Volume 7, Number 2 Fall/Winter 1984 
CONTENTS 
Human Dignity and Psychotherapy Elisabeth Lukas .............................................. 67 
Logotherapeutic Support Groups for Cardiac Patients Edward Lazar . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85 
The Quest for Meaning among Today's Youth Karl Dienelt . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89 
Working with Troubled Adolescents Jane R. Silvius . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96 
The Explosion of Meaning Robert E. Carter ............................................. 100 
Rehumanizing the Computer Age through Logotherapy Philip A. Dinauer ............................................ 103 
Humor in Logotherapy Michael F. Shaughnessy ....................................... 106 
Combating Stress and Burnout among Correctional Employees Leonard E. Miller and Steven T. Adwell ......................... 112 
Growth Stages in Logotherapy James E. Lantz .............................................. 118 
The Noetic Curative Factor in Group Therapy James E. Lantz .............................................. 121 
Book Review .................................................. 126 
Letter from the Editor 
This issue of the Forum is published in honor of Dr. Viktor Frankl on the occasion of his eightieth birthday. In a sense, to honor him has been the purpose of all the Forums since their inception in 1978. 
We honor Viktor Frankl by presenting literally a forum for all those who apply his ideas to their own lives, as well as to the lives of their clients and patients. Frankl once said that he has laid the foundation on which others can build. And what a strong philosophical, medical, and educational foundation it has been! And yet, as he himself also has said, it is the fate of a foundation to become concealed as others build on it. Frankl's foundations are far from concealed, but his followers have added applications he may not have thought of in the thirties and forties when he formulated his concepts. 
The forum has been careful to publish and present to the international community of professionals and lay people only those ideas and applications of logotherapy that are firmly based on Frankl's foundations. We have opened our pages to the academicians who build on his world of ideas; to the practitioners who extend his applications; to the researchers who test his theories; and to the general readers who use his concepts as "bibliotherapy," to prevent and cure their own diseases -or mere dis-eases -and to attain sanity in an insane and fast-changing world. 
In all articles we strive for clarity of expression and thought. It was fascinating to read in the report of Dr. Lotte Bodendorfer, one ofFrankl's first students, that in 1951 one of the main criticisms was directed against Frankl's "violating" the ancient principle of the medical profession not to let lay people "have a glimpse behind the scenes." Dr. Bodendorfer defended Dr. Frankl by saying that he did his best by using obtuse phrases and Latin and Greek words. Times have changed and Dr. Frankl himself uses simple language in his lectures and his popular writings. The Forum is committed to make logotherapy accessible to anyone, academicians, professionals, researchers, and lay readers. To spread his ideas to as wide an audience as possible has been our way to honor Dr. Frankl throughout all our issues, and we present this special issue -an appraisal of his life's work -in the same spirit, as a gift, in hopes that he may live many more years to see what his students, followers, and patients keep adding to the foundation he has laid. 
Berkeley, March 1985 Joseph 8. Fabry 
Recollections from the Early Days 
Lotte Bodendorfer 
Vienna, 1947. Ruins everywhere -the Opera House, the State Theatre, St. Stephen's Cathedral burned out. Widespread starvation, despite Russian peas and American Spam. I live in the Russian zone but with the yellow four-zone pass I can move freely and decide to study medicine. Not with enthusiasm but because I wanted to prepare for a future, in spite of the hopeless present, I wanted to think about something better than our everyday needs. 
On my daily walk to the university I passed the Poliklinik Hospital. One day I walked in the company of another medical student. He asked me: "Have you ever heard the lectures of Frankl?" I asked him what he lectured about. The answer: "Psychotherapy and the Theories of Neuroses. He's good. Try it. He lectures every Wednesday between 3 and 7 p.m. You have to hear him!" Interesting subject, well presented -that appealed to me. 
Next Wednesday I walked expectantly into the Poliklinik. The guard stopped me. "Frankl lecture? Straight ahead, across the court yard, then turn right to the auditorium." It was close to lecture time and I had to sit on the steps. Standing room only like at an opera premiere! A babble of voices, the students discussed previous Frankl lectures -technical terms filled the air. Suddenly a hush fell: Professor Frankl had taken his seat at the lectern. 
An energetic, stocky man, with dark hair, striking features, and a resonant, powerful voice that grabbed my interest from the first sentence: "Ladies and gentlemen ..." He continued his series of lectures on neuroses. Frankl spoke clearly, vividly, with many case histories from his practice, and he flavored his lecture with quotations from literature and philosophy. He wandered through the realm ofthe psyche as if it were the Rax mountain whose climbing tracks are so familiar to him from his weekly rock climbing tours. I was fascinated. If this was part of medicine, then I wanted to become a psychiatrist. For the first time I heard how to help a mentally disturbed patient. But this was not the only gift of this lecture. In these depressing postwar times where it didn't seem worthwhile to make plans because everything was so meaningless, came a message of courage and hope: we are not the helpless victims of fate, we have control over what to make of our lives, we can find meaning, there was a future! I had had my doubts and had begun my studies more out of a feeling of duty toward my parents than out of love for learning. Frankl was very convincing. That first Wednesday was followed by many more -for years. And the dutiful study became a commitment to work: I wanted to become a psychiatrist and work as Frankl did! 
Of course I asked myself: Who is this man who is able to spread hope in this disastrous time? I learned that logotherapy had been forged in the white heat of the concentration camps. Frankl had found that one could discover, in life at its grimmest, a variety of meaning potentials "in spite of everything," to quote the title of one of his earliest books. When in 1945 he again was a free man, he had nothing to fear but his conscience and his God. Now he could write down, pass on, and live by example the message ofthe meaningful life and suffering. "Every tear teaches us a truth," says a wise poet. Frankl learned many truths: from the lowest humiliation in the death camps his spirit rose to the noblest heights. 
Professor Frankl lives as he teaches, for others, for his work, untiringly true to his high ideals, and proclaiming to the world: Life has meaning and is worth living in all situations. One can find meaning in the darkest moments, and perhaps especially then. Frankl loves life, appreciates the power of the human spirit, the beauty ofthe world -from the humblest little flower to the magnificence of the Alps and the ocan. He fights for the good and the positive in the lives ofevery one of his patients, and he proved that one could transcend oneself and say "yes" to life "in spite of everything." 
This I wanted to say in deep gratitude, to my 80-year-old teacher as one of his earliest students. 
LOTTE BODENDORFER, M.D., is a practicing psychiatrist in Uppsala, Sweden. As Frankl's student she becme one ofhis favorites, and in 1951 was given by him the assignment to reply to criticisms against logotherapy. These early criticisms included the accusations that(]) he allowed lay people to "have glimpses behind the scenes ofpsychotherapy, "(2) that he advised patients to live with their illness and merely change their attitude toward it, and (3) that he neglected the "animalistic part" of the human being. In her reply, the then graduate student argued that (]) Frankl, in his medical books applies many seldom used and Latin and Greek words to protect "the medical work from the grip of lay people, " (2) he carefully and repeatedly makes the point that a modulation ofattitudes is reserved only for situations ofunavoidable suffering, 
(3) he does not neglect the "animal part" ofthe human being but stresses the specifically human part (the spirit) which transcends and includes the "animal" (psychological) dimension. 
After her graduation, Dr. Bodendorfer moved to Sweden. She uses the principles oflogotherapy not only in her work but in private life. "It helped me over the most difficult periods. IfI knew no way out, I wrote to Dr. Frankl and always received a prompt and helpful answer. I'll always he grateful to him." 
6 
The Meaning of Logotherapy for Clinical Psychology 
Elisabeth Lukas 
Strictly speaking, clinical psychology is many years younger than logotherapy. The "clinical" part of psychology, that is the practical application of its theories, was until recently part of medicine, and logotherapy, too, has its roots in medical science. 
But psychology is not only a young science but also, as is fitting for youth, an aggressive discipline. It presses forward, to gain ground, and it is lucky to find the Western world in a condition where it is badly needed. 
Today, we are protected not only by a social net, but by something that could be called a "psychological net." We are exposed to psychology everywhere~-in school, at work, in court, and in the clinic. You ask people how they did "at their psychologist," and the answers range from an embarrassed shrug to a more or less veiled expression ofannoyance, and once in a while some praise. But praise is rare. Clinical psychology, young, aggressive, and often tactless, is viewed with suspicion by physicians and patients alike. 
For these growing pains the older approach of logotherapy could be a motherly aid. It could advise clinical psychology because it has knowledge and wisdom. Logotherapy has knowledge in that it has pieced together a mosaic of basic anthropological understanding of human nature -which can easily be applied in individual cases. To add this knowledge to the therapeutic intervention would expand its scope, and also enrich the art of improvisation and individualization that is badly needed in clinical daily practice. 
Logotherapy's wisdom is needed because every therapeutic intervention is an interpersonal encounter which must never lose sight of empathy and human dignity. Logotherapy is well aware of this and has developed something like "professional ethical guidelines." If such guidelines were considered, therapeutic mistakes and iatrogenic damage would be prevented, and the reputation of psychology would be benefited. 
The Knowledge of Logotherapy 
• 
Logotherapy knows what human beings basically are and what they are striving for, and it guides them in their search. 

• 
Logotherapy knows about arousing human spiritual resources, and makes therapeutic use of these. 

• 
Logotherapy knows what keeps people going in situations of unavoidable suffering, and supports them on the way. 


To illustrate how these theories translate into practice: At a symposium of gynecologists in Munich one problem was extensively discussed but no solution was found. The problem and its background: 
Science is now in a position to foretell, with 90 percent accuracy, whether a baby will be born with defects. The physicians face the question of how they should tell the parents, and especially the pregnant mother, about an unfavorable prognosis. In their dilemma the idea was born to seek the help of psychology. Who but a clinical psychologist would be able to solve this problem? The symposium recommended that the participants seek the advice of clinical psychologists. 
The attempt failed because, surprisingly, the clinical psychologists had no helpful suggestions. They hinted at some mystical connections between an unwanted child and its possible defects, and then withdrew from the problem. No general "prescription" was available for talks with parents. They said it depended on the circumstances, it was a matter of judgment and besides, this sort of thing was beyond the competency of a clinical psychologist. 
For this dilemma logotherapy can offer its rich experiences. But logotherapists, too, will not do any prescribing and rather describe what is important in such cases. And what is important, to people in general, is not so much that everything be pleasant, that everyone be healthy and have enough material things to enjoy life. All this is welcome when it happens, but it is not an absolute existential necessity. What is important is that people experience their lives as meaningful and, when the end comes, that they see they have not lived in vain. 
In our case this means: The birth of a handicapped child does not reduce the meaning of its parents' lives; on the contrary, it offers them new tasks to fulfill. And the greater the difficulties the more vital are those tasks. This is why parents can be told: "Whatever fate has in store for you, now you are needed more than ever. Your love is needed, your cooperation, your unconditional yes to the child. If you1l find the strength for this, fate cannot do you any harm." 
The question remains how the patients will muster this strength. Here, too, logotherapy can be helpful by arousing their potential strength from the resources of their human spirit. Frankl himself, by his own example, has illustrated what the "defiant power of the spirit" can do. As if a mysterious spark would leap across, an example of heroism has an encouraging effect on others. The contagious heroism, in this case, is the inner attitude someone is able to take in the face of unavoidable suffering -an attitude that kindles admiration and respect in others. Logotherapy offers the method of"attitude modulation" that helps people confronting their fate to find a healthy and affirmative attitude. 
In a Socratic dialogue the logotherapist may be able to show the prospective parents that many families are unhappy although their children have developed normally, and that many a happy family was able to integrate a handicapped child into their circle. Defects, in whatever form, are no sentence to unhappiness but a challenge to the human spirit to make the best of a situation. And in the end, the situation may turn out even better than it would have been without that challenge. 
One last question remains -the question of the existential anchoring of such a positive attitude. Of course, logotherapy does not presume to compete with religion. But ifwe are not anchored in some faith that enables us to face the ups and downs of life, we have to face these questions through philosophy. In cases 
8 
of adversity such as the medical prognosis ofa defective birth, the questions that demand answers are: "Why?" "Why me?" Physicians or psychologists ought to have some kind of answer, and they can find it in the teachings of logotherapy. Logotherapeutic experience shows that questions born of suffering require patience because the answers may become manifest only much later -in retrospect many things become clear that are hidden initially. The prospective parents have to be helped to see that they need time to come to a conclusion a bout the situation. If there is a consensus among parents of handicapped children, it is the realization that they would not have wanted to miss having had just those children. And this, after all, is a great comfort. 

The Wisdom of Logotherapy 
This example indicates that clinical psychology needs the complementary knowledge oflogotherapy. But knowledge is not enough. (Scientific knowledge alone is not suffi,:ient to save humankind, as we have learned from the atomic research in scientific laboratories.) Knowledge must be complemented by wisdom, and this is true also for clinical psychology whose therapeutic techniques and psychological strategies too easily propel patients into subhuman, if not inhuman, channels and plunge them deeper into illness. 
What is the logotherapeutic wisdom which may have significance for clinical psychology? Not the development of new fashionable techniques; rather a consideration of the basic values and goals of all therapy. These "professional ethical guidelines" may be listed under the following headings: 
1. 
Normalize, don't psychologize. 

2. 
Encourage self-help. 

3. 
Don't take away responsibility. Point #I admittedly sounds provocative, and yet it contains an ancient wisdom that tells us to let sleeping dogs lie, or not to solve problems that do not yet or no longer exist. The logotherapeutic "Socratic dialogue" requires a high degree of caution and intuition. It should not be done in an attempt to tear open old wounds at any price so they will start bleeding again and only increase the pain. Nor should it draw attention to present failures in order to see them as excuses for future ones. If people consider themselves psychologically ill, this in itself traps them in their illness, and tracing the neurotic development only paralyzes their resistance against the neurosis. We therefore have to be careful with hypotheses and interpretations, and direct our therapeutic attention to the successes of a life, to what is positive and valuable in a human existence. Old scars, for instance, may form a strong, tear-resistant tissue which, if recognized as such, will make the organism tougher and more impregnable than before. Even pain may have its purpose; it is a powerful warning to act, to bring about change, to straighten things out. But it is the principle of hope that results in the most effective therapy as long as it is nourished by professionally justifiable means and is not choked off. In sum: whenever the effect of psychologizing 


patients is greater than the gain in stabilizing them, psychotherapy becomes iatrogeny. 
The reference of "stabilization" leads to the second professional ethical guideline of logotherapy -the principle of self-help. Who causes a physical or psychological wound to heal? Not the physicians. They can treat it with ointments and dressings but the process of healing is accomplished by the selfhealing powers of the body. Modern medicine increasingly becomes convinced that health is more likely when the natural inner immune system is supported than when the attempt is made to "drive out the devil with Beelzebub, "through artificial chemical interventions. 
Eventually clinical psychology must also become aware that there are not only psychological causes of illnesses, but also noetic self-healing forces which can conquer such illnesses, and even prevent them. A "wise" psychology will seek out and promote these self-healing forces so that wounds will close whose origins cannot be eliminated regardless how intensely the patient will brood a bout them. All specifically logotherapeutic methods have as their goal the promotion of self-help, and the low number of relapses seems to show that they rarely miss this goal. 
The third professional ethical guideline deals with responsibility. We know that not every illness can be cured and that logotherapy is no panacea. But one thing must be prevented --the taking away of responsibility from the clients, their knowing that they are responsible for their lives. Except for psychotic phases which lie beyond the responsibility of the sick person, mental patients, too, have some freedom to handle their illness one way or another. They can use the illness as an excuse for all sorts ofthings, or as a means to manipulate others. They can make it easy on themselves by claiming their parents made mistakes or that others have failed them. Especially the neurotic tends in that direction. 
This is the place where psychotherapeutic "wisdom" comes into play to challenge patients to act with responsibility within the limits oftheir free space, rather than support their "declarations of dependence." Human beings are as dependent as they feel, and similarly as free as they are willing to rise above their fate -that is the guideline that shows the way out of the neurotic trap. 
Where there is freedom there is also responsibility, and where life is worthy of being called human, it must be directed toward a meaning that is to be fulfilled. The task of psychotherapy is not to intensify the patients' self-observation and self-pity or to create a new dependency on the therapy, but to help them restore their responsibility and human dignity and become aware of why and to what end they want to get well. Psychotherapy is no substitute for meaning! 
These are the guidelines which logotherapy can offer to clinical psychology -not to instruct or patronize, but to help that young and promising discipline gain and earn the trust of its patients. 
ELISABETH LUKAS is a practicing /ogotherapist and head ofa counseling center in Munich, and a lecturer of /ogotherapy at the universities of Munich and Innsbruck. 
Viktor Frankl's Meaning for Psychology 
William S. Sahakian 
Frankl's debut in the field ofpsychology was initially from the field ofclinical psychology or, more specifically, from psychotherapy. With time, however, appreciation for his contributions spread to other areas of psychology. His entry into academic psychology was a smooth and natural one, steeped in the tradition of the influential Viennese psychotherapists: Freud, Adler, and Moreno. Adding Lorenz's name to these three, and we should, because Lorenz is the luminary of ethological psychology, Austria, capped with Frankl's contributions to psychology, has given the world five major contributors with works of global influence. It is remarkable indeed that such a small country has commanded such a large share of a highly specialized field of psychology. 
Frankl's Rise in Academic Psychology 
At the present time, only Lorenz and Frankl have survived their colleagues, and they alone continue to contribute to psychology. Our interest, however, is with Frankl and the role that his contributions play in psychology. While it is true that Frankl began publishing as early as 1938 (and even earlier) with his "Zur geistigen Problematik der Psychotherapie, "his rise to world prominence appears to have flourished four decades later. The reason for this 40 year hiatus is obvious: the academic world and psychology were put on hold until the conclusion of World War II; Frankl's confinement in concentration camps deterred his pursuit of and publications in the field of psychology; his early writings in German did not circulate among psychologists of the Englishspeaking world until the mid-1950s; and the spread ofhis ideas required time to generate and circulate from the date ofthe American publication of the Doctor and the Soul: From Psychotherapy to Logotherapy in 1955. Consequently, it was not until the I960s that Frankl began being cited in English language textbooks. 
After researching the matter, it was found that Frankl was but moderately cited in books on abnormal psychology in the latter 1960s, extensively cited in the 1970s; and by the decade ofthe I980s only one out often books in the field of abnormal psychology failed to mention him. Thus, 90 percent or better of all books being published at the present time in the field of abnormal psychology acknowledge the importance of Frankl's ideas. What a remarkable feat! Few psychologists can boast such a monumental achievement. 
The spread of Frankl's logotherapy does not end with books on psychopathology, but extends to psychotherapy, and to psychology at large. Perusing books dealing with general psychology or introduction to psychology, it was found that by the 1970s and 1980s Frankl's views had won their way into these texts as well, so that virtually every student studying psychology has become familiar with Frankl's name, and the majority ofthem conversant with his ideas. 
11 
Frankl's recent popularity has assumed added dimensions and directions. Increasingly he is commanding more coverage in texts and encyclopedias of psychology and psychiatry. In his 1983 publication, Principles of Ahnormal Psychology, 7 Munsinger saw fit to provide more coverage than Frankl usually receives in textbooks. Discussing logotherapy, Munsinger elaborated on the important role Frankl plays in psychology. He regards logotherapy as "a major form of existential psychotherapy" and distinguishes it from psychoanalysis. It is regrettable that he seems to believe that logotherapy "as practiced by Frankl" examines "the values and moral conflicts of the patient" (p. 90), as if this is its only use. One reason for this narrow conclusion is attributable to Schultz's11 failure to discuss major logotherapeutic tenets, such as paradoxical intention and dereflection. He does, however, treat the "existential vacuum." 
Nevertheless, these techniques of Frankl, paradoxical intention and dereflection, along with other logotherapeutic tenets have over the years increasingly found their way into psychological literature. 
There are other areas where logotherapy has had its impact. These include encyclopedias, chapters within books, and professional journals. A recent encyclopedia that includes not only logotherapy but the biography of Frankl is the Encyclopedia of Psychology, 1 and in the third edition of their Psychopathology Today: The Current Status of Abnormal Psychology, 10 Sahakian and his colleagues saw fit to allocate an entire chapter on logotherapy. It shows the commanding position logotherapy holds currently, especially when one takes into consideration that Frankl's Viennese predecessors: Freud, Adler, and Moreno were allocated considerably less space. Frankl has held that enviable position since the book's initial publication in I 970. Frankl and his contributions were considered of sufficient importance to earn him an everlasting place in the history of psychology, according to Sahakian.8 
Frankl's Personality Theory 
By the opening of the decade of the 1970s, Frankl not only developed a system of psychotherapy, he introduced enough conceptions to form a theory of personality.9 It was a considerably well developed theory of personality based on a fundamental hypothesis of motivation, termed "the will to meaning." It differed from the Freudian pleasure motive and the Adlerian power motive (drive for superiority) in numerous respects. Frankl not only supplanted pleasure and superiority with will, but he repudiated "drive" for "will," a pull replaces push. But will also implies choice rather than a deterministic drive ofpleasure or lure of superiority, drives that one must of necessity obey. 
Frankl's was more than a newer development of existing personality theories, his was a radical departure. Existing personality theories developed the human personality from its animal basis, grounded on instincts, drives, and human physiology. Even A. H. Maslow's theory of personality is grounded on an animal or instinctual basis. Unlike his predecessors and contemporaries, Frankl daringly postulated purely human characteristics: freedom of will; will to meaning; meaning of life; humor; noogenic processes; existential experiences, such as the existential vacuum and existential tension; noodynamic processes; transcendent experiences, including the human capacity for self-detachment and self-transcendence; the intuition of phenomenological meanings; and the human's ability to restructure attitudes that render situations tolerable even if they cannot be changed. This is but a partial catalogue of Frankl's personality theory, and this list by no means exhausts either the number of elements that comprise the structure of his personality theory or the dynamic processes operative in the personality. 
Franklian Psychotherapeutic Techniques 
In citing the personality characteristics developed by Frankl, no mention has yet been made of his psychotherapeutic devices. Perhaps he is best known to psychologists and psychiatrists for his contributions in this area of psychology. especially for his introducing techniques of dercflection; paradoxical intention; self-detachment: logoclrama: humor; restructuring attitudes to cope with life's irresolute problems: the acquisition of meanings to deal with irremedial suffering: medical :ni'1istr::,: and the technique of the common denominator. Scarcely a psychologist can be found who can boast of such a repertoire of important contributions to psychotherapy. 
Of all the contributions of Frankl, the one that appears to have made its way into currently published college textbooks in abnormal psychology is primarily paradoxical intention; dereflection follows secondarily. But even more than these concepts, he is more often mentioned for his stance as an existential psychotherapist. Some books cite him as a logotherapist, and a few others merely make mention of logotherapy's being a psychotherapy for resolving those conflicts arising from moral problems. 
Frankl, Learned Helplessness, and Depression 
In the third edition oftheir Abnormal Psycholof?y, 2 Davison and Neale make a fascinating comment, but regretfully neglect to develop it. They write: 
It might be useful to relate Frankl's views on depression and its treatment to learned helplessness. Certainly the concentration camp induced helplessness and hopelessness, an utter disbelief that an individual could exert any control over his or her life. Profound depression was commonplace. Logotherapy might be an effective way to reverse the helplessness depressed people experience in contemporary society, under less horrific and brutal conditions (p. 259). 
In current psychology, learned helplessness is becoming a carefully analyzed field in which considerable experimentation is conducted. Currently, research in this area is gaining in popularity. Research in learned helplessness, initially spearheaded by Martin Seligman, is being pursued hy a number of psychologists. Seligman began publishing his views in the decade of the 1970s, culminating them in his Helplessness: On Depression, Development. and Death in 1975. 12 This, of course, signifies that Frankl, whose statements on learned helplessness antedate Seligman's, is the first person in psychology to offer a means for coping with learned helplessness and its concomitant or ensuing depression. 
Furthermore, Frankl had a first-hand acquaintance with learned helplessness while undergoing his concentration camp ordeal. During this period, he acquired a novel technique of contending with learned helplessness, a method that was later shared with the world. Accordingly, more than 30 years before Seligman, Frankl offered his logotherapeutic device for coping with learned helplessness and its consequential depression. Perhaps the technique can be coined 'iutural self-transcendence" or "self-transcendence of present conflicts." Reflecting on his concentration camp experiences, Frankl wrote: 
Any attempt at fighting the camp's psychopathological influence on the prisoner by psychotherapeutic or psychohygienic methods had to aim at giving him inner strength by pointing out to him a future goal to which he could look forward ... It is a peculiarity of man that he can only live by looking to the future ... And this is his salvation in the most difficult moments of his existence ... 
l remember a personal experience. Almost in tears from pain (I had terrible sores on my feet from wearing torn shoes), I limped a few kilometers with our long column of men from the camp to our work site. Very cold, bitter winds struck us. I kept thinking of the endless little problems of our miserable life ... 
I became disgusted with the state of affairs which compelled me, daily and hourly, to think ofonly such trivial things. I forced my thoughts to turn to another subject. Suddenly I saw myself standing on the platform of a well-lit, warm and pleasant lecture room. In front of me sat an attentive audience on comfortable upholstered seats. I was giving a lecture on the psychology of the concentration camp! All that oppressed me at that moment became objective, seen and described from the remote viewpoint of science. By this method I succeeded somehow in rising above the situation, above the sufferings of the moment, and I observed them as if they were already of the past. Both I and my troubles became the object of 
74
an interesting psychoscientific study undertaken by myself.3-rr 72Thus, not only learned helplessness and the averting of depression, but the 
method of contending with such situations was initiated by Frankl many decades prior to the psychological community's awareness of it as an issue worthy of psychological investigation. 
Dereflection as a Technique in Dealing with Impotence 
In an article my daughter, Barbara Jacquelyn, and I published in 1972,9 we stated: 
Dereflection, a technique for counteracting hyperintention and hyperreflection, especially in cases of anticipatory anxiety, insomnia, frigidity, and impotence, serves to alleviate the pressure created by demands and expectations. In principle, the idea is corroborated by Masters and Johnson6 in their research on human sexual inadequacy (pp. 239-240). 
Today, dereflection has become a standard technique that sex psychotherapists utilize in dealing with psychogenic impotence. It is known that in the majority of cases, impotence is psychological in nature, and consequently responds to psychodynamic techniques. Anxiety is commonly associated with impotence,5 and dereflection is an effective way of dealing with sexual anxiety. Oddly 
14 
enough, psychologists do not seem to employ paradoxical intention in these cases, at least it is not a common subject of discussion in texts on the sexual therapy of impotence. Two leading books on sex therapy: Helen Kaplan's The New Sex Therapy: Active Treatment of Sexual Dysfunction4 and Human Sexual Inadequacy6 by William Masters and Virginia Johnson emphasize dereflection directly or indirectly. 
Kaplan's injunction is not to be concerned or worried if one fails to achieve an erection, while Masters and Johnson enjoin one to dereflect rather than assume a spectator role during sexual intercourse. Citing primary goals in treating male impotence, Masters and Johnson advise first of all "to remove the husband's fears for sexual performance," and secondly "to reorient his involuntary behavioral patterning so that he becomes an active participant" rather than an objective observer (p. 196). They add: "The more the male strains the more distracted he becomes ... therefore, the more entrenched the continued state of penile flaccidity" (p. 197). Thus, dereflection combats the anxiety that underlies impotence and alleviates excessive striving that leads to futility. It seems that paradoxical intention is an advisable technique to employ in such unproductive cases. 
Paradoxical Intention as a Technique in Sex Therapy 
The absence of any mention of paradoxical intention in textbooks on the psychotherapy ofsex is difficult to understand. My forecast is that it will sooner or later be introduced and its value credited to Frankl in future books treating this subject. It is disconcerting that derefleetion and paradoxical intention are implicitly or explicitly utilized in sex therapy without crediting Frankl. Much worse, writers on sex therapy allude to it without realizing that it was originally Frankl who initiated these psychotherapeutic techniques of paradoxical intention and dereflection. According to the sex therapist Kaplan, "there is probably no other medical condition which is as potentially frustrating, humiliating, and devastating as impotence."4 -P· 257 This being the case, it is small wonder why men hyperreflect when victimized by this condition. In order to reverse the process, sex therapists advise employing dereflection. In the second edition of his Human Sexuality, 11 Schultz mentions a common practice that sex therapists employ in dealing with impotence: 
The male learns to concentrate on giving his partner pleasure -not in order to achieve an erection, but simply in order to give her pleasure. So that such pleasuring can occur without stress, intercourse is usually forbidden by the therapists. Erection is not expected, but may occur (pp. 260-261 ). 
In giving advice in this manner, it is obvious that sex psychotherapists are aiming toward dereflection, but paradoxical intention is also alluded to in their instructions, when they advise patients not to conclude sex play with intercourse. When the man is told that he cannot have sex despite his having an erection, the psychotherapist is obviously recommending paradoxical intention. Thus, in cases of secondary impotence, impotence of psychogenic origin, paradoxical intention, as a reinforcement for dereflection, becomes an effective device in sex therapy. 
Concluding Comments 
If Frankl's rise in the arena ofpsychology is so dramatic at this relatively early stage of its dissemination, it seems reasonable to predict that his rise has not as yet peaked. At the present time at least his climb has not as yet abated. 
To be sure, there are other aspects of Viktor Frankl's meaning for psychology that have not been discussed in this brief essay. One, for example, is the potent influence and interest Frankl's views hold for the populace at large. Many ordinary individuals, who have never taken a course in academic psychology, are familiar with Frankl and his logotherapy. It is possible that more laypeople are aware of his psychology than all the professional psychologists alive today. Is there any greater testimony to a psychologist than this? 
WILLIAMS. SAHAKIAN, Ph.D., isprofessorofpsychologyandphilosophy, Suffolk University, Boston. 
REFERENCES: 
L Corsini, R. et al (Eds.). Encyclopedia of Psychology. 4 vols. New York, Wiley, 1984. 
2. Davison, G. C., and J. M. Neale. Abnormal Psychology. 3rd ed. New York, Wiley, 1982. 
3. 
Frankl, V. E. Man's Search/or Meaning: An Introduction /0 Logotherapy. Rev. ed. Roston, Beacon Press, I 962. 

4. 
Kaplan, H. The New Sex Therapy: Active Treatment of Sexual Dysfunction. New York, Brunner/ Maze!, 1974. 


5. 
McCary, J. L Human Sexuality. 3rd ed. New York, D. Van Nostrand, 1978. 

6. 
Masters, W. H., and V. E. Johnson. Human Sexual Inadequacy. Boston, Little, Brown, 1970. 

7. 
Munsinger, H. Principles of Abnormal Psychology. New York, Macmillan, 1983. 

8. 
Sahakian, W. S. His/Ory and Systems ofPsychology. New York, Halsted Press ofJohn Wiley; and Cambridge, MA, Schenkman, 1975. 

9. 
____and B. J. Sahakian. "Logotherapy as a Personality Theory." The Israel Annals of Psychiatry and Related Disciplines, 1972, 10, 230-244. 

10. 
B. J. Sahakian, and P. L Sahakian Nunn. Psychopathology Today: The Current Status of Abnormal Psychology. 3rd ed. Itasca, IL, F. E. Peacock, 1985. 

11. 
Schultz, D. A Human Sexuality. 2nd ed. Englewood Cliffs, NJ: Prentice-Hall, 1984. 


12. Seligman, M. E. P. Helplessness: On Depression, Development, and Death. San Francisco, 
W. H. Freeman, 1975. 
16 
Viktor E. Frankl's "Place" in Philosophy 
George Kovacs 

Philosophy tries to ex pl ore and comprehend the present and the actual world through reason; it claims to be a reflection on "that which is," on the nature of historical development and on the "logos" underlying human existence and the fullness of reality. According to Hegel's famous, insightful remark, however, "... every individual is a child of his time; so philosophy too is its own time apprehended in thoughts" (p. 11 ).4 The task of philosophy, then, is to participate in and thu& to apprehend the contemporary world. The thought of Frankl as a whole (now in twenty-seven volumes, with translations into twenty languages) constitutes a substantial and incisive understanding ofthe foundational attitudes and anxieties of the individual, of the mentality and of the main concerns of human existence in the present historical situation. His readers readily recognize in his writings the description (diagnosis) as well as an understanding response (remedy, therapy) to their own crises in living; they rediscover themselves in the search for meaning(s) in living. Frankl's system of thought, focused on the key philosophical concept ofself-transcendence and on the idea of self-detachment (p. 160) 1 (as they are emphasized more and more in his later works), is a comprehensive philosophy of human existence (a phenomenological philosophy and psychology): it is more than an "existentialist psychotherapy" (p. 119). 7 The term "logotherapy," as the designation of Frankl's thought, suggests that philosophy (the search for wisdom and knowledge: "logos") belongs to the well-being (health) of the human being, that the search for meanng is therapeutic, that there is a healing function of meanings and values in human living (pp. 19, 63), 3 (p. 272).2 The dilemma of meaningfulness and meaninglessness belongs to the main questions ofphilosophical thinking and specially to existential thought; it cannot be reduced to a merely psychodynamic and psychotherapeutic phenomenon ( or function). 
Frankl's examination ofthe philosophical foundations of psychotherapy, his analysis of the theoretical (and sometimes even ideological) assumptions of the divergent psychotherapeutic techniques, and his concern with the theories of neuroses lead to a new understanding of the nature as well as of the boundaries of psychotherapy. There is no psychotherapy without foundation in philosophy. According to Jaspers the contemporary psychotherapist "has to be a philosopher, consciously or not, methodically or haphazardly, in earnest or not, spontaneously or following contemporary fashions" (p. 28). 5 Frankl, like Jaspers, is a philosopher in earnest, methodically, and consciously; he is a philosopher in his own right even as a member of the phenomenological, existential trend of thought. Frankl can agree with Jaspers that "... the self-revelation of an individual extends far beyond what may be accessible to any psychotherapeutic plan. It carries one on into the philosophical realm of the individual growth of a self" (p. 19).5 Frankl brings a new challenge to philosophy and psychotherapy by integrating the principle of meaning into the fullness of human living and into the possibilities of healing; he opens up the psychotherapeutic relationship to a Socratic, philosophical dialogue. Frankl's main contribution to philosophy, his "place" in contemporary philosophy, may well be determined by his creation of a new bridge between philosophy and psychotherapy (and also psychiatry and psychology in general), by his focusing their respective horizons and potentialities. He is constructing the bridge between philosophy and psychotherapy from both sides of the spectrum and anchor& it on solid grounds in the two disciplines. As a philosopher and a psychotherapist, Frankl is the founder not only ofthe system of logotherapy but also ofa new, radical philosophy of psychology (psychiatry and psychotherapy) as based on ontology and on existential anthropology. He shows not only the foundation and the richness ofmeanings in human existence, but he also reflects on the question of ultimate meaning as well as on the connection between Meaning and Being (reality). This grasp of the dimensions as well as of the foundations of meaning situates the thought of Frankl in the development of existential-phenomenological philosophy that is open to and even includes some considerations of an overall view of reality (metaphysical reflection). The philosophical clarification of ideas and of principles (e.g., those of psychotherapy) is as crucial according to his methodology as their (whenever it is possible) empirical vertification. In the final analysis, then, logotherapy is neither a philosophy by itself nor a psychotherapy in isolation from the other schools: it is, much rather. a way of thinking that is also healing and at the same time a methodology of healing that is also a process of thinking ---a dialogue between philosophy and psychotherapy. 
New Possibilities of Thinking 
The practice of dialogue, however, is a philosophical activity; it does not leave the realm of philosophical reflection, but it rather opens up new possibilities for thinking. The exercise of dialogue (the dialectical encounter between opposing minds and meanings), according to its Socratic origin, belongs to the methodology of philosophizing; the more essential the nature of thinking the more it reaches out towards new (and other) fields and horizons. The great thinkers came to their own central insights and to the final structure of their thoughts not through the restrictive (monological) attachment to one field of specialized knowledge but through the expansion and through the free pursuit of research leading them to a deeper grasp oftheir initial realm of inquiry as well as to a new unforeseen domains of knowledge. Frankl's way of thinking unfolds the questions regarding meaning by moving from philosophy to psychoterapy and from psychotherapy to philosophy without counting the numbers of "back and forth," because the dynamics of this journey is not a restriction but rather the expansion ofthe inquiry, of the search for true knowledg-: ,:nd wisdom. One of his lasting contributions to philosophy consists in the systematic and incisive exploration of the nature, source, function, reality, and experience of meaning (and of the overcoming of nihilism) with the help of the radicalization of the Socratic way of thinking (dialogue, irony, existential concern). Frankl is a truly Socratic thinker, teacher, and therapist of our times; he is one of the most comprehensive and successful practitioners of existential dialectic and understanding in the twentieth century. His thoughts deserve a focal "place" in the history of contemporary philosophy; he belongs to the company of those seminal and great thinkers who not only describe insightfully but also relate therapeutically to the crises of their own times. 
Great thoughts, according to Nietzsche's warning, are comprehended most slowly; it takes a generation to become aware of their true teachings. Frankl's thought is still young (some times it may be even too close to its contemporaries chronologically and yet at a distance from their true understanding) although he is no novice to the testing passage of time (his first publication is dated 1924 and his latest 1984). The dawning of the age of logotherapy, nevertheless, is here. Frankl developed logotherapy as something teachable (communicable) and learnable: its theory, principles, and techniques rest on good grounds. His thought is not a final philosophical and psychotherapeutic system; it is "free toward its own development and open for a cooperation with other schools" 
(p. 19).6 Frankl looks at his work as the "laying of the foundation" of logotherapy (p. 11)6 as a meaning-centered psychotherapy. He brings to the meeting with the other schools of psychotherapy (and philosophy) his own discovery, his own mind. Frankl's teaching (the idea of logotherapy and the analysis of existence) does not consist in reading and interpreting some great psychological and philosophical texts; it is first of all his own discovery and primordial insight that begins already in his early youth with the struggle with the feelings of ultimate meaninglessness and thus with the reflections on the question of meaning (the overcoming of skepticism about meaning) and it reaches a more and more explicit and an increasingly higher degree of systematization and conceptual clarification with the passage oftime (p. 7),6 (pp. 144, 145, 172). 1 His experiences in the Nazi death camps further strengthened and validated his concept of the "will to meaning" (p. 27).6 This practical (living) and theoretical (intellectual) confrontation with the questions of meaningfulness and meaninglessness in human existence (also influenced by trends in philosophy, psychology, and in the sciences) is not an exercise in some extra-philosophical understanding but, much rather, the pursuit ofthe Socratic task to search for meaning (and even for the ultimate meaning) in living and for a deeper self-knowledge. 
The Place of Meaning in Living 
There are philosophical as well as psychological aspects of this search; the clarification of basic concepts and the development of initial though primordial insights (intuitions and experiences) may not come about without confronting (questioning and rethinking) already established and easily accepted ideas and ways ofthinking. New thoughts become clearer and deeper, or they may be cut down to size, by critical reflection and by the encounter with other (opposing, doubting) thoughts. Frankl's familiarity with the great philosophers and psychologists is an indication of the methodological and comprehensive approach to his task. His thought is not the result of commenting cin and interpreting the "great texts" (e.g., the writings of Freud and Scheler); it is his own creative awareness of the "texture of living," of basic human experiences, ofthe function and "place" of meaning in living. Many of his ideas and often his primordial insights, however, do have significant thematic relationships with the works of other great thinkers. This connection and the openness of Frankl's thought as a whole contain the seeds of development and unforeseen possibilities for growth; they also make more difficult at the same time the final description ofhis "place" in the history of philosophy. Several great thinkers ofthis century expressed not 
only interest in but also a high regard for Frankl's work. Heidegger came to visit him in Vienna. Their conversation and his contacts with Jaspers, Binswanger, and Marcel are mentioned by Frankl (p. 145)1 without an account of their no doubt significant and positive intellectual dialectic. He also met and conversed with Buber. What does Frankl see in and think of his great contemporaries? What did these central thinkers judge the most significant in Frankl's work? The answers to these questions are still to come; they are not yet (p. 12)1 in the published writings of Frankl. The judgments ofthe interlocutors of Frankl will be enlightening not only for the appreciation and grasp of his foundational thought but also for the assessment of his focal "place" in the history of philosophy and in contemporary culture in general. 
The exploration of the background and of the development of Frankl's thought is essential for grasping its systematic unity as well as for its further unfolding. The examination of historical ("genetic") relationships and of the thematic connections (parallels, similarities, e.g., in concepts, principles) is indispensable for an in-depth assessment of his philosophy and psychotherapy. Thus his "roots" in Scheler and some thematic connections with ideas of Heidegger and Husserl (and other philosophers) are as valuable for the realization of the foundational nature of his thought as his background in Freud and Adler. The issue at stake in these relationships is not the openness of Frankl's thought to the other schools (of philosophy and psychology) but rather the discernment of creative, systematic, and even prophetic Franklian analysis of human existence focused on the pursuit of meaning and on self-transcendence. 
One ofthe most significant contributions by Frankl to contemporary philosophy and culture may well consist in teaching in action (by example) how to think well and how to live with courage in a world that is being tested by the crisis of reason and the skepticism about meaning. His works represent the practice of Socratic "irony," of Socratic dialectic; they show and question the assumptions of ideologies, they unmask the often disguised "-isms" of our times, they overcome the attitudes ofexistential despair and intellectual uncertainty by the open, dynamic, prospective, and comprehensive yet discerning way of thinking. His insights are diagnostic, descriptive and therapeutic; they show the origins of meanings (of ideas and attitudes) and describe what they really are, and indicate where they lead to. The practice ofthis Socratic way ofthinking is essential and foundational for Frankl's system of thought; it is a positive "omen" of his lasting "place" in the history of philosophy as well as in the rehumanization of psychotherapy. 
20 
A Therapeutic Way of Thinking 
Frankl's way of thinking is therapeutic for philosophy today; it renews philosophy not as a content of thought but as an activity, as the search for "logos," for meaning, wisdom, and knowledge. Philosophy is the child of (its own) time, the gift of the search for knowledge and truth in time. Human thinking is neither omnipotent nor impotent. The Socratic search for wisdom (for meaning as guide in living) is not in vain, for it can be found and realized in time, in the present, actual world. Wisdom, however, is viewed by the authentic thinker who searches for it, according to Frankl, as "knowledge that includes the simultaneous consciousness of its boundaries" (p. 35). 3 Frankl's therapy for thinking, the challenge to philosophy, psychology, and to the sciences, consists in unmasking and thus retracing the boundaries of as well as the distinctions between the domains and the methodologies of the various fields of knowledge. Meanings are "available" for the individual; they can be found and discerned in time by a process of thinking that is aware of its own boundaries, exigencies, and potentialities. 
The future of Frankl's therapy (logotherapy) and analysis of existence (Existenzanalyse) is determined by the depth of its Socratic method of thinking and thus by its responsiveness to its own time, to the questions and anxieties ofliving in the contemporary world. His "place" in philosophy, therefore, is on solid ground; he is already recognized as the thinker and physician ofour times, as the contemporary philosopher and psychotherapist of the search for meaning. "Any therapy which wins success will be highly characteristic of the people of that time; it will have the contemporary features of its patients" (p. 29).5 
GEORGE KOVACS, Ph.D., is professor ofphilosophy at Florida International University, Miami, Florida. 
REFERENCES: 
I. Frankl. Viktor E. Die Sinn/rage in der Pvychotherapie. Miinchen, Piper, 1981. 
2. 
____ Die Psychotherapie in der Praxis. Wien, Deuticke, 1982. 

3. 
____ Der leidende Mensch: anthropologische Grundlagen der Psychotherapie. BernStuttgart-Toronto, Huber, 1984. 


4. 
Hegel's Philosophy ofRight. Translated with notes by T. M. Knox. Oxford, Oxford University Press, 1980. 

5. 
Jaspers, Karl. The Nature of Psychotherapy. Chicago: Phoenix-University of Chicago Press, 1965. 

6. 
Kreuzer, Franz. Im Anfang warder Sinn. Wien, Deuticke, 1982. 

7. 
May, Rollo. Angel, Ernest. Ellenberger, Henri F. Editors. Existence. New Yor, NY, Simon and Schuster, 1958. 


Viktor Frankl's Meaning for Pastoral Counseling 
Robert C. Leslie 

There is a special appropriateness in writing about pastoral counseling in the year in which Viktor Frankl becomes eighty. Logotherapy has found a positive response from the religious community almost from its beginning, and a part of the response comes from the tools which logotherapy provides for the ministry of counseling. Frankl's emphasis on the central need to find a personal meaning for life echoes a major theme in the personal ministry of Jesus, and his perception of suffering as providing a way to realize meaning underscores a theme prominent in .Judea-Christian thinking. For pastoral counselors working with older people, logotherapy offers more specific help than any other system in the psychotherapeutic world. 
Although the roots ofpastoral counseling are deeply embedded in the age-old religious tradition of caring for people in need, pastoral counseling as a discrete discipline is largely a postwar phenomenon. The major early texts in pastoral counseling were written in the late forties and early fifties. x.1o.1 5.22 These texts were primarily oriented to counseling techniques and drew heavily from techniques being used in the secular counseling world. At about this same time two major books. by David Roberts 18 and by Albert Outler16 appeared in which the relationship of psychology to theology was examined in detail. Brooks Holifield9 summarized the messages of these authors by saying that Roberts emphasized that "psychology should deepen theology," while Outler emphasized that "theology should deepen psychotherapy." These two hooks brought to sharp focus a dialogue between the psychological and theological worlds which was to continue throughout the 1960s and, indeed, into the present. 
It was during this very period in which pastoral counseling was being developed, both in practice and in theory, that Frankl did his early writing. Two of his earliest writings carried titles that alerted the religious world to a context very unusual for a psychiatrist: The Doctor and the Soul and The Unconscious God. Frankl's thinking was thus available in the very period that pastoral counseling was coming into its own and was beginning to differentiate itself from secular psychological theory. 
My own discovery of Frankl and my decision to spend a sabbatic year studying with him (1960-1961) was no accident. In my efforts at relating psychology to theology I had tried a number of psychological theories but had always found them unsatisfactory, particularly in the doctrine of the person (usually called the doctrine of man) which they espoused. Encouraged by pastoral counseling colleagues Aaron Ungersma and Donald Tweedie, both of whom had spent profitable sabbatics with Frankl, I inquired about studying in Vienna and was given immediate encouragement by Frankl. Subsequently we three pastoral counselors wrote books about logotherapy which became a part of the psychology-theology dialogue.12.1 9 ,20 Moreover, Frankl's early lecture tours to North America in 1957, 1960, 1961, and 1963 were sponsored by the Religion in Education Foundation under the directorship of J. Randolph Sasnett, taking Frankl to universities, psychological clinics, and numerous religious organizations and institutions. Theological schools, including my own, were especially receptive to him. 
It is easy to understand the favorable response that Frankl has elicited from the theological world in general and pastoral counseling in particular. It is, first of all, Frankl's view of the human being that commends logotherapy to the pastoral counselor. Frankl's view stands in the tradition of William James and Gordon Allport rather than in the tradition of Sigmund Freud or B. F. Skinner. The human person is seen as having the distinctive attribute of being able to choose when confronted by situations of stress. This power to choose is consistent with being created in the image ofGod, only "a little lower than the angels ... crowned with glory and honour" (Psalm 8:5). 
In the 1975 English edition of The Unconscious God. Frankl writes:"... The main theses propounded in the lecture entitled, The Unconscious God,' remains still valid and tenable. There is, in fact, a religious sense deeply rooted in each and every man's unconscious depth. "7 Thus Frankl is asserting what the world of faith insists, that no person can be understood apart from the person's connection with the larger world that includes God. 
When Frankl criticizes psychoanalysis, it is largely in terms ofthe inadequacy of the psychoanalytic view of the person. Frankl is in agreement with Gordon Allport who wrote a telling critique of Freud's view of the ego: 
One ofthe oddest events in the history of modern psychology is the manner in which the ego -or self -became sidetracked and lost to view ... I am inclined to believe that history will declare that psychoanalysis marked an interregnum in psychology -between the time when it lost its soul, shortly after the Franco-Prussian War, and the time when it found it again, shortly after World War 11.1 
It is not by chance that Allport wrote the preface to Frankl's Man '.s Search for Meaning. 5 Both Frankl and Allport argue for an active, purposive self that, although influenced by the past, is never determined by the past. 
A second factor in commending logotherapy to pastoral counselors is the stance of the counselor. It has always been an assertion of the religious community that the personal orientation ofthe counselor makes a difference in how counseling is carried out. Whereas secular counselors insist that the counselor's personal world view is unimportant for carrying out effective counseling, the religious world has taken a different point ofview. What a counselor believes is seen not only as important but, indeed, as crucial in how counseling is done. The point of view of logotherapy and the point of view of the religious world are similar at this point. 
Frankl takes a fundamentally optimistic stance as a counselor. He believes that an area of freedom is present in every person's life even in the most impossible circumstances. This optimism is not a pollyana distortion ofthe real world but is a point of view that is based on a profound philosophy of life in which the person is seen as a determiner of his or her own destiny. Frankl believes this with his whole being and has demonstrated it in his own life. His optimism is in spite ofthe circumstances of life. It is caught up in the title of one of his untranslated books, the translated title of which is: Say "Yes" to Life in Spite of Everything.3 
This optimism is no arm-chair academician's orientation but is a working philosophy for the active counselor. It is an optimism which leads the counselor to throw the weight of his or her influence on the side ofthe counselee. It means an active involvement in the counseling process as opposed to a cold, objective, removed approach. Frankl, himself, plays down his own involvement with his patient, but having seen him in action many times, I know that a part of his effectiveness grows out of his willingness to involve himself in a personal way with his patients. They know that he is concerned about them, that he cares for what happens to them, and that he is prepared to go out of his way to assist them. For the pastoral counselor, such an involved, committed stance is natural. Pastoral counseling is by definition a function of the pastor, of one who takes care of the needs of the parishioner. Without apology, the pastoral counselor cares deeply for the counselee and participates with him or her in the crises of life. 
A third feature of logotherapy that appeals to the pastoral counselor is the active role of challenger. Whereas much counseling limits itself to demonstrating acceptance, logotherapy adds to acceptance the distinctive feature of challenging. Elisabeth Lukas, in her elaboration of logotherapy, is quite definite at this point: "Ifan unhealthy attitude is apparent, the therapist dares to question it and help the clients see that they have their choices ... Psychotherapists ... must challenge and argue in favor of a more positive attitude. "13 
In implementing the challenging role, Frankl is following the practice of the ablest therapists. One such person writes of the need of clients to have both "a helping hand and a pointing finger to see the situation as it is and as it may be remedied. "21 This combination of support and challenge was characteristic of the ministry of Jesus. He regularly challenged a person's usual pattern, but he did it only after some kind of demonstration of acceptance and support. The story of the encounter of Jesus with the Rich Young Ruler is instructive here. Before he challenged the over-privileged young man to "go, sell, ... give, ... come, follow" he supported him with a loving look (Mark, 10:21). 
I observed Dr. Frankl treating a woman patient in a lecture-demonstration before a group of professional counselors in Berkeley, The woman was very much overweight and was embarrassed about her appearance. Frankl's initial comments were inquiries about the degree to which her endocrine system had been checked out. Discovering that her treatments had been limited to psychotherapy, he noted pointedly the American proclivity to focus exclusively on the psychological when in such a case the organic and the spiritual approaches were both also needed. He first talked with the woman about the problems with her endocrine system. He then focused attention on her interests and the degree to which she was free to pursue these interests in order to discover greater meaning in her life, whether she was overweight or not. Here are some of the words he directed to her: 
24 
You are not responsible for your five miscarriages but you are all the more responsible for what you make out of this predicament ... To produce some children, this is not possible, but to accept this fate of bearing a distasteful organism with an enlarged pituitary -this should be an incentive for you.6 
Of particular interest to me was the woman's own testimony regarding the effectiveness of Frankl's approach. One year later, when Frankl was visiting again in the San Francisco Bay Area, I was standing beside him following his lecture to an overflow audience in a large suburban church when this same woman spoke to him. She was clearly a healthier, happier person than she had been a year earlier. She said to Frankl: "Following my talk with you, I took the first constructive step on my own behalf that I had taken in several years. "6 Although still very much overweight, her whole manner was positive and affirming. Frankl's challenge had found its mark! 
A fourth characteristic of logotherapy which reinforces the religious approach in counseling is self-transcendence, our ability to reach beyond ourselves to other people we love, or to causes that are important to us. By fixing attention on some person other than the self, or some purpose larger than the self, the needs of the self become secondary to the needs of others, and the problem of egocentricity is lessened. In American life, the thrust of selftranscendence was illustrated by President John F. Kennedy when he concluded his Inaugural Address with these words: "And so, my fellow Americans, ask not what your country can do for you, ask what you can do for your country." Frankl had previously expressed a similar idea: "We had to teach despairing men that it did not really matter what we expected from life but rather what life expected of us. "5 
In many ways self-transcendence is at the heart of both logotherapy and pastoral counseling. Just as church architecture draws the eye upward to a gothic arch, and just as religious living directs attention away from a selfcentered to a God-centered way of life, so logotherapy expands the horizons of attention and moves from narrow self-preoccupation to broader and more inclusive interests. Jesus put the issue very clearly: "Whoever would save his life will lose it, and whoever loses his life for my sake and the gospel's will save it" (Mark 8:35). 
A final emphasis in logotherapy that finds a congenial rapport with pastoral counseling is the positive value found in suffering. The distinguished theologian Reinhold Niebuhr wrote a prayer which has circulated widely in the religious world. It reads: "God give us grace to accept with serenity the things that cannot be changed, courage to change the things that should be changed, and the wisdom to distinguish the one from the other. "14 Niebuhr and Frankl are in agreement here, for Frankl has always insisted that unnecessary suffering serves no purpose, that every effort needs to be made to alleviate suffering. He also agrees with Niebuhr on the need to accept what we cannot change. Indeed, he goes even further in affirming that the very way in which suffering is faced can make for a meaningful life. 
When C. G. Jung declares that "neurosis is always a substitute for legitimate suffering, "11 he is emphasizing what Frankl has asserted. A refusal to face the fact that life is difficult, that problems are to be solved, and that tragedies are to be endured leads to neurosis. Neurosis, in this sense, is unlived suffering. Roy Fairchild, a pastoral counselor who is an able interpreter of Jung, writes: 
Neurosis can be understood as the suffering of a human being who has not yet discovered what life means for him. A person's symptoms (e.g., depression, apathy, anxiety, and compulsive activity) alert the individual that it is time to move on to the next step in his development. He finds that next step ... in becoming aware of the unlived life in him and in identifying where it is trying to move.2 
Psychiatrist M. Scott Peck begins his book The Road Less Travelled with the words: "Life is difficult."17 Frankl never underestimates the difficulties which life brings, but he puts the emphasis not on the problems but on the attitude that can be taken toward them. For the person who faces an incurable illness and inevitable death, Frankl directs attention not on the negative prognosis but on how the person can realize meaning in the very way in which the uncertain future is faced. 
In his eightieth year, Frankl subscribes to a statement he wrote long ago. By choosing what attitude a person takes to his or her fate, that person, Frankl declares, "is free -free 'from' all conditions and circumstances, and free 'to' the inner mastery of his destiny, 'to' proper upright suffering. This freedom knows no conditions, it is a freedom 'under all circumstances' and until the last breath."4 
ROBERTC. LESLIE, P H.D., is emeritus professor ofpsychology andpastoral counseling, Pacific School of Religion, Berkeley, and curator of the Frankl Library and Memorabilia at the Graduate Theological Union, Berkeley. 
REFERENCES: 
I. Allport, Gordon. "The Ego in Contemporary Psychology," in Personality in Social Environment: Selected Essays. Boston, Beacon Press, 1960, 71 ff. 
2. 
Fairchild, Roy W. "Pastor, Meet Dr. Jung." Pacific Theological Review. VII, 1975, 5. 

3. 
Frankl. Viktor E. Trotzdem Ja zum Leben sagen. Vienna, Deuticke, 1947. 

4. 
____ Homo Patiens. Vienna, Deuticke, 1950, 66. The quoted passage was translated by Donald Tweedie. 

5. 
____ Man's Searchfor Meaning. Boston, Beacon Press, 1962, 77. 

6. 
____ Lecture discussion at Pacific School of Religion, Berkeley, October 7, 1963. Frankl Library and Memorabilia. Graduate Theological Union, Berkeley. 

7. 
____ The Unconscious God. New York, Simon and Schuster. 1975, 10. 

8. 
Hiltner, Seward. Pastoral Counseling. Nashville, Abingdon, 1949. 

9. 
Holifield, E. Brooks. A History ofPastoral Care in America. Nashville, Abingdon, 1983, 328. 

10. 
Johnson, Paul. Psychology of Pastoral Care. Nashville. Abingdon, 1953. 

11. 
Jung, C. G. "Psychology of Religion," in Collected Works ofC G. Jung. Princeton, University Press, 1971, 2:75. 

12. 
Leslie, Robert C. Jesus and Logotherapy. Nashville. Abingdon, 1965. Reprinted as Jesus as Counselor, 1982. 

13. 
Lukas. Elisabeth. Meaningful Living. Berkeley, Institute of Logotherapy, 1983, 46, 47. 

14. 
Niebuhr, Reinhold. "From Life's Sidelines," in The Christian Centurv, Cl 40, 1984. I195. 

15. 
Oates, Wayne. The Christian Pastor. Philadelphia, Westminster Press, 1951. 

16. 
Outler, Albert. Psychotherapy and the Christian Message. New York, Harper and Bros., 1954. 

17. 
Peck, M. Scott. The Road Less Travelled. New York. Simon and Schuster Touchstone, 1978, 15. 

18. 
Roberts, David. P1,ychotherapy and a Christian View of Man. New York, Scribner's, 1950. 

19. 
Tweedie, Donald F. Logotherapy and the Christian Faith. Grand Rapids, Baker Book House, 1961. 


20. Ungersma, Aaron. The Search for Meaning: A New Approach in Psychotherapy and Pastoral Counseling. Philadelphia, Westminster, 1961. 
21. 
Whitehorn, John C. Foreword in Jerome Franck, Persuasion and Healinf{. Baltimore, John Hopkins Press, 1961. vii. 

22. 
Wise, Carroll. Pastoral Counseling: Its Theory and Practice. New York. Har~er and Bros., 1951.


·-·-·-·-·-·-·-·-·-·-·-•-. 
f t
You are invited to the Logotherapy event of the year: 
f THE NORTH AMERICAN REGIONAL CONFERENCE t
i i
ON LOGOTHERAPY 
i Theme: Logotherapy and Life --Purpose and Meaning in Transitional i f Times. , 
i Place: Radisson Muehlebach Hotel, 12th and Baltimore, Kansas City, i ' MO. Phone (816) 471-1400. ' 
i Sponsored by: The Kansas City Chapter of Logotherapy in conjunction i , with the University of Missouri. , 
i Program: Thirty logotherapy experiences through major addresses, schol-i ' arly papers, workshops, symposia, and panels, as well as a banquet '
i i
and Institute luncheon. 
• Keynote Address: "Dealing with the Tragic Triad: Suffering, Guilt, and • Death," by Dr. Elisabeth Lukas, director of a Counseling Center in & Munich, Germany, teacher of Logotherapy at the universities of '
it i
Munich and Innsbruck. 
• 
Banquet Speaker: Dr. Joseph Fabry, Executive Director of the Institute t of Logotherapy: "The Gifts of Logotherapy." i 

• 
Other Featured Speakers: Dr. Robert Leslie, emeritus professor of Pas-•t toral Counseling, Pacific School of Religion, Berkeley; Dr. Arthur t 


Wirth, Washington University, St. Louis; Dr. Hans Uffelmann,6 medical professor and professor of philosophy, University of Mis-6 ' souri; Dr. Edith Eger, psychologist and medical professor, El Paso; ' i and Dr. James D. Yoder, Chapter director and adjunct graduate i , professor and psychologist, University of Missouri. , 
6 Registration Fees: General $75, Institute of Logotherapy members $70, 6 , Students (9 hours or more) $45. ,
i Send Registration and Inquiries to: Dr. James Yoder, Kansas City Chap-6 ter, InstituteofLogotherapy, 1041 Holmes Road, Kansas City, MO '
i i
64131. Tel. (816) 941-0880. 
'·--· -• -• -• -• -• -• -• -• • . 
I 
Logotherapy in the Psychotherapeutic Smorgasbord 

James C. Crumbaugh 
This is largely an informal rather than a technical paper, and I am therefore writing it in the first person instead of in the scientifically objective third person. It represents the reflections of an old psychologist after forty years in the profession, twenty-five years as a psychotherapist, and twenty-two years in the clinical application of the principles of logotherapy. In contrast to General Ma.::Arthur's soldiers, old psychologists do die --but they also refuse to fade away. So, while I have retired from active clinical practice and am now participating in the training program of the Institute of Logotherapy, I still watch the passing caravan ofa smorgasbord of psychotherapeutic practitioners from occult to orthodox; and I try to analyze the common valid factors and to predict which techniques will last and which will fade with the wind. 
It appears to me that almost every system will work -and work best --for some therapists and for some patients, but that logotherapy contains a larger quantity of the factors which make for general psychotherapeutic success. Therefore I believe it is most likely to survive the ravages of time, even though it has not yet become a dominant method in any of the major psychotherapeutic circles. While there are common psychological factors in all successful psychotherapies, logotherapy seems to develop these factors more directly than any other therapy. 
It is interesting that although almost all of the competing systems claim superiority, they usually produce about the same success rates. This was indicated by the classical studies of H'. J. Eysenck, Eugene Levitt and others a generation ago, and later "outcome" studies have not changed the picture. We should also note that most outcome studies have suggested that spontaneous recovery rates of untreated patients are essentially the same as -sometimes greater than --the rates for patients who receive psychotherapy. There is general agreement, however, that many individual patients do receive great help from treatment in the cases of almost all therapeutic approaches. 
The reason appears to be that all therapies employ certain common psychological factors, even though they call them by widely differing names. I would not argue that logotherapy under its own name produces a greater proportion of successes, but rather that the successful applications of other approaches employ factors that belong to the core of logotherapy. After we analyze these factors, we may then better determine which system expresses them in the degree and fashion most likely to survive. 
We should first observe that Lukas, Crumbaugh and others have confirmed 
Frankl's finding that only about 20 percent of a typical clinical population of patients are likely to gain best results by logotherapy. Of the remaining 80 percent, a proportion can be best helped by some other psychotherapy, while another segment will respond only to medical treatment and not to the talking therapies. Logotherapy, being a cognitive system, requires substantial functioning of the higher processes of conscious experience. Organics and severely emotionally disturbed patients may not he able to function at this level, although many of these can later be helped by logoth::rapcutic techniques when cognition clear-;. But the patients who can be,t be helped b:. psychotherapeutic ,ystern), other than logutherapy an:,! contend, u~.ually rc,,punding primarily to tLc ,am,: p),ychologic..Jl factors which we are about c,Jns!der, and which are in lll\' opinion imbed<led in the tccLnique~ ,Jf'ogotl:r:::rap\ aud ·.:learh delineated in !he1hcnrctical concept> uf Iogotherap). ]t :~ 3ust th,d in these ct1ses !he cognition 1 CL.l uired t;~ rncthc,d o!Lb'-' · Uh·• rt, uch fur thern at that particu-:,;1; t1rr1c-. r~·n~nkl h:b c::11ph1L-;:l~~d th..~t Jt!~ct,~ry i~ rc:i!ly ;1ll adjunctive procc:~ L1H:. \V h.;c h d ucs ~1 dt t nnfhct \\,,Jt L;~ 1: y qf her t ht.:rap:y~ and \vhicb rnay often have 

dt .~ tirne n1or\~ conduciYc to 
: he f:'J.Llent";.; dL:1.:~iL.1.ii.: cugnlti\·1.::: ftinctii1r11ng. 
·1h,.: iollov,t1,f !in.: p,yc!,, ~-il principle~ are the nnly ones which l have ,,,)c;cncd as hm,icaiJy Lclpfui in p,ycLotherapy. They arc. I belic\'e. found in a greater or k\.,ei degtc:e 1r; all ,uccc~,cful psychotherapies: and rhey ali can be analyzed, l aim tu ~lrnw. to a substantial in the tcchni4ues of 
i,:)got111c1·~1 p:,,: 
l. Cathur.1i1. l i1io is the i~c,t known and most easily recogmzcd of the five; it 1s oft.:n rekrrcd to :b cmution~d ventiiation or ·'getting it off your chest." The procc::,, uf draw,ng t,ul the p,1tients' inm.:r fceiings. encouraging their expression "" a norrn;d p:Ft ,,l thcm:,ches, i, as ancient ;is the Greek \\-Ord chosen to rep:c:,t:nt ;t. A citlwrt,c is :1 purilying agent. :rnd psychotherapy is a mc:.ins nf emotional vent(btiPn or clean.,mg. \V,: are all famiiiar with how much it helps 1u,t ro tc1ik to ,omeonc \\ hen we have experienced an emotional trauma, such as ,he loss of a :,ned one. Fo1 this rcJson we commonly sec tu it th,1t a bereaved fncnd i, not kit a!(mc during the initial period ofloss. lfwc arc anxious, worried 01· cicpre~,cc u\er ~l,rrn: difficulty, 'AC tend to turn to our family or friends as a rneaw, of ·•r:iuwing off ste:1m." ln fact, it is a major function ofthe marital union t,,1 offer thi~ ventihttion when either partner i, feeling hlue, and failure to fulfill this lx:sic human need i~ an important cause of marital estrangement. When one er both mern bers of the coupk get so wrapped up in tbcir own feelings that they fail to respond to the needs of each other. the marriage is on Its way to the mortuary. 
So without stopping to reason why, we unconsciously turn to a listening source when emotional pressures build up within. If we have no available outlet, if we feel rejected by those to whom we would turn, we withdraw into our own shell and suffer -until steam builds up to the breaking point, and then we wind up with a psychotherapist. Almost at once we feel better, because therapists let us blow off to our hearts' content, and listen patiently --for $50 to $80 an hour. 
An Atlanta psychiatrist of my acquaintance used to say that psychotherapy 
really does only what we once did for ourselves. In an earlier day we took troubles to a friend, who might be the person next door, or our preacher, or maybe the family doctor. Now we haven't any neighbors, we've quit going to church, the physician is an automated specialist who has no time for personal gab, and we can't be sure of who our friends are -so who is left but the custodian of the couch? 
2. The second and in the long run the most important principle of psychotherapy is that of relationship, which is the close and intimately personal exchange of feelings that occurs between the patient and therapist. The psychoanalysts speak of "transference" and "counter-transference", while the existential therapists use the term, "encounter." In this relationship the patient comes to utilize the therapist as a source of emotional attachment and dependency. Most patients come for help only when their basic human contacts have so broken down that communication of deep feelings is difficult or impossible; they are thus in anxious need of someone who not only listens to and accepts their feelings but also encourages this expression and further shares his/ her own sentiments. This, of course, overlaps with the first principle ofcatharsis, but it is more than simply accepting and ventilating feelings: It requires that emotional closeness which tells patients that they are wanted, loved and respected as genuine persons, that the therapist has a real interest in them. 
The relationship is one ofemotion rather than oflogic, offeeling rather than intellect, although rational factors may serve as the common binding element which primes this encounter. It has been called "existential communication" in contrast to the communication of information, and represents the kind of relationship without words that we commonly form with children and pets. We all need at least one person with whom we maintain this type of intimacy; and when we have no other source, we turn eagerly-without awareness ofwhyto a paid therapist. 
While the therapist is skilled at inducing and sustaining transference, its psychological values are more convincing in their natural state as found in everyday human interaction. The late existential psychologist and leading logotherapist, Edith Weisskopf-Joelson, pointed out that the paid therapist works under the handicap of the patient's knowledge that the fee is instrumental to the relationship. This creates the suspicion that the only real professional interest is in getting the money; it makes difficult the belief in the genuineness of the feelings which are expressed, and destroys the sense of having a truly intimate human contact. She felt that all therapy should be conducted in clinical settings in which acceptance of the patients is unrelated to their ability to pay. There is much to be said for this, and it points up the importance ofestablishing additional relationships with nonprofessional sources where there can be no question of a commercial motivation. 
3. Another principle ofwhich the therapist makes use, even unconsciously as a result of the very nature of the professional environment, is prestige suggestion. Just as the physicians'white frock and black bag invest them with an image oflearned authority, so the psychiatrists' or other psychotherapists' solid wall of diplomas (though some ofthem may represent one-or-two-week post-graduate 
30 
seminars for which no examination was required), their antiseptic receptionist, and the office couch or chaiselongue create a stereotype of professionals who not only dare to invade but actually understand that greatest ofall mysteries, the human mind. The patient, already in need ofa dependency relationship wherein a parent-figure with authority takes responsibility and offers mystical protection in return, easily accepts even the mere presence of this person of mystery in the same fashion that an African aborigine accepts the tribal witch doctor. Here is a superior being with special curative powers which can magically erase the painful symptoms of emotional conflict, the symptoms which the patients have come to regard as otherwise incurable because they have tried without success everything from hypnotism to Hadacol. 
The psychological effect of such prestige is to reduce anxiety and tensions. This is accomplished through the fact that as soon as the patients come under the therapist's protective wing they feel no longer alone in facing situations with which they have regarded themselves as inadequate to cope and which have therefore been frightening. The fear subsides, they feel better, and give the therapist full credit, even though the latter may have done nothing more than to exercise the vested interests of the office. 
4. 
The fourth principle of psychotherapy, which usually occurs only after the operation of the first three, is commonly referred to as insight. We gain an understanding of the way we have trapped ourselves by using negative "adjustment mechanisms" which represent an attempt to escape from problems instead of facing them. As a result of repeated expression of our feelings about a given problem, and of the therapist's acceptance of these feelings and probing the reasons for them, the particular methods by which we have escaped facing-or defended ourselves against -the problems become gradually clear. The therapist perceived them long before we begin to see them, and slowly leads us around to an understanding of what has been going on within ourselves. 

5. 
Reeducation. This final principle requires previous attention to the first four factors. Assuming they have been properly handled, we can follow this final step as the means of drawing ourselves back to face the problems without running or making excuses for failure; and we can then plan new approaches that deal realistically with the difficulty in the most practical way. This is what the therapist leads us to do after we have utilized the other principles, including insight into our old, inefficient and emotionally damaging methods of dealing with problems. 


The Logo Viewpoint 
Now let us examine these five principles from the viewpoint of logotherapy and see if they are therein included. Regardless of whether logotherapists follow Lukas' four steps (as do Fabry and The Institute of Logotherapy training courses), or Crumbaugh's five steps of "logoanalysis", or one of the other systematic procedures which have been specified by various practitioners, they will almost invariably be found to incorporate all of these principles. We can clearly find them in the Introductory Course toward certification as taught by the Institute. 
Catharsis can hardly be avoided, even in the stainless steel techniques of supposedly impersonal behavior therapy and behavior modification. It becomes a part of the encounter process in existential techniques, including logotherapy. The five techniques of logotherapy (self-distancing, modification of attitudes, the Socratic dialogue, paradoxical intention, and dereflection) all bring about catharsis. The therapist listens to the client's expression of feelings, and draws them out in areas of inhibition. 
This is why the second principle is relationship or encounter. The therapeutic interview establishes this at some level in all therapies, and logotherapy emphasizes it. The Socratic dialogue particularly applies relationship in regard to the therapist, and dereflection is not complete or successful until it brings the client to establish relationships with others, creating a sense of personal identity. worth and fulfillment of what some have called the "need to be needed." 
The third principle. prestige suggestion, is a part of the logotherapeutic procedure for all who accept the philosophical basis of the system as presented in "logophilosophy" and in "the roadmap of logotherapy" in the Introductory Course. The "prestige" of logotherapy lies not so much in the diplomas on the wall but the solid philosophical foundation Frankl has laid. 
Insight, the fourth principle, is brought about in logotherapy through the techniques of self-distancing and the Socratic dialogue. The purpose of this helping procedure is to lead clients to accept responsibility for their situation, to see their rationalizations (through which they have been claiming "to be a victim"), to reject this claim and to act in a positive direction (to take the "attitudinal value," in terms of logotherapeutic concepts). And the completion of this procedure leads to the fifth and final principle: 
Reeducation (or reconditioning, in the terminology of the behavior therapies). Fruition of the logotherapeutic process will have produced a reduction of neurotic symptoms and an awareness of new life meanings with attendant goals. And these meanings, while ostensibly centered upon various life activities, will always be reflexive to the relationships established through the encounter process of the second principle: That is, we seem on the surface to find meanings in the things we do (in vocations, avocations, causes), but the reason they are meaningful is that they establish us as unique individuals and create a status as worthwhile in the relationships which we bear to other beings. We become reeducated in ways to achieve goals that we had written off as unattainable in fulfilling meanings which we have newly discovered. This process is not a separate phase oflogotherapy, but rather the result ofthe successful application of the various techniques oflogotherapy. It becomes manifest in the final phase of commitment or dedication to these new goals. And the goals bring true fulfillment through their part in the maturation of interpersonal relationships. 
Because the latter are the core of personal meaning, to find which is the primary objective of logotherapy, and because this is also the primary thread which runs through all successful therapies, I hold that Frankl's orientation is the most direct distillation of what leads to psychotherapeutic success, and that it is therefore most likely to survive the long-term assaults of the critics -even though it may never be the "main" modality of the psychotherapeutic community. 
It will be interesting to check developments against the above prediction. 
How rapidly they occur will depend largely upon how hard you as practicing logotherapists work. It can at least be said that logotherapy is "on the move." 
JAMES C. CRUMBA UGH, Ph.D., retired as clinical psychologist at the VA Medical Center, Biloxi, MS, is a regional Director of the Institute of Logotherapy. 
,·-·-·-·-·-·-·-·-·-·-·-i 
6 A PRE-CONFERENCE SEMINAR ON LOGOTHERAPY 6 J BY ELISABETH LUKAS J
i i
will be offered at the Radisson Muehlebach Hotel in Kansas City.
i Date: June I 5 to 19, 1985. i 
i Sponsored by: The Institute of Logotherapy, Berkeley, in cooperation i J with the University of Missouri, Kansas City. J 
i The seminar offers a unique opportunity for professionals, students, and i J laypeople to get instruction from a leading practicing logotherapist, ' i author of five books on logotherapy, and a widely sought teacher and i J speaker on Dr. Frankl's ideas and methods. She was the keynote speaker , • at the Second and Fourth World Congress of Logotherapy, and will give •t the keynote address at the 1985 Regional Conference in Kansas City. t 
i Pre-requirements: A basic understanding of logotherapy through the i J reading of literature or introductory seminars or workshops. , 
i i
Credits from the Institute: The seminar counts as the Intermediate Course ' in Logotherapy or, for those qualifying for the Diplomate Training, Ji as part of the advanced seminar. i 
J Fees for the Seminar: $300. J 
i University Credits: The Continuing School of Education (Counseling i J Psychology) at the University of Missouri will carry the training Ji sessions for a two-hour credit. Graduate credit: $125. Undergradu-,•J ate credit: $100. Continuing Education credit: $75. 
i Send registration, payment, and inquiries about the Lukas Seminar to: i J The Institute of Logotherapy, 2000 Dwight Way, Berkeley, CA J
i i
94704. Tel. (415) 845-2522. 
• Registration blanks for university credits can be obtained from the Con-! A tinuing School of Education, UMKC, 5100 Rockhill Road, Kansas A J City MO 64110. Phone (816) 276-1188. J 
L·-·-·-·-·--·-·-·-·-·--' 
Education for a Synthetic Planet: Logotherapy and Learning for Responsibility 

Arthur G. Wirth 
More and more we sense that our world takes on the quality of a synthetic planet. We are the designers of the world that decides our physical and spiritual fate. We are responsible as never before -· but we face our future with a worldview which denies us access to our capacities for choice-making as responsible selves. 
I shall argue that a new education is needed for the synthetic planet -an education for responsibility. The principles of logotherapy provide a perspective that can help us learn to design a world that can sustain us instead of threatening our well-being. 
First I shall say something about the concept of "a synthetic planet." Then I shall indicate how our present arrangements in schooling and work divorce us from our distinctive strengths as humans. Finally I shall indicate the value of logotherapy as a guide for an education for responsibility. 
The Synthetic Planet 
In a recent issue of Manas George Nelson introduced the idea of"a synthetic planet." He pointed out that some seven thousand years ago things began to move in the new direction. When the hunters and gatherers left the natural environment and settled down to become farmers, they cleared fields, dug irrigation systems, built villages and cities. Finally, with the machines of science and industry, the modifications became transformations. Nelson's own words convey a more vivid picture: 
"Our synthetic planet is one largely created in the past century by a mass technological society ... Today the synthetic environments are encroaching everywhere in the form of suburbs, highway networks, and vast industrial complexes ... To get the full blast of transformed urban environment one has to look at cities like Houston, Texas. 
"Houston was given its impetus by the oil industry and is already an urban wasteland of some 500 square miles, practically none of which could be attributed to any God in full possession of His senses: a chain ofasphalt 'gardens' littered with parked cars like lizards sleeping in the humid heat, punctuated by clusters of 50-70 story 'weeds' every five or ten miles. These fetid growths are strung out along cluttered highways already jammed with the rusty heaps ofjob-hungry refugees from the North, occasionally embel
lished by the stretch limousines of the new billionaires."5 The picture is familiar -a picture of technological ugliness -functionally powerful, but feeble in nurturance: fragmented, replete with irrational material sprawl and growth, rapacious in its use of land and resources, and full of antagonistic relations of alienated humans. Elsewhere I have pointed out that two institutions, basic to our survival in our era of technology -work and education -reflect too many similar features. 7 We have only to note the parallel symptoms of malaise: absenteeism, drug and alcohol abuse, hostility to authority, careless work and sometimes sabotage or vandalism. Weekly events make us aware of our self-destructive ways. The technological wasteland is injurious to our health. In the aftermath of Bhopaul some experts are urging an immediate international inventory of hazardous facilities. The Bhopaul tragedy sharpened our awareness that we are synthesizing substances of unbelievable lethal quality. At home the people of West Virginia now know that. But the outreach is global. We learn that American-supported factories have permitted liver damaging mercury exposure to workers in Jakarta, Indonesia, and in Nicaragua. The British Oxford Committee on Famine Relief now estimates that 22,500 people die each year from exposure to Western-produced insecticides such as chlordane, heptachlor, malathion, and kepone. The time of reckoning is at hand at the global level, not only for the high-tech West, but as a consequence of the accumulated stress on nature from our burgeoning human numbers everywhere. A story about Eddie Albert in the ceremonies when he received the "World Without Hunger Award" makes the point: 
He was in China, he recalled, discussing with government officials some of the problems stemming from centuries of devastation of Chinese forests and the resulting critical loss of topsoil. In a trip up the Yangtze River, he said, his Chinese hosts pointed out to him the many sampans on the river being pulled upstream by Chinese peasants. In many of these sampans, he was told, were four or five buckets of topsoil. Over the centuries it had been washed from the land and down the river. The peasant farmers had made the journey of hundreds of miles to reclaim it from the river's mouth and laboriously carry it back upstream to renew their small plots of land. Such were the harvests and burdens of environmental degradation. 1 
We know the situation. What we need most, is the reminder of Renee Dubos -that alienation and chaos in human affairs and relations have the same origin as between us and our natural environment.4 
This brings us to the quality of our efforts in the two interrelated critical institutions -work and education. Work is needed to produce survival materials. Education provides the knowledge, skills and attitudes to do the work. 
Recent critiques are helping us see that both are contaminated by a serious common flaw -the technological-fix error. It assumes that problems of all systems, material production or human learning, will yield to technical answers designed by outside experts. Behind the error is the world view, deeply endemic in the West, that the metaphor of mechanism is the ultimate definer of our natural and human environments. 
35 
"Efficiency" in Work and Education 
In work, the quintessence ofthis perspective may be found in the methods of Frederick W. Taylor. As the twentieth century opened he offered a rationale for the re-design of human work on the planet. It was a hrilliant effort to employ quantitative time-and-motion studies to produce the flawlessly efficient production system. Thinking, decision making, and creative choice-making were ,1hstracted from people at work and placed m the hands of managers and their :1::ied techniciam. The separation of de-<killed "hired hanch,. from authoritative cffic1c!lcy o:p:~rts led tn antagnnistic rclati,m,,.. and thed,:grading '.)fwork that is a ;najor \Ol\rcc of nurcconnmic malai~e ,; , we mo\e tu th1,· do,c of the century. 'n c,i11catiPn :he co1rn·,erpart ha, been to ,ccK dfici•~ncy in education by Jcfinir.g sctno:1 n g a:~ a prodnetion fu net ion. Fr:1gn1l::·~tet~ b\:.i._ t)f kDO\~:Ied~t ~1 re 
:ntn pccgrarri1., .Jin1id tc '~t:~·ure q:.-i.:intlt.!tivc result~ nn tr-·:-!'\. T<.~,·1ch;__•r~ :·:re to tt--.i::k nfllnrn~tn learn
_1:~f. iL ;.:·:~ n_:, n:-~l'H~ ~c~;tricti\c -n1casurab:c i:1pt.:ts_ ,1:1;;n)t\, h(~fi~~~.:inral c,hj:.:cti\' ·, :, ,-:·n1nr~... ,ind fnrch. i_ ..:'::: .r sc}1,.,1tJl t5 rFr.r:.,l;\,\ do\v;-: :,1 '' rTH:r,.~urahic CtJn1pnrzi..:nts cd 

[11 tn:c' \1CO,d, or(, A. Bower~. 'ihe 0rrlic 11ic,n ni ,ys;tcms th,:ory lO th:: t_cJchinr p: oces~ .. 1s likely to tn,n'-lfnrrri :,,.;af_~hn1g and learning intn t.1 rnechanlc"i po~it1'.1,tic;:illy oriented prnce~s . in effect it cre;1tes an encap,uLtted ,c.::lmologic«l universe where only 1e~hnological and managcmern problems ar,: 
.\t w,irk and ~chooi t:1e human actor·, are f()bbed of th,,ir unique humafl 
'.,J iv.: i:11,entinnal, purpo'.iin. meaning \c;:krng, qluc creatin!!. The ci ~tn:ped ·~, u•·:d c~f t/ffic1ency reduces opportunitit\ for adult~ and children tt·,, c..:pt:!;encc them~c!ve, as responsible agents. The efficiency ,:xperh thcm':elvcs (hcbm1 re~;~1<nsih1ky "\Ve arc guided only hy tlw ,mp'.:1~<Ji::d, Lompctitn,e iorct=_s ,:f the market.~~ 
· 1:c ;rn;ige may he overdrawn, htit it truthfully portr;1ys a world lurching u :,,J"J nn\ reri\s while more and rnmi:· devoid uf human re,pomib1litv 
YL't i• nc,:d ;wt he that way. 
In the past Jceades, with Viktor Frank! among 1hc kading forerunner,.,, e 
h,l\ e h·.:cn giver multiple analyse:: about the underlying phi!osophical under-· pi:,nings of c>ur harmful way,. from the frontiers nf physics to the insight< of hum:mistic existrntial psychology we are led to S(;e that the reductionist. mechanist:c mr1del from the seventeenth century has made us enemies against nature and ourselves. 
A new perspective on the nature ofthe world and the people in it is emerging. 
The hasic shift is from a Newtonian to a twentieth-century post-Newtonian world-view. Newton's genius in the seventeenth century provided a magnificent image ofthe world as a lawfully regulated mechanism. Positivist science. based on this model, combined with applied technique, became the genie that produced the mechanical marvels of industrial production. The model was so powerful, however, that it unwittingly was turned against the source that created it -human thinking and creativity. 
The fatal flaw occurred when the positivist scientific methods, that had 
unlocked the secrets of physical nature, were turned to explain human life itself. One response was scientific behaviorism. It aimed at reducing understanding of human behavior and life to the explanatory mechanistic model of the physical sciences. To retain the power of controlled experimentation of the hard sciences, humans were viewed simply as complex versions of mechanical-type conditioned organisms already under study. An image of the human person emerged in the phrase of the French philosopher La Mettrie, as l'homme machine. 
Since Einstein's e =mc2 equation, however, the world we live in takes on less the quality of a clocklike mechanism and more the qualities of a "dynamic energy transformation system." We experience the consequences, in the emerging age of computer and nuclear technology. Turbulent change becomes the dominant reality with which we have to cope. The source ofturbulent change is the thrusting, probing human mind itself -the creative human mind is the leading-edge agent of change within the transformation energy system. If adaptation to turbulent change is the primary quality for survival, then it is fatal to stay fixated on a relatively passive image of persons as l'homme machine. 
As early as the agony of Dachau and Auschwitz Viktor Frankl reminded us that it is a betrayal of the human spirit to sink into passive, zombie-like behavior. When confronted with extreme circumstances we tap our deepest capacities for creative response only as we assume the mantle of responsible freedom: the freedom to create active, experiential, and attitudinal values. 
Ernest Becker picked up the theme in The Structure of Evil. He said a fundamental task is to drop the rickety mechanical image of humans and replace it with a concept closer to the truth of human reality, i.e., the human being as homo poeta -humans as meaning seekers and meaning makers. Becker confronted the question of how humans do evil to themselves. He held that evil is created when we design structures, industrial or educational, which cripple our capacity as homo poeta to "stage our world so we can act in it productively and creatively" -structures which keep us out of touch with our power to be choice makers of values and meanings.2 
To all who have eyes to see we have arnved at the moment when the need is compelling to shift from l'homme machine to homo poeta. The deepest need for the philosophical shift is to give us an image of our true nature that will enable us to act in terms of our well-being -personal and social. I shall comment briefly about how logotherapy can help restore a saving quality to the education and learning of our young. 
Redesigning Education 
If the young enter a world of work which stifles the best of their human qualities then an education for human learning will yield only frustration. The design of a synthetic planet which supports human dignity and well-being requires simultaneous redesign of work and schooling. Fortunately we do not have to rely only on idealistic motivations to promote change in work. There are realistic pragmatic reasons pushing for salutary re-design. As one example I refer to the important ideas of Robert Reich in The Next American Frontier. 6 
37 
The underlying transforming factor of world economics, Reich argues, is the emergence of a single global market. 
The United States, Reich says, opened the twentieth century with a revolutionary mode ofeconomic production: ( I) the creation of uniform mass production techniques which could use low-skilled rural or immigrant labor, combined with (2) a hierarchical, top-down style of scientific management. 
We are now in a new "era of a single global market" which has eroded the advantages of the earlier industrialized nations. Third-world countries are employing the standard mass production techniques and, with a cheaper labor force, they can out-compete countries in the northern hemisphere. As a result, Reich argues, we have to learn quickly that the hierarchical form of organization based on the machine model of production must be replaced. 
For survival, industrialized countries must now learn to capitalize on the special strength which third-world competitors cannot match ---better educated "human capital" (human talent). More specifically it means making more intelligent use of a better-educated work force while shifting toward areas of high-technology production that are marked by new orders of complexity, and rapid change. People at work are needed who have the skills to innovate, collaborate, and solve problems under conditions of non-standardized flexible production. They need to be capable offlexible, life-long learning. In short, the need is to shift to a horizontal participative style of management that taps the brains of all the people at work. 
If our economic survival requires changes in work that honors human dignity we will need a quality of education that supports it. The present definition of education as a production function that produces a nation of nervous rightanswer givers is simply dysfunctional. 
The correction needed cannot come from technical tinkerings. We need an approach to education which will equip both students and teachers with a concept of learning related to their true nature as homo poeta. It is a model of human nature that cannot be extrapolated from the mechanist assumptions of positivist science. We need a model, now being created, that provides us with an image of our human nature grounded in both the "transformation of energy" paradigm of modern science, and the wisdom literature of religious insight. 
We can gain glimpses of the possibility. If the universe, in a deep sense, is a transformation of energy system, it may no longer be seen as a physical mechanism -with all mental and spiritual qualities inexplicably standing outside and apart from it. 
The human phenomena of love, nurturing, insight, awareness, and growth in understanding are intrinsic aspects of it. They are on the leading edge of transformation in our lives as humans. Each of us is an individual, unique, irreplaceable expression of the creative energy of the universe with its higher capacities. We are active agents, responsible for the quality of life that emerges in our corner of the scheme -on our "synthetic planet" earth. 
Logotherapy as Guide in Education 
Viktor Frankl pioneered in helping us identify our distinctive ways for being 
creators of values by tapping our highest capacities. The priority for a new education of our young must be to engage them in a kind of learning that will put them in vivid touch with these capacities. They need contact with teachers and culture models who will help them shake off the shallow motivations ofthe present: materialist consumerism and the blind will to win status and power over others -goals which are the sources of meaninglessness and the existential 
vacuum. 
To discover alternatives there is no better model than the wisdom writing of Frankl. With access to his insights students could learn that Frankl helped his patients overcome meaninglessness and hopelessness not by giving them formulas for happiness or success but by asking them to face up to their duty as human beings. To be human, he pointed out, is to have the capacity to create values and the responsibility to do so. The individual overcomes despair and finds meaning by creating and realizing values: creative values by acting, working, building, planning and executing; experiential values by receptivity toward the world in surrender to the beauty of nature or art; and attitudinal values, or the ways in which we bring ourselves to handle the unmanageable tragic situations in life. If we live from the primary concern of asking "What can I bring to this moment -this situation?" it means we can live with a sense of deep honor and respect for what is represented in ourselves and all other people. While living more and more from this base of self-acceptance we may free ourselves from the enervating need to please others, to pursue "success" compulsively as defined by the social system. 
Our essential task then becomes simply to be what we can be, to do what we can do, to honor what we see through our own eyes and to say truthfully what we see -to live authentically. And we must resist factors which exert pressure on us to live otherwise. The basic task then is always present -and always within our capacity. The image of the human being in Frankl's thought is the image of "the responsible self." 
Teachers in their work and as persons must embody the human spirit which Frankl describes. The mindless qualities in classrooms derive in large part from insipid "right answer" games in which teachers elicit monosyllabic answers to questions of Who? What? When? Where? The circle cannot be broken until teachers work from some other model. They, themselves, must be living and working from their nature as homo poeta. 
Teachers must have done more than "take courses." They must have thought their way into the significance of their subject matter. They must be continuing scholars so they can free themselves from the coverage of a text. Then they can be alert to the questions or quandaries of students, and from these get inquiries under way to guide them. To share the probings of a dedicated teacher or researcher is to learn the disciplined skills of question raising, hypothesis projecting, and data collecting necessary to test truth claims against experience. To discover the possibility of integrity under committed teachers or researchers is to have first-hand evidence that authentic truth seeking is possible. 
More than intellectual rigor, though, is required. The teacher, as much as possible must be present as a person to the students. Caring and concern are essential ingredients of a climate of trust. To free people from the feeling of being manipulated as objects, individuals must feel that there are occasions when a teacher will really see and hear them, and will be flexible enough to let them move with interests of their own. 
Teachers committed to meaning seeking will continue to experiment with their teaching styles to learn how to shift responsibility for learning to the learners. They become then facilitators rather than taskmasters. They will help individuals or groups to define their own goals and to devise means for reaching them. 
These brief sketches of alternative styles of work and education, which put people in touch with their nature as homo poeta. point clearly to how significant the thoughts of Viktor Frankl are for the needed reform. 
Frankl stood against the strong determinist theories and philosophies of the early twentieth century. He insisted we honor the capacity of the human spirit for responsible freedom: the capacity to design and create ideas and institutions in terms of our well-being; the capacity to confront the world with appreciation and wonder; the capacity to exert defiant human will in the face of unavoidable tragedy. 
As we prepare to enter the twenty-first century nothing seems more important than to nurture the learning of the young so they live from that sense of their being, so they sense their capacity to shake free from the demeaning metaphors of mechanism, so they will feel responsible for designing a world in accord with the highest potentials of the human spirit. 
ARTHUR G. WIRTH is professor of history and philosophy of education, Washington University. St. Louis, Missouri. 
REFERENCES: 
I. Albert, Eddie. "World Without Hunger Award," World Development Forum, 2 (21), 1984. 
2. 
Becker, Ernest. The Structure of Evil. New York, The Free Press, 1978. 

3. 
Bowers, C. A. "Emergent Ideological Characteristics of Educational Policy," Teachers College Record. 79(1), 1977. 

4. 
Dubos, Renee. The God Within. New York, Charles Scribner's Sons, 1972. 

5. 
Nelson, George, "Designing a Synthetic Planet," Manas, XXXV/1(45 and 46), 1984. 

6. 
Reich, Robert. The Next American Frontier. New York, Times Books, 1983. 


7. Wirth, Arthur G. Productive Work in Industry and Schools: Becoming Persons Again. Lanham, MD, University Press of America, 1983. 
Logotherapy: A Critical Component of Modern Nursing 
Patricia L. Starck 
Florence Nightingale, who is recognized as the founder of modern nursing and who gave respectability to a profession by basing it on theory and scientific principles, would be in awe of the expectations and responsibilities of today's nurse. However, Miss Nightingale's principles and precepts as practiced for soldiers in the Crimean War still form the basis of promoting health. Basically, she believed in sanitation, good nutrition, and putting the patient in the best condition for nature to heal him.2 
The nursing profession has come a long way as a result of societal changes including the Women's Movement, consumerism, and the rapid exploration of technology. The nurse of today must be a patient advocate, a collegial team member, and a coordinator ofa complex array of patient services. The realm of nurses is health restoration and maintenance whereas the physician focus is on pathology or disease. 
Futurists predict an even more complex role for the nurse of tomorrow. By the year 2000, society will present different challenges to health professionals. The increasing number ofelderly will mandate innovative, cost-efficient healthcare strategies which will mean less institutionalization and more care in the home or ambulatory setting. Nurses are in a unique position to meet this challenge. As these changes emerge, new types of care will be introduced and marketed to attract consumers or the lay public in need of health care. Nurses will offer their services in private practice, in group practice, and in collaborative practice with physicians. Patients with chronic problems such as diabetes or spinal-cord injury will have a nurse to help them adjust to daily health needs and foster increasing quality of life through a long-term nurse-patient relationship. 
The rapid escalation oftechnology in the health-care industry will continue to demand the skills of well-educated nurses. In fact, with the trend toward de-institutionalization for health care, the hospitals will become more like large critical-care units with only the severest cases admitted. Emphasis will continue to be on cost containment as limited resources must be allocated in as equitable a manner as possible. 
Challenge for Tomorrow 
The role of modern nursing and the challenge for tomorrow will be in four areas: prevention, health promotion, illness care, and rehabilitation. To be effective, nurses must assist patients/ clients to find meaning and purpose in life in order to generate the energy necessary to work at achieving an optimal level of health. 
In monitoring individuals to modify lifestyles in order to achieve health, nurses must often help people find meaning in sacrificing. For example, patients who want and need to quit smoking see themselves as giving up an immediate pleasure for some nebulous long-term reward. Behavior modification may yield results, but they may not last. Instead, if the approach is taken that the patients are responsible for their life and health, nurses may decide to place less emphasis on the patients' desire to smoke, and instead concentrate on their desire to enjoy their grandchildren for a long and happy life. Nurses often are known to give advice, even to the point of nagging: "You should quit smoking; smoking is very bad for you." A logotherapeutic approach would encourage the patients to choose their own attitudes: "What can you do to promote a long and healthy life so that you can watch your grandchildren grow up?" This approach incorporates Frankl's three ways of finding meaning: a task to be accomplished, an experience to be enjoyed, an attitude to be adopted. 
Traditional Roles 
Care of ill patients has been the more traditional role ofthe nurse. In this role, Frankl's concept of suffering can be useful. Frankl compared suffering to the behavior of gas in a chamber. No matter how much or how little, it fills the entire chamber. A nurse will encounter various responses to suffering~· anger, hostility, rebellion, guilt, stoicism, or others. In a logotherapeutic approach, the nurse can help the patients focus on the meaning of the suffering experience in their lives. They can be assisted to focus on what they have learned about life and how the suffering experience has resulted in growth in character. As Frankl purported, suffering can be a movement in one's life, something that cannot be erased and cannot be taken away. To help patients cope, nurses may find Frankl's concept of the noetic dimension or the dynamic power of the human spirit as a helpful focus. 
Nursing staff in a hospital have a 24-hour per day responsibility for patients and therefore have opportunity to build a close therapeutic relationship. In critical care situations, nurses are on the scene and are the ones to detect early problems which can be life threatening. For example, the physician performs the intricate surgery of heart transplantation but without good nursing observation to detect early signs of hemorrhage and to institute immediate action, the patient could die. The nurse's role of dealing with such constant pressures and heavy responsibilities without a large measure oftangible rewards may result in frustration and a sense of helplessness. In my observation and testing of nursing students, they score high on the Purpose-in-Life test1 indicating a sense of mission and purpose to their lives. This attitude is no doubt a key factor in being successful in nursing. 
Nurses in a hospital setting must confront suffering and dying on a daily basis. In a recent study3 hospitalized patients were interviewed about their beliefs as a result ofsuffering experiences. When asked what nurses could do to help, patients gave far greater emphasis on interpersonal action, such as listening or giving encouragement than on physical action, such as a back massage or giving medication. Data in Figure I substantiate the importance of the personal interaction between patients and nurses. 
Rehabilitation 
Rehabilitation is another domain of nursing care that, while important in the past, is likely to be ofeven greater importance in the future. Here, logotherapy's emphasis on attitude can be invaluable as the key to success. Frankl's premise that life challenges us is never more evident than in cases of spinal-cord injury, amputation, and other permanent debilitating conditions. Helping the patient find meaning in such an experience is probably the greatest challenge a nurse can face. The nurse must assist the patient to adopt a positive attitude toward a fate that cannot be changed. 
In conclusion, logotherapy and its precepts can be critical components of modern nursing which focuses on challenges in prevention, health promotion, illness care, and rehabilitation. Nurses who practice logotherapy have a sense of purpose in their own lives which gives some immunity against burnout. Future nursing roles will focus more on care in the homes and community as opposed to hospital settings. Without the support system and auxiliary services of an institution, nurses \Vill be more autonomous and self-reliant. Logotherapy as a useful framework for nursing practice can help to assure success in patient interaction. 
PATRICIA L. STARCK, R.N., D.S.N., is dean of the School of Nursing, Health Science Center, University of Texas, Houston. 
Figure 1. Nursing Actions Suffering Patients Find Helpful 
(Meaning in Suffering Test. Starck, 1983) 
Physical Interpersonal 
Exercise Talking Making sure equipment is Medication Giving Encouragement close by Bathing/ Shaving Caring/ comforting Offering pillow Change Position Being nice and considerate Giving support Putting pillow under back Listening Consolation Comfort measures Showing concern/interest/ Showing a true interest Come when I call openness Understanding attitude Massage/ Backrub Empathy/compassion Jokes Checking on me Touching Holding my hand Feeding me Smile, kindness Being sociable Giving water or food Verbal reassurance OK to cry Monitor closely An extra cup of coffee Not talking loud 
Presence Being polite/ helpful Giving instructions Undivided attention Explaining what to expect Not being snappy Willingness to share Bragging on me when Gentleness/ patience do something good Cheerfulness Keeping me occupied Not fussing Cheering me up Asking about pain 
REFERENCES: 
I. Crumbaugh, J. C. and L. T. Maholick. Purpose '>( life Test. Munster, IN, Psychometric Affiliates. I 976. 
2. Nightingale, F. Notes on Nursing. London, Harrison, 1859. 
3. Starck, P. L. "Patients' Perception of the Meaning of Suffering." The International Forum for Logotherapy. 6(2), l 983. 
Rehumanizing University Teaching 
Mignon Eisenberg 

Educators see a twofold task: the didactic transmission of facts and the traditional transmission of rules and values. 
Frankl has always seen the educational role of logotherapy as neither of the two. Values cannot be taught, they must be lived. Meanings cannot be given to students. The only thing teachers can give is their personal example of their own dedication to a great cause of research, science, and truth finding, I .r. 57 Frankl sees the task of education to sharpen the students' "inner ear" to listen to the voice of their conscience which, in our age of crumbling traditions, does not always agree with societal rules and values. Education must encourage students to listen and to obey their conscience, but to obey it responsibly. 
These ideas are slow in entering the main stream of education. Yet, logotherapy is beginning to be taught in various countries, in the United States, in Europe, in Latin America, in South Africa. 
I have taught it, for four years, in Israel, as guest lecturer at Tel Aviv, Haifa, and Jerusalem universities. 
Logotherapy as a special course proved to be a success beyond expectations. And it has resulted in the demand for training workshops for professionals and lay workers in the helping professions, as well as for lectures and seminars to people of many disciplines and age groups: social workers, school counselors, teachers, pre-and post-retirement counselors and group leaders, employment counselors, prisons personnel, nurses, doctors, psychologists, teachers, widows, spouses of professionals, manpower groups of health insurance companies, hospitals, kibbutz representatives dealing with aging, workers in intergenerational relations, student groups, martiage counselors. Most of these activities were sponsored by universities in their continuing-education programs. 
The growing demand for logotherapy and logoeducation can partially be traced to: 
• 
The innate spiritual quality of healthy persons, responding to the call for ideas and ideals, feeling affirmed as valuable, searching human beings, and gratified in finding their innermost yearnings validated by scientific theory. 

• 
The prevailing climate of existential despair and frustration, confusion, burnout, indifference, boredom, alienation from society and self, with people of all walks of life ridden with anxieties and fears, anticipating future shock, joining cults or drug subcultures in search for an anchor in their floundering lives. 

• 
The revitalizing and rehumanizing attributes oflogotherapy, conveying an uplifting view of the human being, not as a pawn or victim, but as a fountain of power, self-determination and self-worth, a compass to coping and survival. 


Frankl's Man's Search for Meaning and Fabry's Pursuit of Meaning we used as textbooks. Students were encouraged to also read other books < logotherapy, and to bring to class newspaper clippings reflecting aspects "logotherapy in action," especially self-transcendence. Different aspects of ti subject were discussed, with students giving presentations and demonstratio1 in the latter part of the semester. 
I saw my mission as educator and logotherapist not in indoctrinating, but, educating students and workshop participants to educate themselves, to refir their spiritual resources. The emphasis was on unlearning destructive assum1 tions and attitudes and negative self-fulfilling prophecies, by raising student consciousness to heightened self-awareness, self-examination and self-wort! To enhance the effect of logoeducation, which I see as training in lift effectiveness, participants were sensitized to the deepest springs of their persor alities, to the child in themselves, to the wisdom of their hearts harboring th seeds of creativity. 
To become ready for learning and living logotherapy, the inner freeze o genuine feeling which precedes cognition must be thawed. We approached thi goal of raising awareness in various ways, each of which was explained am discussed, so students and workshop participants can use all approaches respective instruments, and new skills with their present and future clients. 
l) 
Personal history forms. At the first session, students were handed a 3-pagt questionnaire to complete at home, containing demographic information, ai well as personal questions promoting self-exploration and tuning in to earl) significant memories and persons. It contained questions such as "What did your mother /father always say? What is the best/the worst thing that happened in your life? What do you most want to know about yourself? What will your friends say about you at your funeral? If they were making a movie about your life, what would the title be?" 

2) 
Introspective papers. At the second session, students were asked to write a "profile" of 3 to 5 pages about themselves, divided into three themes: Intrapersonal communications, inter-personal communication, and social commitment. These profiles were returned to them at the third session with handwritten comments on the margins. Toward the end of the course, students handed in a final integration paper, "Logotherapy and I," addressed to the same themes, yet -four months later. This new "profile" of 5 to 7 pages was to incorporate lectures, presentations, readings and group experiences, as well as any outside learning sources. 

3) 
Breathing and meditation exercises, autogenic training, and guided as well as unguided phantasies, at the beginning or end of most sessions. The importance of proper diet and vigorous exercises outside the classroom was stressed and discussed. 

4) 
Experiential group encounters, alternate list making, games and exercises. Often the class was divided into small groups, so the students could discuss and evaluate the respective experiencing and exercises amongst themselves, sharing feelings and reactions, constructively confronting one another. 

5) 
Project life review/ oral history taking. Each student was to interview a person older by at least one generation, over 5 to 8 weeks, one hour each week (taped if possible) and to prepare a written, comprehensive report and evaluation for the end ofthe course. Sample questions and directions were distributed. Sample questions: What advice can you give me? What would you do differently could you live life over again? 

6) 
Case presentatiom, brainstorming by the entire class. Students were invited to bring and role-play conflicts and case studies oftheir friends or clients. Personal problems were often presented and ways of solutions explored. 

7) 
Individual brief conferences with each student at least once during the semester. which often turned into counseling sessions. Students had my private phone and address. 


Students, workshop and seminar participants were given learning opportuni
ties where human values came into play, fostering their penchant for becoming 
more human by learning survival skills: Love, trust, acceptance, diversity, 
dignity, creativity. compromise, tolerance, understanding, listening, reverence, 
moving from dependence to independent thinking, dependability and interde
pendence, accepting polarities in themselves and others, discovering their ability 
to change situations by personal decisions and to accept fate by modulation of 
attitudes. 
It was rewarding to hear students voice Albert Schweitzer's view that "good 
fortune obligates." They had become aware not to take good fortune -·-outer 
happy circumstances, health, intelligence, freedom, capacity to work -~ for 
granted but to use it to help others. It is an obligation to repay the world. This 
attitude inspires others to rethink their lives and do likewise. 
The time has come to revolt against a value system that places pleasure, power, and material goods at the top, and to replace them by responsibility, commitment, and meaning. Logotherapy cannot be expected to bring about this revolution alone. But it can set in motion the rehumanization of values. The proper place for this to start is the rehumanization of education. 
MIGNON EISENBERG, Ph.D., isa National Certified Counselor, director of Human Development Facilitators, Chicago, regional director ofthe Institute of · Logotherapy, and a licensed logotherapist. For the past four years she has been 
a guest lecturer at l5raeli universities. 
REFERENCE: 
L Frankl, Viktor E. 'The Task of Education in an Age of Meaninglessness" in New Prospects for 
1he Small Aris College, Sidney S. Letter, ed. New York, Teachers College Press. Columbia 
University, 1968. 
Logotherapy's Impact on Counseling 
the Executive 
Frank E. Humberger 
I remember my first words at Seminary after coming out of the executive's money jungle: "How lucky I am now that my only deadline is a paper or a test: No more sweating it out in industry where each month's end was a frantic drive for the 5 percent additional gross business that would assure all of us a pay check." Just making money was meaningless to me. Rut making money for a profit and payroll was a necessity. Being responsible to my 75 employees was a meaningful challenge; the necessity of making money to he responsible was debilitating. 
Twenty-two years in that j unglc taught me that 1he "ends" arc profits. I was judged a success or a failure by that standard. The "means," or tools, in that pursuit are power and money. Twenty-eight years in the counseling field have taught me that the ends arc personal growth, the means are education and training. Both sets of means require stamina, courage, endurance, integrity, interpersonal skills, and dedication. Both are vital to the survival and growth of humankind. Each is exciting to its respective adherents. Those who, by their own choice, stay in the power-and money-jungle all their lives, gain personal satisfaction in meeting the daily business challenges. Those who, by their own choice, stay in the human sciences field live fulfilling, meaningful lives, in serving humankind. 
As an executive, I believed I served humankind in that most basic need of survival. I risked my small savings, with those of my mother's, to provide "men, money, machines" to make a profit which would assure another month of operation, another month of food for my employees, another car for some of them, and a unique product for General Motors. 
To motivate everyone to work as hard as I did, I established profit sharing, which 1 called "religion-in-business." A board was elected from the plant to make all major personnel decisions. Not only was the plant producing quality at a cost, but it was also doing it with the tools of humaneness, of sharing the responsibility for fairness and honesty. For example, when one of the supervisors who had recently left the plant, wanted to return to her former position, her previous subordinates complained to management that she should not be allowed to return under profit sharing because she had betrayed the plant when she quit by taking three women with her to a competitor. She was appraised of this, admitted it, was reinstated on the employees' terms. Morale hit a new high. Fairness and holl-:sty go with profit sharing. 
Making profits while keeping human values is possible in profit shari:, .. Bockmann I points out the need for balance of money and meaning in any organization. This indicates that perhaps I was a "Franklian" in 1949, eighteen years before I met Viktor in Vienna in 1964! Viktor Frankl has meant a new thrust for me in my concern for the executive's life/ career meaning. I used profit sharing to get employees to work hard and then incidentally discovered a new community, a corporate spirit of project-entrepreneurialism -much as is the corporate life style of today. 
Thanks to my intuitively being a logotherapist 40 years ago I gained the insight to seek out Frankl after reading his book, The Doctor and the Soul. Thus began a new direction, a transition from "making money" (primarily) and "doing good" (secondarily) to "doing good" (primarily) and, if it happens to follow, "making money" (secondarily). Success and failure were now gauged with a reversed sequence of standards. 
Whereas power and money are the tools for making money, education and training are the tools for doing good. I have been educated and trained as a logotherapist who can do good with those who make money. I have learned self-distancing and attitude modulation. Each ofthese logotherapeutic tools has had a profound impact on my life, and on the lives of many of the 500executives I have counseled over the past 22 years. 
Self-distancing 
One of the questions we career counselors ask is: "Dream a while -what would you really like to do as a career?" To answer this, the executive has to stand off to self-distance, and analyze strengths, weaknesses, needs, and values, and finally wants. It's possible to have strengths as a marketing manager, for example, but to have burnt out in that capacity, and say, "I don't really want to use these strengths any longer." One executive -a terminated bank senior vice-president burnt out by 25 years of financial manipulating -when faced with this question, dreamed of running a boat-charter business in Tahiti. The counselor took him seriously, helped him self-distance to recognize strengths and weaknesses (including the fact he did not know how to sail), and counseled his wife about such a move. This executive never did make Tahiti, but did find a rewarding management position as a developer of a marina and, though this was not his primary goal, made more money than he had been making in the bank. 
Frankl's self-distancing can be combined with self-transcending. A 47-yearold marketing vice-president, in pursuing his self-distancing, decided he had always wanted to be a president of a small to medium-sized corporation. As he further pursued this, he discovered a "strange voice" within him with the haunting question: "Is this enough for you: Does it answer your real quest in life? Do you remember once when you said you'd like to make a lasting contribution to life?" J n college he had had a dream of being a great philosopher or a minister, so he now took the self-transcendent jump and investigated the ministry. The counselor asked to meet with husband and wife, during which meeting the executive's wife negated the decision: "You've not kept any paying job for more than 10 years -and now you want to go into a nonpayingjob just when our daughters need money for college! Go into ministry, but you go without me and the kids! J'11 find a man who keeps a paying job." Selftranscendence had been negated in favor of immanent reality. Harry had to find other ways to make a lasting contribution to life. He took a vice-presidency in marketing but with the awareness of a new self that reached out to others in self-transcendence. 
A more direct case of self-transcendence concerned a 55-year-oid manager who was given early termination in a corporate crunch. His dream had always been to be of service to older persons. His mother had taught him to help old people, one of whom she was herself. But marriage, children, and economic necessities had driven him into corporate managerial work. He said the termination was a "call from God" (mother?) to serve the more needy. He set up a repair shop in his basement, solicited neighbors, and soon had customers beating a path to his basement door for his half-price work. He is now doing lots of good and making a satisfactory profit. 
Paradoxical challenge is effective with obsessive-compulsive perfectionists, such as Daryl, a 35-year-old upward-mobile sales manager who had been told by his father to "aim for the top" and "cover all bases on the way." Daryl made some mistakes which had caught the eye of top management. They decided that Daryl was not ready for the fast track. Daryl blamed a fellow executive who, he said, was "after his job." He became extremely depressed, and so angry that he "could kill that man." When the counselor asked him how he would do it, he said, "with my 357 Magnum." The counselor agreed that this would do the job, and asked how soon was he planning the murder? Daryl, puzzled, looked up laughing: "You don't mean it, do you? I wouldn't do anything like that. ""Then how?" pressed the counselor. "This is ridiculous, now let's get on with something else," Daryl requested. This glimpse of paradoxical intention with its use of humor gave him confidence that the counselor was on his wave length. He started pouring out his guilt feelings about an earlier near-homicide, and how it had haunted him to the point of immobilizing him in his present decisionmaking. The confession released his human spirit from the guilt prison. Daryl was now ready to challenge reality, to do "something creative." He analyzed his corporate position, determined that he must leave, and obtained a fast-track position in another firm. His guilt feelings, his blaming, his hostilities, and his depression -were behind him, thanks to a few moments of the paradoxical challenge which freed his spirit to challenge reality. 
Defiant Power 
The arousal of the defiant power ofthe spirit was necessary for a 50-year-old chief executive client whose spirit had become "mired down" through eight years of psychiatric analysis. It had made him look for "something to surface," to give him the "aha" experience from his past. Such therapy had lowered his self-esteem, developed broken family relationships, caused peer disrespect, and an unhealthy case of mea culpa, with consequent distrust of everyone. 
The logotherapist must be careful with such compulsive psychologizers not to make a negative paradoxical approach, because their distrust oftherapy is high. For example, we cannot suggest to such clients, "Tell us how awful you are," because they may think we believe their low self-esteem. Rather, we need to suggest at least one positive factor, such as, in the case mentioned, "you are a moral person, so you are capable of being responsible to yourself and those around you." This came as a positive suggestion picked out of the many 
49 
psychologisms he had been exposed to. His spirit, looking for release from psychologisms grasped at this straw and reinforced him between sessions: "I am a good man ... I can get out of this." At a later session he said, 'Tm feeling in-between --between what I was and what I can be." Frankl has taught us that this is the power of the spirit lifting us up in our search for meaning. What else but the defiant power of the human spirit has this force? By attitude modulation, ever so gently employed, this man, years ago strong, then dehumanized by analysis, was on his way to growing stronger than ever. His old ally, his spirit, again is in charge of decision making. 
Attitude modulation is a creative tool in counseling the executive. Executives develop low periods, even sometimes apathy and boredom -wondering, for example, why they should go to work in the morning. They tend to live split-level lives, as one executive said: 
At work I say to the world how great I am and my product is the best ---while my gut is producing ulcers. At home I struggle for those few precious minutes to be accepted as a person, while knowing damn well that my worth lies only in my paycheck. 
Mary, a 29-year-old black, a specialist in personnel training, could not hide her boredom, and was terminated. About 50 percent ofsuch terminations come as a result of the employee's setting it up, either consciously or unconsciously. Mary "set up" the termination so as to get into counseling to figure out her next move. At the same time, her male companion had just left her. Her self-esteem plummeted. The counseling included career tests and resume-writing -but to no avail, as she continued regressing. I applied a special version of attitude modulation, promoted by the "as if' technique, and combined with dereflection. I said: "Mary, act as if you were an accountant, a salesperson, a manager, and so forth." I role-played simulated job situations to bring her mind into the present. As a follow-up to each role play, she did some informational interviewing in the field, thus keeping her mind and body activated. In this dereflcction process, she found a vocation in technical sales that had always been a hope of hers -one about which she had forgotten. Now she was integrated at work: Being and acting were at-one: At home she reconciled the loss of her man as understandable in view of her former negative, apathetic attitude. 
A special version of attitude modulation and paradoxical intention was employed with Ben, age 43, an accountant who, because of his efficient methods had worked himself out of his collections specialist position. His corporation had no new position for him. He was a perfectionist who had "failed." I explained that, contrary to failure, he had been quite successful, and thus success was the reason for his termination. Such explanations were useless. He grew increasingly depressed. Then I suggested Ben exaggerate his negative position: "Suppose you don't get a job for a whole year, or maybe even two years, what will you do?" Ben, the perfectionist, in spite of his anxieties, knew this was ridiculous because he had too many talents for this to be reality. He chided me for even suggesting this. This paradoxical wish ofthe fear released the fear and brought him to reality. He tackled the career counseling process with the ferocity of the perfectionist that he was. Within a month he had a new position. He had learned that he need never again fear reality. 
Dereflection lowers hyperreflection. George, a terminated high level municipal executive, was a practicing Christian, but neither prayers nor Scripturereading helped the counseling process. My usual self-esteem build-up through attitude modulation or positive thinking failed to ease the fast developing hyperreflection "depression trap." I finally led him to see an "interim" solution: I've got to do something -I can't sit here and stew while waiting for a job to come along." High-level positions need to be chosen carefully, often requiring a long period of investigation. This was waiting time that George could not tolerate. He got a part-time, interim job which kept him busy while waiting for that "right-job." He began to sell articles door to door. Tension left, a sense of well-being engulfed him: "Look, I'm really OK, my new boss wants me, and I'm doing well.'' He confirmed a belief in himself that he would probably do well any place he worked. He was bright, hard-working, and administratively articulate. But termination can cause a slide downward into the hyperreflection. The anxiety in this case was broken by dereflection, "doing something," even if it did not employ all of George's talents. 
Paradoxical intention strengthens the capacity for self-distancing, while dereflection turns the patient's attention away from something negative (the problem) and toward something positive (a person, a cause, a meaning). Attitude modulation strengthens the defiant power of the spirit and builds a positive attitude in the person's will to meaning. 
Here is a list oflogotherapeutic methods as they were applied in counseling an alcoholic executive named Terry. 
ATTITUDE MODULATION 
1. 
Abstinence. Alcoholism, a physical problem, has to be fought at the start with physical detoxification. Except for two short periods of his 37 years between ages 15 and 52, Terry had drunk liquor, wine, or beer, or all three, every day of his life. Detoxification was supported by the logotherapeutic efforts mentioned pelow. Results of his abstinence included hands not shaking, stomach not bloated, morning anxiety disappearing, eyes becoming clearer, restful sleeping, no sweating at night. 

2. 
Self-esteem building. These physical improvements had a feedback effect on his spirit. His improved self-image led him to discover worthwhile traits, interests, values, purposes, "causes." 

3. 
Reality dialogue. While "abstaining" and "esteeming" it was necessary to balance his life with "reality." This was accomplished by numerous written exercises covering some critical incidents, followed by in-depth discussion of their meanings. · 

4. 
Mobilizing the defiant power of the spirit. He was made aware of the resources of his spirit, especially his conscience where he could take a stand against the years of teachings of guilt through mother's and wife's and society's "rules." Because he was a devout Christian, these positive values were furthered not only through counseling and exercises but also through prayer and study of Holy Scriptures and Christian authors. 


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DEREFLECTION 
I. Intensive assignments. These assignments kept Terry so busy he had little time for brooding. In fact, they exhilarated him: "I can weep only so much ---I am beginning, after hours and weeks. to feel times of a rush of joy and pride, pangs, hurt, loss, stumbling --also times when experiences of sustained stupidities can evoke only laughter." 
2. A study ofpast incidents n_f"right "and"wrong, ""judgments, ""hostility." 
He was asked to apply these experiences to present and future life decision making. Such decision making takes old data and emotions and puts new interpretations on them. This dereflection promotes self-transcendence from the old to a new self. 
3. A detailed analysis ofguilt and obli!;ation. Because guilt and obligation had operated negatively in Terry\ life for nearly 50 years and because he wanted a "'nev. life" 1t became imperative to clarify their source. The source lay in mother's rules fort heir own (mother's) sake, defied by the rebellious kid coming down on his mother. The usual scenario: kid becomes hostile to mother for causing guilt, mother says "now don't be a willful little hoy," criticizing not the acts of defiance, but the attitude of defiance, so kid placates, is sorry, and furious. Terry had an opportunity to witness this dynamics (during our counseling period) while developing a companionship with a 47-year-old woman. She intimidated, he acquiesced much against his "will" (conscience?), started feeling angry, she chided, he placated, she lectured, he became infuriated, but because she was a "good woman" he bit his lip. The acquiescing was the breaking point. He learned to hear the voice of his conscience. 
PARADOXICAL INTENTION AND HUMOR 
I. Facing the fear. During the "reality dialogue" the counselor was ever alert to the "aha's," particularly within the hostility incidents. These moments distanced Terry from his history of failures, giving hope for the future. He still needed to break the cycle of fear. "Why do I need to be afraid of guilt and obligation when I see it so clearly?" We had occasion to test this fear with his woman friend. When she bullied again, Terry faced the bully, with humorously exaggerated fear in his heart. The result was different from regular paradoxical intention, but beneficial nevertheless. The woman dropped the relationship! By facing the fearful, Terry had rid himself of this intimidating woman. 
2. 
Facing, not avoiding. Terry faced the woman's guilt-and obligationproducing ways square-on: no lip-biting, no placating, no "fix-it" reaction. Terry, following the counselor's suggestions, listened intently for a few moments, then said, smashing fist against his open hand, "NO!! I'm not going to put myself into any more of those situations." 

3. 
Terry s laughing at his years of reacting rather than acting, became a commonplace experience in his counseling process. Note above: "experiences of sustained stupidities can evoke only laughter." We counseled intensively for four months, and month three became integration month, during which time Terry separated himself from his previous self-isolation, from guilt and obligation servitude, and from a rebellious willful lad into an outward-looking adult. 


He was now ready to search out vocation, family ties, and life-purpose. 
FRANKE. HUMBERGER, Th.D., is chairman of Executive Services Associates, Bellevue, Washington, and a certified logotherapist. 
REFERENCE: 
I. Bockman, Walter. Sinn-urientierte Lei1ungsmu11vation und Mitarbeiterjuhrung. Stuttgart, Enke. 1980. 
Logotherapy and Buddhistic Thought 
Hiroshi Takashima 

When I first read Frankl's Man'.s Search for Meaning in 1955 I was impressed by several of his precepts that coincided with age-old Buddhist thought. 
One was his concept of human nature as a totality of three dimensions -the body. the psyche, and the spirit. This corresponded to a 300-year-old Japanese idiom that conceives the human person as a three-dimensional unity. The Japanese terms ofthese three dimensions are Shin, Gi, and Tai. Shin stands for the human mind that cannot be analyzed by the scientific method. It means "awakening," "self-knowledge," or "wisdom," and corresponds to the human spirit as the term is understood by Frankl. 
The term Tai means body and corresponds to the somatic dimension. 
Gi is a concept that lies between Shin (the human spirit, or mind with freedom) and Tai (body), and can be translated with "technique" and also with "brain function"which corresponds to Frankl's psyche (mind with no freedom). Lying between the concepts of spirit and body, Gi combines the physiological and psychological dimensions as Frankl sees them. These parallel concepts are discussed more fully in my book Humanistic Psychosomatic Medicine. 2 
Why Versus How 
The second similarity between Frankl's and Buddhist thought lies in his emphasis on the "how" rather than the "why." 
When he was forced to live in the concentration camps, he found that most inmates asked in desperation, "Why? Why am I here?" Frankl, realizing that they had lost all they possessed -material things, reputation, friends -and what was left was what they were: human beings with their human spirit, their healthy core. In this unchangeable situation it was useless to ask, "why." What led to an answer was the question of "how." "How can I live in this situation?" The "why" is oriented toward the unchangeable past, the "how" is directed toward the future where there is still freedom, at least the freedom of attitude. 
Frankl's emphasis, in his logotherapy, also is on "what is left" instead of on "what is lost." The latter represents the Christian tendency of thinking (going back to the idea of original sin with the consequence ofguilt feelings), while the question of "what is left" represents the Japanese Buddhist way of thinking. 
In most Western religions, God resides in the supranatural dimension, while human beings, as well as all animate and unanimate objects dwell in the natural dimension which humans can explore and use. In Japanese thought, Buddha, humans, animals, plants, and nonliving things such as rocks are all united in one dimension which is called "Buddha nature." 
For Christians, God is the Creator of nature and humans (the ultimate beginning), and for Buddhists everything becomes the Buddha at the end (the ultimate end). In both cases, the "ultimate" cannot be discussed by the scientific or any other method. But an existential approach is possible. Western people, influenced by the Christian way of thinking, say, "A man has two legs. "This is a statement of possession. Then they ask why a man has two legs, and the answer is that God has endowed him with two legs so he can walk. There is a purpose in having two legs, and when this purpose cannot be fulfilled there is sorrow. 
Japanese people influenced by Buddhist thinking, however, say "In a man two legs are" (translated literally). This is a statement of being. It expresses the idea that one should accept things as they are and that the reason "why" they exist is beyond our ken. When we know that two legs exist as part of the body, the important question becomes: "How can I use them?" rather than "Why do I have them?" The emphasis is not so much on purpose but on value. 
Generally speaking. Christian thinking emphasizes a state of possession, so when we lose something we think "how much is lost." In constrast, Buddhist thinking emphasizes a state of being, so when we lose something we think "how much is left." The attitude of"how much is lost" leads to a reflection about the reason of the loss, a tendency to think, "what should I have done," and leads to a feeling of responsibility for an unchangeable past, and guilt. We can overcome these feeelings by a strong will power in our spiritual dimension. However, when this proves too much of a burden, we may develop a depression. 
The attitude of "how much is left" leads to a feeling of thankfulness, emphasizing "what still could be done," and promotes a calmness of mind, although this may lead to a lack of initiative. 
To illustrate this difference further: When Pope John Paul II was shot and nearly died, the first words he uttered were "Why me?" In contrast, a Japanese priest who nearly died in a car accident said, when he realized he was still alive, "How can I live tomorrow?" 
One of the most widely used logotherapeutic methods is the modulation of attitudes, especially in cases where patients face the tragic triad --unavoidable suffering, guilt, and death. The patients are led to change their attention from the "why" to the "how," from an unchangeable past which has become part of our "fate" to the future where we still have the freedom of choice. 
Living with Disease 
The third area of similarity between Buddhist thought and logotherapy is the Buddhist concept of "living with disease," accepting the unavoidable. I have discussed this more fully in a chapter in Logotherapy in Action. 1 
If patients suffer from an incurable disease, it is useless to fight against it because it will only cause more stress and may make the illness worse. It is better to live with a disability, to "make friends with it," as it were. This I have done in my own life. Some 36 years ago 8 ribs were removed and one of my lungs completely collapsed. I have learned to live with this condition which includes dizzy spells as a result of large doses ofstreptomycin injections. As a physician I have a task to perform and a commitment to my patients which has helped me overcome (dereflect, self-transcend) my condition. In fact, I have gained by my illness. Because I could not do any physical work, and especially sports which took a great part of my time in my youth, I concentrated on studying medicine as well as philosophy, and my life has become richer. 
When I read Frankl's books I came across a sentence, saying, "Every illness has a meaning." This sentence intrigued me and was part of the reason why I visited Frankl in Vienna in 1964. and started to make logotherapy part of my life and work. 
HIROSHI TAKASHIMA, M.D., Ph.D., is executive director of the Japan Chapter ofthe institute ofLogo therapy and president ofrhe Society of Humanistic Anthropofug;. He is a practicing physician in three clinics in Tokvo. 
REFFRE;\ICES: 
TaL.,,himc,, Hiroshi. "Living with Disease." in !,n1;orhera;n in Acrion. Fahry et ai, eds. ;\v,,ilal--le fr<1m the Imtnute of Logotiierapy. Originally puhlished in New York. Jason Aromon. 1979 
2. _____ Humanis111 PsFho.1mni11ic Medicine. Berkeley. Institute of! ogotherapy. 1984. 
The Promise of Logotherapy in the Socialist World 
R. E. Stecker 
In my experiences with logotherapy, my clients and I myself have benefited most by its concept of freedom and conscience. We live in a different society from the one in which Viktor Frankl works as a therapist and teacher. The Western world secs freedom as a given condition and pays little attention to responsibility. We in the East emphasize responsibility through an ideologically conditioned conformism. Both situations tend to produce meaninglessness. Freedom without responsibility leads to chaos, and conformity prevents discovery of individual meaning. Freedom is no condition, but a means to an end. Freedom "from" limitations, Frankl points out, must be supplemented by a freedom "to" meaningful goals. Logotherapy, with its emphasis on the uniqueness of every individual and every situation, and its insistence on the possibility of choice, even though within limits, sets free the energies for a meaningful mastery of life. 
What is liberating is the awareness that the beneficial encounter between individuals docs not depend on methods which can be learned but on intuition which cannot be learned but can be set free. This leads to a strengthening of conscience and frees us to work with our potentials. 
Logothcrapy assumes that the specifically human dimension cannot be destroyed by illness or other factors. The counselor, in talking with clients, can count on this healthy core which opens up possibilities that they had not been aware of. It is reassuring to know that there are areas where manipulations and distortions have no effect. Prayer, too, has the quality of genuine encounter,just as honest discussions among individuals. Perhaps this is the reason why religion remained vital in spite of the many dissensions from within and attacks from without. The search for meaning is concerned with genuine encounter and also makes us aware of dead ends by showing us where meaning cannot be found. When people realize where the search for meaning is blocked they will not invite despair by trying to force open locked doors and will then focus their efforts on new and possible tasks. Here personal conscience, rediscovered by logothcrapy, comes into play. But here, too, the difficulties begin because we have become used to a long-practiced reductionism. Repeatedly, in our therapeutic encounters we see how eagerly people of all ages respond to this healthy but repressed or ignored dimension of the spirit. The world is full of indoctrinations and ideologies. The church, too, is guilty of ideologizing, which blocks its own field of action and its true tasks. It is when we succeed in challenging people to respond to their longings for personal meaning that they become alive and involved in activities or experiences which enrich them and demand their commitment. The fear ofthe institutions that attempt to thwart everything that wants to grow, indicates that the noetic dimension is creative and powerful. But 
57 
the time has not yet arrived when human beings are allowed to be as God had intended them to be. 
Logotherapy is little known in the German Democratic Republic. In the discussion and practice of medicine, psychology, or theology, it is hardly ever mentioned. Its emphasis on the uniqueness ofeach individual makes it difficult here to introduce logotherapy into the mainstream of discussions, although it agrees well with the intentions of the church. 
Report of a Study 
Recently, however, a number of publications indicate an interest in medical ethics as an important subject for our society and its members. One such study was published in 1984 under the leadership of Dr. Planer-Friedrich, head of the Department of Theological Studies of the Union of Protestant Churches in the German Democratic Republic. The three-year study was carried out by physicians, psychologists, and theologians and dealt with the question of"meaning of life and human health." 
"Today we recognize a meaningful life as a prerequisite for health," the study states. "All models of meaning that are important to society assume a capacity to work, and physical and psychological stability. Illness is seen as a threat to meanmg. But this concept is possible only when we interpret the meaning oflife in a way that considers illness a mere 'accident.' However, health," the study maintains, "is no natural condition. Our natural functioning depends on our environment, and on the cultural and mental conditions in which we live. Our health also depends on our physical, psychological, and mental capacity to adjust to and endure the conditions of our work and our life in society. Healthy are those who are able to reconcile their lives in their various dimensions with the cultural norms." 
The study attempts "to demonstrate the interrelationship among the somatic, psychological, and cultural processes as they apply to our understanding of health and illness. Special attention is focused on the question of meaning.'" Four dimensions of human life are mentioned: the somatic, the psychological, the social, and the "spiritual," that is, the dimension of meaning. The study underlines the meaning dimension "because it has so far been widely disregarded, and it is exactly this dimension where the church has an important function in society." The "spiritual" dimension, which is set in quotes on purpose, is the one where the question of meaning has its place "to which there are answers on various philosophical levels." 
One can sense the difficulties of this church-oriented study in dealing with the problem of meaning in a socialist society. The study maintains "that the question of meaning has an impact on attaining and maintaining health," and thus wants to counteract reductionism. It quotes a Soviet author, I. I. Brechman: "Obviously, not only physical but also moral stimuli are needed to maintain health." 
And the report endeavors to make us aware that the "meaning dimension of human life increasingly is considered anthropologically and socially relevant and can no longer be disregarded ... The discovery of meaning is based on personal experiences which present a reality that is lived and remembered, and therefore concerns every individual." 
During the three-year-long discussions it became clear that values have a place in these considerations but "no strict distinction is made between values and meanings. This may be a semantic problem. At any rate, the concept of value belongs to the field of ethics, and ethical motivations are always linked with questions of meaning." In these sentences one again can sense the difficulties which the authors of the study encountered. But they also show that a clear concept of value is needed. The logotherapeutic idea of values as societal "universal" meanings (which, however, may clash with each other) and individual meanings (which are unique for each situation but require the consultation of one's conscience) would be useful here. But nowhere in this study is the concept of conscience mentioned which certainly would be appropriate in a theological discussion. The study restricts itself to medical-ethical and educational questions, and completely passes over the concept of conscience. In its case histories, too, the study, even on the "spiritual" dimension, works only with psychotherapeutic possibilities. Here the specifically human dimension is implied, but it is dealt with in the somatic and psychological dimension. Thus the vista is narrowed down again. 
Education 
The study also investigated educational concepts and practices in the German Democratic Republic to find answers to the question, "Does education consider the search for meaning as affecting our entire life and the entire person?" And, "How can the ability be transmitted to maintain our identity in a changing world?" This touches the ideological assumptions that are at the core of the entire educational system in a socialist society. 
"Socialist education," the study states, "involves the entire society, and its primary goal is the evolvement of the Marxistic-Leninistic philosophy." In this connection the study quotes the "law of the uniform socialistic educational system" ( 1965). 
"The goal is the best education for the entire population, to develop socialist personalities who will consciously shape our social life, control nature, and lead a fulfilled and happy life worthy of being called human. Socialist education helps citizens to form a socialist society, master the technical revolution, and contribute to the development of a socialist democracy. It provides a modern general education and a highly specialized training, and at the same time develops character toward a socialist morality. It enables people to be good citizens, do valuable work, continue to learn, be socially active, plan and take on responsibility, live healthily, use leisure time meaningfully, and cultivate the arts." 
Here, reference is made to all the previously mentioned dimensions except the meaning dimension. But the study does raise this question: "In what way does the educational system of the German Democratic Republic enable people to lead a meaningful life?" It quotes two young people from a poll conducted by the magazine Junge Welt (Young World): "Life begins to have meaning when one participates in the formation of society." And, "Meaningful living means to work through the party, to further our cause, and to actualize ourselves." In 
59 
both cases the social good is set above personal wishes, and the social goal is primarily reached through work and achievement. "Meaning is found through active achievements which enable the individual to acquire the objective meaning existing under socialistic living conditions." 
Missing again is any reference to conscience which is so important in the logotherapeutic concept of education. The emphasis is on the passing on of traditional values, as is also the case in the Western societies, but with one difference. What is passed on in the schools of the German Democratic Republic are theoretical norms. When these theories are tested in practice by society, however, it turns out that the hoped-for uniformity of values and meanings in the various parts of society does not (yet) exist, but that different values of a personal, group, and social nature compete with each other. "Values are often not transmitted in ways that the individual can convert them into meanings." Such conflicts are blamed on a lack ofwillingness to iearn, and thus are treated as a personal moral fault. Thus, like in bourgeois society, an ethic with a double standard may develop (or be maintained) when public norm and private meaning fulfillment differ. 
The emphasis on achievement and a cognitive-centered attitude toward life, which characterizes all industrial nations, cries out for the inclusion of the widely ignored dimension of the spirit. As was pointed out at the Third World Congress of Logotherapy, personal responsibility and an intuitive search for meaning is a precondition to living as a human being and perhaps to the survival of the human race. The problem lies in the widespread reductionism in a society seeing human nature in a reductionist way. The corridors of the subhuman dimension are populated with experts of all kinds. 
A Christian education, in the words of this theological study, "creates a free space where discussion can be practiced. Such an education has a different concept of the meaning of life which does not merely complement the socialist educational system." Its aim is to guide the human being, through an encounter with God, toward the depth of life. It is hoped that this will not be taken as a purely religious view. It is doubtful that God makes these fine distinctions. Logotherapy allows us here more latitude. 
R. E. STECKER is a pseudonym for a pastoral counselor in the German Democratic Republic who wishes to remain anonymous. 
The International Forum for 
LOGOTH E RAPY 
JOURNAL OF SEARCH FOR MFANINC