diff --git "a/SOURCE_DOCUMENTS/journal_002_1.txt" "b/SOURCE_DOCUMENTS/journal_002_1.txt"
new file mode 100644--- /dev/null
+++ "b/SOURCE_DOCUMENTS/journal_002_1.txt"
@@ -0,0 +1,1922 @@
+
+Aspects and Prospects of Logotherapy 
+A Dialogue with Viktor Frankl 
+In June 1978 Viktor Frankl and LOGOTHERAPY editor Joseph Fabry spent a weekend on the Alpine mountain top of the Rax to discuss the aims and purposes of this magazine. We thought the following excerpts of the talks would be ofinterest to the readers ofour first issue. 
+Fabry: It has been said that logotherapy is a therapy whose time has come. But when logotherapy was conceived about fifty years ago, the time was quite different from our present in value priorities and attitudes. In what way would you say that logotherapy has changed with the times? 
+Frankl: When I developed logotherapy in the late twenties and the thirties, it was a therapy designed for a special type of patient confronting us in the framework of individual psychotherapy. In the meantime the type of suffering that such patients experienced has become ever more widespread, and today we may conceive of it even in terms of a collective neurosis. 
+Decades ago, it was the single individual who, often on an intellectual basis, was wrestling with the problem of a meaning to life or, for that matter, a meaning to his personal existence. In the meantime, this existential frustration has grown to become the malaise of the average person regardless of educational background or intellectual level. To be sure, today the symptomatology of this ailment is often so covert that the etiology is not always perceptible. Just think of today's drug scene, the inflation of sex, or violence. It is not always clear that behind these manifestations lies an existential vacuum. But even in the more overt manifestations of the pervasive feeling of meaninglessness, such as suicide, the traditional psychotherapeutic approaches distract our view from the real issue rather than leading us to a proper understanding. 
+Fabry: Logotherapy, then, pointed out a new source of suffering, or rather an old source which had not been considered much in psychotherapy, namely meaninglessness, and opened up a new source of alleviating the suffering; after all, logotherapy is to help individuals in their search for meaning. 
+3 
+Frankl: Logotherapists voice our conviction in terms I've tried to express through some of my book titles: Man is being steadily in search for meaning, our will to meaning is frustrated by the present society but those who know how to listen, again and again perceive a cry for meaning. But when we logotherapists voice our convictions that what the human being needs first and foremost is meaning, we are used to getting the answers from our col!eagues with different orientation that "in the final analysis" it's just castration fear, poorly settled Oedipus situations, inferiority complexes, the punishing superego, the socioeconomic situation, the product of certain learning or conditioning processes, or the lack of macromolecules. Not to mention the rehash of cliches such as unreleased energetics and dynamics, be they bio-or psycho-. In any case, the trouble is seen as result of interplay of forces within a psyche that is interpreted after the model of hydraulics: if there is tension it must be vented, because otherwise the stress takes its toll and the system will explode. Thus, we are indoctrinated in understandi.r,g ourselves not as deciding agents, nor as free and responsible beings, but as victimsand victims of chimeras at that. For, as to "stress." even as Hans Selye, the originator of this concept agrees, it "is the salt, or the spice, oflife" 
+But if you depict human beings as victims, if you mirror your patients as something-and not as someone-not as agent (and patient, literally means a "sufferer," while agent is a 
+"doer"), you have placed them in a position of an cmirely dependent entity-dependent also on your therapist. 
+Fabry: You have defined logotherapy as "education to responsibility." What rm does the therapist or counselor play in such an education? 
+Frankl: The counselor's part is a direct consequence of logotherapy's philosophy. When ,he thnapist teaches his patients that "in the fir,al amilysis" what counts is instinctual gratification, self-actualization, self-expres
+and that their partners are just tools ro pursue these goals, when the partners thus are made into safety valves for tension reduction, then people cease to know what life is really all about. They have been made 1c bdievc that the causes to which they have 
+dedicated their lives are "nothing but" means to an end, namely to serve their narcissistic tendencies. After some period of being exposed to such a variety of indoctrinationswho can still maintain the original and genuine ''wisdom of the heart,'' or what I have come to call "man's pre-reflective ontological selfunderstanding,'' which has taught him all along that his existence is basically characterized by self-transcendence; which means, that the human reality is always pointing to something beyond itself-to something or someone: a meaning to fulfill, or another human being to encounter lovingly. Only in this way we become truly human beings, we become really ourselves (thus actualizing both our 
+humanness and our selves, our personhood and our selfhood) only to the extent to which we transcend ourselves by forgetting and giving ourselves. No longer is another person thought of and sought for as a mere tool, be it for instinctual or so-called humanistic purposes. Now the other person is met in his own right, for his own sake. No longer is a cause served just for the purpose of living out our own potentials and capacities but for its own sake. Self-actualization still remains a beautiful goal and whoever has attained it should be congratulated, but in the long run it will turn out that it is the reward that falls in our lap after we have transcended ourselves, not caring for actualizing ourselves but being concerned about others out there in the world: about things to do, and people to love; about assignments that wait for us, or persons who need our help. 
+Fabry: These are the philosophical underpinnings of logotherapy. In what way does the logotherapist differ from other therapists in applying this philosophy of life? 
+Frankl: Those whose theories and therapies reduce the patient to a product resulting from processes and -in order to be repaired-dependent on some other processes, as for example transference, unlocking repressed feelings, acting out old hangups and old hates, or whatever these processes may be called, such types of therapists of course can expect their patients to remain patients as long as they can financially afford it. I am not weary of emphasizing that logotherapy is no cure-all. Nor can logotherapists accomplish miracle cures. But if you consider, for instance, the 
+
+4 
+short-term therapeutic results of practicing logotherapists applying the logotherapeutic technique called "paradoxical intention," you will forgive my saying so that this constitutes our pride. The same holds true for the many cases that are brought to our attention by letters received from all over the world-from readers of books, from people having attended our lectures, courses, and workshops, and seminars-to the effect that they have spontaneously administered logotherapy to themselves with striking results and within incredibly short time spans. I recently received a letter that said something like, "I believe in logotherapy because it worked after I tried it on myself, and I had 
+read about it in only one single book.'' 
+Fabry: I have had similar experiences in my groups. Once people have become aware that they are not the helpless victims of their past or their conditions and that they have those tremendous resources of their spirit, they can help themselves-and others. 
+Frankl: To be sure, there is something presupposed if we say that the effects of logotherapy make us proud, and that is the fact that any good logotherapist claims for himself what he ascribes to others, that is a "will to meaning," in other words, a hierarchy of values in which helping others has an unquestioned priority over being paid by others. In fact, the words of John Ruskin are regarded by us as truly valid: "There is only one power -the power to rescue; and there is only one honor-the honor to help." And what a power! You may remember the saying in the Talmud: "Whoever rescues one single soul is to be regarded as if he had rescued the whole world." To heed the second half of that Talmud saying is up to the representatives of that type of therapy which for so long has turned into big industry. The second half reads: "He who has destroyed one single soul is to be regarded as if he had destroyed the whole world." 
+Frankl: Our western world, in contrast to eastern cultures, has turned to a belief in science, even an idolatry of science. 
+Fabry: But aren't those who believe in science rather than in a strictly religious meaning orientation also entitled to get help in their efforts to remain mentally healthy? 
+Frankl: Of course they are. But they can remain mentally healthy only by becoming truly human. In fact, logotherapy is concerned with the search for meaning not only as a matter of health, and in no way as a matter of morality, but rather as one of the most intrinsic human phenomena. Anyway, you cannot turn the wheel back and you won't get a hearing unless you try to satisfy the preferences of present-time Western thinking, which means the scientific orientation or, to put it in more concrete terms, our test-and statisticsmindedness. So why should we lose, unnecessarily and undeservedly, whole segments of the academic community, precluding them a priori from understanding how much logotherapy is needed today or, as some others have attested, how much logotherapy "speaks to the needs of the hour.'' Why should we give up, right from the beginning, getting a hearing from the modern researchers by considering ourselves above tests and statistics? We have no reason not to admit our need to find our discoveries supported by strictly empirical research. Logotherapists feel deeply rewarded whenever we observe, or are made aware of, our theories being in accord with old truths. What greater compliment can we expect than learning that the eternal truth has been rediscovered in our "discoveries"? Perhaps we 
+have only couched these truths in scientific terms. But if so, we also translated them into the plain language of today so that everyone may understand and benefit from it. Anyway, we feel happy whenever logotherapy is validated by experiments-not only by my former students but also by reseachers who originally had felt rather skeptical about logotherapy. 
+Fabry: How do you see the future of logotherapy? What do you see especially valuable in its philosophy and therapy as personal meanings seem to become ever more important and as our traditional values seem to become increasingly unreliable as guidelines to living? 
+Fabry: This happened increasingly during the past years? 
+Frankl: Yes, and I feel deeply rewarded by such scientific research. But we still need more experimentation and empirical validation in 
+5 
+
+a field that, to be frank, for too long was founded merely on the intuitive capacities of a young Viennese student. 
+Fabry: Called Viktor Frankl. 
+Frankl: That's why I welcome all sober anct solid empirical research in logotherapy, however dry its outcome may sound. 
+Fabry: Here, I hope, our publication will have a function. 
+Frankl: This is my fondest hope. I hope this journal will carry, among other material, pertinent research reports. I hope equally strongly that the research reports will be balanced by single case studies, papers on innovating modifications of logotherapeutic techniques, philosophical articles, and articles of a personal, experiential, or if you prefer, existential quality. I am the last to impose directions in this respect on the editor or the authors. 
+The same is true of your parallel assignment, as the director of the Institute of Logotherapy. While the journal can serve as a pool of resources made available in written form, the Institute will serve the same function with regard to teaching, training, and helping those who suffer from the ills of the present time. Again, and I am convinced that I am also speaking in your name, when I say that no restrictions should be imposed-neither on your Institute associates nor on your journal authors, except for one: both facilities should be reserved to logotherapy as a groundwork; that is to say, everybody is invited to go beyond it by creatively developing new ideas that he may derive from logotherapeutic principles and from the conceptual framework of logotheory. What I want to say is that the "father" of logotherapy does not withhold his blessings from the offsprings of logotherapyexcept from those who are too proud to acknowledge the heritage. 
+Anyway, to every creative spirit ample space should be given, in the Institute as well as the publication, to be filled with new concepts, new methods, new techniques, new fields, and to chart new fields in which one may apply what logotherapy in its present stage has already to offer. 
+Fabry: I am certain that I speak for the Board of the Institute and for the Editorial Board of the magazine, when I say that we are pledged to such a purpose. 
+
+6 
+
+Some Implications of Logotherapy to Community Psychology 
+Uriel Meshoulam 
+The Community Mental Health Movement (CMHM) is a practical movement aimed at solving concrete problems left unsolved by traditional psychology. The movement arose "out of an explosion of discontent" (1) caused by the disenchantment with traditional psychotherapies, a shortage of professional help, and lack of satisfying answers to many contemporary problems of our society. 
+But discontent with the old paradigm is not sufficient; a new paradigm must emerge. Logotherapy, with its assumptions about human nature and its phenomenological approach to the study of human behavior, may offer such a paradigm. It offers unconventional solutions to some of the community mental health problems. 
+Four major logotherapeutic propositions are presented that lead in that direction: The noogenic nature of the "collective neurosis of our time"; self-transcendence as a means of finding meaning; the view of the human being as free and responsible; and logotherapy's short-term techniques. 
+The Noogenic Nature of the Collective Neurosis of Our Time 
+
+One major concern of the community mental health movement is the steadily growing gap between the need for psychotherapy and the supply of professional time. Frankl accoums for the growing psychotherapeutic need by stating that "doctors today are approached by many patients who in former days would have seen a pastor, priest, or rabbi; they are confronted with philosophical problems rather than emotional conflicts." These cases have become so common that they are justifiably called ''the collective neurosis of our time" (2). 
+The increased psychotherapeutic need, therefore, is caused not by an increase in psychogenic disorders but by a neurotic-like condition whose roots lie in spiritual problems, moral conflicts, and existential crises. The collective neurosis is noogenic rather than psychogenic, and characterized by a nihilistic attitude toward life, an alleged meaninglessness of life, conformism, boredom, and an inner emptiness. 
+These noetic conditions create a heavy burden on mental health clinics, and a large part of the professionals' time is spent dealing with them. The problem is twofold: the increasing need for psychotherapeutic help; and the acute shortage of trained psychiatrists, clinical psychologists, and related professionals. 
+Logotherapy points to the increased need for noetic (spiritual) rather than psychological care. This allows us to turn to other counseling professions, such as social workers and ministers for assistance to people seeking meaning in life. There is no reason why relatives and friends, teachers, family lawyers or physicians cannot be trained to assist with spiritual and philosophical difficulties. Actually, people do seek assistance by turning to others for whom Caplan 
+(3) coined the term "care-givers," and who can constitute a major source of help. Factual support is provided by a study (4) indicating that 42 per cent of those in need of help consult their clergymen, 29 per cent their physicians, and 20 percent members of the helping profession. 
+Nonprofessionals and care-givers as providers of noetic care offer other advantages: 
+1. They are not biased by psychological theories and a medical approach. Common sense and an appropriate sound philosophy 
+7 
+are in some situations more essential than professional expertise. Frankl cautions that, traditionally, the physician is not prepared to cope with the existential vacuum in any but medical terms, and thus sees all problems as pathological. 
+2. 
+Nonprofessionals are more likely to develop friendship-like relationships because they are perceived, and perceive themselves, as less of an authoritarian figure. Logotherapy stresses the value inherent in an IThou relationship between counselor and counselee. 
+
+3. 
+Persons in need spontaneously select care-givers whom they expect to provide the best rapport. This way the provided assistance fits the individual's needs. 
+
+
+Self-transcendence as Means to Finding Meaning 
+It is logotherapy's belief that meaning can be attained by helping others. No one can help others better than those suffering (or having suffered) the same difficulties as those whom they have decided to help. Riesman (5) termed this phenomenon the "Help-therapy principle." Frankl calls it help through self-transcendence. The blind is uniquely equipped to help others who are blind or who are becoming blind; the incurably sick can help those in the same situation; divorced people can tell others, who are in despair because their partner has left, what meaning has come to them as the result of having been forced to become independent, develop their potentials, meet new friends. The same system is used by Alcoholics Anonymous, Synanon (for addicts), weight watchers, Recovery Incorporated (for former mental patients) and similar organizations. 
+To demonstrate what can be done for people by letting them help others, two projects are described here briefly: one for old people, the other for drop-outs and delinquent youths. 
+Johnston (6) describes the Foster Grandparents Project carried out in Summit County, Ohio. Each foster grandparent, needy people over 60 years of age, spent four hours a day with an emotionally disturbed or physically handicapped child of preschool age. The children received personal attention which they could not get before. Foster grandparent and child developed a warm relationship which benefited both. The children became happier, more relaxed, and were reported to sleep, play and eat better. The helpers attained content and meaning in a formerly empty life. They demonstrated their deep concern about the welfare of the children, seeing the project as a selfchosen task well worth living and working for. 
+Klein (7) describes a program initiated by the Institute for Youth Studies at Howard University, Washington, D.C. Drop-outs and delinquent youths were trained for a few months, and simultaneously started to work as aides in child-care centers, as counseling aides with delinquent children, and as classroom aides in elementary schools. Although most participants brought with them a fatalistic view, poor self-esteem, and a strong sense of alienation, their life style changed, their educational aspiration level was raised, and some of them prepared for and received high-school equivalency certificates. The project succeeded in "finding real channels for moving these young people from their 'outsider' and 'spectator' roles ... into meaningful 'participant' roles in society" (7, italics in source). 
+The Concept of Freedom and Responsibleness 
+Institutionalization is often dehumanizing. Basic human rights are taken from the inmates, along with their sense of responsibleness and freedom. They are stripped of their every-day duties and become dependent upon the ward's staff. They trade in their freedom for the comfort of being released from the overwhelming burden created by the difficulties of their lives. The probability of their leading normal lives in the community is reduced by their being regarded as chronic and lost cases. The treatment in institutions tends to interfere with their readjustment to their community, makes the process of resocialization difficult, and in this sense is anti-therapeutic. 
+Logotherapy sees human beings as primarily and unconditionally free and responsible. They can neither be excused of their responsibleness nor be robbed of their freedom. On the contrary, the patients' perception of 
+
+8 
+themselves as free and accountable is an essential prerequisite for achieving the goal of treatment. 
+Programs which place more responsibility on patients and permit them more freedom have yielded encouraging results. The "therapeutic community" approach was pioneered by Jones (8): Selected patients were encouraged to lead a democratic life by self-organizing their community life and selfmanaging their affairs. 
+Fairweather's (9) project at the Palo Alto Veterans Administration Hospital, California, was inspired by the therapeuticcommunity approach. In accord with logotherapy's philosophy, patients were made collectively responsible for tasks previously taken care of by the staff. A patients government was established, an employment service was independently run by the hospital patients, and responsibility and initiative rather than compliance was reinforced by the staff. Compared with a control group, which was treated in a traditional way, Fairweather's patients improved their social functioning and were discharged sooner from the ward. Because conditions in the ward were similar to those in the outside world, the patients found it easier to adjust after their return to the outside world. The crisis caused by a sudden change from a "no responsibility" institute to the demanding community was prevented. Fairweather's patients stayed outside the walls of the institute longer and did better in their community and in their jobs. 
+Short-term Techniques 
+If we intend to solve mental-health prob
+
+lems from the community vantage point, 
+we need effective short-term techniques. 
+Logotherapy's short-term techniques of 
+
+paradoxical intention and dereflection are 
+not aimed directly at the elimination of 
+symptoms but at changing the client's atti
+tude. The self-administration of the tech
+niques has a number of advantages for 
+community mental health: The client can 
+practice them, after learning their appli
+cation and rationale, in a relatively short 
+time. The problem of transfering what is learned in the therapist's office to everyday life situations is avoided because the application of these techniques involves reallife behaviors. Through encouraging selfapplication of the techniques, clients are reminded that they can take responsibility for their own recovery by taking a stand toward their symptoms. The emphasis on attitude change toward one's own symptoms and toward one's concept of self as a responsible being explains the long-lasting effects of these therapies. 
+The encounter between logotherapy and the Community Mental Health Movement promises to be fruitful and points to further interaction between the ,wo disciplines, for the benefit of both as well as for the benefit of our community life. 
+URIEL MESHOULAM is assistant professor ofpsychology, Department of Psychology, Merrimack College, North Andover, Massachusetts, and staffpsychologist, Human Resource Institute, Norton, Massachusetts. 
+REFERENCES: 
+l. Hersch, D. The Discontent Explosion in Mental Health. American Psychologist, 1968, 23(7), 497-506. 
+2. 
+Frankl, V.E. Psychotherapy and Existentialism: Selected Paper on Logotherapy. New York: Washington Square Press, 1967; Touchstone paperback, 1975. 
+
+3. 
+Cowen, E.L. Emergent Approaches to Mental Health Problems: An Overview and Directions for Future Work. In: Cowen, Gardner and Sax, eds., Emergent 
+
+
+Approaches to Mental Health Problems. New York: Appleton-Century-Crofts, 1967. 
+4. Gurin, G., Veroff, J., and Feld, S. Americans View Their Menial Health: A Nationwide Interview Survey. New York: Basic Books, 1960. 
+5. 
+Riesman, F. The 'Helper' Therapy Principle. Social Work, 1965, 10(2), 27-32. 
+
+6. 
+Johnston, R. Some Casework Aspects of Using Foster Grandparents for Emotionally Disturbed Children. Children, 1967, 14(2), 46-52. 
+
+7. 
+Klein, W.L. The Training of Human Service Aides. In: Cowen, Gardner, and Sax, eds., Emergent Approaches to Mental Health Problems. New York: 
+
+Applewn-Century-Crofts, 1967. 
+
+8. 
+Jones, M. The Therapeutic Community. New York: Basic Books, 1953. 
+
+
+9. Fairweather, G.W., ed. Social Psychology in Treating Mental Illness. New York: Wiley, 1964. 
+
+
+9 
+
+
+Logotherapy' s Message to Parents and Teachers 
+Elisabeth Lukas 
+
+Parents, educators, physicians, therapists, and politicians worry about the development of our young generation. They cannot take quite seriously those childish-adult scatterbrains, yet they do have to take them seriously. They wonder what is wrong with the young who have "discredited" Freud and Adler by appropriating to themselves all privileges of sexuality and power without ever becoming "happy." Gone are the suppressed, subdued, shy youngsters with their inferiority complexes as described (and psychologically interpreted) before the two world wars. The postwar generation is largely self-confident, unrestrained, reckless, brutal, suicideprone, and drug-addicted. At least this is the way in which today's young people are tagged; their symptoms are characterized as those of a decaying society. The conflicts between the generations are growing, their world views are clashing, and mutual criticism manifests itself in discord and violence. All this has been sufficiently described--the anarchism, terrorism, juvenile delinquency, the hippies, and the furious threats by frustrated fathers along with the helpless shouldershrugging of confused mothers. 
+Young people running wild, dissatisfied with the world and themselves, set on changing the world yet unable to change even themselves--how did it come about? We psychologists usually place responsibility on external circumstances such as the war-and postwar years, the loss of natural instincts, the breakdown of traditions; but few of us acknowledge that we ourselves have contributed a good deal to the situation. 
+For half a century we have undermined the basis of educational practice. Every few years we have "instructed" and confused parents and teachers by proclaiming a new educational style without knowing how these experiments would work out. We have designed a crazy human image, the model of a monster either pushed blindly by its drives or hopelessly suppressed by society--in either case a creature unable to take care of itself and in need of protection. 
+In addition, we have psychologically supported the emancipation of mothers and helped millions of children achieve a high standard of living while feeling lonesome and neglected. We have coddled this growing army of small psychopaths by a special kind of education-via-the-media, by exposing them to models of brutality on the idiot box until they muddle up the normal and abnormal, the valuable and worthless because their perception of the value gestalt is fundamentally disturbed. We psychologists have confounded liberty and antiauthority, blurred the difference between the child's laziness and its response to excessive demands, and finally found classic excuses for any sort of aberration. The traumas of childhood justify their behavior; the parents are the scapegoats. The most fashionable scapegoat, however, is society itself whose structure (whatever this is supposed to mean) is made responsible for all mental ills of our day. The only one whose responsibility is not discussed is the individual him-or herself. 
+
+
+Education for Responsibility 
+As a professional psychologist I can afford to make this criticism. And I can also address myself to the parents who suffer just as much as their children but bear the brunt of the insecurity which we, the "experts," have created. In my practice I have talked with hundreds of desperate parents and learned that everybody they asked for counsel had 
+
+IO 
+a different advice. 
+The concepts on which such counsel is based differ even among the counseling services. Psychoanalytically oriented and behaviorist institutions are at variance with each other, schools differ with educational counselors, physicians have other ideas than therapists, the practices in children's homes are clashing with the theories, and in the middle are the parents, caught in the crossfire of the pontifications of the various experts, abandoned in their frustration of not knowing how to handle the children who get out of hand and laugh at all those abortive educational efforts. "They are old fogies," the young people tell the counselor, referring to their parents;and the counselor nods weightily in agreement, fearful lest he lose the young people's confidence--he does not want them to walk off and laugh at him as they do at their parents. 
+We do not need theories of neuroses caused 
+
+by unconscious traumas, repressed sex sym
+bols, inferiority complexes, and the rest, 
+but education for responsibility. We need an 
+education that directs the young toward 
+meaning and values; and, just as important, 
+an education that directs the parents toward 
+teaching and living meaning and values. 
+The crisis of our time can be seen as a pri
+marily educational problem: A failure to 
+educate people so they see themselves as full 
+human beings. 
+The parent generation in Germany can look back on extraordinary accomplishments: it has built up a war-devastated land into a flowering economic paradise. Even the threats of inflation and unemployment during the past years have been unable to shatter the total economic edifice. But building up provides more meaning than inheriting its results because building up is goal-directed and endows the effort with meaning, whereas inheriting provides neither goal nor meaning. On the contrary, fortunes that fall in our laps are valued little. The young cannot accept as meaningful goals homes that are already built and painfully paid for, the large cars standing in their parents' garage, and they cannot derive their youthful ideas from the strength of the Deutsche Mark. I am not, once more, going to point an accusing finger at the parents--they are no supermen and superwomen, and in most families they do what they can for their children. If accusations must be made at all, they must be directed against my coprofessionals. Why, in all those decades, did my colleagues not tell parents to give their children a value orientation? All problems of the toddlers and all crises of puberty have been talked to death in popular discussions. But parents have not been prepared for the most important step in their children's life when the young must prepare themselves to find their own tasks and challenges--for this central moment of searching for meaning in the maturing process! 
+Areas of Blocked Meanings 
+In fact, the opposite is true. In three areas of education the views of the contemporary experts have actually stifled the orientation toward meaning and values. Let me briefly discuss the three areas: 
+The first is accomplishment. Nowadays it is risky for a psychologist even to use the word for all its negative connotations the experts have heaped on it. Catchwords like "achievement pressure" and "excessive demands" on the "overworked" child have made such inroads that today teachers are scared of the students, and parents are scared of the children. "Don't ask for achievement" was drummed into the teachers, and "don't accomplish" into the students. Those who study are ridiculed for their ambition, those who work are seen as selling out to the Establishment, and those who save money are pitied as bourgeois. How can a generation with such a philosophy of life understand the constructive work of their parents? How can the young people feel satisfaction with their own work, pride in workmanship, how indeed can they be at all motivated to seek fulfillment in work, even in hobbies if everything that results in human accomplishment has been devalued into derision? 
+The second area for which the experts have to accept responsibility is the concept of the group. For a time only sociological groups seemed to exist, the individual did not count. The group dictates to its members, it pressures and absorbs them. Woe to those who try to break out, woe to the youth who won't walk the scene unkempt and in bluejeans. They are not "in." Smoking, alcohol, drugs are taken for the sake of the group. 
+II 
+
+If you are not good in bed you lose the approval of the group. If you don't join in ridiculing authorities the group laughs at you. I have seen parents asking the counselor for advice because their "abnormal" children love classical music, causing trouble with their peers. A youth who is not familiar with the latest beat groups and pop singers does not count. What madness to subordinate all individuality and interests, talents, views, and meaningful satisfactions to an imaginary group which consists of conformists. How ardently have the psychologists and educators drilled into the parents to knuckle down uncritically to The Group: if all children read comic books, the parents must not withhold such literature from their children· if all classmates read detective stories until midnight, so must their child. How are these young people in later life to find their own personal style, their own tasks, the muchvaunted self-actualization; how can they mature into that unique and unexchangeable identity that every person should and must attain, if they have nobody and nothing to orient to but "the others?" 
+The third area in which our experts have sowed dangerous misconceptions among people concernsfreedom. 
+The young people's shout for freedom is as loud as their concept of freedom is false. True freedom demands the highest measure of responsibility. It does not allow the chaos of reckless acts regardless of consequences. Freedom does not mean to do what you want but to want what is calledfor. I do not mean dictated by an outer authority but called for by the inner authority of the conscience which is responsive to what in logotherapy is called "the meaning of the moment." Free are those who include themselves in a structure they recognize; unfree are those who reject any kind of structure. 
+In the mistaken belief that they can win 
+freedom by throwing out rules, disregarding 
+laws, and overstepping limitations, young 
+people frequently succumb to dependencies 
+they don't even recognize. The conking out 
+of a TV set can be a catastrophe for a week
+end because the youngsters have become 
+so dependent on it that they don't know 
+what to do with their free time. They only 
+know what not to do with it, they know 
+their freedom from, namely from work, 
+tasks, responsibleness. 
+True freedom means a freedom to--productive creation, affirmation of somebody or something, the carrying out of a selfchosen task. Many of the young are far removed from such a concept, accepting dependencies on the most ludicrous fashion fads and demonstrating their desire for freedom by revolt and violence. Here, too, educational help should be available when they are still very young so that the ability for free and goal-directed decisions is combined with the awareness of responsibleness. 
+"Preventive Education" 
+These comments are sketchy, designed to outline the central concerns of modern counseling. Frankl's logotherapy is psychotherapy, philosophy, and anthropology combined, but it also includes valuable educational aspects. To reveal the meaning crisis of our youths in all its aspects is not enough. What is needed is to offer parents and children genuine help and thereby reduce--if not prevent--the world-wide spreading of the existential vacuum. 
+We psychotherapists are easy victims of the illusion that we can heal everyone's ills. True healing would mean that no one needs us. We like to fight fire instead of fighting arson. We play doctor for sick minds without being able to protect the healthy ones. We do not acknowledge the proverbial wisdom that one ounce of prevention is better than one pound of cure; if we did we would give pedagogy our priority, not psychopathology. 
+A mutual relationship exists between education and mental health. Educational counseling institutions have long discovered that, to be successful, parents need to be aware of the therapeutic resources of the human spirit. It is time for psychotherapeutic institutions to recognize that preventive education of our children and young people is mandatory. While the psychotherapist tries to renormalize one human being, two others lose their grip on life because their education in the widest sense of the word was insufficient. Most psychotherapies, starting from the sick and abnormal, present a reductionistic caricature of the healthy human being. Psychotherapists will have to learn to concern themselves with healthy persons. There is only one contemporary psychotherapeutic theory that provides the 
+
+12 
+necessary spiritual underpinnings--a view of humankind that starts from the multidimension of the healthy person and deducts from it what the sick person needs. This theory does not deduce from the clinical history of compulsive sexual neurotics an all-dominating instinctive drive in the healthy person; nor does it conclude from conditioned abnormal reactions of patients that the nor
+mal individual is a learning machine without a will. That theory, Viktor Frankl's logotherapy, finally puts an end to psychological and sociological determinism that chains human beings all their lives to their childhood experiences and sociological environments. 
+It took psychotherapy half a century to restore to humans what they always knew in their unconscious: that they have freedom of choice, responsibleness, and a will to meaning. This is the direction in which we must counsel parents today, for the sake of their children's future. This is the direction in which we must guide the young people if we wish to lighten their burden. Let us never forget: our investments in an education toward developing a full human being are the premiums for the only existing life insurance for a meaningful life. 
+Translated by Max Knight. 
+ELISABETH LUKAS is the head ofa counseling center in Munich, Germany, and the originator ofthe logo-test. 
+
+13 
+
+Logotherapy and Senior Adults 
+Alan P. Farr 
+The main thrust of this study was focused on Viktor Frankl's concept of meaning. The precise structure utilized was the search-formeaning group principle as outlined below. In addition, two useful guidelines were taken into consideration by the group leader in view of the fact that he was relating to senior adults and their specific needs. 
+The first guideline followed Erik Erikson's epigenetic life cycle theory (1) in which the human life structure moves toward the eighth and final phase of "mature adulthood." In this phase the basic virtue is "wisdom" and the nuclear tension is indentified as "integrity vs. despair." In working with elderly people, one 
+soon becomes aware of the erodin_g effects of despair within the lives of those who have lost effective contact with personal meaning. To counter such despair, the person's sense of integrity is reinforced through discovery, or rediscovery, of past and present personal meanings. 
+The second guideline used by the group leader is Robert Butler's "life-review princiole" (2). This principle provides the means whereby aging persons are helped in rediscovering meaning in past situations which at that time seemed to have little or no meaning. It also provides new opportunities for evaluating the past and even discovering that what had appeared meaningful (and had been integrated into the personality structure as meaningful) was not actually the real meaning at that stage of life. The shift in emphasis usually results in a strengthening of that person's sense of integrity rather than weakening 
+it. Hence, the life review centers on past mean
+ings, evaluates them in the light of present 
+needs, and then assesses them in terms of 
+handling present and future life situations. 
+
+
+The Formation of the Search-for-Meaning Group 
+The need for such a group arose initially from a request made by several senior adults for help in discovering a therapeutic medium which would be relevant to their existential needs and circumstances. I indicated to them that I had found Viktor Frankl's concept of logotherapy to be particularly valuable to people of all ages and circumstances. I then outlined his concept of meaning and its realization by means of a value system which incorporates creative, experiential, and attitudinal values for discovering personal meaning in all life situations. I also referred to Frankl's contention that there is a creative potential within every person and that, as we discover our own particular area of creativity, we also identify a wider dimension of meaning within ourselves and our environment. Likewise we are able to draw upon experiential values. It is possible to experience the creativity of other people and integrate it within our own personal meaning structure. Identified with these two important values is a third, and very necessary, set of values known as "attitudinal." This refers to the attitudes which we bring to bear upon the situations with which life confronts us. Even though there may be occasions when it appears as though there is nothing available to us whereby we may exercise our creativity, and nothing of other people's creativity to which we can respond experientially, our hold on meaning can still be maintained by the positive attitudes which we adopt even toward such denigrating circumstances. 
+At the conclusion of this brief introduction to logotherapy, an elderly woman responded by saying, "It appears as though we are on the way to discovering something which we 
+
+14 
+older people desperately need, and that is a sense of meaning-for-living which is personal to our individual needs and circumstances." And so the search-for-meaning group came into being as a means for meeting the needs of senior adults. 
+Within a short time approximately 20 people were meeting on a regular weekly basis, their ages ranging from 62 to 82 years. No terminal date was set for the group, on the assumption that to do so might limit important meanings of which we might not be aware at the time of its inception. However, individual members had the right to discontinue attendance without pressure being applied in the direction of keeping that person within the 
+group. This procedure worked extremely well 
+and appeared to minimize the over-all level of 
+anxiety. In such a group it was also important 
+that the leader avoid pressuring the members 
+to move more rapidly in self-disclosure than 
+they were prepared to move at any specific 
+time. Also, it seemed wise to point out that 
+even though the sharing of thoughts and feel
+ings by members of the group in regard to 
+their discoveries of meaning would be of 
+value to all, the meaning which would be most 
+relevant to the individual would be that which 
+was unique and personal to him or her. 
+Viktor Frankl's book, Man's Search for 
+
+Meaning, was chosen as the basis for group 
+interaction. As members began to identify 
+with the insights provided by the author they 
+moved away from theoretical concepts to
+wards personal meanings which they dis
+covered even in the midst of suffering and 
+deprivation. On the basis of such a study, it 
+was not surprising to find a large measure of 
+support, nurturance, and encouragement 
+within the group. There is no doubt that this 
+contributed greatly to the considerable per
+sonal growth which took place. The following 
+example illustrates these attributes and also 
+indicates how they can provide stimulus for 
+releasing important creative impulses which 
+had been blocked by a series of traumatic per
+sonal experiences. 
+The Case of Jean 
+"Jean," approaching her middle sixties, had been a remedial speech teacher in one of the large county school systems. Her father became a chronic invalid and the mother was unable to cope with the situation. Hence, Jean was required to resign from her teaching position in order to care for her ill and aging parents. After several years the parents died but by then Jean felt that she had been away so long from her specialized work that it would not be possible to make an effective return to it. Basically she had lost confidence in herself and in her personal skills. Previously she had displayed considerable creativity in poetry, prose writing, painting, and in composing interesting and instructive plays for performance in schools. She was convinced that either she no longer had these skills or that the effective expression of them had been blocked by a series of negative circumstances. In the midst of a crisis situation which was impinging upon her from many sources, she decided to attend the search-for-meaning group. Here it soon became evident that she was undergoing emotional suffering more severe than any other person within the group. However, her lack of an adequate self-image made her hesitant to talk about her suffering in case she could not control her feelings and thus "dissolve into tears.'' 
+One day Jean brought to the group a poem which she had recently composed. Through it she expressed a great deal of personal suffering which she had experienced in recent years and she offered herself to the group through this creative art form. She was obviously deeply moved by the supportive and nurturing response from the members of the group. A few weeks later Jean was encouraged to share with them an incident relating to her struggle to recapture her artistic ability in regard to painting. For months she had struggled against an inner resistance until finally she reached the point where, as she said, "I broke through the barrier, lifted the brush and began to paint. Soon there were hills in the dis
+tance, acres of blue water, and in the fore
+ground a neat, flat, serene little island with 
+rows of neat little trees. The brush soon frus
+trated me, however. I threw caution to the 
+winds and began to paint with my hands. The 
+hills became rougher and rockier. The lake 
+began to blow up a storm with white-caps and 
+waves corning at the island. Then, impulsively, 
+I pushed my thumb up through the middle of 
+the island and there suddenly was a rough 
+chunk of rock with nothing growing on it. I 
+was surprised! I wasn't sure I liked it. It wasn't 
+in the original plan. Then I walked up to the 
+
+15 
+island and with my thumb sliced down through it, cutting it in half like a miniature Half Dome. With a brush I put in some rocks at the foot of the cliff to show where the missing half of the island had fallen in. Again I was puzzled as to why I had done it. That wasn't 
+part of the original idea, either." 
+
+A few days later, Jean showed the finished canvas to a friend who immediately exclaimed, "A chopped-off island! Who is that island?" Somewhat startled, Jean replied, "I guess it must be me." At the next search-for-meaning group she recounted the details of her attempts to return to painting and the members responded to her with interest and understanding. When it seemed as though she had concluded her story, the group began to move into other areas of concern. Jean looked at me with a smile of amusement on her face and quietly said, "I haven't quite finished my story yet!" She then proceeded to expand upon the metaphor of "the chopped-off island.'' Jean stated that she had now moved on from a concept which had been comfortable because it symbolized a point of retreat for her and a means of isolating herself from the traumatic aspects of daily life. Then, with considerable conviction she said, "I have discovered that I am not the island! I am a real person. I know this makes me more vulnerable to the shock-waves of life and of living in a world of real people and events. But I am a real person and must be prepared to accept all the forms of responsibility which accompany my realness, including the painful episodes. With the supportiveness of you people in this group I believe I will be able to make it." 
+At the conclusion of this meeting I said to Jean, "When you confronted me with the fact that you had not completed your story, and requested the right to do so, I felt a strange sense of excitement. I realized that it must have taken a great deal of courage for you to assert your rights under the circumstances. The exciting thing to me is that it illustrated the fact that you are no longer that island. You have the ability as a real person to move backward and forward to and from the island. In the meeting today you demonstrated your intention to spend far more time on the mainland than you have been doing in the past. You really have come a long way in these last few months, haven't you?" She laughed and replied, "I believe I surprised even myself. But I know for sure that I wouldn't have dared to assert myself if I had not been able to trust the supportiveness of the people within the group. A person needs a great deal of support and real encouragement to soar on the wings of the spirit." 
+Although it may seem as though the main emphasis in this illustration is upon the recovery of creative impulses, the full sweep of Frankl's value system was being continually utilized by the group members and drawn upon by Jean in her successful attempt to recreate the potentials which had been stifled by circumstance. Through a clearer understanding of the personal meaning which can be achieved through the exercising of creative, experiential, and attitudinal values, Jean discovered a practical means for maximizing personal growth in the mature adult phase of her life. And in doing so, she became a kind of catalyst for the latent creativity of others within the search-for-meaning group and for their expression of the deep human feelings which previously they had been hesitant to share. 
+The Alchemist Model 
+Many approaches to the problems of aged people appear to focus on the "solitary alchemist model." This identifies the senior adults in terms of their being involved in life's final and crucial problems-that is, placing all past experiences, successes and failures, philosophies, and religious concepts into a metaphorical crucible and frantically crushing them together under the urgent pressure of approaching death. This approach is used by those who consider death to be the negation of life and the cancellation of those values which had previously appeared relevant to their personal awareness of living. Unfortunately this attitude frequently contributes to the despair factor in Erikson's concept of integrity vs. despair in the final phase of the human life cycle. 
+Within the logotherapeutic approach the "alchemist" image is negated by a realistic awareness that even death itself can be regarded as a legitimate part of the structures of personal meaning. Also, within the searchfor-meaning group the "solitary" aspect of the alchemist model was superseded by a corporate concern, as the genuine acceptance of the group became evident. There was no place for a private crucible in which the pain of 
+
+16 
+separation, the sense of loss and deprivation, and the feelings of abandonment and despair could be deposited. Other members of the community of concern were encouraged to add ingredients from the resources of their own creative experiences and to share their reserves of strength with one another. Hence, 
+REFERENCES: 
+1. Erikson, E. ff. Identity and the Life Cycle. New York, 
+N.Y., International University Press, 1959. 
+
+2. Butler, R.N. Aging and Mental Health. St. Louis, Mo. Mosby Mo., 1973. 
+the search-for-meaning group (with its emphasis on creative, experiential, and attitudinal values) provided a valuable human impetus for enabling individual members to move their own experiencing of meaning out of the private archives of personal awareness into the existential area of corporate ownership. 
+ALAN FARR is Minister of Senior Adults, Uniting Church, Adelaide, Australia. 
+17 
+
+Paradoxical Intention: A Review of 
+
+
+
+Preliminary Research 
+L. Michael Ascher 
+
+Logotherapy is unique among existentially oriented psychotherapies in that it provides specific therapeutic directives (1). These directives are subsumed under the aegis of "paradoxical intention", a label first employed by Frankl in 1939. Due to the effectiveness of the technique in a wide variety of clinical contexts, it has been employed extensively and with great success both by logotherapists (e.g., 2, 3, 4, 5), and by those espousing alternative therapeutic models (e.g., 6, 7, 8, 9, 10). 
+The major problem with paradoxical intention is the dearth of well controlled experimental investigations of the technique. Rather, the relevant literature is composed almost entirely of uncontrolled case studies. The value of such data in corroborating hypotheses regarding the efficacy of a therapeutic procedure is, of course, nil. Recently, however, several researchers have been able to provide supportive data from reasonably well controlled experiments. The purpose of the present paper is to review these studies. 
+The first published report which focused on a controlled investigation of paradoxical intention was conducted by Solyom, GarzaPerez, Ledividge, and Solyom (11). Their pilot study utilized 10 patients each complaining of numerous recurrent obsessive thoughts. The subjects were required to choose two obsessions which they considered to be of equal strength. They were then provided with the rationale of paradoxical intention and instructed in its use. They were asked to apply the paradoxical intention procedure systematically to one of the two obsessions (the "target" symptom) and to deal with the other obsessive thought (the "control" symptom) in ways that they were used to. Thus, whenever they experienced the target symptom patients were told not to try to avoid it, but to dwell on it and to elaborate the thought. Each subject was seen individually for one hour per week during a six week period. Other aspects of their treatment remained unchanged. For five of the ten patients, the target symptom was much less frequent or eliminated. For three patients the target symptom was unchanged, and two failed to apply the technique appropriately. Although there are many criticisms of the Solyom, et al study (11), notwithstanding its "pilot" status, its importance is reflected in the fact that it represents the first attempt to place paradoxical intention within an experimental context. 
+A paper by Ascher (12) extended by Ascher and Efran (13) provided a second successive approximation to the goal of providing a well controlled investigation of paradoxical intention. From a sample of self referred individuals complaining of sleep onset insomnia, five who resisted the behavioral treatment of choice were utilized in a multiple case study. Each client had provided at least two weeks of baseline data and had been exposed to ten weeks of a multi-technique behavioral program. At the conclusion of the period during which behavioral procedures were employed, clients reported that the degree of improvement which they had 
+experienced was not sufficient to warrant the cessation of therapy. On the other hand, most felt that they had reached a plateau and that further progress would have to come from another approach. 
+At this point, a paradoxical suggestion was administered in a manner similar to that employed by Milton Erickson and others in a clinical setting (e.g., 7). That is, the paradoxical instructions were presented in a context which could be most readily accepted 
+
+18 
+by the specific client. For example, clients who had been treated by dynamically oriented therapy prior to consulting with the present author, typically complained that we were not getting to the "root" of the problem. They were not able to sleep because of some "unconscious" conflict and the therapeutic approach to which they were now being exposed did not seem capable of dealing with such material. In response to this criticism the author would suggest that the present therapeutic techniques could address such "unconscious" information if the client were able to produce situations at home which were optimal for this material to surface. For example, such a condition occurred, the author suggested, at bedtime, while the client lay awake thinking. The longer he or she lay awake, the more significant were the thoughts. Sleep actually was a way of keeping unconscious material in the unconscious. Thus, the client was instructed to try to remain awake as long as possible after turning out the lights at bedtime. The five clients in Ascher and Efran's (13) study provided with this type of rationale experienced the immediate reduction of their sleep onset latency and further attention to this problem was terminated after two or three weeks. Ascher and Efran were successful in applying paradoxical intention in the manner typically employed by a large number of therapists in a therapeutic setting; further, they utilized the technique with clients complaining of clinically significant levels of insomnia. The five controlled case studies thus provide substantial support for the clinical efficacy of paradoxical intention. 
+It should be noted that there are at least two methods for providing clients with a rationale for the use of paradoxical intention. Ascher and Efran (13) utilized a procedure which places the explanation in the context of the client. This is particularly effective in enhancing cooperation of resistive individuals. Unfortunately, because of the idiosyncratic nature of the explanations, and the need for spontaneity of administration (Ascher, in press), such a procedure rarely lends itself to experimental research. The alternative is to provide the client with the rationale as the clinician actually conceives of it (14, 5). Such an explanation would be similar for all clients and would therefore be suitable for the purposes of controlled research. 
+Turner and Ascher (I 5) presented data from the first controlled experimental investigation of the clinical efficacy of paradoxical intention. As was the case with Ascher and Efran (13), Turner and Ascher (15) employed individuals who self-referred to an outpatient clinic complaining of clinically significant levels of sleep difficulty. Each of 50 subjects was randomly assigned to one of five groups. These included three treatment procedures (paradoxical intention, progressive relaxation and stimulus control) and two control conditions (placebo and no treatment). Clients were provided with weekly sessions of individual therapy conducted over a one-month period. The results indicated no significant differences between the two control groups and no significant differences among the three treatment groups. However, the data analysis did yield significant differences between the experimental conditions on the one hand and the control conditions on the other. Thus, when compared with progressive relaxation and stimulus control, two procedures which have substantial evidence supporting their effectiveness in ameliorating sleep difficulty, the experimentally untested technique, paradoxical intention, produced equally satisfactory behavior change. This suggests that paradoxical intention can be considered among those procedures which are effective with individuals exhibiting primary sleep disorders. 
+In an attempt to partially replicate the data obtained by Turner and Ascher (15), Ascher and Turner (16), again employing insomniacs, randomly assigned clients to one of three conditions: paradoxical intention, placebo control, and no treatment control. The results indicated a significant difference between clients receiving paradoxical intention and those exposed either to a placebo procedure or to no treatment. The study by Ascher and Turner (16) thus provides some additional support for the efficacy of paradoxical intention in ameliorating disorders of sleep, when compared with control procedures. 
+Ascher and Turner ( 17) are in the process of completing a second replication and extension of the Turner and Ascher (15) article. In addition to the five groups which compared the Turner and Ascher (15) study, 
+
+19 
+a sixth condition combines progressive relaxation, stimulus control, and paradoxical intention into one treatment package for primary insomnia. Another difference between the two studies concerns the therapist. In the Turner and Ascher (15) study, the senior author administered the four procedures. In the Ascher and Turner (17) study, the authors have chosen to supervise experienced therapists who, in turn, provide therapy directly to the clients. In most other ways, 
+the two studies are identical. A preliminary analysis indicates that the present experiment replicates the data of Turner and Ascher (15) indicating no differences between the control groups or among the three original treatment groups (paradoxical intention, progressive relaxation, and stimulus control), but obtaining differences between the control procedures vs. the treatment techniques. 
+The three studies collectively (15, 16, 17) seem to indicate that paradoxical intention represents a viable method for ameliorating clinically significant levels of sleep disturbance. 
+Ascher and Turner have now begun to explore variations of the paradoxical intention procedure in an effort both to determine the basis for its effectiveness with sleep disturbances and to enhance that effectiveness. For example, a study which is close to completion compares the two modes of rationale for the use of paradoxical intention provided to the client; appropriate control groups are included in the design. Specifically, 40 clients presenting with clinically significant levels of sleep disruption were randomly assigned either to one of two paradoxical intention groups, or to one of two control groups. Instructions administered to clients in the paradoxical intention groups were either a straight forward explanation of the dynamics of the procedure as the present 
+
+REFERENCES: 
+1. Frankl, V .E. The Doctor and the Soul: From Psychotherapy to Logotherapy. New York: Knopf, 1955 
+2. 
+Gerz, H.O. The treatment of the phobic and the obsessive-compulsive using paradoxical intention.Sec. Viktor Frankl. Journal of Neuropsychiatry, 1962, 3, 375-387. 
+
+3. 
+Gerz, H.O. Experience with logotherapeutic technique of paradoxical intention in the treatment of phobic and obsessive-compulsive patients. American Journal of Psychiatry, 1966, 25, 548-553. 
+
+4. 
+Frankl, V. E. Paradoxical intention: A logotherapeutic 
+
+
+experimenters understood it (14, 5), or a rationale which seemed to fit the idiosyncratic context within which the client exhibited the sleep dysfunction (6, 7, 18). The former rationale is that typically used in the experiments by Ascher and Turner, and the latter 
+was incorporated by Ascher and Afran (13) into their study. A placebo attention control and a no-treatment condition composed the two control procedures. A preliminary analysis of the data indicated that clients exposed to either paradoxical intention procedure experienced significantly greater improvement in their sleep behavior than did clients assigned to either control condition. This study therefore suggests that paradoxical intention can successfully ameliorate disorders of sleep when it is administered in the manner of any legitimate therapeutic technique (i.e., when the client is fully informed of the rationale of the procedure and that this rationale does not vary from one client to another). This should not imply criticism of the more dramatic and spontaneous method of administering paradoxical intention (as utilized, for example, by 13, 6, 7, 18), it simply indicates that both methods, under the appropriate circumstances, can be effective. 
+While the studies reviewed in the present paper contain some shortcomings, they serve to demonstrate that paradoxical intention can be exposed to controlled experimental investigation. They also provide tentative evidence that paradoxical intention is a clinically effective procedure, at least with clients complaining of disruptions of sleep. 
+L. MICHAEL ASCHER is associate professor, Department of Psychiatry, Temple University, Philadelphia, and a psychiatrist in private practice. 
+technique. American Journal of Psychotherapy, 1960, 14, 520-535. 
+5. 
+Frankl, V. E. Paradoxical intention and dereflection. Psychotherapy: Theory, Research and Practice, 1975, 12, 226-237. 
+
+6. 
+Haley, J. Strategies of Psychotherapy. New York: Grune and Stratton, 1963. 
+
+7. 
+Haley, J. Advanced Techniques of Hypnosis and Therapy. New York: Grune and Stratton, 1967. 
+
+8. 
+Haley, J. Problem Solving Therapy. San Francisco: Jossey-Bass, 1976. 
+
+
+
+20 
+9. 
+Raskin. D.E. and Klein, Z. E. Losing a symptom through keeping it: A review of paradoxical treatment techniques and rationale. Archives ofGeneral Psychiatry, I 976, 33, 548-555. 
+
+10. 
+Rosen, J. Direct Psychoanalysis. New York: Grune and Stratton, 1953. 
+
+
+II. Solyom, L., Garza-Perez, J., Ledwidge, B.L., and Solyom, C. Paradoxical intention in the treatment of obsessive thoughts: A pilot study. Comprehensive Psychiatry, 1972, 13, 291-297. 
+12. 
+Ascher, L.M. Paradoxical intention as a component in the behavioral treatment ofsleep onset insomnia: A case study. Paper presented at the Association for the Advancement of Behavior Therapy, San Francisco, CA., December, 1975. 
+
+13. 
+Ascher, L.M. and Efran, J.S. The use of paradoxical intention in a behavioral program for sleep onset insomnia. Journal of Consulting and Clinical Psychology, 1978, 46, (3), 547-550. 
+
+
+14. 
+Ascher, L.M. Paradoxical intention. In A. Goldstein and E.B. Foa (Eds.) Handbook ofbehavioral interventions. New York: John Wiley and Sons, in press. 
+
+15. 
+Turner, R.M. and Ascher, L.M. A controlled comparison of progressive relaxation, stimulus control, and paradoxical intention therapies for insomnia. Submitted to the Journal ofConsulting and Clinical Psychology. 
+
+16. 
+Ascher, L.M. and Turner, R.M. Paradoxical intention and insomnia: An experimental investigation. Paper presented at the International Congress of Behaviour Therapy, Vienna, Austria, September, I 978(a). 
+
+
+17. Ascher, L.M. and Turner, R.M. The behavioral treatment of insomnia: An experimental evaluation oftherapist and client factors. In progress, I 978(b). 
+18. Watzlawick, P., Weakland, J., and Fisch, R. Change: Principles ofproblem formation and problem resolution. New York: William Norton and Co., Inc., 1974. 
+
+21 
+Logotherapy 
+Viktor E. Frankl 
+
+The .fo!lowin:< is rhe first authentic defini:ion of loJ?,olherapy and its main features, wril!en hy Viktor Frankl for Psychotherapy Handbook, edited by R. Herink, to be published, New York, New American library. 
+Logotherapy (I), or existential analysis 1Existenzana/yse) as it also has been called "" its founder, Yiktor E. Frankl of Vienna, 1, referred to by many authors in terms of the Third Viennese School of Psychotherapy (after Freud's psychoanalysis and Adler's individual psychology). To Frankl, logos means meaning, and logotherapy, indeed, centers and focuses on Frankl's concept of a "will to meaning," (2) the striving, that is, to see in life, and fulfill, a meaning and purpose. Today, however, ever more patients complain of a sense ;)f meaninglessness (3) and emptiness which Frankl has termed "existential frustration" or "existential vacuum," respectively. So far, two test devices have been developed in order to measure an individual's existential frustration, namely, James C. Crumbaugh's PIL Test (4) and Elisabeth S. Lukas' Logo-Test. Existential frustration need not but may well result in neurosis in which case Frankl speaks of a 
+•·noogenic neurosis" in contrast to the conventional, i.e., the psychogenic neurosis (5). According to statistical studies conducted in various countries both in Europe and America, about 20 percent among the cases of neurosis accruing in clinics and hospitals are noogenic. In such cases, logotherapy is the method of choice. However, it also lends itself to the treatment of obsessive-compulsive (6) and phobic cases in which anticipatory anxiety has established a vicious circle: a symptom evokes a phobia, the phobia provokes the ,ymptorn to reappear, and the reappearance , ,! the wrnptnm reinforces the phobia. A 1 •L'lll herapeut1c Iechnique that Frankl de
+;cnbeu in a paper published by him in 1939 (8), namely, "paradoxical intention" (9), is devised to break this feedback mechanism by inducing the patient to deliberately "try to do, or wish to happen," the very things he fears. In other words, the pathogenic fear is replaced by the paradoxical, ironical wish. What thereby is achieved, is a complete inversion of the original avoidance pattern of behavior on the part of the patient. Another logotherapeutic technique, "dereflection" (I 0), counteracts the fact that, as Frankl has pointed out, the more an individual aims at pleasure, the more he is liable to miss it (11). For pleasure is, and must remain, an effect of loving encounter (12) or meaning fulfilment, and is destroyed whenever it is made a target. As Frankl sees it, frigidity and impotence result from the very attempt of a male patient to demonstrate his potency, or female patient to prove to herself her capacity of orgasm. As to the treatment of noogenic neuroses, however, it is in no way the job of a psychiatrist to prescribe meanings, as it were. 
+It is rather up to the patient himself to choose his own meanings. And each person does have his own meaning, and so has every situation confronting him. "Man's search for meaning" thus winds up with a Gestalt perception, the perception of the meaning gestalts as they are inherent in each and every life situation. There is no life situation conceivable, Frankl teaches, that really would lack any meaning. Because meaning is available first through creating a work, or doing a deed; second, through experiencing something, or lovingly encountering a person; last but not least, however, there is a third possibility as well: even facing an unchangeable fate, say, an incurable disease such as an inoperable cancer, man may bear witness of the human potential to turn one's predicament into an achievement. Thus, life is unconditionally meaningful. But this contention does not involve moralizing but is based on a phenomenological analysis of the "pre-reflective 
+
+22 
+ontological self-understanding" (13) observable in the man on the street. Recently, logotherapy's axiology, like many other basic concepts evolved by Frankl, have been validated by empirical research on the grounds of computerized data that had been obtained from several thousand subjects. 
+REFERENCES: 
+I. Frankl, V .E. The Doctor and the Soul: From Psychotherapy to Logotherapy. New York: Knopf, 1955. 
+2. Frankl, V. E. The Will to Meaning: Foundations and Applications of Logotherapy. New York: New American Library, 1969. 
+3. 
+Frankl, V.E. The Feeling of Meaninglessness: A Chal
+
+lenge to Psychotherapy. The American Journal of Psychoanalysis, 1972, 32, 85-89. 
+
+4. 
+Crumbaugh, J.C. Cross Validation of Purpose-in
+
+
+Life Test Based on Frankl's Concepts. Journal of Individual Psychology, 1968, 24, 74-81. 
+5. Frankl, V.E. Psychotherapy and Existentialism: Selected Papers on Logotherapy. New York: Washington Square Press, 1967. 
+6. Solyom, L., Garza-Perez, J ., Ledwidge, B.L., Solyom, 
+C. Paradoxical Intention in the Treatment of Obssesive Thoughts: A Pilot Study. Comprehensive Psychiatry, 1972, 13, 291-297. 
+7. 
+Gerz, H.O. Experience with the Logotherapeutic Technique of Paradoxical Intention in the Treatment of Phobic and Obsessive-Compulsive Patients. American Journal ofPsychiatry, 1966, 123, 548-553. 
+
+8. 
+Frankl, V.E. Zur medikamenti:isen Unterstiitzung 
+
+der Psychotherapie bei Neurosen. Schweizer Archiv fiir Neurologie und Psychiatrie, 1939, 43, 26-31. 
+
+9. 
+Frankl, V.E. Paradoxical Intention: A Logotherapeutic Technique. American Journal of Psychotherapy, 1960, 14, 520-535. 
+
+10. 
+Frankl, V.E. Paradoxical Intention and Dereflection. 
+
+
+Psychotherapy: Theory, Research and Practice, 
+1975, 12, 226-237. 
+11. 
+Frankl, V .E. The Pleasure Principle and Sexual Neurosis. The International Journal of Sexology, 1952, 5, 128-130. 
+
+12. 
+Frankl, V.E. Encounter: The Concept and Its Vulgarization. The Journal of the American Academy ofPsychoanalysis, 1973, 73-83. 
+
+
+13. Frankl, V.E. The Unconscious God: Psychotherapy and Theology. New York: Simon and Schuster, 1975. 
+
+23 
+
+
+
+IN MEMORIAM 
+
+J. Randolph Sasnett 
+1890-1978 
+
+J. Randolph Sasnett, executive director of Educational Futures, International, Pasadena, California, introduced Dr. Viktor Frankl to the American university community. The following are excerpts ofMr. Sasnett's introduction of Dr. Frankl at the Inauguration of the Frankl Library and Memorabilia at the Graduate Theological Union, Berkeley, on February 13, 1977. 
+This is one of the deep experiences of my career: to have the opportunity to introduce one whom you honor today with the founding of a Library and Memorabilia which will conserve and perpetuate the incomparable work of Viktor E. Frankl, M.D., Ph.D. of Vienna. 
+I first learned of Viktor Frankl in 1954 from 
+an article in Woman's Home Companion, 
+"We Are Born to Believe." In it, Frankl was 
+quoted as saying, "To deny the spiritual side 
+of man's nature does it great violence." I 
+saw in this professor's holistic philosophy of 
+personality a challenge to the biologically
+based view of personality then prevailing in 
+U.S. 
+higher education. I wrote to Viktor Frankl and asked for a consultation. We met in New York and I offered him the sponsorship of our agency on a lecture tour to selected 
+
+U.S. 
+colleges, universities, and theological seminaries. He accepted. 
+
+
+The tour started in mid-September, 1957, and during the next month we visited 22 representative institutions with faculty members from seventy-five other colleges, universities and seminaries participating. Up from Princeton to Columbia, Union, N.Y.U., Yale, and on to Harvard, Brandeis and others, across to the University of Chicago and Mid-West institutions, and finally the University of Washington and down the coast to California campuses. It was a grueling tour, but the responses everywhere were so overwhelming that the early and late planes, the long hours of lecturing, the late bedtimes, the adapting to campus hosts and their varied situations, were all subsumed in the satisfaction of finding that what Viktor Frankl came to share of his philosophy of personality was what people had been waiting to hear, to believe, to teach, and to act upon. 
+This first successful tour resulted in two 
+others under our sponsorship. Institutional 
+set-ups and responses were the same. And by 
+that time, Viktor Frankl was on his own... 
+with more invitations to U.S. institutions than 
+he would ever again be able to fulfill in en
+suing years. 
+Viktor Frankl was the right man, in the right place, at the right time. This man and his eminent disciples have changed the psychological climate in American scholarship: an enlarged view of Man has emerged in higher education which now takes into account a human being's noetic dimension. 
+Out of hundreds of memorable situations which Viktor and I share from our month's touring in 1957, I would like to close with two anecdotes: one serious, one humorous, which might delineate in some abstract way the measure of the man. 
+The first scene is a lecture room at Harvard University. Gordon Allport, the distinguished social psychologist, is Frankl's host. The lecture has ended. As I sit in the back of the room I am wondering if Viktor Frankl of Austria has stood the test of this great man's 
+
+24 
+professional judgement. Dr. Allport walks slowly to the podium. He stands for what seems to me an interminable moment. Then he says, "Dr. Frankl, you have presented to us a masterful exposition of Logotherapy, in excellent English, and in so doing you have built for us a new bridge to Vienna." 
+My last scene is in an airplane leaving Seattle for California. As you all know, Viktor is an avid mountaineer. Having been a Washingtonian for ten years of my professional life, I was eager to have Viktor see Mt. Rainier which was dear to my heart. During our stay in Seattle the mountain had been swathed in clouds, but as our plane left Seattle the sun came out and suddenly high in the heavens beside the windows of our plane Mt. Rainier was revealed in all its snow-capped majesty. I tapped Viktor, whose head was buried in a letter he was writing. "Viktor," I said, "there's Mt. Rainier." He raised his head, looked out the window, and followed the mountain as we circled and flew South. Then he resumed his writing. Somewhat shaken by his indifference, I said, "Viktor, what do you think of our Mt. Rainier?" "Randolph," he replied curtly, "we save mountains like that for our grandmothers to climb." 
+And so ... I give you my cherished friend, Viktor Frankl, whose intellectual intrepidity and daring have helped us all to scale new heights from which to view the nature of men and women in all their uniqueness and spiritual outreach. 
+
+
+25 
+
+The "Ally Approach" in Teaching and Counseling 
+Margaret G. Alter 
+
+One of the most distinctive features of logotherapy is Viktor Frankl's affirmation that life meaning endures in spite of unavoidable suffering. This value, the attitudinal value, is radical and liberating. Its practical application to teaching and counseling is timely and invaluable. 
+Many teachers and counselors have felt the impact of popular psychology, the human potential movement. Their work is hampered by the sentimental permissiveness advocated by such authors as John Holt, George Leonard, and James Herndon. The news media is full of cliches: "What do you want out of life?" "Fulfill your potential." "Listen to your feelings." "Express your anger." Teachers and counselors in difficult and low-income areas know only too well that they have been betrayed. Popular psychology with its emphasis on education-as-fun simply does not work. The communities mistake teacher understanding and affective concern as indifference. Parents complain angrily, "Teachers don't expect anything of our children. They don't care." In fact, teachers care too much. But caring teachers read the wrong materials only to find that many popular new methods fail. One beleaguered teacher from Watts received overwhelming support from local parents when she declared: "The kids need directions. They don't know what they want out of life! They see pushing and pimping and whoring. Is that how they are to fulfill their potential? No! To care for these kids is to make them become competent in spite of their feelings! I have to support them by determined tough expectations." This teacher became an ally to help change their expectations of life. 
+In a halfway house for heroin addicts, one participant in an encounter "game" shouted at a shaven inmate who had broken one of the house rules, "You broke it because you felt like it? What kind of reason is that? You've been doing what you felt like all your life and look where it's gotten you!" Later I commented on his harshness. "Yes," the inmates agreed, "it's safe here to say what we really think. Here we're protected from destroying ourselves.'' 
+Mrs. B., one of my clients, a middle-aged woman once hospitalized for schizophrenia, seriously questioned the popular challenge to "freely express your anger. " "I get so angry," she confided, "that I want to kill someone. I'm glad I don't have a gun. Once when I was working in a store, I threatened to throw something at a customer.'' 
+Popular psychology, rooted as it is in the lives of the priveleged, has little to offer to those who live daily with unavoidable suffering. Logotherapy asks a different question. Not "what do you want out of life," but rather, "what is life asking of you at this moment?" Frankl insists that it is not the pursuit of happiness that leads to a meaningful life; it is the self-transcendent willingness to meet life's challenges that leads to happiness unpursued. 
+This philosophical position also has practical therapeutic applications. Frankl not only faces unavoidable suffering with his patient, but he faces it as the patient's ally. This therapeutic application of attitudinal values became readily apparent in a taped interview made during Frankl's visit to California in October, 1963. Frankl interviewed an obese woman who suffered from a variety of incurable physical problems. 
+
+26 
+The clinician presenting the case to him read a brief summary of the patient's problems: psychogenic obesity occurring after five miscarriages. Frankl received the reports and began gently to raise some questions about her weight. "When did the overweight first appear? How did the doctor explain it? How were the miscarriages explained?" The woman, now 47, explained that she had been at least 30 pounds overweight since her early twenties and that the miscarriages were not explained. Doctors only urged her to try again. "Why is the diagnosis only psychiatric?" Frankl asked. "When the doctors tell you it is psychogenic obesity, you feel responsible. The organism has its own disturbances." 
+The patient explained that her doctors had worked separately, the psychiatrist not consulting the others. Frankl at that point completed his move into a position as an ally in her suffering. "Everyone is satisfied if he labels you as a passive dependent type. And you feel responsible and guilty. But you are not responsible for these miscarriages and so forth. You are afflicted by a disagreeable and inconvenient organism. You are free to face the challenge of dealing with that organism, of accepting the obesity, accepting the loneliness. You can say to yourself: 'I'll make the best of it. I'll lead my own life. I'm not responsible for my obesity, but I am responsible for the way I live with it.' 
+Frankl became her ally in suffering, an ally helping her face the professionals who failed to help her, and helping her understand the difficult body in which she lived. The patient brightened as the interview developed. Frankl confidently reappraised her situation and applauded her courage. I have found the ally approach immediately useful in both teaching and counseling. 
+In my treatment of Mrs. B., mentioned above, I recognized a number of neurological and psychological limitations which placed considerable strain on her: she easily became lost, she was upset by noise or confusion, and she was so afraid of potential anger that she was unable to ask directly for needed support from friends and family. Even in the face of this suffering, her courage and love of life were obvious. Even though she easily lost her way, she loved to take trips around the city by bus. She planned these carefully and in detail in order to assure her safe return home. 
+Though she became upset by too much tension, she still planned evenings out with her husband and friends, occasions she greatly enjoyed. In spite of a limited ability to handle demands placed on her, she found volunteer work which was satisfying, useful, and involved little tension. I became her ally applauding her courage in continuing activities in spite of her limitations. I drew attention to her own joyful appreciation of little things which others might find ordinary. Together we faced the facts that there were many things she would never be able to do: she would never drive, never be able to hold a job, never be able to have large dinner parties, and then together we began to plan how structuring her life would enable her to have the most possible joy within her limitations. Weekly she became happier and more confident. 
+I have found Frankl's ally approach enormously successful for treating people who are prone to mild or moderate depression. After listening to one client describe her struggles with recurring bouts of sadness, I asked her to describe her favorite coping techniques. With her I faced the fact that the periods of sadness might continue, but I expressed my confidence in her ability to change her attitude toward her suffering. She need no longer be its victim. The depressive feelings continued to come, but she learned to set limits on their power over her. 
+Frankl offers teachers a new kind of toughness, to replace the toughness which has been eroded by the impact of popular psychology on public education. The teacher from Watts knew that the question "what do you want out of life?" led nowhere for many youngsters. The residents of the halfway house knew that following feelings can lead to a dehumanizing life of anarchy and personal chaos. Most teachers know that children without sufficient skills and competence are doomed to a life of continuing frustration, humiliation and unhappiness, and most teachers know that learning, for many youngsters, means suffering to accomplish what is painfully hard for them. The teacher has an opportunity to be a child's ally in this struggle. 
+"It isn't fair!" exclaimed a thirteen-yearold boy. "I work harder than most kids in this class, and I still can't read as well. Why do I have to have dyslexia?" 
+"What are your options?" the teacher 
+
+27 
+asked, immediatley challenging him to change his attitude toward this unavoidable dilemma. "None! I'll always have to work harder at reading." 
+"That's right. It's tough, and it isn't fair, and I think you show a lot of courage. I'm proud of you." 
+The teacher was his ally. She was on his side facing the hard facts, and affirming his courage. Suffering is a fact of life that can be recognized and handled. 
+Often a teacher has to break the news to a young person that he does not know as much as he thought he did. One community college instructor handed a paper back to a student explaining to him that he was practically illiterate. "You leave verbs out of your sentences. You do not check your spelling, and your papers have little logical order." 
+The student was stunned at first and then angry. ''I did very well in English in high school," he snapped defensively. "Our teacher there said we only had to write what we felt." 
+"Well, " said the instructor seriously, "if you write like this, I'm afraid you will look quite ignorant. I would be no friend to you if I allowed it to continue in the name of English composition. I must insist that you pull this together and write it again." 
+The teacher saw farther than the student. She knew that he had no competence in writing, and she was prepared to be an ally with him against his own laziness. Suffering need not be avoided; it can always be faced. 
+Frankl's technique of making himself an ally in the face of unavoidable suffering offers an invaluable tool to contemporary counselors and educators. 
+MARGARET G. ALTER is a licensed marriage, f amity, and child counselor with a private practice in Berkeley and also an instructor at Peralta College for Non-Traditional Studies, and co-author with Robert C. Leslie of Sustaining Intimacy, Christian Faith and Wholeness in Marriage. 
+
+28 
+
+"Rebirth" of a Marriage 
+Gunter Funke 
+Mrs. R., 47, suffered from increasingly severe depressions for eight years. For three years she received psychotherapy. Medical examinations showed her depression as not being endogenous. 
+About the previous therapy, she reports, ''The gift of life was given back to me.'' Her ego strength was stabilized, she found the courage to assert herself against her husband, while before that she had been completely submissive to him. The therapist saw her dependency on her husband as a reason for her depression. "When I was able to free myself from my husband, the depression lifted." 
+Her husband, however, felt alienated from her and blamed the psychotherapist for "siding with her against him." He refused to participate in the therapy, became hostile. This turn of events caused a severe relapse of her depression to the point where she considered suicide. 
+The therapist suggested that her depression was intimately linked to her marital situation. Her alternative seemed to be: divorce or depression. In her dilemma she came to me, a religious counselor. "I'm still very dependent on my husband," she said. "I don't think I can stand on my own feet. But when I am with him I feel desperate. What shall I do? The best thing for me is to disappear (suicide)." 
+In our initial discussions I outwardly went along with the suggestion of her therapist, and together we planned details of her separation (what kind of apartment to choose, how to move, what to do about their store, common property). The more we discussed these possibilities the more doubtful Mrs. R. became about a divorce. That slowly freed her for new alternatives. 
+First, however, I asked her what prevented her from taking actual steps toward divorce. She mentioned some material reasons which I did not consider important enough to warrant suggestions of my own. Finally, pressed by me for a reason why she should not divorce her husband, she broke into tears and said: "I don't see how I can leave a man with whom I have lived so long, whom I love, and who loves me, just because of a depression." Here we had come to the point where there was nothing more to demask, we had hit the bedrock of her human existence, and I considered her feelings so strong and genuine that I felt justified to suggest an alternative along her own, and not her therapist's value judgment. 
+I said: "Divorce or depression is not your only choice. You have these alternatives: to leave your husband and possibly get rid of your depression, or to stay with him even at the price of remaining depressed.'' 
+Now began the spiritual struggle for Mrs. R. in which she needed help to make conscious what in the depth of her unconscious she had already decided. I asked her if she realized what her statement really meant. Was she really ready, for the sake of her love for her husband to bear her depression? She had doubts, but I dared pointing out to her that she was preparing to make a great sacrifice, and that only her love could enabie her to go through with it. In our conversations she more and more tended to side with love plus possible depression against freedom with possible nondepression. Eventually she said: "I won't allow my depression to destroy my love.'' 
+Here, a change of attitude took place. 
+
+29 
+Mrs. R. adopted a new attitude in an unchanged situation. She made a decision that was her own. She realized her capacity, even in suffering, to transcend herself for the sake of someone she loved. And now she received a surprise which, from a logotherapeutic point of view, was no surprise at all: her depression lifted--because, for the first time, she saw a meaning behind her being depressed! After she told her husband about her decision, the depression disappeared almost completely. 
+What happened then was another development. When her husband realized that his wife had made a decision in his favor, even at the price of suffering, he also experienced a change of attitude. He was ready to participate in the therapy: together we were allies in a common struggle against Mrs. R's depression. He devoted more time to her, talked about a "rebirth" of their marriage, participated with her in a communication training course, and declared his willingness to reduce difficulties which he realized were at least partly his fault. A vacation was planned and taken together. I became superfluous. 
+The treatment made use of several logotherapeutic methods: A Socratic dialogue which made Mrs. R. aware of her value preferences, an emphasis on her choicemaking ability and responsibleness; dereflection of her attention from her depression to her husband; and paradoxical intention that made her not run away from her depression but able to face it. 
+Translated by Joseph Fabry 
+GUNTER FUNKE is pastor and pastoral counselor in Oldenburg, Germany. 
+
+30 
+
+The Boy Who Was Afraid to Come to School 
+Bianca Z. Hirsch 
+Logotherapy appeals to the school psychologist because of its practical applications. There is little time to delve into the why and wherefore of unwanted behavior patterns, and little information about events that might have caused them. The behavior may have no deep-seated causes, and logotherapy can be tried because the antecedents are not critical to the therapy. 
+In paradoxical intention "the patient is encouraged to do, or wish to happen, the very thing he fears" (1). But a child who is afraid of a certain situation is not a "patient." Paradoxical intention can be adjusted to the individual case and the method can be modifi~d and improvised. 
+A special-education teacher told me about her concern for a 10-year-old boy who refused to come to school. There had been no problem, neither in his regular class, nor in the special class for aphasic children to which he had been transferred to help him with his difficulty in processing what was being said and in mixing up a series of events. Recently, however, without apparent reason, he refused to come to school. Neither threat nor promise would change his mind. Although his teacher visited him at home and offered to drive him to school, Alfred refused. There had been no difficulty on the school bus, nor had he been scolded by the principal or any other member of the faculty. He had no problems with his classmates. Nonetheless, he refused to come to school. 
+I visited Alfred and we talked about many 
+
+things. I respected his decision about not 
+returning to school, and asked him whether 
+he would drive with me while I completed 
+some errands. He agreed. We drove past his 
+school but did not stop. The next day I asked 
+him to remain in the car while I delivered some papers to the principal. Before I left, I told him in no uncertain terms that under no circumstances was he to get out of the car and go near the school. He looked at me quizzically but obliged. The next day I picked him up again, and again we stopped at his school while I spoke to the teacher. I repeated my warning to him not to go near the school. On the third day, I drove him to the school where a kickball game was in progress. He was allowed to watch from the car but I told him he could not attend classes. Halfway through the game we left. The next morning, when I arrived at his home, his mother informed me that he had left in time to catch the bus. I called the school and learned that he had arrived on time, eaten breakfast with his classmates, and was playing in the yard. 
+
+
+Paradoxical intention had worked in a special way. Alfred had been given the opportunity to make use of his capacity of selfdetachment, and to look at himself and his activities from the outside, and with a sense of humor. After all, it did seem funny to a 10year-old to be told he could not go to school. He had been given the opportunity to make his own decision. 
+Later the reason for Alfred's refusal became known. He had been moved to the special-education class but because he was good in sports, after a while had been allowed to participate in the physical-education activities with his former regular schoolmates. He had become afraid they would look down on him because he was in a special class and had difficulty understanding rules of games and following directions. Although he excelled in the sport activities, he was afraid his friends would laugh at him. By refusing to go to school he protected himself from embarrassment. 
+31 
+His desire for socialization and the joy of playing on the team provided him with enough motivation to return. His self-detachment gave him the opportunity to realize that his teacher cared (rather than punished him) by transferring him to the special class, and that 
+REFERENCE 
+l. Frankl, V .E. The Will to Meaning: Foundations and Applications of Logotherapy. 
+New York and Cleveland, The World Publishing Company, 1969; paperback edition, New York, New American Library, 1976. 
+his classmates admired his ability in sport (rather than ridiculed him). Paradoxical intention helped him to see himself as a person who could make decisions rather than as the victim of an unchangeable disability, and to change his attitudes toward participation in school from the negative to the positive. 
+BIANCA Z. HIRSCH is a school psychologist in the San Francisco school system, working with aphasic students. 
+
+32 
+A Quadruplegic Finds Meaning 
+Margaret Shilup 
+The following "case history" is taken from a paper written in partial fulfillment of the requirements for Frank l's seminar at the United States International University, San Diego, California. 
+Bob was 31 years old when, in an industrial accident, he received hundreds of thousands of volts of electricity throughout his body, which made it necessary to amputate both legs to his knees and both hands to the midforearms. 
+I was special nurse to Bob during the weeks in the hospital. When he awakened from the operation, he had to be told that his arms and legs had been removed. He looked down at his body in horror. He said, "I'm not even half a man anymore." He was heavily sedated for a while, but I knew that one day he would have to face the condition of his life reality. Bob was a young man who had liked to work with his hands, and was not versed in the world of ideas. I searched for thoughts by which I might spark him with a meaning for his life and his predicament. 
+His physical recovery was a medical chal
+
+lenge in itself, but I felt deeply the need to in
+fuse him with a purpose for living, a meaning 
+that would make his condition tolerable. I had 
+read Man's Search for Meaning and decided 
+to employ some techniques described there. 
+From his bed, Bob was able to see a majestic 
+
+old fir tree. I suggested little games, such as 
+pretending we were bugs climbing up the tree, 
+and then compare notes about our adventures. 
+He was not too impressed with that, but was 
+willing to do anything to get his mind off the 
+reality of his condition. I felt that this was 
+both self-detachment, or leaving one's self 
+for a while, as well as self-transcendence, or 
+becoming a part of nature. It was a way of leaving oneself behind and experiencing life in other ways. 
+One day he began to chuckle. It was the first time I had heard any sound of joy in him. I decided to draw this out as much as possible and enlarge on it. I asked him why he was laughing. He said, "This little bug just bumped into a huge fat worm and almost fell out of the tree." I began to laugh as merrily as I could until he joined me, and we laughed until tears were rolling down our cheeks. We were sharing, and I knew he had achieved self-detachment and a sense of humor in the midst of his tragedy. 
+Later, when his seven-year-old boy brought him a jigsaw puzzle, he was able to see the humor in it and laugh heartily, and thank the boy for the gift. 
+Bob would have times of depression. The doctors had told him about the artificial limbs they would fit him with and teach him to use, and this had a disturbing effect on him. I decided to make him aware that his condition, as limiting as it was, had many possibilities. I would get him into a wheel chair and take him to visit other patients. It seemed a good idea to get him interested in other people's lives. 
+A young man, paralyzed from his neck 
+
+down, had learned to use his teeth to hold a 
+paintbrush and paint some rather lovely pic
+tures. I took Bob to visit him. They became 
+friends and looked forward to seeing each 
+other. They discussed their accidents and 
+present conditions. Courage is contagious! 
+Bob was impressed with the young man's ac
+
+complishments. Bob would tell me how much 
+more fortunate he was, because he would 
+have hands and feet that were functional. I 
+felt he was transcending his human condition. 
+
+Bob had become dependent on me because he could do nothing for himself, and he was 
+33 
+afraid for me to leave the room. I wanted to build up trust, and also teach him to begin feeling some power within himself. I designed a gimmick with which he could push the call light button with his bandaged stump. Then I would say, "I'm going outside the room. Push the button and see how fast I'll get here." It became a game and we extended the time until I could go to lunch. I designed a similar gimmick by which he could work the remote control on the television set. This gave him a sense of independence and control over his life. 
+I began to read to him for short periods. I read Man's Search for Meaning. He would say, "Stop. Read that over again." We would discuss different parts and how they related to his own condition. He was particularly impressed with the meaning one finds in suffering. He memorized: "The sort of person a prisoner becomes is the result of an inner decision. Fundamentally therefore, any man can, even under such circumstances, decide what shall become of him, mentally and spiritually. He may maintain his human dignity.... The last inner freedom cannot be lost." And, "They were worthy of their sufferings; the way they bore their suffering was a genuine inner achievement. It is this spiritual freedom-which cannot be taken awaywhich makes life meaningful and purposeful." 
+Bob left for a rehabilitation center. After he had returned home, I went to visit him. He confidently walked toward me on his new legs. He had a can of beer in the hook that served for a left hand. He held out his right hook to me, and I clasped it. He glowed. 
+Bob opened a small business and is able to support his family. Last summer, in a specially equipped car, he drove his wife and two children on a tour of the United States. He told me:"I was very empty before my accident. I stayed drunk all the time and was bored to death. My wife was planning to divorce me. Now I truly know what it means to be happy and to love someone completely.'' 
+Bob is a remarkable young man. In an almost impossible situation, he found meaning within the severe limitations fate had bestowed on him. 
+
+
+34 
+CONTENTS 
+Letter from the Editor .............................................................2 Aspects and Prospects of Logotherapy, an interview with Viktor E. Frankl ............................................................ 3 Some Implications of Logotherapy on Community Health Uriel Meshoulam ...........................................................7 Logotherapy's Message to Parents and Teachers Elisabeth Lukas ........................................................... 10 Logotherapy and Senior Adults Alan P. Farr .............................................................. 14 Paradoxical Intention: A Review ofPreliminary Research 
+L. Michael Ascher ......................................................... 18 Logotherapy Viktor E. Frankl ...........................................................22 In Memoriam J. Randolph Sasnett .................................................24 The "Ally Approach" in Teaching and Counseling Margaret G. Alter ..........................................................26 
+"Rebirth" of a Marriage Gunter Funke ............................................................. 29 
+The Boy Who was Afraid to Come to School Bianca Z. Hirsch ........................................................... 31 
+A Quadruplegic Finds Meaning Margaret Shilup ...........................................................33 
+Book Reviews .............................................................. •.. • . 35 
+The "Ideal" LogotherapistThree Contradictions 
+Elisabeth Lukas 
+I. The Logotherapist Must Be Pessimist and Optimist 
+The logotherapeutic admonition, "Take people as they should be and help them become what they could be," sounds optimistic; even more so if we attribute to human beings an extra dimension, the spiritual, which lifts them above other life forms and enables them to overcome misfortune. But of course a logotherapist must not stick her head in the sand; she must be enough of a pessimist to recognize reality, to accept it as it is, and to explore the causes and facts that constitute the patient's problems. 
+Logotherapy attracts therapists who believe in human goodness. Cynics are not interested in logotherapy. But idealism, optimism, and the belief in human nature are not enough to be a responsible logotherapist. Not every illness has psychosomatic, causes, not every depression is noogenic, and not every psychically ill patient suffers from the existential vacuum. 
+Logotherapists, like any other therapists, are obliged to gather all information that serves to interpret a situation. They have to be aware of possible misinterpretations and must not overestimate their abilities: referrals to other branches of the medical professions are sometimes necessary. Two case histories will illustrate this point. 
+Mrs. B. was an adult woman complaining about chest pains. Since the pain increased at times of psychological stress and no organic symptom could be found, the diagnosis "psychogenic" seemed reasonable. The pain diminished with relaxation exercises and logotherapeutic conversation. Finally it disappeared. 
+Six months later Mrs. B. returned complaining about pain in the lower right stomach area. Her family doctor smilingly talked about nerves and sent her to me. 
+I am much afraid of organically caused pain that is erroneously referred to the psychologist who, under such circumstances, is bound to fail. I was pessimistic enough to send Mrs. B. first to another physician. Lo and behold, this physician who wa~ unbiased and did not know that she ever had psychogenic disturbances, easily diagnosed gall stones. Without my pessimism precious time would have been lost. 
+Another case: I substituted for a sick psychologist in charge of children in our counseling center. One patient was a girl whose teacher had complained that she was masturbating in class and had asked my colleague for help. The class psychologist thought the girl needed analytical play therapy, and that's what the girl got. 
+I had the girl examined by a medical doctor. It turned out she had a chronic vaginal inflammation. For that reason she fidgeted in school and scratched between her legs. Yet for six months she had been treated with play therapy. Appropriate medication brought relief within two months. 
+Logotherapists differ from most of their colleagues in their belief that a chance of recovery exists in spite of the circumstances. The logotherapeutic creed is that every human being, through the resources of the spirit, has the chance-despite past, personal makeup and inherited genes-to change his or her life and fill it with meaning. 
+It's a wonderful thought, yet again and again I am overcome with doubts and in
+3 
+dined to give up a client as "hopeless." But every time I make a special effort not to deny the patient his chance. Sometimes, when I am desperate, I turn to other patients who themselves are searching for meaning, and tell them about my problem (without identifying the person concerned) and let them find arguments I could use. Many times my own clients helped me in this way, giving me at the same time a lesson in optimism. 
+A 35-year-old woman, Mrs. R., came to me because of her existential frustration. Her husband had died eight years ago and left her with a small child. She lived in modest circumstances, a homemaker leading an unexciting life. She never went on a vacation, rarely left her house, and had few friends and experiences. She was dissatisfied with her life, critical, in perpetual bad humor, and hence unattractive to others who avoided her. 
+In long sessions I tried to lead her to see some meaning potentials in her life: professional, social, leisure activities. Even a savings plan was discussed to make short vacations possible. But she found something wrong with every idea. 
+One day it was I who was disheartened. A young girl with whom I had worked a long time, had become involved in a crime. I felt in no frame of mind now, on top of it all, to put up with the usual negativism of the frustrated woman. So I told Mrs. R. that this time we would not discuss her situation but that of another patient. I would appreciate her comments. I then reported on the downfall of the girl and my fears that she would not recover from her criminal involvement. 
+But now my patient found words of comfort and optimism! "The present situation," she said, "may just be a passing phase. Some have to fall before they can rise. I would not condemn her like everyone else does, but let her know that you are willing to assist her in the future if she wants it." I thanked Mrs. R. and recognized that she, in saying what she did, had also helped herself-it was the first time in a long period of negativism that she had adopted a positive stance. From then on it became easier for both of us to look more positively at her own situation (which was much less difficult than that of the girl) and find clues for changes in a direction meaningful to her. 
+The logotherapist listens to her patients and learns from them-she gives and takes. Therapy cannot be carried on from books but must be developed from the words of the patient and, perhaps more important, from what lies behind the words. 
+The logotherapist must be a mixture of optimist and pessimist in many ways. She must see the patients' plight but must believe they can escape it. She sees the severe limitations of all chances in some situations but believes to the last that there exists at least one chance. She knows the patients' weaknesses, yet treats her clients as fully acceptable persons. She recognizes the fetters of childhood and education, yet helps patients to liberate themselves from these straitjackets. She knows about the patients' limitations of action, but encourages their responsibility to act within these limitations. Fanatics, who always need a scapegoat, will not like this attitude; they prefer to blame society, politics, and all civilization for ruining a person's life. To blame is easier than to help. 
+I mistrust reformers who begin their reforms by accusing. It is our own weaknesses we see most clearly in others. Before we accuse, we'd better look into ourselves. Those who will not acknowledge their belief in a last island of unconditional freedom in the human spirit, must forego logotherapy. But then they also must be willing to accept themselves as products of mere chance. 
+II. The Logotherapist Must Explore Causes and Ignore Causes 
+The logotherapist must ignore causes, especially those that cannot be changed and if dwelling on them produces more harm than good. If you keep reminding a child that grew up in an orphanage that he was abandoned and that, because of his early childhood experiences, he will never amount to anything, you make him a mental cripplewhich he would not have to be as a result of his being raised in an orphanage. ft is unpardonable to even indicate to a handicapped that her handicap is the cause of her failures, although there may well be a connection. Nor should the young or the elderly be permitted to use their age as excuse for foolish actions. Some connections are better left alone; if too much attention is paid to them, they can paralyze the healthy power of the human spirit that can defy those connections. 
+
+4 
+A married couple was in despair because their 4-year-old foster son liked to play games in women's clothing. The child had come from the slums and they feared he had a genetic disposition toward homosexuality. They watched his every move and interpreted every word in that light. They were shocked by such harmless comments as, "Daddy is much gooder than mummy." Had the boy been their own, they probably would have paid little attention to his games and comments. But their worry about his possibly harmful genetic background was felt by the child. He noticed the special attention given him when he put on mother's skirt, he felt important, and repeated the act. 
+The child's background may well have been the reason for his conduct, yet my advice to the parents was to ignore it. In my talks to them I did not dwell on the alleged abnormal tendencies of the child. I did not claim that the child's behavior was normal but proposed to the parents to treat him as if it were. "Don't pay much attention when he puts on a skirt and expresses preferences for his father's affection," I told them. "Build up the father as a model. Let father work with the boy around the house, let the boy watch when father washes the car, tell him stories about brave men. Tell him that he might become such a man himself one day.'' I asked them to treat the boy as if he were their own natural child. 
+The foster parents did this, and after some time the symptoms disappeared. I cannot tell what caused the odd interest in women's clothing but the "abnormal genes" could have done a lot of damage if they had continued to preoccupy the parents' minds. 
+Causes sometimes must be ignored even if they obtrude themselves on the therapist. Go easy when you have a premature "aha!" experience during the first sessions, and look with caution at "obvious causes" presented by the client. 
+A mother told me, "Our little daughter is afraid of the dark. Unfortunately she was present when Grandma was found dead in bed, and ever since she is afraid of the dark." The explanation seemed plausible. But on further inquiry it turned out that the little girl had been afraid of the dark even before her grandmother died, and had wanted to 
+"L-iJ only when the light was on. I also discovered that the child had been not all that fond of her grandmother and felt it was actually "quite good" that she had gone to heaven. Therapists, generally, are willing to spend a lot of time to search for causes, but sometimes they have to summon the courage to ignore them. It is not the logotherapist's task to uncover causes at any price but only where it serves a purpose. And sometimes a better purpose is served by ignoring causes. 
+A related contradiction in logotherapeutic practice concerns the patients: They must learn to accept their fate, and they must also learn to fight their fate. In short: Be able to accept; be determined to resist. 
+How the logotherapist deals with the patients' causes of illness will influence their approaches in overcoming their illness. When causes cannot be changed, the logotherapist will ignore them and the patient must learn to accept them. When causes ca, be changed, the logotherapist will attempt to explore them and to activate the patient's forces to combat them. In the first case, the logotherapist might use such methods as modification of attitudes or dereflection, in the second, paradoxical intention or strengthening of the will. 
+"Be able to accept, be determined to resist," is a precept not popular today. People in our civilization are spoiled. They cannot accept suffering, they rebel against their fate, they insist on their "right" to live a pleasurable life, and become aggressive-hysterical when faced with hardship. How can such people face illness and death? How can they stand up to economic setbacks, unemployment, and want? Some conditions can and need to be fought. But it is a great gift to be able to accept the unavoidable, to have the courage to defy one's weaknesses, to overcome one's insecurities, to rise above one's greed, to transcend oneself. One need not yield to every temptation, fall into a depression because of a disappointment, scream at every provocation, and practice oneupmanship at every opportunity. 
+To ignore causes and yet tolerate them, to explore causes and fight them-this is a great contradiction in the concept of logotherapy. 
+5 
+
+III. The Logotherapist Must Have Her Own Value System, And Yet Fully Accept The Value System of Her Patients 
+Any therapist accepts the patients' value systems unless the values are unhealthy. She respects other people's religious, political, and moral views even if she does not mean that she herself has no value system. She may be an atheist and yet be able to discuss Orthodox Catholicism with, say, a bride. She must be flexible enough to answer questions in such a way that she neither denies her own attitude nor shakes the patient's faith. The Socratic dialogue is a proper vehicle to reply questions with questions, and thus help the patients find their own answers. 
+But the logotherapist has an additional obligation. She also gives answers, and these derive from her own value system. Hence her value system must range over a wide spectrum, her spiritual dimension must contain an ample reservoir from which to draw even in cases of the most delicate subject. For example, the question about God can hardly be avoided in many therapeutic exchanges. It would make no sense to say that a logotherapist should belong to a specific religion, yet she will have to have some concept of the divine. This concept may be merely the belief in the goodness of humankind, in the true and the beautiful-yet even these represent a communication bridge to the believer. In politics, too, the therapist may have specific alignments, and yet have an understanding for the positive goals of the opposition parties. There is always a meeting ground if one's own value system is abundant enough to dispense with dogma. 
+I have been able to help patients who believed in the literal existence of the devil, and others who denied the existence of a higher power in any form. I am reminded of a case, quoted by Frankl,' of an Orthodox Jew who was in despair because he had lost his sons in the concentration camps and was unable to have any more children. During the course of the therapy sessions it became clear that his misery centered around his belief that he was prevented from being reunited with his children in heaven. According to his faith, his children, having died innocently, would go to heaven which would be barred to him, as an earthly sinner. By applying his patient's beliefs, which Frankl himself did not share, he was able to bring about a change of attitudes in the old man. By quoting passages from the Talmud, Frankl helped him see a possible meaning behind his suffering: It is written in the Good Book that our tears are saved for the Day of Judgment. Was it not conceivable that God had demanded the old man's great sufferings so he would be admitted to heaven and thus see his children again? 
+The logotherapist, in some cases, must even say "no" to the value system of her patients, especially to views reflecting reductionism, pandeterminism, and nihilism. "No, it is not true that you are nothing but an animal that has to respond to its instincts." "No, it is not true that you are a helpless victim of your past." "No, it is not true that nothing matters because nothing is real." The logotherapist must use her own value system at least to the extent to help her patients see that, although they are instinctual, victims of circumstances, and that negative forces operate in them and the world, they can take a stand against all these drawbacks. 
+Beyond such exceptions, the logotherapist must be able to draw from her own values without inflicting them on the patient, and she must be tolerant enough to put her own views into the terminology and concepts of the patient. It is vital that the patient understands, and if understanding is helped by using the word "devil" for "illness," or "evil" for "disaster," then the logotherapist is well advised to use these words. 
+High on the list of the logotherapist's values is concern for the patients. But she must not overestimate her capacities. Many ills cure themselves, and many suggestions offered in good faith cannot be used by the patient. The logotherapist must learn from failures but not take credit for every success. She must be aware of the self-healing powers of her patients and their ability to mobilize these powers to improve their lives. By the same token, people are free to decide against therapeutic help, against their recovery, and perhaps against their only chance. This, too, we must respect, even when it hurts. We cannot do more than place our efforts for 
+
+6 
+the patient high on our scale of values-the final responsibility remains with the patient. 
+The value system of the logotherapist plays an important part in another area, too. What we tell our patients is evidence of our own life philosophy. We must be willing to act according to our advice to our patients. We reveal ourselves as genuine to the degree that we stand behind our own words. 
+Our genuineness must be apparent to our patients if we are to help them, but our genuineness itself contains a contradiction: We must acknowledge our continuing search for meaning, and also show that we have found fulfillment. This contradiction, too, can be resolved because nobody's search for meaning is ever concluded and fulfillment reached once and for all. We all keep searching, all our lives long, and we logotherapists must not be ashamed to admit it. 
+I have recently begun a book about my experiences as a logotherapist. I had procrastinated, using lack of time and family responsibilities as excuses. Actually I was scared of the idea of writing a book and also hesitated to plunge into the enormous work connected with it. 
+Then, one day, I noticed my first gray hair. This is no tragedy but I reflected one moment as if being touched by the breath of transitoriness. I still feel young, have many plans for the future, but time passes. I remembered the advice I had given to a client two years ago. 
+Mrs. H. was 29 but had started to dye her hair since she Jiscovered her first gray hair at the age of 25. She had developed a strong allergy against the dye and was in danger of losing her hair if she continued to dye it. She became so desperate that she considered suicide. I attempted a modulation of attitudes and drew her attention to the fact that the first gray hair can be seen as a warning signal: time is passing. Do what you want to do. Stop postponing. Usually, the warning comes at a later age, but having received it at 25 it gave her more time to do things. 
+She began to see her gray hair with new eyes: not as a reminder of her aging but of the things she still wanted to do. She started rug weaving, a hobby she had postponed, she traveled, she took courses. Since she considered aging as an impulse to living she never thought of death any more. 
+I thought of Mrs. H. when I discovered my first gray hair. "This is the test of my own logotherapy," I thought. "Do I accept my own advice, do I stand behind it?" 
+I have started to write my book. My first gray hair told me: "If you want to write a book, start now. Tomorrow it might be too late." 
+This, perhaps, is the ultimate criterion for the "ideal" logotherapist: To follow the prescription which she prescribes as healthgiving to others. 
+Translated by Max Kni?,ht. 
+
+REFERENCE: 
+I. Frankl. V.E. Man's Search for MeaninR: An Intro~ due/ion to Logotherapy. Paperback edition, New York: Pocket Books, 1977. 
+ELISABETH LUKAS is the head ofa counseling center in Munich, Germany, and the ori?,inator ofthe lo?,o-test. 
+All the training, experiences, and techniques ofthe therapist will not brinf!, about a cure {from addiction) without one ingredient that is central to logotherapy: a trust in the humanity of the patient. From everything the therapist does must emanate a deep conviction that behind all that chemistry that can be treated, and all those psychological forces that can be manipulated, stands a human spirit that can be appealed to. And a further conviction of the therapist that behind all that weakness and failure in the patient, there is a healthy core. that can enable the patient to build a new, meaningful, and happy future from the ruins of the past. The patients must feel this basic trust by the therapist, and sometimes the trust of only one person is sufficient to prevent them from a relapse to addiction, sickness, and despair. 
+Elisabeth Lukas in "Logotherapy in Action" 
+7 
+
+The Noetic Unconscious 
+Joseph Fabry 
+The question has been raised what role the unconscious plays in logotherapy. Implied is a suspicion that logotherapy pays little or no attention to the unconscious, and thus disregards one of Freud's greatest contributions to the understanding of human nature. 
+The opposite is true. Both logophilosophy and logotherapy are strongly based on a concept of the human unconscious, and not only accept Freud's views of it but extend them. 
+Freud added an entire dimension-the psyche-to our understanding of the human person. Frankl added still another dimension-the spirit. Human beings, he pointed out, can be understood and kept healthy only when they are seen in their three-dimensional totality of body, psyche, and spirit. The human spirit has long been considered in religious counseling. It is still widely neglected in medicine, probably because the words "spirit" and "spiritual" are seen as belonging to the realm of religion, and not of science. 
+The human spirit, however, as understood in logotherapy, is seen as a specifically human dimension, possessed by all persons regardless of their beliefs, including the atheist, the agnostic, and the humanist. Its resources include our "will to meaning," our goal orientation, our ideas and ideals, our creativity, our imagination, our capacity to love beyond the physical, our self-transcendence, our sense of humor, and our conscience. In the dimension of the spirit we make the decisions, not only about what kind of persons we are, but also what we still want to become, what we want to do with our lives. 
+The spiritual dimension (which, to avoid 
+confusion with the "religious," Frankl also 
+calls the "noetic" dimension) has a conscious 
+and an unconscious part. Freud introduced unconscious instinctuality. Frankl adds the unconscious spirit. "Depth psychology has followed man into the depth of his instincts, but too little into the depth of his spirit. Since 'depth' refers to the unconscious, it necessarily follows that the person in his depth, the spirit in its depth, or, for that matter, human existence in its depth is essentially unconscious" .4• r. 10 We cannot know consciously what in essence we are. "The self does not yield to total self-reflection ... Human existence exists in action rather than reflection. " 4: P 10 The actions of the artist, the religious person, the lover, as well as a person's major decisions, are based on unconscious, intuitive decisions 
+and rationalized only later. 
+The Spiritual Unconscious 
+Frankl, commenting on his nosition in relation to Freud and Jung, said that "a dwarf, standing on the shoulders of a giant, can see farther than the giant himself." 2· r. 1 From the vantage point of Freud's shoulders the unconscious is perceived not only as instinctual, but also as spiritual. And from the shoulders of Carl Jung the spiritual unconscious is perceived not merely as collective and archetypal, but as personal and existential. The spiritual part of the unconscious is seen as a region in which we are not an ego driven by an id, but a self, a person relating to others as human beings to be loved and understood rather than as objects to be used and manipulated, 1, r 27 
+Our unconscious, then, has not only an instinctual part into which sexual desires and aggressiveness can be repressed, but also a spiritual part into which we can repress our will to meaning. One might say, perhaps in oversimplification, that the instinctual 
+
+8 
+unconscious contains much that is wrong with us (and which we do not want to face), and that our spiritual unconscious contains much of what is right with us (and which we have ignored). 
+Our three-dimensional totality is seen as one dimension, the body, housing the other two, the psyche and the spirit, each of which have a conscious and an unconscious part. These invisible aspects of the human being can be schematized in the manner shown below: 
+Instinctual 
+
+We do things because we are driven 
+We respond to a 
+"need" Motivation is pleasure, power, prestige 
+We act for selfactualization 
+Spiritual 
+We are the drivers, make decisions, take responsibility, accept commitments 
+We make a personal 
+choice Motivation is meaning 
+We act for selftranscendence, for the sake of someone or something beyond ourselves. 
+
+
+
+
+-•----The Conscious 
+,._ 
+Vl 
+V'l
+C 
+
+
+l -•----The Unconscious 
+The Instinctual and The Spiritual 
+
+The instinctual and the spiritual, then, are both unconscious, but the border between the conscious and the unconscious is fluid and permits transition from one to the other. According to psychoanalysis, in repression we turn something conscious into something unconscious, a process that can also be reversed. But, according to logotherapy, the line between the spiritual and the instinctual is sharply drawn and can not be broken. What is instinctual can never become spiritual, and vice versa, neither in the conscious nor in the unconscious. That means, among other things, that repressed sexuality or aggressiveness, made conscious, cannot produce meaning. On the conscious level, sexuality may well be filled with meaning by "serving as the physical expression of love."'· r. so It also means that the resources of the human spirit cannot be reached as long as psychological (or somatic) disturbances are blocking it. To distinguish between the instinctual and 
+the spiritual, the following comparison presents some guidelines: 
+Since our instincts are something we have, and our spirit is what we essentially are, it follows that "the real criterion of authentically human existence only derives from discerning whether a given phenomenon is spiritual or instinctual-whereas it is relatively irrelevant whether it is conscious or unconscious. This is due to the fact that-in contrast to the psychoanalytical concept-being human is not being driven but... being responsible-existentially responsible, responsible for one's own existence. " 4· r. 26 "Authentic existence is present where a self is deciding for himself, but not where an 
+· r 27
+
+id is driving him. " 4 
+Our spiritual dimension, its conscious as well as the unconscious parts, constitutes our essential self, with all its potentials toward meaning fulfillment; our instinctual, on the other hand, contains "somatic and psychic 'facts' which, however, cannot be clearly distinguished. "Any physician who has ever tried to elucidate the multi-dimensional etiology of a psychosomatic condition knows very well how difficult it is to differentiate between psychogenic and somatogenic components. " 4· r. 27 
+9 
+
+Therapeutic Consequences 
+
+The therapeutic consequences of the expanded unconscious will have to be explored for a long time to come. Logotherapy has made a significant beginning by introducing such methods as the Socratic dialogue, the separation of patient and symptoms, the modification of attitudes, paradoxical intention and dereflection, and new dream interpretations. 
+Just as psychoanalysis assumes that drives and instincts which have been repressed and caused neuroses must be made conscious to achieve a healing, so logotherapy assumes that our will to meaning, too, when it has been repressed and caused an existential vacuum or existential frustration must he made conscious to make life meaningful. And just as psychoanalysis uses free association to help patients contact their instinctual unconscious, so does logotherapy use the Socratic dialogue to help them contact their spiritual unconscious. 
+The term "Socratic dialogue" derives from the method of the Greek philosopher of eliciting information from students that already exists deep within them, rather than of pouring information into them. The teacher is seen as a midwife of ideas. Similarly, the logotherapist does not "give" meaning to his patients but helps them find their own. If we know in the deepest part of our spiritual unconscious who we are and who we want to become, what our goals ar~ and in what direction our meanings lie, then the logotherapist becomes a midwife who helps us give birth to our potentials and our meanings. 
+The prerequisite for the Socratic dialogue is an atmosphere of trust, which enables patients to discover their true selves, to dare to talk about their hopes and wishes, and to develop ,, 1, tlistic step-by-step approach toward meanings as they see them. In a group, participants get reinforced in their selfawareness by what others in the group reveal about themselves, their choices, and their solutions toward finding a meaningful life. Group members motivate each other by serving as examples of how they solved problems, overcame difficulties, broke out of traps, and made choices in periods of transition. 
+The first step toward a cure is to help patients gain distance from their symptoms•, to make them aware that "fears, obsessions, depressions, feelings of inferiority, and emotional outbursts are not an integral part of what they are but only qualities they have, which they can modify, and possibly overcome." Logotherapists make "patients conscious of what they unconsciously know: that they are first and foremost human beings with the capacity to find meaning; only secondarily are they individuals who have certain shortcomings which can be overcome, and unwanted patterns which can be broken." 
+The next step is a modification of attitudes•, ''to help patients gain new perspectives of themselves and their life situation." It may be a switch from a "Why did this happen to me?" to a "What can I do now?" Or a change from "This is the way I am" to "This is the way I can be." Failures of the past are not accepted as excuses for new failures but as challenges to be overcome. The "defiant power of the human spirit" is evoked, and the "awareness of freedom and responsibleness which constitutes authentic humanness is set against (a) neurotic fatalism. " 4· P 28 
+The two logotherapeutic methods of paradoxical intention and dereflection have a proper place in achieving the separation of patient and symptoms, and in the modification of attitudes. "Paradoxical intention means that the patient is encouraged to do, or wish to happen, the very things he fears." 5· r. 117 It breaks unwanted behavior patterns by the use of the specifically human qualities of self-detachment and sense of humor, and shows patients that they are not the helpless victims of their circumstances but agents who can take a stand against them. While paradoxical intention is useful in cases of phobias and obsessive compulsions, dereflection is indicated where the behavior pattern to be broken is caused by a "struggle for pleasure" which "is identical with hyperintention of pleasure"-a major factor 
+104
+underlying sexual neuroses.3· r. Dereflection uses the human quality of selftranscendence, our human capacity to shift from self-reflection toward attention given to others. In sexual neurosis, instead of striving for potency and orgasm, the patient is motivated to give himself, instead of observing himself, to forget himseJf.5, PP-151-152 
+
+IO 
+Paradoxical intention and dereflection are the direct consequence of logotherapy's picture of the human dimension as an unconscious well of resources, including selfdetachment, self-transcendence, and a sense of humor that can be mustered and used in therapy. 
+Where these resources of the spirit are unconscious, the interpretation of dreams, a highway to our instinctual unconscious as used in psychoanalysis, also serves as access to that spiritual unconscious. Dreams not only indicate repressed desires but also repressed or ignored or thwarted resources of the spirit such as the will to meaning, goal orientation, creative gifts and religious decisions, and-perhaps most important-the. muffled voice of our conscience that tells us in conflict situations what in the deepest vaults of our self we have decided to do. 
+All these methods are often only preliminaries to the final application of logotherapy-a common search of patient and therapist for the doors through which the patient wishes to walk in search for meaning. Logotherapy is a method of assisting patients to use the resources of their spiritual unconscious, become aware of the freedom of either action or attitudes-and to lead them to independence and responsibility. 
+REFERENCES: 
+I. Fabry, J.B. The Pursuit of Meaning. Boston: Beacon Press, 1968. Paperback available at the Institute of Logotherapy. 
+2. 
+Frankl, V.E. The Doctor and the Soul. New York, 
+
+Alfred A. Knopf, Inc.; second, expanded edition, 1965, paperback edition, New York, Vintage Books, 1978. 
+
+
+3. 
+Frankl, V.E. The Will to Meaning. New York and Cleveland. The World Publishing Company, 1969; paperback edition, New York, New American Library, 1976. 
+
+4. 
+Frankl, V.E. The Unconscious God. New York, Simon and Schuster, 1976. 
+
+5. 
+Frankl, V.E. The Unheard Cry for Meaning. New York, Simon and Schuster, 1978. 
+
+6. 
+Lukas, Elisabeth, "The Four Steps of Logothcrapy," Uniquest 7, Berkeley, Uniquest Foundation, I Lawson Road, Berkeley, CA 94707. 
+
+
+JOSEPH FABRY is executive director ofthe Institute of Logotherapy and editor of the 
+International Forum for Logotherapy, 
+Berkeley. 
+If you take people as they are you make them worse; ifyou treat them as they ought to be you help them come closer to what they can become. 
+J. W. Goethe 
+
+Love should be essentially an act of will, of decision to commit my life completely to ... one other person . ... To love someone is not just a strong feeling-it is a decision, it is a judgment, it is a promise. 
+Erich Fromm 
+
+
+11 
+
+
+We live in an age, as a nation and as a culture, in which the time-honored roles and foundations of life have begun to erode. Clear-cut reasons for living and dying, once assumed to be sine qua nons of human life, have progressively disappeared-leaving a vacuum of purpose and meaning that we frantically try to fill with other, less satisfying, meaning-substitutions. And this is where America 1979 is: a society filled with men and women, trying to escape from existential loneliness and ending, almost always, with short-term success but long-term failure. 
+Nowhere is this tragedy more evident than in the consultation room of the physician. It is here, as in no other place, that the pain and artificiality of successful living, spelled out in terms of "doing your own thing," is apparent. Hidden behind the well-dressed business man is, more often than not, a man caught in a network of work, striving, fear of failure, and fatigue which sooner or later reaches the point of ennui whereby he senses his goals to be shallow. with no deep commitment to anything beyond job, family and hedonistic satisfaction, knowing that none of this is enough to give life ultimate meaning. 
+C.G. Jung once wrote: "Among all my patients in the second half of time-that is to say, over 35-there has not been one whose problem in the last resort was not that of finding a religious outlook on life .•. This of course has nothing to do with a particular creed or membership of a church." 1 In his call for religious commitment, Jung is calling for a self-transcending meaning and direction in one's own personal life. This call is peculiarly felt by many in the mid-life years, but is by no means limited to that period. There is 
+
+
+
+
+
+
+Logotherapy in Medical Practice 
+George R. Simms 
+evidence of an increasing sense of meaninglessness among young people who feel that life holds nothing of transcending value despite education, social connections, and financial success. At the core of their anti-social behavior lies an unstilled yearning for direction, for a meaning beyond a graduate degree, an insurance policy, or a secure job. None of this is inherently wrong but, by itself, it is incomplete. "Man does not live by bread alone." We know this in our hearts, but we are forced to repress this truth in order to become socially acceptable. The price we pay is high. 
+To find an over-arching meaning which illuminates our hearts and guides our path is the great task of adult life. To avoid this task is to run the danger of missing the central core and purpose of life, to live on the periphery only to find that we have "missed the mark." Without an individually forged-out meaning and purpose, it becomes impossible to withstand the great and small crises and tragedies which make up so much of daily existence. 
+Shortly before his death Senator Hubert Humphrey was asked what, for him, was the single most important lesson in life. His answer: "What I have learned from living is that there are some things over which man has no control. You are buffeted by events that are unpredictable. And one has to learn to live with the uncertainties of life." Sounds almost too homely, much like a sermon we hear on Sunday morning and then quickly move on to more "realistic" issues of daily life. But the paradox is, he was right because life, to be lived to its fullest, can only be experienced by those who have struggled through to the point where they, too, have found a self-transcending meaning which makes pain and suffering bearable and fruitful. 
+
+12 
+Application to Modern Medicine 
+
+What does all this philosophizing have to do with modem medicine? It cannot unravel the biochemical mysteries of life, nor can it help in performing marvelous new operations. Yet, philosophy is closely linked with modern medicine, for the patient of today, perhaps more than any time in history, is plagued with a disease not remedied by medicines or operations of any kind; a disease so devastating that it leads to death (through suicide, alcoholism, drug abus·e, overwork) in unparalleled numbers, and causes personal misery and economic loss of untold proportions. This disease is seen in every doctor's office under the guise of a host of symptoms, and from all indications is increasing at an alarming rate. Our medical training has not prepared us to deal with it and indeed, many physicians themselves suffer from it. It is called an existential vacuum by some, a noogenic neurosis by others. It is characterized by an inner loss of direction and an inability to endure pain and suffering without devastation and loss of identity. While pain and suffering (the two are not synonymous) have been with mankind since the beginning, it is strangely peculiar to contemporary western society that our external, sociologic development has cut us off from the deep, unconscious moorings which have always provided inner stabilization and ability to understand the trials and vicissitudes of life. 
+What can the modern-day physician offer such patients? Superficial advice, tranquilizers, heavy escapist "trips," psychotherapy for their "disease"? All of these measures are currently in vogue-and of little avail. The answer lies in the re-orientation of what the sickness is and who is really sick. Scientific medicine since the Enlightenment has tended to divorce itself from a philosophic-religious base and develop a neutral, objective perspective of what is wrong with the human body and mind. While this separation has been highly effective (and indeed remedial) in many areas of science, it has created the disastrous effect of 'externalizing' everything and creating a medical-mooel explanation for every symptom and complaint a person has. Thus the plight of modern man and woman: we suffer from 'dis-ease' (i.e. an inner dissociation based_ on a lack of inner, spiritual 
+direction which alone gives meaning and cohesion to psyche-soma interrelationships) but are told we have a 'disease' over which we have no control and for which we must submit to a certain, external regimen (pills, psychotherapy, etc.) prescribed by someone alien to us. While this method may be comforting and even efficient, it nonetheless avoids the fundamental fact that 'disease' comes from within the person, is a function of the way we live and can only be changed with the help of someone else who can help the 'diseased' patients find their own way to inner health. This brings us to the realization that we can only bring others as far as t~ey themselves have come. The greatest need for physicians today is to re-evaluate their own quest for meaning, and out of that search can then flow illumination for their patient. There is a definite place for medication or therapy but these modalities are incomplete in themselves, and can only be maximally effective when based on a philosophic-religious (in the sense the term was· used by Jung) foundation within the physician himself. Only then can healing begin to take place, because the life force within the patient is often catalytically sparked by the quality of insight and understanding of the physician. This is particularly true when working with young people who have multiple psychosomatic complaints, and with terminally ill patients, or with those afflicted with a chronic, debilitating disease. The aim is not the magical curing of the organic pathology per se (often that gratifyingly happens in the process), but rather a deeper healing whereby inner strength, direction and restoring are brought about. 
+The Reality of Pain and Suffering 
+
+What is healthy or sick, right or wrong, popular or unpopular are all functions of the value standard held by our society. This brings us to the bedrock fact that our contemporary, jet-age value system is indeed 'diseased,' because we have been fooled into believing that we can live as if there were no self-transcending truths and no self-transcending meanings. We have never been taught that pain and suffering are the touchstones to the deeper wellsprings of life, and only those who have truly accepted their pain have been allowed to find a deeper meaning in it, and this very meaning has transformed them and 
+13 
+given them a beauty and a purity not otherwise possible. HWhat matters above all else is the attitude in which we take our suffering upon ourselves."2 And so it is. Pain and suffering cannot be avoided. The only choice is how we choose to deal with that pain. It becomes either a curse or a blessing, a means of growth and beauty or a vehicle for inner deterioration and ugliness. The choice is solely up to each of us in every new life situation. But it is uniquely in the midst of our crises and pain that the physician-if himself inwardly healed-can be of inestimable service to his patient. 
+Logotherapy-treatment through m~ngis in its broadest sense the foundation of true physical and emotional healing, because it provides the reference points from which the physician and the patient can explore what the patient's symptoms mean within the context of his life setting. Health is more than the absence of symptoms. And by the same token removing symptoms does not necessarily bring about health. Health is wholeness, with implications spiritually and emotionally as well as physically. To this end, and for this purpose, the physician is called-both as counselor and helper-to minister to his patients. It is a unique ministry, but one which our times and our patients yearn for. Its model: "Ars Totum Requirit HominemThe Art Requires the Whole Man." 
+REFERENCES: 
+
+I. Jung, C.G.: Modern Man In Search of a Soul, Cambridge: Harvard Books, p. 229. 
+2. Frankl, Viktor E.: Man's Search for Meaning, New York: Pocket Books 1972, p. 178. 
+GEORGE R. SIMMS, M.D. is assistant clinical professor ofmedicine and director ofthe Family Medicine Residency Program, University of California, San Diego, School of Medicine. 
+The logotherapist can help his client see old age as a time not of stagnation but of potential inner growth. Ideally, the therapist can prepare his client for old age long before his magic 65th birthday; better still, the person, using the principles oflogotherapy, can prepare himself. A good time to start a hobby in preparation for retirement, it is said, is in junior high school. 
+Hobbies, however, hold meaning for the elderly only in rare cases. There is nothing wrong in collecting stamps, playing cards, or sewing dolls. Retirement is certainly the time when a person can indulge in all sorts of activities he was unable to do because of the pressure of routine, and the logotherapist can even help such a person rediscover hobbies long abandoned. But the old person needs to be reminded that his goal is not to keep busy but to find meaning; he now has the opportunity to find meaning in areas he may have neglected, including intellectual pursuits, creativity, human relationships, and devotion to causes. Rather than trivialize his existence with an overemphasis on hobbies and games, the retired person can now use his accumulated wisdom and experience for what he considers important. 
+Robert C. Leslie 
+in "Logotherapy in Action,, 
+
+John Vickers, interviewed at the Metropolitan Opera, for TV: 
+Interviewer: "You once said, to live is to be committed. That's a wonderful thing because your life has been a commitment. " 
+Vickers: "I think that all that talk about finding happiness has gone on and on and on ad nauseum, and I think it misses the point. With the greatest possible respect to the American Constitution (sic) I think there is something wrong with saying we have the right of the pursuit of happiness. I do not pursue happiness. There is a great writer by the name of Viktor Frankl, and Viktor Frankl devised a whole new theory of psychotherapy, and in his theory he maintained that a pursuit of power, a pursuit ofmoney, a pursuit of happiness, every one of these things, will be elusive, and even if we pursue them and find them, they will destroy us. But if we can find an absolutean absolute truth, an absolute beauty, an absolute light, whatever you may call it-and if we search and we serve that light with the whole of our being, we may find that we have happiness, we may find that we have power, that we have wealth, but they are by-products. ,, 
+14 
+A Practical Outline of An 
+Eight-Week Logogroup: 
+
+Finding Meaning Every Day 
+John M. Quirk 
+Required reading:* Frankl, Man's Search for Meaning, Part Two 
+(Basic Concept of Logotherapy) Fabry, The Pursuit ofMeaning Fabry, ed. "Viktor Frankl-Festival of 
+Meaning" Uniquest #7. 
+Goals: 
+Groups of ten are formed to provide participants with the tools to restructure their lives in a manner meaningful to them, and to bring their daily behavior closer to the overall values of their life's philosophy. 
+The group helps its members to actually live as they, in their innermost selves, know they ought to live. This goal is based on logotherapy's assumption that deep within their spiritual unconscious people know what kind of persons they are and still can become, and what is meaningful to them. Superimposed upon this innate knowledge about the self are the masks they have donned in self-preservation and fear. Meaning results when they cut through the masks and fears, and live in accordance with their true selves. 
+To find meaning, self-awareness must be followed by actions. Specific steps have to be taken in the desired direction, unwanted patterns must be broken. Goals must be set and pursued, step-by-step. 
+Mrs. B. was in despair because her relationship to her husband and her two sons was deteriorating. She wanted to be more affectionate, a better wife and mother. Belaboring herself with such general statements did not change her situation. I asked her: "What have you done during the past month which illustrates that you are not the kind of wife you want to be, and not the mother you want to be, and most importantly, not the kind of person you want to be?" I let 
+
+
+her write in her journal every week a sentence starting with, "I was not affectionate this week when... ," and give several specific examples. At our fourth sharing group meeting, Mrs. B. had listed a number of nonaffectionate behaviors. For instance, her husband came home from work at 1 o'clock at night. While he undressed in the bedroom, he sat down on the chesterfield and turned on the television. This, Mrs. B. said, "drove me up the wall." The group did some brainstorming about what could be done to break this nightly ritual. Mrs. B. selected one new behavior suggested by one woman in the group. "If he were my husband," the participant said, "I would get out of bed and sit next to him, watching the program with him until he was relaxed enough to go to bed," At the following session, Mrs. B. reported she had tried that approach, and her husband had put his arms around her shoulders while they both watched a meaningless program. The next morning, when her boys left for school, she had hugged them. She had repeated these new behavior patterns three times during the past week. "I was really affectionate last week," she said proudly. These picayune little changes enabled her to see that she was capable of being more affectionate. From these actions she could build a new structure into her life. Brooding about what she "should" do had only led to frustration. She had kept telling herself, "We should have more time together,'' and "We ought to think of one another as the most important person in the world,'' and then contrasted her ideals with her actual miserable situation. 
+First Session: Introduction to Logotherapy 
+Listed on the blackboard are the topics of the eight weeks: 
+1. 
+Introduction to logotherapy 
+
+
+2. 
+My value hierarchy 
+
+3. 
+Handling tension 
+
+
+•Available at the Institute of Logotherapy, I Lawson Road, Berkeley, CA 94707 
+15 
+4. Meaningful changes in daily activities 
+S. How to deal with critical situations 
+6. 
+How to deal with meaninglessness 
+
+7. 
+How to deal with depressions 
+
+8. 
+What I have learned for daily living. 
+
+
+
+First I want to know how the members of the group feel about themselves. · 
+EXERCISE: 
+
+On a scale from Ito S, where do you stand? (1 signifies feeling low, 5 signifies on top of the world.) In which direction are you moving? 
+Participants may say things like, "I am 2 and going up," or "I'm 3 and holding," or "I'm 1and hanging in there." 
+This self-rating helps me respond to the needs of the group. With mostly 1's and 2's, I will concentrate on their present problems. In a group of 5's "and ready to go," I can take a more intellectual approach and talk about logotherapy because they can accept and apply it to their own situation. 
+I talk about the basic concepts of logotherapy: the three dimensions-the somatic (physical), the psychological, and the "noetic" (the human spirit). It is important that the participants understand the concept of the noetic dimension as the area of their essential self. They have a body and a psyche, but they are their noos (spirit). They also must understand that the human spirit is not reserved for religious persons but. is a human dimension that is part of everybody. To understand human beings in their totality they have to be seen in their three-dimensional totality. 
+
+EXERCISE: 
+
+List moments when life has meaning for you, and list the noetic sources of this meaning-creativity, compassion, commitment, choice, discovery of a truth or value, selftranscendence, awareness of uniqueness, assumption of responsibility. For instance: 
+My life has meaning Noetic sources when 
+lam at work Creativity, being paid for my education, supporting my family 
+play with my Compassion, uniquegrandchildren ness, responsibility 
+I go jogging Value of health 
+I make love Compassion, 
+uniqueness 
+Take away the noetic sources, and work becomes a drag, playing with grandchildren a burden, jogging a strain, and making love a mutual masturbation. (For a more thorough discussion of the noetic see Fabry's article, "The Unconscious in Logotherapy" in this issue.) 
+
+
+EXERCISE: 
+List in your notebook events during last week that made your life more meaningful. List events of last week that made your life feel meaningless. Discuss these topics in groups of threes and fours. 
+
+
+HOMEWORK: 
+1. 
+Draw a road map of your life from the beginning to the present, with its ups and downs, and main events. Extend your map into the future. No drawing skill is necessary. Let forms, symbols, and colors flow from your unconscious. Use large paper and colored pens or crayons. 
+
+2. 
+Answer these three questions: 
+
+
+• 
+Who do I think I am? 
+
+• 
+Who does my family want me to be? 
+
+• 
+Who do I want to be? 
+
+
+Second Session: My Value Hierarchy 
+The road maps are spread on the floor. Participants explain their maps and add comments and questions to those of the others. Questions may include: 
+• 
+What surprises you in your map? 
+
+• 
+What were turning points in your life? 
+
+• 
+Where were the periods of growth? 
+
+• 
+What was meaningful at the time? What seems meaningful in retrospect? 
+
+• 
+What values seem important to youl? Where do they come from? 
+
+• 
+What are your hopes and goals? 
+
+• 
+What are your feelings in looking at your map? 
+
+• 
+What can you learn from it? 
+
+
+Attention is given to the use of colors, symbols, and other ways in which the unconscious may have sent messages. One woman, for instance, drew her graduation from college (which she remembered as a happy event) the same color as her subsequent 
+
+16 
+divorce (which had plunged her into great misery). She realized that now, eight years later, her noetic unconscious recognized the meaning of her divorce on the same level as her graduation-a maturing toward independence. 
+EXERCISE: 
+List in your notebook: 
+• 
+Values you learned from your family. 
+
+• 
+Three ways in which you are like your mother/father. 
+
+• 
+Three ways in which you are different. 
+
+• 
+Three behaviors in the past week when you acted like your mother/father. 
+
+• 
+Three behaviors in the past week when you were different. 
+
+
+
+At this point I discuss Frankl's distinction between meanings and values as guidelines to daily behavior. Underlying these is logotherapy's basic belief that life does not owe us pleasures but offers us meanings in every moment and in every situation. To recognize "the meaning of the moment" and to respond to it is to lead a meaningful life. But this responsibility-response-ability to the demands of the moment-often requires difficult, even seemingly impossible, decisions. In this choice-making, values are helpful because they are universal meanings, useful guidelines in standard situations. Relying on values saves a personal search for the meaning of the moment but can cause existential conflicts-between different values, or between outside values and inner conscience. Thus, choices still must be made-either a choice of one value over another, or a choice of personal meaning over accepted societal values. 
+
+EXERCISE: 
+
+1. • List examples of value conflicts you have experienced. 
+• 
+List incidents where you took a stand against accepted values. 
+
+• 
+In groups of threes, and looking at your road maps and lists, discuss what values you accept as your own, how strong they are, and what changes you wish to make. 
+
+
+
+2. In the entire sharing group, the values of each individual are written on the blackboard. Look at the combined list and 
+• 
+List your present hierarchy of values. 
+
+• 
+List the hierarchy you would like to list truthfully five years hence. 
+
+
+
+HOMEWORK: 
+
+1. 
+Draw a pie of daily activities-how much time you spend, in an average day, on various activities. 
+
+2. 
+Write two statements: 
+
+
+• 
+The best day of the week is when .. . 
+
+• 
+The worst day of the week is when .. . 
+
+
+
+The group members are handed the Social Readjustment Rating Scale1 and are asked to evaluate their current tension according to the scale. They are also handed the Purpose in Life and Seeking of Noetic Goals tests2 and asked to fill them out. 
+Third Session: Handling Tension 
+Participants are asked to reevaluate their road maps and add to them if they wish to. Where were their periods of stress? Of equilibrium? Of growth? 
+Frankl's stress theory is discussed which distinguishes between physical-psychological stress and noetic tension. In physical-psychological situations the goal is homeostasis by either overcoming or adjusting to it. Noetic tension, on the other hand, is part of human growth and of the search for meaning; it must not be adjusted to, or tranquilized away. Frankl defines noetic tension as 
+The tension between what I am and what I 
+have the vision of becoming (growth). 
+My outreach toward what u1 am meant to 
+be" (will to meaning). 
+My outreach toward people to love and 
+causes to serve (self-transcendence). 
+
+In the noetic dimension, a tensionless state leads to the existential vacuum. Those who are unable or unwilling to face their healthy tension, fill their emptiness with unhealthy tensions such as violence, rebellion, and aggression. 
+To determine the physical-psychological stress, the Social Readjustment Rating Scale is examined. The purpose is to avoid an unnecessary accumulation of psycho-physical stresses which can occur in happy events as well as crises. A stress of 150 points or more may cause sickness. 
+Some stresses are unavoidable, others can be postponed or avoided. It is not ad
+17 
+visable, for instance, immediately after a death in the family to give up the old home or change jobs. Participants are encouraged to fill out the Rating Scale periodically. 
+To determine the tension in the noetic dimension, a comparison between the PIL (Purpose in Life) and the SONG (Seeking of Noetic Goals) tests is useful. The PIL test measures present meaning orientation, the SONG test the motivation to find meaning. Those scoring low on PIL and high on SONG lack meaning but have strong motivation to find it, and therefore will benefit from logotherapy. Those scoring low on SONG have to be motivated to use their will to meaning. 
+
+EXERCISE:' 
+
+In groups of threes or fours, discuss how you can reduce present physical-psychological stresses, while keeping up the healthy tension of a search for meaning. 
+Write in your notebook examples from the past week when you were motivated to 
+• 
+Make a meaningful choice. 
+
+• 
+Make a responsible decision. 
+
+• 
+Take on a self-chosen task. 
+
+• 
+Respond to the demands of the moment. eDo something for someone or some cause. 
+
+
+drop it into a basket. Pick one of the other packages, not knowing whose material it is. Read the material through and write down a plan of how your unknown client may structure his or her life for the next month, or longer, in order to approach the desired goals. 
+By means of the symbols on the packages, find the person whose materials you have worked on. Everyone is alternately "consultant" and "client," and the exercise is useful for both. The consultants realize that practical changes can be suggested and made, and have enough distance to see possible changes they would not have. been able to see in their own life. When these consultants in turn become clients, they hear about options in their daily behavior they had not suspected were there. They may select from these options. New choices become visible, traps are sprung, doors are opened. 
+This exercise may have unexpected bonuses. In my first sharing group, my material was picked up by a shy woman who would have felt helplessly flustered if I had personally asked her to make suggestions to me. What she had written, however, was extremely helpful. When she realized the usefulness of her suggestions she had a new self-image which in turn benefited her. 
+
+
+HOMEWORK: 
+• 
+List five behaviors which are meaningful· 
+
+• 
+List five behaviors which are meaningless to you. 
+
+• 
+List up to ten things you have to do in the next month. 
+
+• 
+List up to ten things you want to do in the next month. Revise your pie of daily activities if nec
+
+
+essary. 
+Fourth Session: Meaningful Changes in Daily Activities 
+EXERCISE: 
+1. 
+Write down your long-range goals for the next five years. 
+
+2. 
+Put a package together, consisting of your recent homework: the five behaviors which are meaningful, the five which are meaningless, the ten things you have to do next month, the things you want to do, and the list of your long-range goals. 
+
+
+Mark your package with a symbol and 
+Consultant and client discuss behavior changes. The clients write down their own, modified version of new meaningful behavior structures-for the next month or longer. They take their version home and check periodically how close they have come to realize what have become their own proposals. Once a month they write in their journal-notebook a statement: "I am nearer to my goal because ... " The first monthly evaluation can be shared at the last session of the eight-week sharing group workshop. 
+Then roles are switched. The former client becomes consultant and finds the person whose life he/she has "restructured," and another round of talks begins. 
+General guidelines for this exercise: 
+• 
+Accept only suggestions that agree with your value system. 
+
+• 
+Keep your structures flexible and revise them in practical, not philosophical terms. Although your values remain stable, priorities change. 
+
+
+
+18 
+• The meaning of the moment may require that you take a stand against a widely accepted value, even against a value ordinarily accepted by yourself. You have "the defiant powerof the human spirit" to do so, but use it only in extraordinary circumstances-never lightly. 
+
+
+
+
+HOMEWORK:. 
+Write your credo-your basic beliefs about the Meaning of Life. Write it in the form of a number of statements beginning with, "Life is most meaningful when ..." 
+FifthSession: How to Deal with Critical Situatiom Traumas and critical situations often are the result ofa conflict between: The way you want to be and your daily behavior. Your long-range goals and your daily needs (physical-psychological). 
+Your long-range goals and your responses 
+to the meaning of the moment (noetic). 
+Yourself-interests and your desire tohelp 
+others. 
+
+
+EXERCISE: 
+
+1. Write down examples for each of these conflicts. For example: I want to be a potter but spend all my day cleaning house and taking care of my family. I want to be a good husband, but have 
+the need for an occasional fling. I am stingy and behave like a saint. I wish I had more time to spend with my 
+mother but I have my own life to lead. 
+2. To make these conflicts at least livable, 
+
+Find out more about your real goals and ambitions, and admit them to yourself even if they are not pretty or socially acceptable. 
+Recycle yourself in the direction of your long-range goals. Empathize with another person. 
+3. In small groups and using the material you have written during the previous sessions and as homework, discuss the changes you might be able to make in these three directions. 
+Take one conflict situation that is bothering you now, and see how you could improve it by taking one or more of the three approaches. Listen to others in the group for behavior changes acceptable to you. 
+Advice giving is discouraged. It results in a "yes-but" reaction. Useful suggestions can come in the following forms: 
+• 
+Example. "I was in a similar situation five years ago, and I know how it feels. What I did to overcome the crisis was ...'' 
+
+•If 
+I were you. "I have never been in such a situation but I imagine if I were I would do this..." 
+
+
+eAct as if. "If I am in such a situation, I act this way..." Participants act out their behavior in the described situation. You may see one that feels right for you, and which you want to try. In the safe situation of the group, you act flS if you actually were the person you want to be and, deep within you, believe you can be. Then. in small steps, begin to "act as if'' in daily life. 
+
+HOMEWORK: 
+
+• 
+List all the reasons why your life is meaningful now. Select the five highest ones and number them from 1 to S. 
+
+• 
+List five situations in which you are irreplaceable, at least to some degree. 
+
+• 
+List five persons who would miss you. 
+
+
+
+Sixth Session: How to Deal with 
+Meaningmne&1 
+Existential despair can be the result of Situations you perceive as meaningless Your existential vacuum A feeling of hopelessness, of being trapped. 
+
+EXERCISES: 
+
+1. 
+Write down an episooe from the past that seemed meaningless. Discuss in small groups: What lessons have you learned from it? What has it done for you? Has anything good come from it? Looking back, can you see any meaning in the old situation? Let others help you by suggesting possible meanings: What did they find meaningful in similar experiences? 
+
+2. 
+In the whole group share your lists of persons and situations where you feel irreplaceable. How do you feel about the lists? What surprises you? 
+
+3. 
+Write down one situation in which you feel trapped. Make a list ofchoices still open to you, including the impractical and even the ri<ficulous. In groups of three or four discuss your lists and see if, with suggestions 
+
+
+19 
+from the others, you can come up with one choice that seems worth trying. What would be a first step toward realizing your choice? 
+The three tenets of logotherapy are discussd: 
+l. Will to meaning, the main motivation for living-stronger and more basic than the will to pleasure and power. Pleasure is a byproduct of having found meaning. Power is a means to an end-to find meaning. 
+2. 
+Freedom of will, to find meaning by changing a meaningless situation or, where this is not possible, by changing the attitude toward a meaningless situation. 
+
+3. 
+Life hos meaning, under all circumstances. The ultimate meaning of life can not be understood in its fullness but can be glimpsed as an awareness that, in spite of apparent chaos, there is order in the universe, and each person is part of that order. To search for participation in that totality is to lead a meaningful life. In daily life, meaning can be found in three areas: in activities, experiences, and attitudes. 
+
+
+EXERCISE: 
+The individual credos from the previous homework are written on the blackboard and a common group credo is developed by combining related statements beginning with the phrase: "Life is meaningful when ... " 
+
+HOMEWORK: 
+Pretend to be someone close to you, and write a letter to a mutual friend telling her that you died. Tell her what kind of person you were, what was important to you, what difference your absence will make, and what is most worth remembering about you. 
+Seventh Session: How to Deal with Depressions 
+Depressions may originate in any of three 
+dimensions-somatic, psychological, noetic
+or in a combination of these. 
+Somatogenic depressions may be relieved 
+by pharmaceutical means, psychogenic 
+depressions by traditional psychotherapy, 
+and noogenic depressions by logotherapy. 
+The original diagnosis should be made by 
+a psychiatrist who considers all three dimen
+sions, including the noetic. 
+In working with psychiatrists on somato
+genic and psychogenic depressions, logo-therapy is supplementary but nonetheless important. For noogenic depressions-caused by a conflict of conscience, a clash of values, or a frustrated will to meaning-logotherapy is primary therapy. 
+In all cases the logotherapist uses the fourstep approach developed by Lukas. 3 The first step is to help the depressed persons gain distance from their depression-to lead them to see that the depression is something they have, not an integral part of themselves. What they are is a human being with many capacities, including the capacity to overcome the depression, where this is possible, or to live within the limitations of an incurable depression while keeping its effects under control by medication. This leads to the second step, a modulation of attitudes, a shift of the patients' search for meaning from the area where it is blocked, to a path still open. If successful, the change in attitude will relieve the symptoms -of the depression-the third step. When patients experience a reduction of symptoms, they be
+come ready for the fourth step-a common search by the logotherapist and the client for a new and meaningful behavior structure (logotherapy in the strict sense). 
+The logogroup is helpful ill mild cases of depression and as supplement for people who are in therapy, with the consent of the therapist. Depressions cannot be denied, wished away, or willed away; they must be faced and lived through. To tell depressed persons to pull themselves together, or that other people are even worse off, will only increase the depression because a feeling of guilt is added when they cannot overcome the depression. 
+In the logogroup, a form of dereflection is applied-a dereflection away from brooding about the depression toward meanings found in daily living. 
+
+
+EXERCISE: 
+List the five areas where meaning becomes accessible: 
+I. When I learn a truth about myself. 
+2. 
+When I have a choice. 
+
+3. 
+When I feel unique. 
+
+4. 
+When I am responsible. 
+
+5. 
+When I am self-transcending. Write down a detailed "I will" list for 
+
+
+
+20 
+tomorrow, and mark the area of meaning for each item. For instance: 
+I will get the kids to school (4) 
+I will make breakfast for Rich (husband) 
+and the children (5) 
+I will not phone mother because that 
+makes me more depressed (1,2) 
+I will mend Sue's (daughter's) pajamas (2,5) 
+I will talk to Mildred (a neighbor) because 
+I know she appreciates it (3,5) 
+I will play the piano because that makes 
+me feel good (l) 
+I will buy a newspaper, but not at the 
+corner. I will ride my bike to the market 
+and get some exercise (1,2) 
+I will help Peggy (a sister) prepare the 
+birthday party for Bobby (5) 
+I will go food shopping for the whole week. 
+Our refrigerator is empty (4, 5). 
+When Rich comes home, I will be dressed 
+nicely and give him a neck massage (3, 5). 
+
+Share your will-list with the group. You may pick up additional ideas from the lists of others and add them to yours. Will-lists make you aware of your choices, your uniqueness, and your opportunities for self-discovery, responsibility, and self-transcendence. Make a list every evening for the next day, and mark how you feel on a scale of 1 to 5. The dereflective effect can be seen in the comment of one group member: "How could I feel depressed? I had no time for it." 
+Will-lists accomplish all four steps of logotherapy: they help group members see that they are not the helpless victims of their depression, they help them modulate their attitudes, reduce the symptoms, and show them the directions of meaning. 
+
+
+HOMEWORK: 
+
+Write, on little pieces of paper, a sentence for each member of the group starting with the phrase, "I really appreciated your being in the group because ... " Do not sign the note. 
+Eighth Session: What We Have Learned for Daily Living 
+This is the last session, and time for a review. Participants indicate for the last time where they stand on the scale from l to 5. What during the past eight weeks has happened to change their standing? What can they learn from the changes? 
+
+EXERCISES: 
+
+1. 
+Discuss the first monthly evaluation (see fourth session). 
+
+2. 
+Write in your notebook and share with the group: 
+
+
+• 
+Two things you have learned. 
+
+• 
+Two things you had not expected. 
+
+• 
+Five reasons why you would be missed if you would be gone tomorrow. 
+
+
+
+The statements of appreciation (last homework) are collected and distributed, so each group member has nine anonymous statements why his or her presence in the group was valuable. 
+
+CONTINUING EXERCISES: 
+Continue journal writing and those ex
+
+ercises that seemed useful to you. 
+Write down every evening: 
+Today was meaningful when .. . 
+Today was meaningless when .. . 
+Write every Sunday: 
+This week was meaningful when .. . 
+This week was meaningless when .. . 
+Do these same exercises the last day of 
+
+each month, and every December 31: What 
+was meaningful and meaningless the past 
+month, the past year? Out ofthese exercises 
+a pet'sonal pattern of meaningful· and mean
+ingless activities will emerge. 
+
+THE GOODBYE EXERCISE: 
+
+Meaningful living implies living in the present while learning from the past and reaching out to the future. 
+Living in the present implies saying goodbye to meaningful involvements whose time has passed. Meaning cannot be captured and held forever. This is true even for routine activities. 
+Example: Driving home from work (which is meaningful from 8 to 5) · to home (which is meaningful from 5 to 8) there comes a point of meaning switch. In my case, when I drive home from work, the Oak Bridge is about halfway. When I reach the bridge and my mind is still on my work, I stop in a side street and meditate until I am free for new meaning opportunities. Only then do I drive on and greet my wife and children. 
+What are the main meaning blocks in your 
+daily activities? 
+What are your "Oak Bridge" routines 
+21 
+between these meaning blocks? 
+How do you say goodbye to one meaning 
+before the next one begins? 
+
+Form a circle, and stand holding each other by the shoulders and say goodbye to the group. You have your past-your notebook. You have your future-your plans to continue with the structure of "Finding Meaning Every Day." 
+Now say goodbye. 
+
+JOHN M. QUIRK is supervisor of the Unitarian Counseling Service and Family Life Centre, Vancouver, B.C., Canada, and 
+REFERENCES: 
+l. Social Readjustment Rating Scale. In Holmes, T.H. and Rahe, R.H. Journal ofPsycliosomatic Research, 11: 213-218, 1967. 
+2. 
+Purpose in Life (PIL) Test and Seeking of Noetic Goals (SONG) Test, Psychometric Affiliates, Box 3167, Munster, IN 46321. 
+
+3. 
+Lukas, E. "The Four Steps of Logotherapy," in Festival of Meaning, Uniquest 7, Institute of Logotherapy, I Lawson Road, Berkeley, CA 94707. 
+
+
+associate minister of the Unitarian Church of Vancouver. 
+
+Principles of Logotherapy 
+Lie Im meaning under al circumstance&. This unqualified claim is possible because meaning is found not only in· what we do (work, hobbies,. commitment to a cause) and what we experience (in nature, art, human relationships), but also in the attitudes we take in apparently meaningless, tragic situations that cause unavoidable suffering. 
+TIie will to meaning is our main motivation-more potent than Sigmund Freud's will to pleasure or Alfred Adler's will to power. 
+We lave the freedom to ftnd meaning-not freedom FROM biological, psychological, social, or cultural limitations, but freedom TO take a stand in all situations in which we find ourselves, in spite ofalllimitations. 
+We have the "defiant power of the human spirit." We are not the helpless victims of our physical limitations, our instinctual drives, our environment. We do not have to take every nonsense from ourselves. 
+We always have a choice-at least in our attitudes. 
+The lmman being is a totality of three dlmensiom-the biological, the psychological, and the spiritual-and can be fully understood and kept healthy only if ALL three are considered. 
+Avoid reductionism which disregards the human spirit and projects the human being into the biological dimension where he is "nothing but" an animal that can be trained, or . the psychological dimension where he is 
+•'nothing but" a machine that can be manipulated. 
+The lmman spirit is our healthy core. It cannot become sick-only blocked by physical or psychological illness. The logotherapist helps the patient gain access to the resources of his spirit. 
+We can tramcend ourselves-reach beyond ourselves toward people to love and causes to serve. 
+We can step away from ourselves and look at ourselves from the outside, with humor, which helps us break life patterns and make changes in the direction of our goals. 
+What we are is determined not only by what we have been but also by what we have the vision of becoming. 
+Each person is unique. Situations in which we feel irreplaceable are likely to elicit meaning. 
+Meaning is found step by step, moment by moment, although quantum jumps such as peak experiences,_are possible. 
+The meaning of the moment Is not always lmtantly recognizable. It may be necessary to be truly a "patient" and wait until it manifests itself. 
+Respolll!libiBty mea• ''respome-abillty"-the ability to respond to the meanings of the ~ment. Our responses are guided by outside guidelines (from society) or by the inner resources ofour conscience. 
+Tension is part of buman existence. The goal of mental health is not equilibrium, the adjustment to life as it IS, but a reaching out to life as it COULD BE. This tension between "being" and "meaning" strengthens our spiritual muscles. 
+Finding meaning Is not a gift but an achievement which may be greatest in situations of unavoidable suffering. No one knows his limits until life offers him the opportunity to test them. 
+Growth often comes as the result of Imposed and unwanted change. Therapy may be needed when growth does not happen after imposed change. 
+Lie does not owe us pleasure; it offers us meaning. Mental health does not come to those who demand happiness but to those who find meaning. Happiness and pleasure are mere side-products of having found meaning. 
+
+
+22 
+
+The Logotherapeutic Intergenerational Communications Croup 
+Mignon Eisenberg 
+
+
+Logotherapy is effective in moving a group from pseudo-encounter and hyper-reflection to meaning orientation. Members are deriving strerigth and support from each other and strive to rise above their limitations and petty concerns, to be worthy of the trust and expectations placed in them by the group. It seems as if multiple vitality, life experience, capacity for self-detachment and laughter, authenticity and affection are pooled in a common treasure chest and made available to every participant. 
+The object of the logotherapeutic intergenerational communications group is to change personal attitudes, promote selfdetermination and self-transcendence, and enhance acceptance of self and others. The group provides a type of consciousness-raising toward responsibleness and altruism. 
+To participate, group members must express a desire for a change in their present situation. This makes for a constructive urgency, a tension towards becoming. 
+Rules for the Sessions 
+
+Groups consist of seven to fifteen members and meet for three hours once a week for eight to fourteen weeks. Sometimes a workshop is held for one weekend, one day, or several hours only. Participants agree to be sincere, validating, confrontive (to clarify, not to criticize), to listen "with the third ear," not to intellectualize. Members are requested to read Frankl's Man's Search for Meaning, The Will to Meaning, Rogers' On Encounter Groups, and Voltaire's Candide. At the end of each session, members write self-reports and reaction papers. Yoga breathing and other warm-up exercises are used to create a favorable climate for receptivity and meditation. 
+The facilitator is part of the group, with the added task of guiding, listening, rescuing. The approach is eclectic. Methods include role playing, logodrama, and all aspects of logotherapeutic principles and techniques. 
+The atmosphere of trust that develops takes the sting out of seemingly insoluble problems. Members are encouraged to ridicule their fears, stimulating their capacity for self-detachment. For instance, a sheet is distributed on "how to worry scientifically": Set a definite time and day; set a time limit on worrying, say an hour, but during that time don't do anything but worry; make a thorough job of it. When time is up, quit. Never worry when you are tired, angry, or depressed. If you must feel sorry for yourself, make your surroundings as aversive as possible for example, sit in a closet. 
+The groups are intergenerational, with group members ranging in age from the upper teens to the eighties and over, representing surrogate families of at least three. generations, with special significance for each: 
+The long-living see themselves in the middleaged and young group members, evoking powerful memories of the past coming to life in the present. They also see their children and grandchildren in the other two age groups, with forceful re-emergence of joys and sorrows, gratifications and guilt feelings. 
+23 
+The life-review process is stimulated and with my parents and mapping the road for facilitated. the future...'' 
+The middle-aged members look, as it were, into a two-way mirror at slanted angles: in the one they see themselves in the older members, their own parents, and the parents in themselves; in the other they see themselves in their children and in the children that will be like them. It makes for a change in time perspective, a restructuring of time left to live, rather than time lived. 
+The young experience confrontation with "parents" and "grandparents" in a nonthreatening atmosphere of trust and support, with permission and invitation to communicate openly, and voice negative emotions freely. Possibilities for value-transforming insight and change ensue. They begin to shed their shields of invulnerability, realizing what strength and wisdom is represented in the older group members; aging and maturing are seen in a new illuminating light. Own parents emerge as warm, caring individuals, with problems and apprehensions not far removed from their own. 
+Self-Reports 
+
+A twenty-year old student announced at the beginning of the course that by the time he reached his thirtieth birthday he would commit suicide because he did not want to grow old. He changed his mind during the course. He wrote in the final self-report: " ...the lines of demarcation became obscure and I saw group members as individuals, rather than prototypes of live stages. At times I felt static, unproductive, apathetic (in short, I had all the characteristics I used to associate with old age), and then looked to the enthusiastic and activated seniors for the inspiration one would expect the aged to get from the young. As Picasso said at age eighty-six: "It takes a long time to become young." In retrospect, I see the group as fellow travelers, who embarked on a journey of self-exploration. At times, each would stop at a different station along his or her road of life, visiting past experiences, taking souvenirs, distributing gifts. The reassessment and self-evaluation that the group prompted me to do has provoked me into pursuing new insights into my life. I have spent a great deal of time talking 
+A middle-aged woman member wrote: " ...fear, guilt, pain, loneliness, love and anger are all in me and it is good to share them and i'eceive the understanding and support of others because they feel the same way. The experience was to me as if we all had been sitting in a boat in mid-ocean, each walled off from the others, living in our own private hells. Gradually we began to look at each other, to see and know one another, and I find it very good. Now I can touch the sky, my boat has arrived. The only guilt I feel i;iow is not having activated my meaning potential sooner...'' 
+Finally, a message from a long-living person: " .. .I have experienced what I have often heard before: that youth is not a time of life, it is a state of mind, a temper of the will, a quality of the imagination, a vigor of the emotions; it is a freshness of the deep springs of life, a predominance of courage over timidity, of the appetite for adventure over the love of ease. This can exist in a person of eighty more than in one of twenty. Nobody grows old merely by living a number of years; people grow old by deserting their ideals. Years wrinkle the skin, but to give up hope and enthusiasm wrinkles the soul. .. " 
+The logotherapeutic, age-integrated encounter group has proven a useful format as part of human development courses in high schools, universities and hospital in-training classes. It is especially suitable for training and educating personnel in the helping professions, as well as for singles, women, the widowed, the divorced, people in transitions. It is a dynamic tool for changing and molding societal values, eliminating personal bias and shattering stereotypes. 
+Frankl's "height psychology" seems to be applicable to universal conflict situations throughout the life span, be it the identity crisis of the young, the mid-life crisis or the 'stock-taking' of the long-living. The common denominator in all these situations is the need for meaning. This discovery, nurtured by the values evinced by group members, elevates participants toward the highest level of learning, how to be human. 
+
+24 
+A new type of person is forged in the sessions, a type of superior person, better equipped to brave the vicissitudes of life, ever reaching for new horizons to conquer. Instant solutions are no longer sought. Group members are aware of Jung's admonition, that " ... the serious problems in life ... are never fully solved. If ever they should appear to be so, it is a sure sign that something has 
+Group Applications: 
+
+Prisons-Unused Laboratories 
+Didi Sibaja-Makai 
+been lost. The meaning and purpose of a problem seems to lie not in its solution, but in our working at it incessantly ... '' 
+MIGNON EISENBERG is director ofHuman Development Facilitators Inc., 520 N. Michigan Ave., Chicago, II 60611. She also teaches psychology at the city colleges in Chicago. 
+
+
+For the past 16 months I have been working with more than 900 psychotic inmates at the California Medical facility of the state prison in Vacaville, California. I spent three days a week with about ten men at a time, selected by prison officers trained to tell if the inmates were capable of working with me that day without a major psychological breakdown. The ward in which we were working is that part of the prison where inmates spend from three weeks to four months before being transferred to other parts of the prison where they live and work under regular prison routine. This ward, therefore, contained the most disturbed and hard-to-handle inmates. Most of them were on prescribed drugs. 
+What I did in Vacaville cannot be called therapy in the traditional sense because I rarely worked with the same men for more than once or a few times, and hardly ever at consecutive meetings. Nevertheless, the effect was therapeutic. 
+Tramformative Design 
+
+I am using "transformative design," a method of therapy that aims at transformation of persons toward their potentialities. It links logotherapy with behavioral science, art, architecture, design, the biological sciences, Eastern philosophy and Western psychology. In Vacaville, I used the principles of logotherapy primarily with art, design, and some physical and breathing exercises. 
+Our program allowed the inmates to paint, according to their own design, the walls of about 20 rooms-corridors, offices, TV rooms, exercise and eating areas. We started out in a group, talking about their favorite colors and their associations with certain colors. I let them close their eyes and imagine colors they associated with happy memories, followed by breathing exercises, "to breathe in the colors they like, and breathe out colors they dislike." We also talked about shapes and symbols, and what they meant to each inmate. 
+We then discussed the colors and design of the room we planned to paint. Or, if the room had already been started, what they might want to change from the original plan. Officers participated in the discussions and the actual painting, especially if the painting was done in their own office spaces. Blue was often 
+25 
+A new type of person is forged in the sessions, a type of superior person, better equipped to brave the vicissitudes of life, ever reaching for new horizons to conquer. Instant solutions are no longer sought. Group members are aware of Jung's admonition, that " ... the serious problems in life ... are never fully solved. If ever they should appear to be so, it is a sure sign that something has 
+Group Applications: 
+
+
+Prisons-Unused Laboratories 
+Didi Sibaja-Makai 
+been lost. The meaning and purpose of a problem seems to lie not in its solution, but in our working at it incessantly ... '' 
+MIGNON EISENBERG is director ofHuman Development Facilitators Inc., 520 N. Michigan Ave., Chicago, II 60611. She also teaches psychology at the city colleges in Chicago. 
+
+
+For the past 16 months I have been working with more than 900 psychotic inmates at the California Medical facility of the state prison in Vacaville, California. I spent three days a week with about ten men at a time, selected by prison officers trained to tell if the inmates were capable of working with me that day without a major psychological breakdown. The ward in which we were working is that part of the prison where inmates spend from three weeks to four months before being transferred to other parts of the prison where they live and work under regular prison routine. This ward, therefore, contained the most disturbed and hard-to-handle inmates. Most of them were on prescribed drugs. 
+What I did in Vacaville cannot be called therapy in the traditional sense because I rarely worked with the same men for more than once or a few times, and hardly ever at consecutive meetings. Nevertheless, the effect was therapeutic. 
+Tramformative Design 
+
+I am using "transformative design," a method of therapy that aims at transformation of persons toward their potentialities. It links logotherapy with behavioral science, art, architecture, design, the biological sciences, Eastern philosophy and Western psychology. In Vacaville, I used the principles of logotherapy primarily with art, design, and some physical and breathing exercises. 
+Our program allowed the inmates to paint, according to their own design, the walls of about 20 rooms-corridors, offices, TV rooms, exercise and eating areas. We started out in a group, talking about their favorite colors and their associations with certain colors. I let them close their eyes and imagine colors they associated with happy memories, followed by breathing exercises, "to breathe in the colors they like, and breathe out colors they dislike." We also talked about shapes and symbols, and what they meant to each inmate. 
+We then discussed the colors and design of the room we planned to paint. Or, if the room had already been started, what they might want to change from the original plan. Officers participated in the discussions and the actual painting, especially if the painting was done in their own office spaces. Blue was often 
+25 
+seen as the color of authority, and most inmates agreed that the wall behind the officer should be blue. They also saw it as the color of the sky, of calmness and lightness, of hope. The combination of authority and hope was new to them, and a fertile field for discussion: was it possible to see hope through authority? Another "cold" color, green, was the color of grass, refreshing but also covering, controlling.· Red and black were associated with rage, and we talked about rage, and what to do with it. Is a raging personality something we are, intrinsically, or is rage something we have and can tum into the directions of our choice? Could they think of incidents when they used their rage to accomplish something useful? And shapes-what were their favorite shapes? Where in nature do we find circles? In flowers, in water when you drop a pebble, the sun, the moon, the horizon. Where in nature do we find a straight line? They were surprised to find no real straight lines in nature. What did straight lines mean? Separation, harshness. And circles? Holding hands, playing games, rings meaning love and friendship. 
+We didn't philosophize. We just let the thoughts simmer. 
+Sometimes the talks went off the subject, occasionally they became uncomfortable, even threatening. I had a whistle to call for help. I used it seven times in these 15 months, four times in one day. The uncomfortable incidents often were rewarding. One inmate challenged me: he didn't think a woman should be in a position to "boss" men. A lively discussion followed. Some in the group defended me. I was not "bossing," I let them make the decisions. I was trying to help. And-why should not women be bosses? After a heated discussion over a woman's "proper place" I was told that I had been working with the leaders of five opposing militant factions in the institution, and that no one had ever brought them together for a discussion. 
+Before the lunch break, we made a list of the work to be done that day. I asked for volunteers: who wanted to do what? They knew they were expected to do what they had committed themselves to do. One would wash down the walls, one would work on the ladder, another one would tape the trim, and soon. 
+
+Principles of Logotherapy 
+
+Many principles of logotherapy were applied. Although they were applied in tiny doses and in areas which, in comparison with their overall situation, seemed insignificant, they had noticeable effects. My experience was similar to that of Frankl when he worked with the unemployed in Vienna in the thirties, many of whom had considered or actually attempted suicide. He found that giving them a chance to be useful, even if it was volunteer work of a minor nature, such as handing out programs at adult education lectures, made a difference. Here at Vacaville, for a few hours, the inmates were treated as human beings, with choices to make. They were given the opportunity to take on responsibility, to make commitments, to be creative, to chat with me and each other as one human being to other human beings. They experienced "achievement," even if it was only a patch on a wall: a tree that one of them had insisted should go against the blue of the wall, an orange circle, the picture of a telephone and an over-sized dime that became a symbol of 
+freedom that was taken from them in the 
+prison and waited for them on the outside. They enjoyed seeing the area they had worked on. They received praise from the personnel who benefited from the more cheerful looks of their working areas. The superintendent of the unit, Dr. T.L. Clanson, reported that the work was "valuable and of benefit to the patients, resulting in the improvement of the appearance of the ward," and told the inmates about how the staff felt. 
+For a few hours, they were more than numbers, they got a glimpse of themselves as they could be, persons who could make decisions. The decisions were merely about colors and shapes in the rooms they hoped they would never see again after their transfer from the psychiatric ward to parts of the prison where control was less strict. They saw from that small sample that even under conditions of strict limitations they did have some control themselves. The hopelessness of their situation often came up. We made lists: what were the worst things that could happen in their specific crisis? What were the best things? What could they do to make them happen? 
+
+26 
+Attention was focused on the present and future, not on the past which hung like a millstone around their necks. The unspoken message was: "You have made mistakes in the past. You cannot unmake them. But you are not fated to repeat them. You do have choices. Not a choice whether or not to get out from these walls, but what you can do within these walls. And to plan what they would do after their release. Here the logotherapeutic idea about the change of attitude was important: They had no freedom to change their situation, but no one could deprive them of their freedom to change their attitude toward that unchangeable situation. These ideas must not be "preached," they must be lived. 
+Attention was also focussed on the uniqueness of the person. I had licorice sticks which I shared with those who worked. One inmate kept telling me, "Give me an extra piece, I am special." I told him, "Yes, you are special, unique. But so am I, and so is your frienp there." He understood. They all understood. 
+The inmates were given opportunities to take on self-chosen responsibility and accept commitments to some limited tasks. They were allowed to experience the satisfaction that comes with responding to a demand, coming from within or without. 
+It was important for them to know that I cared, that I was genuine and didn't play games with them. I dealt with them in the same way I dealt with the officers and psychiatrists. I answered all their questions honestly or, if I did not want to answer them, said so. 
+I told them frankly about my limitations within which I had to live: I have glaucoma, am blind on part of one eye, I have hypoglycemia that requires a strict diet, can eat no vegetables and fruit, have sinus trouble, am allergic to most pain killers, and am a manicdepressive, for years on a heavy dose of lithium. They could see me put drops into my eyes and medication into my mouth, and still they also saw me full of joy and excitement. I joked and kidded with them, and helped them see themselves with a sense of humor. 
+The results of such a short-time "therapy," applied sporadically, is difficult to judge but I have some evidence. I have drawn "loners" into our activities, including many who had severe suicidal tendencies. I met many of my former "students" who had been released from the strictly supervised ward into the less guarded part of the prison in a much shorter time than was thought possible, and who thanked me for it. And I have the testimony of the program administrator for the unit, 
+R. W. Mygrem, who said that "patient response was outstanding. Previously withdrawn and recluse patients became interested and active in Ms. Sibaja's designing process, which allows them to express their thoughts and ideas." The prisons of America and those of the world are unused laboratories for many experiments with logotherapy that have barely begun. 
+DIDI SIBAJA-MAKAI is an environmental psychologist, social ecologist, and originator of Transformative Design. 
+Now that you have been living in what is known as the free .world, what would you define as the essence of freedom, and does freedom have any dangers? 
+Freedom is possibility. It means everybody uses himself in maximum. It doesn't mean I can use my freedom to break the windows of my neighbor. That is banditism and anarchy, not freedom. It is possibility to be myself, respect myself and respect everybody else. And to understand the necessity to cooperate with everybody for the benefit of society. This is freedom. 
+Albert Makov, Soviet violinist, emigrated to the United States 
+Gaining self-confidence cannot be postponed until the client is ready to commit himself to a course ofaction; self-confidence should be a featured part of logoanalysis from the beginning. I have used for this purpose an exercise called "Act as if ... " It requires the client to do that which he fears most-to imagine that he is the self-confident person he would like to be, and to set aside regular periods during which he acts as he thinks this adequate person would act. In time he gets to feel as he acts, and then he is no longer acting. 
+James C. Crumbaugh in "Logotherapy in Action" 
+27 
+
+
+
+
+
+
+Group Processes for Dyslexic Adolescents 
+Vera Lieban-Kalmar 
+Logotherapy is useful for teachers by helping students establish their goals and coping skills. It conceives them holisticallytheir feelings, thoughts, and aspirations-and makes them aware of their inner resources. I am using logotherapy to help dyslexic adolescents accept and overcome their neurological handicaps by realizing their own potential. 
+My special class consists of about 12 students, 14 to 18 years of age, who meet for four periods a day. They show various learning disabilities and behavioral problems caused by dyslexia. They are selected for my class by a variety of tests which reveal discrepancies between low verbal abilities and high manipulative performance; a tendency to reverse digits, poor learning retention in spelling, reading, and arithmetic despite average or above-average intelligence; low self-image and low tolerance of others. Under stress they tend to recoil into immature behavior. Their limitations make them bewildered about the established rules and mechanics of the school and prevent them from reaching their goals. My task is to change them into functionally and emotionally maturing human beings in accordance with what is normally expected of that age group. 
+To attain a sense of responsibility toward self and others, as well as toward the demands of life itself, the dyslexic student must develop a positive self-image. Logotherapy's four-step approach• is a useful process. The students are led to see • that dyslexia and its symptoms are conditions they have, and not an integral part of their personality, not anything they are. They are human beings with all sorts of limitations and potentials (step Igaining distance from symptoms). Instead of feeling the helpless victims of their circumstances, they are helped to see that some limitations can be overcome, others must be accepted, and in any case they can develop their potentials (step 2-change of attitudes). As a result of these two steps, their condition becomes more bearable (step 3-reduction of symptoms), and this opens them up toward goals that seem meaningful to them (step 4-search for meaning). 
+This development of a new self-awareness is helped by exploratory experiences that lead to personal validation. Talking about these experiences and listening to similar experiences by others enhances awareness and validation of self and others. From here on the personality can unfold toward acceptance and the assumption of responsibility toward the demands of life. 
+
+Human Development Programs 
+Such processes require a safe climate and a setting adjusted to the students' emotional maturity level. Both these conditions are supplied in two programs originating from the Center for Human Development and the Human Development Institute.• I found their theory and practice well in accordance with the teachings of Frankl. These programs emphasize the development of a positive self-image and acceptance of self and others· and, in the most advanced units, the development of values, ethical decision making, 
+•center 
+for Human Development, 1852 Bonanza Street, Walnut Creek, CA 94596. Tel. (415) 935-7090. 
+
+J. 
+Gibbs and A. Allen, directors. 
+
+
+Human Development Institute, Palomares University, 7574 University Avenue, La Mesa, CA 92041. Tel. 800552-8840. G. Ball, director. 
+
+28 
+and coping with the realities of pain, death, failure, or guilt. In my classes I apply logotherapy within the framework of the Human Development program. 
+The Human Development Program is centered around group interaction in a classroom. This in itself is not new. What makes this approach successful is the establishment of definite ground rules. These rules are similar to those for logotherapeutic sharing groups developed by Fabry.2 Before forming group interactions, called "circle sessions " the leader creates a climate of acceptande. A definite agreement is worked out to which the students commit themselves. The agreement consists of five basic rules: 
+1. 
+. Each group member is attentively listened to. 
+
+2. 
+Everyone gets a turn. 
+
+3. 
+Everyone may pass one's turn without penalty. 
+
+4. 
+The circle session is shared equally by the participants. 
+
+5. 
+Only positive comments about other members of the group are allowed: no put-downs. 
+
+
+
+A series of activities and topics are shared within the circle. These activities may be carried out in dyads, triads, or as a whole group. The circle leader, who in later sessions may be a student, introduces the preselected topic to which all members of the group can relate. These topics are structured on a developmental scale of personal risk-taking in revealing self-disclosure (see box on p. 30). Participants share their experiences related to the selected theme. The Socratic dialogue is used to encourage each group member to reflect on personal feelings, thoughts, values, goals, and purposes. Thus, a push is ventured into the .resources of the human spirit. Such questions are raised as, "What were you feeling as you experienced this? What is your feeling about it now? What new understandings did you gain from the experience of others? From your own experience? What was common to everyone's experience shared within the group?" 
+Circle sessions differ from "encounter" groups in some basic approaches. In encounter sessions members are allowed to express any positive or negative feelings toward others; in circle sessions only positive feelings are accepted. Encounter groups discourage preplanned topics to promote genuineness and spontaneity: circle sessions rely on a developmental progression of topics, allowing for gradual increase of risk taking. Encounter groups aim at problem-solving; circle sessions aim at value formation gauged at the members' maturity level. 
+The circle session group process uses Adler's Gemeinschaftsgefuhl (feeling of fellowship)3 as a basic component in the socialization process of a personality. This socialization develops in a climate where each individual can feel safe when volunteering self-disclosure. The insights gained come from acceptance and approval-not by the group leader but by the participants who have taken the risk of sharing and of being understood. Based on this understanding and trust, three generalizations form the socialization of a personality: 1) Other people feel, behave, and think, too. 2) Everyone's specific feelings, behaviors, and thoughts are his or her own. 
+3) If each person is thus unique, then I must be unique, too.• 
+Attitudes change as members arrive at such understandings. They become receptive to the experiences, feelings and thoughts of others, and can empathize with them. This receptiveness and empathy becomes instrumental in the formation of their own values. And with the development of values, selfconfidence and maturing of the personality sets in. One student said: "Last year I was real bad; I used to mess up a lot, get mad with the teacher and the rest of the kids, but I don't do it any more. There is no sense in it." Another student confided: "I used to get kicked out of class for fighting and using bad language, but this year is different; I guess I'm growing up." A mother told me: "I noticed that Will has become more interested in what is going on in our family; it is easier to reason with him; he hasn't been in much trouble this year, he's starting to read street signs and picks up a paper to look up the sports section." A father commented: "Last year Dorothy used every excuse she could think of to stay out of school; this year she is unhappy every day she misses; 
+29 
+she keeps better order of her things and fights less with her brother." The students gain a new attitude toward themselves, their classmates, their goals. Because they feel trusted and understood they learn to accept themselves and develop courage to take responsibility for their actions. In the growing change my students go through, Frankl's statement becomes realized: "Logotherapy is ultimately education toward responsibility: the (person) must push forward independently toward the concrete meaning of his own existence."' Education toward responsibility is,achieved. 
+REFERENCES: 
+I. Lukas, E. "The Four Stages of Logotherapy," in Vlktor Frankl-Festival of Meaning, Berkeley; Uniquest Foundation, 1977. 
+2. 
+Fabry, J. "Application of Logotherapy in Small Sharing Groups." Journal of Religion and Health, XIV (4) 197S. 
+
+3. 
+Adler, A. Der Sinn des Lebens. Frankfurt: Fischer Taschenbuch V /74. 
+
+4. 
+Rogers, C.EncounterGroups. New York: Harper & Row, 1970. 
+
+
+S. Frankl, V. The Doctor and the Soul. New York: Knopf 19SS. Paperback, 1978. 
+VERA LIEBAN-KALMAR is a learning disability specialist for the Richmond (California) Unified Schools, an associate trainer at the Humanistic Development Institute, and a member of the Board of Trustees of the Center for Human Development and of 
+the Institute ofLogotherapy. 
+EXAMPLES OF SELF-DISCLOSURE TOPICS: 
+• 
+Things I like about myself. 
+
+• 
+The time I helped others and succeeded. 
+
+• 
+When I made an important decision. 
+
+
+, EXAMPLES OF ACTIVITIES: 
+• 
+Tape Recorder: In dyads, partner A listens to partner B for two minutes on a chosen topic. Then partner B repeats to partner A for one minute what he/she has heard, without interpretation. Partner A responds about what he/she feels about being listened to. Activity is reversed. 
+
+• 
+Adjective Wardrobe: Each student tears a paper into eight pieces, and writes on each piece a word that describes him/her. This is their "wardrobe" which they are asked to consider, one word at a time, and decide what they want to try on, wear, or discard. Do they like the word? Keep it? Expand it? Discard it? How do they feel? What have they learned about themselves? 
+
+• 
+Strength Bombardment: Each person is selected in turn to receive a positive statement from everyone else in the group. Their feelings and insights gained are discussed in the group. 
+
+
+
+Being responsible means listening actively to one's conscience. The more the person liberates himself from coercions the more he is responsible and the more he feels obligated toward someone or something. The person's conscience is experienced as an "ought, "not as a "must. •• In contrast to the superego, which is the must-conscience offear, punishment, and coercion, the ought-conscience is a matter ofprivate decision. 
+Joseph B. Ghougassian in "Logotherapy in Action" I wouldn't say the concept of the individual is obsolete. It is premature. The real human individual does not yet exist. 
+
+Herbert Marcuse 
+
+Our need is to develop new and very strong traditions that revere life. Ramsey Clark 
+One of the tragedies of our age is an abdication ofpersonal responsibility to the experts. Joel Elkins, director ofpsychiatry John Hopkins Hospital 
+Persons can grow only in the communion of personal encounter. Paul Tillich 
+30 
+
+Applications in Pastoral Psychology 
+Melvin A. Kimble 
+
+
+Religion, like psychotherapy, has the challenge to bring healing and wholeness to persons plagued with the brooding sense of lostness, which characterizes the sickness of our times. Logotherapy provides the pastoral counselor with the theory and the techniques to meet this challenge and, from the boundary line of medicine, offers its share in the helping ministry. Many pastors will welcome this offer because in this secular age they have at times become uncertain about their therapeutic role. 
+Pastoral psychology has found in logotherapy an ally in assessing the human situation and apprehending the totality of the human person. The logotherapeutic tenet that self-transcendence is the essence of existence opens the door to a deeper under standing of the capacity to dedicate and devote oneself to something beyond oneself. Logotherapy provides pastoral psychology with creative interpretations of the ontological differences and anthropological unity of personhood. It enriches the pastor's understanding of meanings and values, of freedom and responsibility, of conscience and commitment, of decision and responsibleness, of suffering and faith, of love and work. Logotherapy exegetes what Niebuhr has characterized as "the basic question of religion," namely, "the problem of meaning."' It dynamically focuses on what Tillich pointed to when he wrote: "Man is ultimately concerned about his being and his meaning." 2 
+Logotherapy offers a uniquely therapeutic theory to expand pastoral psychology and serve as a model for contemporary pastoral counseling. Because it affirms faith in un
+conditional meaning and because it boldly 
+follows a person into the labyrinthian depths 
+of the spiritual dimension, logotherapy helps 
+pastoral psychology rediscover human nature. 
+Pastoral counselors earnestly have been trying to understand persons in their depths; now counselors need an understanding of what encompasses human heights. Logotherapy provides pastors with an anthropological view of human reality in its totality and thereby enriches their counseling ministry. This article suggests how some concepts of logotherapy provide counselors with helpful interpretations of human phenomena. 
+Logotherapy and Time 
+
+Logotherapy takes time seriously. Its existential thrust stresses the temporal nature of human existence and the irreversible quality of human life. Logotherapists do not engage in extensive Freudian subterranean excavations, neither do they dismiss the past as a "bucket of ashes." Rather, they accept the counsel-seeking person as responsible for his or her personal life and for learning from life's experiences. 
+Memory implies time elapsed. In remembering, persons take responsibility for values actualized and values denied. From time to time an individual must bear the pain of remembering himself or herself as one who denied values closely identified with one's self-image. Memories of the past sometimes painfully recall unfulfilled self-expectations. When persons leave potentialities unfulfilled, they experience guilt. However, guilt is not only the feeling carried over from the past; but also the memory of certain positive, 
+31 
+purposeful deeds and experiences, and even the acceptance of unavoidable suffering. Logotherapy's understanding of time is poignantly stated in this passage: 
+All that is good and beautiful in the past is safely preserved in the past. On the other hand, so long as life remains, all guilt and evil is still 'redeemable' ... Life is not a finished film ...or an already existent film which is merely being unrolled. Rather, the film of this world is just being 'shot.' Which means that the future-happilystill remains to be shaped; that is, it is at the disposal of man's responsibility.3, p. 34 
+Even the anxiety of death becomes a positive factor in an existential synthesis which focuses on personal responsibility: 
+What threatens man is his guilt in the past and his death in the future. Both are inescapable, both must be accepted. Thus 
+man is confronted with the human condition in terms of fallibility and mortality. Properly understood, it is, however, precisely the acceptance of this twofold human finiteness which adds to life's worthwhileness, since only in the face of death is it meaningful to act. 4,p.Jo 
+The pastoral counselor can integrate logotherapy's emphasis on the importance of time with Tillich's ideas about the mystery of time and its potential for meaning fulfillment: 
+The mystery is that we have a present; and even more, that we have our future also because we anticipate it in the present; and that we have our past also because we remember it in the present. In the present our future and our past is ours. 2, p. 36 
+
+
+
+The Awareness of Possibility 
+Logotherapy sees persons as deciding beings. They exist as their own possibility, having both actuality and potentiality. The freedom to choose and to change is ever present, although within limiting · circumstances: 
+Man is not fully conditioned and determined; he determines himself whether to give in to conditions or stand up to them. In other words, man is ultimately self-determining. Man does not simply exist, but always decides what his existence will be, what he will become in the next mo
+ment. 5, P. 206 
+Reinhold Niebuhr, from his theological orientation to humankind, has written that "the essence of man is freedom." 1, P-17 
+Tillich has further elaborated on individual freedom: 
+Man is essentially "finite freedom"; free
+dom not in the sense of indeterminacy 
+but in the sense of being able to determine 
+himself through decisions in the center of 
+his being. Man, as finite freedom, is free 
+within the contingencies of his finitude. 
+But within these limits he is asked to make 
+of himself what he is supposed to become, 
+to fulfill his destiny. In every act of moral 
+self-affirmation man contributes to the 
+fulfillment of his destiny, to the actuali
+zation of what he potentially is. 6• p. 52 
+Pastoral counselors need to. heed the concept of freedom as developed by Frankl, Tillich, and Niebuhr lest they blindly "bless" the life styles of self-pitying, choice-denying persons seeking their counsel. 
+The awareness of possibilities and the understanding that a person is a deciding being conveys hope, seen in relationship to freedom. To be free is to face possibilities, to transcend the present situation and see one's capacity to alter the status quo, even if limited to one's own attitude toward unavoidable suffering. Without such a concept of freedom, there can be no hope. 
+
+
+Responsibleness-the Essence of Existence 
+Responsibleness is the goal of a logotherapeutic transaction. The counseled person is told that responsibilities cannot be escaped, but are to be fulfilled. Logotherapy holds a mirror before the clients as they view the unpleasant realities of their present situation, and educates them to see themselves as responsible for the way they reshape their future. Their existential sovereignty over their lives is thereby reaffirmed. 
+The logotherapist does not moralize or impose a world view on the persons who seek help, but assists them in elucidating the meanings that are awaiting them. By bringing into focus specific personal meanings and tasks, the logotherapist punctures the psychotherapeutic fallacy that has caused counselors to be timid in raising questions concerning human destiny lest they violate 
+
+32 
+some psychological code. The counselor becomes a catalyst in singling out from the clients' own mouths clues as to where they might look in the future for meanings to fulfill. In this way the counselor illustrates the potentialities for meaning that are everpresent in their lives. 
+Logotherapy does not focus on the past and does not use the distortions of the past to support an attitude of irresponsibility. Neither does it focus on the future in such a way as to breed some groundless hope or unrealisitic illusion. Instead, it helps those who suffer from existential vacuum to redeem their past by molding their sufferings into something positive. It assists them in understanding that their future need not be a fateful repetition of their past or the extension of ·their present suffering or void. To be free is to be free toward the future. The emphasis on responsibility in logotherapy brings hope, because it assumes that persons have the freedom to alter and fashion their lives and, thereby, their future. In a sense, to deprive clients of their freedom means to deprive them of their future, of their hope. This is what the deterministic models of human nature are likely to do. Freedom and responsibility ~e essentially human characteristics. If they are ignored, clients are deprived of the uniqueness of their humanity. 
+Frankl provides an illuminating summary of meaning confrontation: 
+Once meaning orientation turns into meaning confrontation, that stage of maturation and development is reached in which freedom becomes responsibleness. Man is responsible for the fulfillment of the specific meaning of his personal life. But he is also responsible /Jefore something, or to something, be it society, or humanity, or mankind, or his own conscience. However, there is a significant number of people who interpret their own existence not just in terms of being responsible to something but rather to someone, namely to God. 
+Logotherapy sees in responsibleness the very essence of human existence. Capitalizing oil responsibleness to this extent, a logotherapist cannot spare his patient the decision for what and to what, or to whom, he feels responsible. 4, p. 12-u 
+The "supra-meaning"4• P-12-13 of logotherapy theory, which describes life's unconditional' meaningfulness and the ultimate meaning embracing all life, further allows pastoral psychologists to be faithful to their own unique counseling orientation. 
+Defrant Power of the Human Spirit 
+
+Logotherapy, in one of its most helpful contributions to pastoral psychology, stressed the "defiant power of the human spirit." While recognizing the holistic nature of the human being, the logotherapist appeals to what lies beyond the client's psycho-physical nature-to the spirit. The spiritual core of a person is recognized as capable of taking a stand not only toward negative and painful external circumstances but also toward its own psychological character structure. Such recognition conveys to the clients a renewed awareness of self-worth and human dignity, and helps them comprehend themselves as being fashioned "in the image of God." Conversely, if they regard themselves as inadequate psychic mechanisms, with_ no control and responsibility for themsevles, they have no capacity to transcend themselves or fashion meaning from their suffering. 
+From a theological perspective, Niebuhr has described this crucial distinction between the spiritual person and the pathological processes of life: 
+Man is a child of nature, subject _to its 
+vicissitudes; compelled by its necessities, 
+driven by its impulses, and confined within 
+the brevity of the years which nature per
+mits its varied organic forms, allowing 
+them some, but not too much, latitude. 
+The other less obvious fact is that man is 
+a spirit who stands outside of nature, life, 
+himself, his reason and the world. 1• P, 13 
+Surprisingly, indeed embarrassingly, there is need to reemphasize this truth in a contemporary pastoral counseling model. 
+The Psychotherapeutic Relationship 
+
+Logotherapy suggests that "the crucial agency in psychotherapy is not so much the method, but rather the relationship between the patient and doctor or the 'encounter' between the therapist and his patient."4• p. 144 Pastoral psychology needs this understanding 
+33 
+
+of a therapeutic relationship that confronts troubled clients with possibilities and challenges them toward decisive action. For such challenges to be accepted, the therapeutic encounter must not be simply between pastor and parishioner, but between two human beings, "in which one confronts the other with logos; that is, the meaning of being."7• p. 9 
+The corrective emphasis of logotherapy emboldens pastoral counselors to overcome their reluctance to confront the humanity of the client and encourages a personal encounter with meanings and values. In a counseling relationship, the despairing or defeated persons must feel free to plumb the depths of their soul and examine, sometimes in an agonizing manner, their reasons for not committing suicide and for continuing their struggle with negative circumstances. Therapists, whether they be ecclesiastical or clinical in their orientation, must assist such clients to gather up the fragments of their lives and help them build a new awareness of their world. 
+Logotherapy recognizes that no one gets well or becomes whole in the office of a psychotherapist or pastoral counselor. Persons only get well in life! By its appellative approach to meanings to be fulfilled, logotherapy synthesizes all dimensions of personhood in a way that provides an understanding of oneself along the lines of realism and hope. It provides clients with an interpretation of their present predicament, possibilities for the future, and paths for responsible actions to move toward that future. By so doing, logotherapy leaves the door open to the God concept and to the specialized role of the pastoral counselor. 
+Any counseling relationship contains the 
+
+risk that the therapist may fail to grasp the 
+existential problem and predicament of the 
+client. Similarly, there is always the possibility that human beings in trouble will irresponsibly choose what is destructive to their psychological or spiritual areas. No therapeutic relationship can force a person to be responsible for becoming what he or she should be. The words of the prophet Jeremiah are as true today as when they were written some 2500 years ago: "The heart of man is a stubborn thing and full of fears." But in the process of helping struggling clients become aware of the necessities and possibilities of their lives, and to accept responsibility for fulfilling the meaning of their lives, the logotherapist will be made aware that this same finite creature has been marvelously fashioned, not as a machine, but in the words of the psalmist, "a little lower than the angels." 
+REFERENCES: 
+1. 
+Niebuhr, R. The Nature and Destiny of Man, Vol. I. New York: Charles Scribner, 1953. 
+
+2. 
+Feifel, H., ed. "The Eternal Now," in The Meaning of Death, New York: McGraw, paper edition, 1956. 
+
+3. 
+Frankl, V.E. The Doctor and the Soul. New York: Vintage Books, 1978. 
+
+4. 
+Frankl, V.E. Psychotherapy and Existentialism., New York: Touchstone paperback, 1975. 
+
+5. 
+Frankl, V.E. Man's Search for Meaning, New York: Pocket Books, 1977. 
+
+6. 
+Tillich, P. The Courage to Be. New Haven: Yale University Press, 1952. 
+
+7. 
+Frankl, V.E. The Will to Meaning. New York: New American Library, 1976. 
+
+
+MEL VINA. KIMBLE is professor in Pastoral Care and chairman of the Department of Pastoral Theology and Ministry at LutherNorthwestern Seminaries, St. Pau~ Minnesota. 
+
+The choice is always ours. Aldous Huxley 
+The basic crisis is not a crisis ofan authority but a crisis ofvision. Father Hesburgh, quoted by 
+W. Sloane Coffin 
+Many of the psychiatrists I know are frustrated visionaries-men who dreamed of contributing to social reform but were loathe to translate their dreams into action for fear that they would violate some medical or social ethic. 
+Seymour Halleck 
+
+34 
+Paradoxical Intention And Autogenic Training
+
+
+
+
+
+Convergence or Incompatibility? 
+Tullio Bazzi 
+Paradoxical intention is celebrating its official fortieth birthday1 and the literature about it is extensive although several of its application aspects are still being developed. 
+A comparison between paradoxical intention and other psychotherapeutic methods is useful to establish its place in therapy. 
+Frankl2 noted the analogy between paradoxical intention and several methods of behavior therapies used under various names. Several behaviorists expressed similar opinions. For instance, Dilling, Resefeldt, Kockett, and Heyse point out that the "effect" (of paradoxical intention) is probably the same as that of flooding and implosive therapy. 2 
+The same opinions are expressed in the French literature. Cottraux3 in a recent manual includes paradoxical intention among the techniques using "paradox" along with the already mentioned behavior therapies and the Palo Alto School techniques.• 
+A comparison between paradoxical intention and Schultz's autogenic training, at least at first glance, shows a basic difference in approach and an incompatibility in practice. The difference is illustrated in the example of blushing: "While Schultz adopts the formula 'my feet are warm' to direct the vasodilatory wave to the ground, Frankl's technique would instead use a phrase such as 'now I want to blush as much as I can.' In short, the hybridization Schultz-Frankl doesn't seem to be easy. 5 " 
+Most authors do not share the same opinions and are not even too clear about them. For instance, Schultz and Luthe6 list among the "intentional formulae" a "paradoxical formula" which corresponds to paradoxical intention. Here are two examples: "I want to write as poorly as possible,'' to be used in cases of writer's cramp, and ''I want to be messy all the time,'' to be used in cases of over-concern about messiness. 
+
+
+In phobias (anxious and obsessive) the neurotic patient is asked ''to take the bull by the horns2"; therefore, the cardiophobic patient who fears to die of infarct must tell himself ''yesterday I felt I would die only once, today I want to try to die five times"; or the bacteriophobic patient who fears infection through object contact is encouraged to touch the objects telling himself: "This way I am sure to get not one but 20 serious infections." 
+Comparison with Autogenic Training 
+
+A further study of paradoxical intention and autogenic training reveals the following differences and analogies: at least in their most obvious aspects, both methods represent directive psychotherapies based on symptoms (or on abnormal behavior). The pathogeny is explained to the patient-for instance, the patterns of neurotic reaction structured as "vicious circles"' but the etiology is not investigated, as for instance in psychoanalysis which explores and interprets the unconscious in search of the cause of the neurosis. 
+On the strategic level the two methods generally appear antithetical: in autogenic training a defensive strategy easily understood by the patient is adopted (for example: gradually obtaining the control of anxiety before facing a phobic situation); in paradoxical intention the patient is asked to undertake an offensive strategy, which at least at first 
+35 
+sight may appear paradoxical or absurd to him. However, the paradox is often an evolution: the more the patient is conscious of the method's aims, the less he considers the method paradoxical, while his neurotic behavior acquires for him a paradoxicalabsurd meaning: The bacteriophobic patient becomes aware that the more he washes the greater becomes his fear of dirt. After he understands how paradoxical intention works, not the method seems absurd but his neurotic behavior does. 
+On the application level, too, the two methods differ. Paradoxical intention demands that patients act, even if 'action" means giving up a behavior pattern, and patient resistance is frequent and strong. Thus, for example, patients encouraged "to take the bull by the horns" comment: "IfI could do that, I would already be cured!" 
+The requirement in autogenic training is more easily accepted by patients-a gradual approach to the generally feared situation. Paradoxical intention requires an immediate and total accomplishment: once the aim is focused on the main effort, action must be quick and strong. The patient is usually alone (i.e. not reinforced by the presence of the therapist) at the moment of application. 
+Therapists applying paradoxical techniques felt the need to overcome possible patient resistance at the application level through some clever devices. In behaviorist therapies these devices are based mainly on procedures derived from learning and conditioning theories and refer to an anthropological reduction pattern ("nihilistic pattern," to use Frankl's expression) in which the human being is nothing but a bundle of learned behaviors or conditioned reflexes. Paradoxical intention, instead, reveals its logotherapeutic origin by calling on self-detachment and a sense of humor-resources from the human dimension. Humor helps patients to step away from themselves, and as soon as they see their fears as being ridiculous, the ensuing antiphobic effects become evident, and the n~urotic behavior pattern is broken. 
+It is exactly in this area of self-detachment, of "distance-taking," that we can find an analogy between Frankl's paradoxical intention and Giorda's8 existence training, which is one version of autogenic training: in paradoxical intention, distance is marked by a sense of humor; in existence training, distance is achieved as soon as the patient, agreeing to practice autogenic training to "transform himself" in search of the absolute, creates the distance between the finiteness of the symptom and the absoluteness of the value-between the self which he intends to transform and the true self toward which the transforming is directed. 
+In 19739 I reported the results of 31 cases of serious obsessive neuroses (17 with a bacteriophobic obsessive pattern). Such cases go a long course whose complex psychopathology has been illustrated by Gebsattel. '0 Frankl2 has pointed out their vicious-circle structure whose therapeutic results are often so disappointing that Speer'' considers these forms inaccessible to any kind of psychotherapy. 
+In 21 cases where psychotherapy was based on autogenic training, no success was attained. In about half of the cases patients were not even able, because of their troubles, to learn the standard exercises of autogenic training. Out of the 10 cases treated with paradoxical intention, seven refused to apply the technique but in the three cases where it was possible to apply it correctly astonishingly favorable results were obtained. 
+In summarizing what has been observed in the cases reported and also in other cases treated with paradoxical intention, three main points emerge: 
+1) Patients agree on the strategy but refuse application because they are unable to use their sense of humor in dealing with their neuroses. For example, in a case of criminophobia2 a mother terrified by the obsessive idea of killing her child could not "joke" about this matter and therefore refused to practice paradoxical intention. 
+2) Patients accept both strategy and application, practice paradoxical intention correctly. As a result, symptoms (or abnormal behavior) disappear and they go back to normality. 
+3) In some cases, symptoms disappear but a socalled "paradoxical reaction to the success of paradoxical intention" arises. At the beginning of my logotherapeutic practice, about 20 years ago, I had the following case: An 18 year old, intelligent and brilliant 
+
+36 
+girl, at the start of her university studies and her career as a concert artist, was utterly blocked by fear of vomiting in public places. I explained to her the meaning of paradoxical intention and then asked her to vomit in front of me while taking a walk. After much hesitation she agreed to try, and the technique was successful. She was able to have a drink in a bar without anything abnormal happening to her. In the evening of this "success" I was informed that the girl had had a strong depressive-anxious reaction. The next morning, without hiding my astonishment, I asked her the reasons for her reaction. I got more or less this reply: "Now that my phobia has disappeared I realize that it was an 'alibi.' Now I no longer have an excuse if I don't succeed in my studies and in my career and this is what I have always feared even though I didn't dare confess it to myself." This reaction to a successful paradoxical intention looked "paradoxical" to me but not to the girl who considered it a "revelation" of her 
+own "truth." 
+Conclusions 
+
+These considerations of paradoxical intention do not pretend to treat the subject fully but only to outline a plan of research, and lead to the following conclusions: 
+1) In the psychotherapeutic situation paradoxical intention appears "paradoxical" to the patient because what the therapist suggests contradicts the patient's expectations. 
+2) Paradoxical intention cannot remain at the stage of intention but must be fully accepted and correctly put into practice by the patient. Patients have to agree completely with the therapist's strategy, and to practice the technique with a sense of humor to "undramatize" their phobias and then have the courage to face them. 
+3) The effectiveness of paradoxical intention has been widely demonstrated if the technique is practiced correctly. The disappearance of the symptoms often leads to normalization even in serious neuroses resisting other therapies. We can also find a paradoxical reaction to the technique's success, when the disappearance of symptoms causes what appears to the therapist an unexpected reaction, while revealing to the patient the real problem "concealed" before by the symptom itself. 
+4) The main obstacle for the patients is to face their neurotic situation with a sense of humor. Some patients can do it by themselves but many need the therapist to help them use their humor when their anxiety is strong or when the content of their obsessive-compulsive idea is particularly frightening. 
+5) Between autogenic training and paradoxical intention there exists some incompatibility on the technical level and in the approach to the symptoms. At the same time both methods converge on the humanisticexistential pattern from which autogenic training (especially in its form of Giorda's existence training) and paradoxical intentionand in a broad sense Frankl's logotherapyoriginate. 
+REFERENCES: 
+I. Frankl. V.E. "Zur medikamentosen UnterstUtzung der Psychotherapie bei Neurosen." Schweizer Archiv fur Neurologie und Psychiatrie. 1939, 42, 26-31. 
+2. 
+Frankl, V.E. Die Psychotherapie in der Praxis. 3rd edition. Wien:Deuticke, 1975. 
+
+3. 
+Cottraux, J. "Les therapies comportmentales." In: Guyotat, J. Psychotherapies medicates Vol. I, Paris: Masson, 1978. 
+
+4. 
+Haley, J. Le strategie de/la psicoterapia. Traduz. Italiana. Firenze: Sansoni, 1974. 
+
+5. 
+Bazzi, T. and Giorda, R. II training autogeno. Roma: Citta Nuova, 1979. 
+
+6. 
+Schultz, J.H. and Luthe, W. "Autogenic Methods." In: Luthe (ed.) Autogenic Training. New York: Grune and Stratton, 1969. 
+
+7. 
+Frankl, V.E. Theorie and Therapie der Neurosen. Wien: Urban & Schwarzenberg, 1956. 
+
+8. 
+Giorda, R. "II training dell'esistenza." In: BazziGiorda, II training autogeno Parte II cap. II. Roma: Citta Nuova, 1979. 
+
+9. 
+Bazzi, T. "Le psicoterapie non analitice nella nevrosi ossessiva.'' VII Convegno Naz. Soc. Psicot. Med. Pisa 6 ott. 1973. II pensiero scientifico Roma. 
+
+10. 
+Gebsattel, V.E. "Die Welt des Zwangskranken." In: Prolegomena einer medizinischen Anthropologie. Springer, 1954. 
+
+11. 
+Speer, E. Der Arzt der Personlichkeit. Stuttgart: Thieme, Berlin, 1939. 
+
+
+TULLIO BAZZI is associate professor, Department ofNeuro-Psychiatry, University of Rome (Italy) and president of the Italian Committee for the Study of Autogenic 
+Training. 
+37 
+
+
+
+
+
+CASE HISTORIES 
+
+A Case of Endogenous Depression 
+Although Viktor Frankl's winter seminars at the United States International University in San Diego are intended io be educational they have therapeutic side effects on some students, supporting the thesis that logotherapy can be self-applied once its principles are understood. The foilowing two case histories were written by students of these seminars. The concluding comments are by Dr. Frankl. 
+Three years ago I was seized with a feeling of worthlessness that was soon followed by a deep depression. I was unable to discover the reason: I was doing well in college, had a good social life, and enjoyed many sports. 
+The depression continued, and I was hospitalized and put on medication. I received no psychotherapy. When I was released, I underwent Adlerian therapy for three months. The therapist interpreted my depression as a feeHng of inferiority, serving as an excuse fo, trying io please my father-a goal, the therapist said, I unconsciously feared I could not accomplish. I found the interpretation interesting, and it seemed to fit my situation, but the sessions produced only short-time relief, then the depression would entomb me again. I felt empty. Nothing seemed to matter. Getting up in the morning required a supreme effort. Life seemed absurd and meaningless. 
+However, just before I received my Master's Degree in counseling, I improved. I felt better than I had since the onset of my illness. I began to work with a Gestalt psychologist. We concentrated on my feelings toward my father. I felt and expressed anger, guilt, shame, and resentment. At the therapist's encouragement, I did a great deal of crying. During many encounter groups I dealt with my feelings. These sessions produced relief but not for long. As I continued the Gestalt sessions, I became again more disturbed. 
+I was hospitalized again, and this time was under the care of a psychiatrist who used Gestalt and bioenergetic techniques. He told me that I had not yet fully expressed the total of my painful feelings stored within me. I pounded pillows and scream.ed. This went on for months. 
+My anxiety became worse. I felt depersonalized. The psychiatrist told me that I had expressed enough feelings and now had to take responsibility for myself, get a job, and stop fooling around. I was a wreck. I could not sleep or eat. I sat in my room and tried to endure an agony that cannot be put into words. 
+Well-meaning relatives told me to pull myself together. They, as well as the psychiatrist, increased their insistence that I get a job. I tried and failed. I felt dead inside. 
+In desperation I went~ another psychiatrist. I was ready to die. He listened as I told him what the others had demanded of me. But he disagreed. He said that I was in no condition to get a job and that exercising a strong will was not enough. He gave me medication s~ific for my depression. 
+I immediately felt better. Here was.a man who realized that my condition was not simply a matter of being weak-willed. He explained to me that my problem was of a constitutional nature, made more tortuous by the therapies I had received. 
+I felt well enough to attend the United States International University in San Diego part-time and to work 15 hours a week, soon to be increased to 20 hours. When I enrolled in Dr. Frankl's course, .I had no idea what to expect. In one of his lectures he gave case histories of people with endogenous depressions. The description fitted my own situation but it seemed that everything I had done in therapy until the last psychiatrist had been actually damaging. Frankl said that endogenously depressed patients must not make value judgements while they are depressed. I had 
+38 
+been encouraged to make value judgements about myself, my relationship with my father, my working capacities. Frankl said the patients must be told of the good prognosis of this illness-that the clouds will lift in time. 
+I was never given such encouragement. On the contrary, I had been told during my most tortuous months that I would get better only when I expressed my painful feelings and, Jater on, only when I would force myself to get a job. Frankl insisted that endogenously depressed patients must not fight their depressions. I had been encouraged to fight my depression which only led to self-reproach and a worsening of the condition. In his lectures, Frankl made a statement I found most pertinent: "I frequently have patients put in a hospital just to demonstrate to them that they are really ill, and not merely lacking will power.'' I had been continually told that my condition was a matter of my lack of will power. He also told his students that in endogenous depressions a person's sense of responsibility should not be challenged. I had been accused of lacking in responsibility at every turn. He emphasized that hyper-reflection and hyper-intention have a bad effect. I had been encouraged both to reflect 
+and intend to the point where I was watching my every move and thought. 
+Looking back on my experiences, I have many feelings. I have no malice toward those who tried to help me because I know their intentions were sincere. 'it is understandable that my family and friends lacked the knowledge of the proper way to help me. It is more difficult to understand the incompetence of the psychologists and especially the psychiatrists who treated me. 
+In retrospect, I see that when I was in my Master's program and was involved and excited in my studies, I began feeling better. Then when I began my therapy of reflection and awareness, I got progressively worse. After seeing the last psychiatrist who, although not a logotherapist, employed treatment including many logotherapeutic concepts, I improved. 
+I have had a difficult time, made worse by improper treatment. While I would not wish a similar experience on any one, I have attained through this experience a goal, a meaning that will sustain me: I hope in some way to help others to see that the endurance of an unchangeable predicament is the ultimate achievement. 
+A Case of Noogenic Neurosis 
+I am an assistant psychologist to two psychiatrists. During my supervision sessions I often disagreed with the psychoanalytical theory my employers sought to teach me. Yet, as their manner was very authoritarian I was afraid to express my contrary opinions. I feared I might lose my job. 
+After several months I began to feel anxiety during my supervision sessions, and sought the therapeutic aid of my friends. However, we succeeded only in making my anxiety worse because we approached the problem in a psychoanalytic manner. We tried to uncover some early traumas that were causing my "transference" anxiety with my supervisors. We studied my early relationship to my father-to no avail. Thus, I increasingly found myself in a state of hyper-reflection, and my condition grew worse. 
+My anxiety rose to such a level at my supervision sessions that I had to mention it to the psychiatrists in order to explain my behavior. 
+They recommended that I see a psychoanalytically oriented psychotherapist for personal therapy, to get to the hidden meaning of my anxiety. Not being able to afford expensive therapy, my professional friends and I increased our efforts to uncover the hidden meaning of my condition. I suffered attacks of extreme anxiety. 
+My recovery began with Dr. Frankl's class "Man's Search for Meaning," at the United States International University. He spoke of the difficulties encountered when one tries psychoanalytically to unmask an authentic response. He reaffirmed my old belief that neurosis is not always caused by childhood traumas. During that four-hour class i began to see how the therapy I had undergone had increased my problem, and that it was my self-suppression in the supervision sessions that had caused my anxiety. 
+I ended the therapy and felt better. Yet, the real change came during my next supervision session. I started to express my opinions 
+39 
+
+been encouraged to make value judgements about myself, my relationship with my father, my working capacities. Frankl said the patients must be told of the good prognosis of this illness-that the clouds will lift in time. 
+I was never given such encouragement. On the contrary, I had been told during my most tortuous months that I would get better only when I expressed my painful feelings and, Jater on, only when I would force myself to get a job. Frankl insisted that endogenously depressed patients must not fight their depressions. I had been encouraged to fight my depression which only led to self-reproach and a worsening of the condition. In his lectures, Frankl made a statement I found most pertinent: "I frequently have patients put in a hospital just to demonstrate to them that they are really ill, and not merely lacking will power.'' I had been continually told that my condition was a matter of my lack of will power. He also told his students that in endogenous depressions a person's sense of responsibility should not be challenged. I had been accused of lacking in responsibility at every turn. He emphasized that hyper-reflection and hyper-intention have a bad effect. I had been encouraged both to reflect 
+and intend to the point where I was watching my every move and thought. 
+Looking back on my experiences, I have many feelings. I have no malice toward those who tried to help me because I know their intentions were sincere. 'it is understandable that my family and friends lacked the knowledge of the proper way to help me. It is more difficult to understand the incompetence of the psychologists and especially the psychiatrists who treated me. 
+In retrospect, I see that when I was in my Master's program and was involved and excited in my studies, I began feeling better. Then when I began my therapy of reflection and awareness, I got progressively worse. After seeing the last psychiatrist who, although not a logotherapist, employed treatment including many logotherapeutic concepts, I improved. 
+I have had a difficult time, made worse by improper treatment. While I would not wish a similar experience on any one, I have attained through this experience a goal, a meaning that will sustain me: I hope in some way to help others to see that the endurance of an unchangeable predicament is the ultimate achievement. 
+
+A Case of Noogenic Neurosis 
+I am an assistant psychologist to two psychiatrists. During my supervision sessions I often disagreed with the psychoanalytical theory my employers sought to teach me. Yet, as their manner was very authoritarian I was afraid to express my contrary opinions. I feared I might lose my job. 
+After several months I began to feel anxiety during my supervision sessions, and sought the therapeutic aid of my friends. However, we succeeded only in making my anxiety worse because we approached the problem in a psychoanalytic manner. We tried to uncover some early traumas that were causing my "transference" anxiety with my supervisors. We studied my early relationship to my father-to no avail. Thus, I increasingly found myself in a state of hyper-reflection, and my condition grew worse. 
+My anxiety rose to such a level at my supervision sessions that I had to mention it to the psychiatrists in order to explain my behavior. 
+They recommended that I see a psychoanalytically oriented psychotherapist for personal therapy, to get to the hidden meaning of my anxiety. Not being able to afford expensive therapy, my professional friends and I increased our efforts to uncover the hidden meaning of my condition. I suffered attacks of extreme anxiety. 
+My recovery began with Dr. Frankl's class "Man's Search for Meaning," at the United States International University. He spoke of the difficulties encountered when one tries psychoanalytically to unmask an authentic response. He reaffirmed my old belief that neurosis is not always caused by childhood traumas. During that four-hour class i began to see how the therapy I had undergone had increased my problem, and that it was my self-suppression in the supervision sessions that had caused my anxiety. 
+I ended the therapy and felt better. Yet, the real change came during my next supervision session. I started to express my opinions 
+39 
+
+to the supervising psychiatrist when I disagreed felt my anxiety fade. As I continued to express with him. I no longer feared the loss of my my opinions when they cliff ered from those job because my peace of mind had become of my supervisors, my condition kept immore important than my job. As I began to proving. During the following two weeks my express myself in this session I immediately anxiety disappeared almost completely. 
+Logotherapy defines a "noogenic neurosis" as a neurosis deriving from the pati,mts •conflict with their own conscience, or from their feeling ofmeaninglessness and emptiness. The noogenic neurosis originates in the noetic dimension, in contrast to a neurosis in the conventional sense of the word which is psychogenic. Although logotherapy pays special attention to the noogenesis, it does not neglect the multidimensionality of the human reality and considers psychogenesis and even somatogenesis-organic causes sometimes responsible for mental illness. It is true that, by and large, such a possibility pertains to psychotic rather than neurotic conditions, particularly to psychotic depressions. However, because psychotic depressions, (usually called "endogenous" depres-
+
+
+Mr. X, 30, separated from his second wife, was referred to me for depression, suicidal thoughts, persistent morning vomiting, inability to fall asleep, chest pains, and feelings of worthlessness. Medical checkups had shown no sign of cardiac pathology. Previous therapy had suggested that Mr. X's symptoms were an attempt to attain secondary gains by inducing his wife to come back to him. 
+During the first two sessions the patient was allowed to ventilate his feelings of hopelessness, depression, helplessness, and anger. We began by examining his "depression." Mr. X was helped to see that he was not as depressed and inadequate as he seemed: he 
+
+sions) more often than one would expect present a mild symptomatology, it is important _ to keep in mind in any given case that we may deal with an endogenous depression. 
+A proper differential diagnosis is important because the therapy has to be tailored accordingly. What I wish to point out is the fact that, at least in severe cares-, pharmacotherapy may be indispensible, and also that psycho~· therapy-which, ofcourse, is indispensable · any case-must be different, and this holds for /ogotherapy as well. The two cases presented above serve as apt illustrations for the need to overcome the pitfalls ofdiagnostic and therapeutic onesidedness and as warning voices, raised by the victims themselves, for all ofus. 
+Viktor E. Frankl 
+
+Case Histories: 
+
+
+
+
+A Combination of 
+Paradoxical Intention 
+And Dereflection 
+Jay I. Levinson 
+had adequately channeled a tremendous amount of energy into his pseudodepression (actually an existential vacuum). This approach allowed the patient to share responsibility for his predicament and to realize that he-adequately, if inappropriately-was directing his life. 
+The "suicide test," as described by Frankl in The Doctor and the Soul, page 262, was utilized. I asked Mr. X if he still felt suicidal. When he replied in the negative I asked him, "Why not?" Frankl states that a patient who can give definite reasons for wanting to live, is not truly suicidal. Mr. X gave several reasons. 
+40 
+to the supervising psychiatrist when I disagreed felt my anxiety fade. As I continued to express with him. I no longer feared the loss of my my opinions when they cliff ered from those job because my peace of mind had become of my supervisors, my condition kept immore important than my job. As I began to proving. During the following two weeks my express myself in this session I immediately anxiety disappeared almost completely. 
+Logotherapy defines a "noogenic neurosis" as a neurosis deriving from the pati,mts •conflict with their own conscience, or from their feeling ofmeaninglessness and emptiness. The noogenic neurosis originates in the noetic dimension, in contrast to a neurosis in the conventional sense of the word which is psychogenic. Although logotherapy pays special attention to the noogenesis, it does not neglect the multidimensionality of the human reality and considers psychogenesis and even somatogenesis-organic causes sometimes responsible for mental illness. It is true that, by and large, such a possibility pertains to psychotic rather than neurotic conditions, particularly to psychotic depressions. However, because psychotic depressions, (usually called "endogenous" depres-
+
+
+Mr. X, 30, separated from his second wife, was referred to me for depression, suicidal thoughts, persistent morning vomiting, inability to fall asleep, chest pains, and feelings of worthlessness. Medical checkups had shown no sign of cardiac pathology. Previous therapy had suggested that Mr. X's symptoms were an attempt to attain secondary gains by inducing his wife to come back to him. 
+During the first two sessions the patient was allowed to ventilate his feelings of hopelessness, depression, helplessness, and anger. We began by examining his "depression." Mr. X was helped to see that he was not as depressed and inadequate as he seemed: he 
+
+sions) more often than one would expect present a mild symptomatology, it is important _ to keep in mind in any given case that we may deal with an endogenous depression. 
+A proper differential diagnosis is important because the therapy has to be tailored accordingly. What I wish to point out is the fact that, at least in severe cares-, pharmacotherapy may be indispensible, and also that psycho~· therapy-which, ofcourse, is indispensable · any case-must be different, and this holds for /ogotherapy as well. The two cases presented above serve as apt illustrations for the need to overcome the pitfalls ofdiagnostic and therapeutic onesidedness and as warning voices, raised by the victims themselves, for all ofus. 
+Viktor E. Frankl 
+
+Case Histories: 
+
+
+
+A Combination of 
+Paradoxical Intention 
+And Dereflection 
+Jay I. Levinson 
+had adequately channeled a tremendous amount of energy into his pseudodepression (actually an existential vacuum). This approach allowed the patient to share responsibility for his predicament and to realize that he-adequately, if inappropriately-was directing his life. 
+The "suicide test," as described by Frankl in The Doctor and the Soul, page 262, was utilized. I asked Mr. X if he still felt suicidal. When he replied in the negative I asked him, "Why not?" Frankl states that a patient who can give definite reasons for wanting to live, is not truly suicidal. Mr. X gave several reasons. 
+40 
+to the supervising psychiatrist when I disagreed felt my anxiety fade. As I continued to express with him. I no longer feared the loss of my my opinions when they cliff ered from those job because my peace of mind had become of my supervisors, my condition kept immore important than my job. As I began to proving. During the following two weeks my express myself in this session I immediately anxiety disappeared almost completely. 
+Logotherapy defines a "noogenic neurosis" as a neurosis deriving from the pati,mts •conflict with their own conscience, or from their feeling ofmeaninglessness and emptiness. The noogenic neurosis originates in the noetic dimension, in contrast to a neurosis in the conventional sense of the word which is psychogenic. Although logotherapy pays special attention to the noogenesis, it does not neglect the multidimensionality of the human reality and considers psychogenesis and even somatogenesis-organic causes sometimes responsible for mental illness. It is true that, by and large, such a possibility pertains to psychotic rather than neurotic conditions, particularly to psychotic depressions. However, because psychotic depressions, (usually called "endogenous" depres-
+
+
+Mr. X, 30, separated from his second wife, was referred to me for depression, suicidal thoughts, persistent morning vomiting, inability to fall asleep, chest pains, and feelings of worthlessness. Medical checkups had shown no sign of cardiac pathology. Previous therapy had suggested that Mr. X's symptoms were an attempt to attain secondary gains by inducing his wife to come back to him. 
+During the first two sessions the patient was allowed to ventilate his feelings of hopelessness, depression, helplessness, and anger. We began by examining his "depression." Mr. X was helped to see that he was not as depressed and inadequate as he seemed: he 
+
+sions) more often than one would expect present a mild symptomatology, it is important _ to keep in mind in any given case that we may deal with an endogenous depression. 
+A proper differential diagnosis is important because the therapy has to be tailored accordingly. What I wish to point out is the fact that, at least in severe cares-, pharmacotherapy may be indispensible, and also that psycho~· therapy-which, ofcourse, is indispensable · any case-must be different, and this holds for /ogotherapy as well. The two cases presented above serve as apt illustrations for the need to overcome the pitfalls ofdiagnostic and therapeutic onesidedness and as warning voices, raised by the victims themselves, for all ofus. 
+Viktor E. Frankl 
+
+Case Histories: 
+
+
+
+A Combination of 
+Paradoxical Intention 
+
+And Dereflection 
+Jay I. Levinson 
+had adequately channeled a tremendous amount of energy into his pseudodepression (actually an existential vacuum). This approach allowed the patient to share responsibility for his predicament and to realize that he-adequately, if inappropriately-was directing his life. 
+The "suicide test," as described by Frankl in The Doctor and the Soul, page 262, was utilized. I asked Mr. X if he still felt suicidal. When he replied in the negative I asked him, "Why not?" Frankl states that a patient who can give definite reasons for wanting to live, is not truly suicidal. Mr. X gave several reasons. 
+40 
+In the third session, he expressed his anxiety about his inability to fall asleep and his morning sickness. Because of his vomiting he had lost weight but was, nevertheless, well nourished. His sleeplessness followed the classic phobic pattern: he would anticipate not being able to fall asleep, and reinforce this with his actual failure to sleep, which in turn reinforced his anxiety. 
+After assuring Mr. X that his body would automatically get the sleep it physiologically needed, I told him that I required his help for investigating his patterns of sleeplessness; I could then form a strategy to help him sleep. The following.instructions were given: 
+Go to bed at the usual time. Keep a written record of how long it takes to fall asleep every night. Keep the record in a place that will force you to get out of bed and walk across the room to write down the time. Make entries every 15 minutes. Remain awake as long as you can to help me get a better picture of your sleeping problems, and bring me the "list of times" at the next session. 
+During the. same session, dereflection was integrated with hypnosis, to treat Mr. X's morning sickness. With the help of a supervisor who was knowledgeable in behavior modification, Mr. X was guided through a pleasant,erotic hypno-fantasy. He then was given the posthypnotic suggestion that when he awoke in the morning he would be able to recall these erotic feelings. He was encouraged to enjoy them to the fullest, and was taught methods to self-induce them. The therapeutic strategy was to dereflect the patient from his unpleasant morning vomiting to the mutually exclusive and pleasant feelings of erotic arousal. 
+In the next session Mr. X apologized for 
+not bringing a "list of times" becau.se he had 
+fallen asleep every night. He had tried hard 
+to stay awake but couldn't. We both l~ughed 
+about his "failure," and I instructed him to 
+bring me the time table next time he was 
+unable to sleep. He never did; the phobic 
+pattern was broken. 
+In the same session, Mr. X reported that 
+he had been sick only one morning the 
+previous week. At the conclusion of the 
+session the hypnotic treatment with dereflec
+tion was repeated for reinforcement. He no 
+longer expected to get sick in the morning, 
+he had broken the anxiety pattern associated with the symptom. 
+A few sessions later, still symptom-free, he expressed his anxiety about facing new situations, his lack of confidence, and his low self-esteem. Here I was able to bring about a change of attitude, by sharing my own past experiences. It was the very challenge of emptiness, I told him, that had provided me with the opportunity to fill my emptiness with meaningful activities. By viewing my despair as "growing pains," I had been able to see it as a potential for finding meaning. Mr. X was able to identify with these feelings, and proceeded to discuss meaningful alternatives to his own perspective of despair. 
+Mr. X remained free of his symptoms for the duration of the therapy. He continued for two more sessions, then called to say that he was feeling better and was leading an active life. I expressed my admiration for his ability to take a positive stand toward the challenges of his life, but suggested that he stay in therapy for a while longer, to monitor his progress and to work on issues surrounding his forthcoming divorce. He refused, and the therapy 
+was terminated. 
+The. prognosis for Mr. X is uncertain because the secondary gain associated with his hysterical tendencies were an important part of his defences. The methods described here are not meant to be a panacea, nor are they intended as a substitute for more intensive therapy dealing with other problems in Mr. X's life. One lesson to be drawn from this case is that symptom alleviation, through techniques, must be cautiously administered, in proportion to the client's needs. The human encounter of logotherapy must not be sacrificed to the use of facilitative techniques for symptom relief which may prematurely terminate the therapy. 
+JAY/. LEVINSON is a clinical psychology intern at the University ofMaryland Hospital, Institute of Psychiatry and Human Behavior. He served as special assistant to Dr. Frankl at the United States International University. 
+We know what we are but we know not what we may become. 
+William Shakespeare 
+41 
+
+
+The Balance Sheet of Meaning in Work 
+Walter Bockmann 
+In the current discussion about worker motivation it becomes increasingly clear that the old theories that try to motivate workers by outside manipulation are failing. Work motivation must come from within. Logotherapy has a valuable contribution to make in this area. 
+High pay, fringe benefits, even responsibility, independent decision making, clear assignment of tasks, autonomy at work are no miracle drugs. Motivation differs from person to person. 
+An example: The supervisor of a West German motor company discusses work problems with a colleague from Italy. The German· mentions that his workers rebel if he doesn't change their places on the moving belts every six weeks. The Italian throws up his hands: "Our workers rebel if I don't leave their working order unchanged for at least six months:0 
+Management usually explains such reactions with cultural· differences, failing to explore what lies behind it. 
+Another example: In the courtyard of a . factory, a man rolls oil drums from one comer to another-but very sullenly. I ask him if he feels sick. In our talk he mentions that he always does this job with another worker· who, however, has been ordered to the warehouse to make lists. "If we are not together," says the barrel roller, "my whole work seems senseless." The list maker presumably feels the same way. If the foreman had understood something about motivation, he would have suspected that something would be amiss. Motivation is sometimes just a matter of social contact. 
+Frederic Herzberg, a principal spokesman 
+of the current · motivational work theories, starts with the correct assumption that workers first of all must be suited for their jobs. This is determined by a test. The test is effective in detecting abilities and knowledge but becomes problematic in the area of social factors, such as relationships with coworkers, supervisors, or assistants. Still further removed from reality are Herzberg's "reinforcers" of motivation. 
+
+Herzberg bases his theory on the "hierarchy of needs" whose father is Abraham Maslow and whose grandfather is Sigmund Freud. 
+According to orthodox psychoanalysis, the human being is a creature who does not act but reacts.The needs are endogenous, they originate in the psycho-physical dimension. These needs go from physiological, security, and social needs, to self-esteem, self-actualization, and aesthetical needs. Only when lower needs are fulfilled, the higher ones are felt. 
+Herzberg's reinforcer theory, therefore, is based on a system which sees the human being as a victim who reacts to the commands of his needs. His reinforcers or motivators are intrinsic factors only, lying within the work situation itself: ·among them are the need for innovation, horizontal and vertical learning, success, recognition, responsibility, and advancement. These are the "satisfiers." Extrinsic factors-coming from the outside to the work situation-Herzberg calls "dissatisfiers," which supposedly follow the principle of • 'The more you get the more you want." Among the dissatisfiers are wages and bonuses, but also job security, prestige, the work climate, relationship to superiors and others. 
+The theory based on the hierarchy of needs is convincing because it is graphic and 
+42 
+mechanistic. But the theory is not realistic because it leaves out the entire human dimension of the spirit where decisions are made. People do help others despite danger to themselves; they perform acts of self-sacrifice; they do reach out for higher goals even when they are hungry. There is more to motivation than need fulfillment. 
+The Logotherapy Approach 
+
+I met Viktor Frankl in 1970. His approach to psychotherapy seemed to me the most contemporary because he consistently includes those causes of sickness that originate in our society and our time. I made it my task to apply his anthropological and philosophical thoughts as sociological and psychological tools to the work situation. 
+The primary motivation for Frankl is the "will to meaning," a concept later accepted also by Abraham Maslow. In Frankl's own experience in the concentration camps, the will to meaning proved of greater survival value than Maslow's fulfillments of vital needs. . 
+Frankl distinguishes three principal pathways to meaning: the realization of the creative, the experiential, and the attitudinal values. In the area of meaning fulfillment in work I have added two more pathways. 
+The first are the psychophysical, and the second the material-financial working conditions. To be meaning fulfilling, work has to take place under appropriate conditions in these two areas. The third area, then, becomes the realization of creative values, which are available as the result of the challenge of work. The fourth area refers to experiential values that can be derived from the social contacts at work, and the fifth to certain attitudes that are significantly determined by the working conditions. 
+How the individual ranks these values 
+is strictly personal-there is no "objective 
+hierarchy." 
+The Balance Sheet of Meaning To apply these ideas to places of work and business organizations often requires a farreaching r.eorganization of working conditions and style of leadership. These changes may coincide with the so-called ''humanization of work"; but not everything that is "humane" is necessarily meaningful for the worker because meaning is unique for each 
+person and each situation. To make a work 
+situation meaningful requires training and an understanding of the "balance sheet of meaning" for each individual worker and the entire work team. This understanding, · in tum, will be instrumental in determining the composition of the work teams, and the assignment of specific tasks. 
+Of decisive significance is the ''phenomenon of compensation" which surprised social scientists when workers unexpectedly marked their work as "satisfying" and "very satisfying." As long as the worker on a meaningless job can use his earnings to "buy" meanings outside of his work situation, for instance on a vacation, his work at least is fulfilling some purpose. Reversely, many people compensate for the emptiness of their lives in family or society by being neurotic workaholics. 
+Balance sheets of meaning sometimes reveal strange conditions: "For heaven's sake, don't take away my asthma," the president of a large trading firm implored me. He used this psychosomatic illness to control his entire corporation. Being afraid they would set off an attack, his employees told him only what he liked to hear, and some of his aides developed the art of consideration to a high degree, serving their own career as well as contributing to operational inefficiency. 
+Another case: A personnel manager asked me to talk to the supervisor of a branch office who was causing a large number of employees to quit. The man, I was told, was willing to talk to a business consultant and psychotherapist. But the management said no. They sent the man on a vacation and reduced his responsibilities in his absence. After his return he did have fewer opportunities to drive others to despair, but all the more he suffered despair himself. The question was never raised how the work might be structured to make it meaningful for him. What cannot be bent (and often no attempt is made and the situation is considered irremediable), will simply be broken. 
+An important factor is work-related experiential values based on social contacts. A bank manager, worried about a team of liberated women who made trouble by showing off their self-confident solidarity before other work teams asked me, "Shall I break 
+43 
+up the team? Then they would quit. They can always find thi~ kind of work, they told me, but not this kind of work team." We discussed the possibility that he might organize all his employees in similarly socially motivated work teams-helping them realize the experiential values of their work. 
+It is an essential deficiency of Herzberg's motivational theory that it does not consider the social contact as a factor of motivation, except for the unrealistic assessment of workconnected factors as "primary satisfiers" and of ·outside influences as ''secondary dissatisfiers.'' 
+During boom times and by using bonuses to the hilt, the limit of the financially possible can be reached-but what about times of inflation and unemployment? Why is work security "secondary"? A motivations theory must be valid not only in fair-weather conditions. 
+Another deficiency: Herzberg counts innovation and success experiences among the primary factors. This sounds good but what does it mean in practice? In the world of mass production, what worker can experience innovation and success? Either these terms are so generalized that they cover everything-then they lose their motivational effect; or they are interpreted for specific cases, then they lose their validity for the impersonal multitude. 
+In the immense army of bureaucrats, how can anyone consider professional advancement as "primary" factor, if advancement is limited, year after year, only to routine or union-determined raises-that is, to factors reduced to secondary status? · 
+Equally far removed from reality is the concept suggested by Herzberg under tile topte, "praise and recognition.'' Praise is to be expressed not verbally to the person but should become obvious through the achievement. Example: The target on the rifle range that automatically shows how many bull's eyes were hit. Counter-example: The supervisor who praises a worker but-according to Herzberg-means more the person than the work, and therefore effects only a superficial satisfaction of short duration. 
+The essential differences between "work satisfaction''-still popular as motivational force-and "meaning in work" is shown in the following table: 
+Work Satisfaction Meaning in Work 
+
+• based on satisfac• based on realization of needs; the tion of values; needs have an obthese values have jective hierarchy. no objective hier
+archy but are experienced individually and result in an individual balance sheet of meaning. 
+
+• assumes the human • assumes the human 
+being is manipubeing is free · to lable, and the commake decisions, pany a cl05ed system. and the company 
+is open to the influences of society. 
+
+eaims at tension-free eaims at building up. satisfaction, withproductive tension out considering the between the present worker's willingwork and willingness to perform. ness to intensify 
+performance in line with meaningful values. 
+
+• expressed as a ver• expressed through bal statement, even 'experiencing values, if the meaning of including values work is low or nonbeyond those of existent-an exthe work itself. Inpression of resignastead of resignation, tion to unavoidable a genuine balance facts. of values is achieved. 
+As the column above shows, meaning fulfillment of work is achieved by an individual balancing of various values and by compensations beyond the material-financial. Because the individual balance sheet of meaning can hardly be gauged by the external aspects of a working place, it must be established by personal inquiry, such as a questionnaire or an interview. 
+The logotherapeutic approach in the work situation begins with a test that helps the employee assess the meanings that his or her place of work actually offer, and compares this with personal meaning expectations. Unfulfilled expectations breed frustrations. However, such frustrations can be compensated by the workers themselves, by realizing other values including those outside their work. Consequently, the balance sheet of 
+44 
+meaning may be positive although the place of work contributes little to it. This recognition is of practical importance for a company where the possibilities to make changes in the place of work are limited but other compensations are available. Such compensations • need not be financial. The balance sheet of meaning can also provide important information about the extent of real and expected realization of creative work contents (job enrichment). Relationships to supervisors which Herzberg classifies as "secondary," often rank remarkably high on the balance sheet of meaning because these relationships affect the material and creative values, and the social aspects of work. 
+In summary: the use of individual balance 
+sheets of meaning permit the best possible working arrangement and the adjustment of work content to the workers' potentials and expectations. The tests given to the individual workers help shed light on the desirable leadership style and a suitable training program. Leadership is meaningful only when its goal is meaning fulfilling for the individual at his or her specific place of work. Only an employer offering employees meaning fulfillment in their work can expect good work performance. 
+Translated by Helmuth Dessecker. 
+
+WALTER BOCKMAN is management consultant and psychotherapist in Bielefeld, West Germany. 
+
+
+
+
+H&C CUSTOM PUBLISHING 
+1YPESETTING AND DESIGN 
+2855 Telegraph Ave. Berkeley, CA 94705 (415) 644-7286 
+Hours: 8:30-4:30 
+45 
+THE INTERNATIONAL FORUM FOR LOCOTHERAPY 
+Journal of Search for Meaning