery of love. 
People may temporarily lose heart -this need not be denied. Terrible things do happen, and logotherapy does not insist that persons must always put up a brave front. They have to be helped to see some reasons not to wallow in their loss of heart. Simone Weil 3 echoes Frankl when she says we are free to choose which way to turn our gaze in the midst of suffering. The choice may indeed be difficult. Persons may become accomplices in their own suffering by succumbing to negative thinking and actually courting an attitude of defeat and despair. Their negative attitudes affect and can inhibit their spiritual freedom at a time when they need it most. 
People can live with "a passion for the possible"2 when they realize that the possible has no fixed limits. Louise is a case in point. What has been mistaken for a limit proved to be a horizon toward fullness of meaning. Steindl-Rast calls living in this kind of hope "living in openness for surprise."2 
In logotherapy hope is offered to any person -the child with difficulty in learning, the talented adult who lost the sense of direction, the person with no apparent reason to live. Meaning for each is found in meaning yesterday, today, and what is yet to be discovered. In its recognition of every moment being filled with possibilities and creative choices to be made, logotherapy is life-giving and hope-filled even when all seems beyond hope. 
JANA PREBLE, Ed.D., diplomate in logotherapy, is associate professor of counseling psychology, Department of Applied Psychology, St. Cloud State University, St. Cloud, Minnesota. 
REFERENCES 
1. 
Frankl, V. E. Man's Search tor Meaning. New York, Washington Square Press, 1963. 

2. 
Steindl-Rast, D. Gratefulness, the Heart of Prayer. New York, Paulist, 1984. 

3. 
Weil, S. Waiting tor God. New York, Harper and Row, 1973. 


A View of Logotherapy from the Alcohol Field 
Marsha J. Koster 
In my training as an alcohol counselor I became acquainted with togotherapy but I saw it mainly for codependents who lost their primary rotes after the alcoholics in their lives began the recovery process. During the Eighth World Congress of Logotherapy in June 1991 I encountered logotherapy from a new perspective. I now see logotherapy as the beginning of a meaningful relationship. In this article I will share some of my perceptions of logotherapy as viewed by someone in the alcohol field. The similarities of how one recovers from the disease of alcoholism and how one finds meaning and purpose through logoanalysis are striking. 
Logotherapy is said to be a no-man's-land between psychology and religion, the door to the spiritual dimension. By opening the door to understand our very existence we enter a land of promise -not unlike the promises offered through the spiritual journey of Alcoholics Anonymous (AA), the principal program of recovery for alcoholics. 
Logotherapy views humans as entities having three aspects -physical, psychological, and spiritual. AA views the disease of aJcoholism as having the same three aspects.The goal in logotherapy is to have a meaningful, fulfilling life. The goats in AA is "not to drink,H but promises a fulfilling life where the feeling of uselessness will disappear. 
Logotherapy is based on an existential philosophy, which often is seen as negating meaning in life. Logotherapy, however, has a philosophy placing a high value on having meaning and purpose in life. Meaninglessness is more accurately termed by Frankl the "existential vacuum."3, p. 31 
People experiencing existential vacuum feel bored, empty, lacking meaning. Something is missing. To fill this inner void they often seek something external, like drug or alcohol. Thus, existential vacuum may lead to addiction, aggression, or depression. C.G.Jung held that alcoholics try to fill their inner void with liquid spirits. To recover, they must replace those liquid spirits with an even greater spirit. 1 
For alcoholics, the "existential call" can be equated with that "moment of truth" when they feel most empty, "hit bottom," and are finally able to hear the exhortation (by an external or internal voice) to grow up, face reality, and assume responsibility for themselves. 
Those in an existential vacuum feel like nonentities, having no existence at all. Many who come to AA feel as though they do not belong anywhere. They describe themselves as the "walking dead." The AA program includes many paradoxes as does logotherapy. To find life, a sense of purpose, individuals must surrender their lives to a higher power. Only then do they truly receive life back. The AA expression, "You can't keep it unless you give it away" applies to the individual's life. 
The Key to Surrendering 
This "surrendering one's life" is not merely a striving to observe some moral laws or commandments but -more radically -actually committing one's whole self to a higher power through a leap of faith, thereby risking everything. When one is empty, one has the greatest potential to receive. 
The key to surrendering control of one's life, yet being able to make responsible choices, is the spiritual component of both logotherapy and Alcoholics Anonymous. In AA this spiritual dimension is referred to as the "higher power greater than yourself." In logotherapy it is termed the noetic dimension.3, P-79 Both have to do with a spiritual call rather than a personal drive. When we allow the spiritual dimension to interact with the human spirit, we are guided to make responsible decisions and are lifted above life's obstacles. With each new obstacle and spirit-guided decision we learn to trust the "call" and value our sense of maturity and responsibility. Each obstacle helps build the monuments of our lives. This is much like the growing process talked about in AA. Frankl resolved that "as long as we suffer we remain psychically alive because we grow through it. "2 Similarly AA maintains that "If we are not growing we are dying." 
Logotherapy encourages individuals to look at their identity, the roles they play, their strength and potentials not unlike the AA's fourth step of fearlessly looking at themselves and identifying their strengths and weaknesses. 
In search for meaning, logotherapists ask clients to look at what is reality and to understand what they can change and not change, similar to the serenity prayer used in AA: "God, grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference." 
104 
Similarities 
AA is often said to also stand for "Altered Attitudes," because having the choice of changing our interpretation of situations and thoughts is a premise of the AA program. We are not responsible for what comes into our mind, but we are responsible for what we do with it. "Stinking thinking" is often what causes the recovering alcoholic to relapse back to drinking. Being able to think creatively about situations, to dereflect or refocus our thoughts and to change our attitudes about situations is basic in logotherapy as well. 
Other similarities include values clarification, selfaffirmation, and developing self-worth. Known as "height therapy," logotherapy seeks to help clients see their full potential and positive strengths in the same manner that AA helps alcoholics find their sense of self-worth. In each of these efforts to assist individuals along a spiritual journey of growth, the only person one can change is oneself. However, when one person changes, others invariably change as a result. 
As for prevention, the need to find external fixes like drugs or alcohol would be reduced if individuals felt a sense of purpose and meaning, along with a sense of self-worth. If individuals and communities understood that they do have choices -that they need not be victims to societal pressures and that they need to accept their part of the responsibility for making choices about what happens in their community, then the consequences on society would change drastically. 
A final similarity, useful in treatment and prevention: when we focus on the positive aspects and on gratitude, we cannot focus on the negative. We have choices and we can choose to discover the potential for turning negative experiences of suffering into positive directions. In the alcohol field we say: write your gratitude list. I, for one, am putting the discovery of logotherapy on my personal gratitide list because it affirms that the spiritual dimension is leading us along common paths. 
MARSHA J. KOSTER, MA, CADC, is manager of the Prevention Div., Santa Clara Co. Bureau of Alcoholic and Drug Programs. 
REFERENCES: 
1. 
Alcoholics Anonymous World Services, "Letter from Carl Jung" Grapevine1, 1975 

2. 
Berens, Ann."Suffering and the Question of Meaning," Proceedings, Eighth World Congress of Logotherapy, 1991 

3. 
Frankl, Viktor, Psychotherapy and Existentialism, New York, Washington Square Press, 1967 


The Will to Being or The Will to Meaning Reflections on Langle and Frankl 
Jim Lantz 
In two recent issues of The International Forum tor Logotherapy Alfried Langle presented his orientation of 5
psychotherapy called "existential analysis psychotherapy. "4, Langle is director of the Society for Logotherapy and Existential Analysis in Vienna, Austria. According to my reading of the two articles, Langle views existential analysis psychotherapy as a "deeper"4 form of psychotherapy than logotherapy, to be used when the client does not follow the "advice"4 given by the logotherapist. To Langle such failure to follow the logotherapist's advice is an indication that the therapist should use existential analysis psychotherapy because this form of treatment helps clients develop "a fresh view of themselves and the world" through "strengthening the self" and "relief from negative aspects of the self. "4 Langle further points out that existential analysis psychotherapy is concerned with "self-development" and the "will to being"4 in addition to the "will to meaning." 
As I read these two articles I experience one single, central concern. In both the theoretical article4 and the case illustration5 Langle seems to elevate the motivational dynamic 
of the "will to being" to a higher level of significance than the "will to meaning." Langle does this by suggesting that the focus upon "self-development" and the "will to being" is indicated when the client is unwilling or unable to follow the logotherapist's advice. 
To my mind, such a suggestion can only mean that Langle believes the "will to being" to be a more powerful motivational dynamic than the "will to meaning." If my reading of Langle is correct, he has started to attack what I consider the focus and foundation of logotherapy: helping the client learn to strengthen the self -paradoxically through a selftranscendent relationship with the world beyond the self. The following material will illustrate my more traditional approach to logotherapy, which I believe is in opposition to Langle's approach. 
Self-Transcendence and the Strengthened Self 
Frankl consistently has pointed out that the most important task of the therapist is to help clients discover or rediscover meaning. For Frankl and other logotherapists the client's experience of a meaning vacuum provides rich soil for the growth of symptoms. Helping clients discover or rediscover meaning in life challenges their existential vacuum and "shrinks" the symptoms that grow in the vacuum. 
Discovery and awareness of meaning take place in 
23
reaction to a self-transcendent relationship. 1, , Selftranscendence can occur in a relationship with a person, an important cause, or with nature. 1, 2,3 The self-transcendent relationship is neither narcistic nor masochistic.3,6 It is, instead, a connection to life and community that results in a feeling of meaning and communion.2,3,6 This circular concern for what lies beyond the self paradoxically results in a meaningful sense of self. 1, 2, 6 The process of helping clients discover meanings and meaning potentials through a relationship with something beyond the self is an effective way of helping them discover the strength of the self that is covered over by a preoccupation with the self .1, 2,3,6 In such a view, a direct focus upon self-development and the will to being, in my opinion, weakens the self. The following two case examples illustrate the self-transcendent approach. 
Joe 
Joe served in combat in Vietnam in 1966 and 1967. He came home, married Joyce, and finished college in 1971. Joe, Jr. was born in 1970. Joe, Sr. was symptom-free for 15 years, but on his son's 13th birthday he experienced his first flashback. In the weeks that followed, Joe had more intense flashbacks and intrusive memories of his times in Vietnam. He started drinking to control his anxiety about these flashbacks. 
Joe and his wife were seen in logotherapy from January 1983 to December 1984. During the logotherapy sessions Joe remembered that he had killed a young Viet Cong soldier who was "about the age of my son." Joe realized that his son's 13th birthday broke the repression about this terrible event. Joe believed he needed logotherapy to "learn how to live with the event now that I've remembered what I did." He learned to become a better father "in honor" of the young Viet Cong soldier, and Joe and Joyce eventually adopted two Cambodian children. Both Joe and Joyce are proud of the way they have found and made use of the meaning opportunities in Joe's "terrible memory." 
Sam 
Sam requested logotherapy to control his alcohol and drug abuse. He was a Vietnam veteran who was afraid he would kill himself. He believed he "should" die because during his time in Vietnam his best friend had been killed after trading guard duty with him. Sam believed his friend would be alive and "I would be dead if we hadn't traded duty." Sam drank and used drugs to control anxiety attacks and depression connected to his feelings about his friend's death. 
Sam eventually overcame his "death imagery," his guilt, and his substance abuse after he started sending his friend's wife and child $350.00 per month to "help them get out ot poverty." This represented the amount of money Sam had been spending on booze and drugs. Sam has not had a drink in more than ten years and is still helping his friend's family. For Sam, making a commitment to his dead friend's family was a way to find meaning in a tragic and horrible event. 
The Self and the Will to Meaning 
Many of my clients request therapy because they feel empty. Some fill this emptiness with drugs, some with sex, others with material goods and running after pleasures. 
Most of these clients want to learn to "love the self' as a way of "filling the self." They are surprised to find that their logotherapist does not believe this approach will be helpful. They are shocked to discover that their new therapist wants them to "give from the self" as a way to find and strengthen the self. They are eventually happy to discover that seeking another's joy or the cessation of another's pain is profoundly gratifying and strengthening to a person's self. They discover being as a byproduct of the awareness of meaning. 
JIM LANTZ, Ph.D. is associate professor at The Ohio State University College of Social Work and director of the 
Worthington Logotherapy Center. Editors' Note: Dr. Frankl withdrew past March as honorary president of the Austrian "Society for Logotherapy and Existential Analysis." (Chairman: Dr. A/fried Langle). At that time Dr. Frankl expressly stated that he no longer wished to share responsibility for actions carried out without his knowledge and often contrary to his convictions and intentions. 
REFERENCES 
1. 
Frankl, V.E. "Self-Transcendence as a Human Phenomenon," Journal of Humanistic Psychology, 6, 1966. 

2. 
____. The Will to Meaning. New York, New American Library, 1969. 

3. 
____. The Unconscious God. New York, Simon and Schuster, 1975. 

4. 
Langle, A. "Existential Analysis Psychotherapy." The International Forum for Logotherapy, 13 (1), 1990. 


5 ____. "A Case History in Existential Analysis Psychotherapy," The International Forum for Logotherapy, 13 (2), 1990. 
6. Lantz, J. "Meaning in Profanity and Pain," Voices, 25, 1989. 
In Memoriam -Max Eisenberg -1920-1991 
The Institute of Logotherapy suffered another painful loss with the death of Max Eisenberg, husband of Mignon Eisenberg, regional director of the Institute for the Midwest and director of the Israel Institute of Logotherapy. 
Max, a native of Switzerland, emigrated to Israel (then Palestine) in 1934, served as one of the first volunteers to the British army in World War II and received the coveted MM (military medal) and another distinction, "Mentioned in Dispatches," the only Palestinian soldier to received both decorations. 
His bravery extended to life itself. Max faced three deadly illnesses, in 1950 he conquered tuberculosis which resulted in the removal of part of one lung, in 1960 he suffered a heart attack and later developed angina pectoris which he overcame by the strict Pritkin diet. His third deadly enemy, cancer of the lung, conquered him July 13, 1991. He lived logotherapy , was a partner to Mignon in all her logotherapeutic efforts, and all who knew him, will miss him. 
Two Poems by 
The Oyster 
A foreign body forces itself into an oyster and causes pain. Gritty sand rubs its soft parts sore, and the oyster suffers. 
The oyster tries to expel the foreign body and fails. The grain of sand remains firm. The pain is not reduced. 
Then the animal dips into the depth of its nature and finds the strength to turn suffering into triumph. 
From discomfort and pain, from the flow of tears, arises, after a long process, an inner growth: a pearl. 
Elisabeth Lukas 
In Response to an Enemy 
Thank you, my friend. You attacked me, and with that you gave me strength to awaken my forgiving. 
You wanted to belittle me and the effect was that I was able to raise myself to my full height. 
You wanted to hurt me, and with that you taught me to endure pain, bravely and with dignity. 
I thank you, my friend. You wanted to destroy me, and with that you showed me the indestructible in me. 
Translated from the German by Bianca Hirsch. 
The Principles of Psychotherapy and its Relationship to Logotherapy 
James C. Crumbaugh 
After 100 years of theory of psychotherapy and the thousands of books written on the subject, of which I am guilty of three, it seems clear that 95 percent of theory -while sincerely originated and pursued by its followers, is unverifiable speculation. 
There are only four principles at work in any psychotherapy, whether it be psychoanalysis, behavior therapy or modification, or cognitive therapy like rational emotive therapy (Ellis), reality therapy (Glasser), or existential therapy (Frankl): 
1. 
Catharsis -emotional ventilation or listening. 

2. 
Insight -helping patients (clients, counselees) understand the real underlying cause of the trouble and their part in it: the breaking down of rationalization or excuses behind which they hide in self-justification rather than doing what can be and has to be done painfully to adjust to the problem situation. 

3. 
Re-education or retraining or reconditioning helping patients get started on the practice of circumventing rationalization and doing what is painfully necessary to handle the situation. 

4. 
Relationship -sympathetic expression of understanding which creates in the patients a feeling that they have a friend. (Schofield2 wrote that psychotherapy today is the only way many can get a friend. Psychiatrist Henry Climo told me if we had the old-fashioned back-fences and neighborhoods, his profession would be unnecessary today.) 


Of these four principles, the first and the fourth are the alpha and omega of psychotherapy, literally the beginning and the end. Though all four grow gradually together, it all starts with catharsis or listening, which in turn begins from to form the relationship. 
These four principles are all that is known about psychotherapy today, after 100 years of study. They may be all that ever will be known. But their application is made different by different therapists, and different applications are responded to differently by different patients. Thus the smorgasbord of therapeutic systems today has some value. 
We in logotherapy get our best results with the logotherapeutic application, and we find many patients who respond best to these applications. We believe that logotherapeutic principles come closer than any others to the heart of the human condition today, and thus have broader application to the emotional problems of everyday life. Therefore we believe it is not primary and per se therapy, but rather a philosophy of life which, if adopted, can prevent the need for therapy in the majority of people. 
When I met with Frankl in the early days, he considered logotherapy as an adjunctive therapy to supplement whatever psychotherapeutic modality might be used, rather than an independent therapy per se. But subsequent studies suggested that it is the therapy of choice in about 20 percent of a typical clinical case load, and the primary diagnosis would probably be noogenic neurosis. 
I first read Frankl's work in 1959. A year later, my boss at the time, L.T. Maholick, went to Vienna to study under him. In the summer of 1961 I went to Harvard to study under Frankl. In the ensuing 30 years the status of logotherapy is still an attitude toward therapy (as Frankl wanted it to be) and not a system of therapy (as Yalom3 said it isn't) though three logotherapists -James C. Crumbaugh, Joseph Fabry, and Robert R. Hutzell -have tried in their practice to make it so. Both Hutzel! and Mignon Eisenberg have set up their own relatively independent systems which could stand alone without logotherapy per se, but which are based on logotherapeutic principles. Elisabeth Lukas, Frankl's primary protegee, has also set it up systematically in her South German Institute of Logotherapy in FOrstenfeldbruck near Munich, but she is only now beginning to be widely known in America, and it is not clear what impact on American psychotherapy she will have. Rosemary Henrion, taking off as did Hutzell, from the early work of Crumbaugh1, is working toward a systematic development, and together we are working on an applied workbook, to be called SELF (Seeking Exciting Life Fulfillment) which utilizes many exercises from Everything to Gain 1 and extends the process through a number of additional exercises in what is aimed at being a systematic development of logotherapy. It is of course too early to determine the degree of success this may have. 
Fabry, at one of the logotherapy world congresses, has said that Frankl is logotherapy and logotherapy is Frankl. If this is true, as I believe it is, it probably won't become a system. But it represents the greatest psychiatrist of the second half of the twentieth century and has the potential to become the philosophy of life needed to salvage the human condition today. 
JAMES C. CRUMBAUGH, Ph.D., L.C., is clinical psychologist (retired) for the V.A. Mendical Center at Biloxi, MS, and regional director of the Institute of Logotherapy. The above article is based on a paper he gave at the Eighth World Congress of Logo therapy, June 1991. 
REFERENCES 
1. Crumbaugh, James C. Everything to Gain. Chicago: NelsonHall Company. 1973. 
2. Schofield, William. Psychotherapy: The Purchase of Friendship, Inglewood Cliffs, N.J., Prentiss Hall, 1964. 
3. Yalom, Irvin D. Existential Psychotherapy. New York, Basic Books, 1980. 
Life Review and Life Preview 
Mignon Eisenberg 
One of the larger hospitals in Chicago features two copies of Man's Search tor Meaning on the bookshelves of every patient's room, next to the standard copy of the Bible. Patients derive renewed hope and solace from this classic. It also helps them in the developmental task of the Life Review, 1 prompted by the realization of personal mortality. 
The Chinese expression for the word "crisis" is made up of two characters, one meaning "danger," the other "opportunity." This seeming contradiction is symbolic of the polarities of the human experience, waiting to be consolidated and refined by the maturing individual. Confucianism sees maturation as a perpetual process of self-cultivation, of becoming (more) human, of being on the Way. In a Franklian sense, to "have" the Way, a person must have had threefold meaning orientation: an existential commitment to the future, experiential knowledge, and the wisdom and strength to be a model to others by one's mature attitude. 
The cathartic and humanizing appeal of logotherapy lies in its verification of and alertness to the paradoxical. The very foundations of therapy through meaning -an unconditional faith in unconditional meaning -were laid against a background of utter hopelessness and chaos. The delicate yet resilient wings of freedom to find meaning were forged out of the iron fetters of oppression and depersonalization of the concentration camps. Frankl's profound philosophical and prophetic manifest rose like a phoenix out of the ashes of a decadent era. Its rehumanizing credo is a resounding affirmation of our uniquely human potential to master our fate and our inalienable option to move from self-centeredness to self-transcendence. This definition of humanness provides a compass for ethical orientation and maturation, viable guidelines for living and rebirth in times of crumbling values. It restores a sense of human dignity even to those who feel condemned and devastated by guilt and suffering. 
The confrontation and acceptance of our finiteness elevates us from the depth of despair and morbidity and inspires us to apply our liberated energies to meaningful pursuits in the Here and Now. 
Butler2 sees the psychotherapeutic function of the Life Review in older people as restorative, counteracting an often occurring fragmentation of the clients' sense of self by encouraging them to reflect on their lives, in order to review, resolve, and reintegrate underlying conflicts and problems. He recommends certain strategies to stimulate the life review: 
•Pilgrimages-actual 
visits to places of one's childhood, youth, and young adult life. 

•Correspondence 
and conversations with family, friends, and neighbors who are familiar with one's past. 

•Reunions 
of high school, college classes, family, religious affiliations. 

•Genealogy, 
family trees, tracing one's roots. 

•Mementos 
of old times, photos, letters, notebooks. 

•Verbal 
or written summation of life work, especially useful for childless people or persons with little contact with their children. 


The logotherapeutic intergenerational communications group3 provides an additional tool to enhance the life review. "Each group member is prone to derive maximum benefit from the intensive self-exploration process triggered by the constantly unfolding logodrama, as it were, of visualizing oneself in the other two generations." Here, the life review serves as an indispensable part of the (logotherapeutic) task of an ever-active process of previewing one's life. 

Logotherapy dialectically broadens the scope of the need to review one's life by injecting the imperative to redirect and restructure one's life wherever possible. This forces the client to engage in a life preview simultaneously with the life review, shifting the emphasis of the process from hyperreflection to dereflection and self-transcendence. The logotherapist intervenes in the open or clandestine selfexploration by engaging the clients in a Socratic dialogue, to help them draw on the meaning reservoir of their lives. In cases of incurable illness or inconsolable grief, the logotherapeutic approach of medical ministry 5 will foster clients' imagery of self-sacrifice and generativity to comfort them and to help them quench their thirst for meaning, rather than persist in often endless debilitating self-recriminations. 
My clients bear witness to the regenerative impact of logotherapy on inventorying their lives, and the discovery of new meanings:4 
•It made me feel I was special in having had some insight into this (suffering) at a very young age. . . I hope someday to become a logotherapist, or at least be in the position to use it in my life dream of being a counselor for parents of terminally and chronically ill children. K.C., age 38. 
•I 
began examining my life and found a lot wanting. I used not to see other people the way I do now, and I feel much more at ease and confident about myself. I also know I want to help others. H.R., age 55. 

•Time 
is of the essence, and there is a lot of things people take for granted. Time is one of them. I would like to think that each day of my life I have done something of value. T.D., age 20. 

•The 
fact that I have gone through what I have gone through has made me a real person ... I am more conscious and caring. Sufferings tend to make us better people. G.L., age 25. 

• 
1 found a sense of new selfworth. I see the way I have lived my life in the past. If I ever had any doubts, Frankl confirmed to me that my life was not wasted. He gave me a sense of pride, of worthiness. All my efforts used to go in one direction, and I never realized that I could change my attitude. F.N., age 68. 

•I 
decided, as much as I may think of the past, I can't go back, I have to look ahead ... Frankl gave me a lot of courage, I did and do the best I can. Having lost husband and daughter, I felt very isolated ... But then I realized it was up to me to change my own attitude. G.R., age 72. 

•I 
don't talk to my plants, I propagate them. It's pleasurable to see the first African violet baby send up the first blossom. Today js Saturday, music and plants. It seems to me music and healthy plants go well together. Me too. S.S., age 75. 


MIGNON EISENBERG, Ph.D., is Regional Director for the Midwest and Director of the Israel Institute of Logotherapy. The above article is reprinted from the International Forum for Logotherapoy 4( 1) which is out of print. 
REFERENCES 
1. 
Butler, R.N. "The Life Review: An Interpretation of Reminiscence in the Aged." Psychiatry 26., 1963. 

2. 
____ "Life-Review Therapy." Geriatrics, 11, 1974. 


3.Eisenberg,M. "Thelogotherapeutic Intergenerational Communications Group." The International Forum for Logotherapy, 2(2), 1979. 
4. 
___"The Logotherapeutic Intergenerational Encounter Group." Dissertation, Southeastern University, New Orleans, 1980. 

5. 
Frankl, V.E. The Doctor and the Soul. New York, Vintage Books, 1977. 


The International Forum for 
LOGOTHERAPY 
Journal of Search for Meaning