Volume 10, Number 2 Fall/Winter 1987 
CONTENTS 
Frankl in the Context of Personality Theorists ....................... 67 Robert F. Massey 
Logotherapy for Chronic Pain* ................................... 85 Manoochehr Khatami 
Lawyers, Liquor, and Logotherapy* ................................92 Robin Goodenough 
Application of Rotter's Learning Theory to Teaching Logotherapy* ..... JOO Vera Lieban-Kalmar 
Logotherapeutic Intervention for Families in Early Chemical Dependence Recovery ........................................... I05 Patricia E. Haines 
Family Treatment and the Noetic Curative Factor .................... 110 James Lantz and Richard First 
Making Logotherapy a Reality in Treating Alcoholics ................112 Rosemary Henrion 
Scheler's "Philosophy of the Heart" and Frankl's Understanding of the Self ..................................................... 118 William Blair Gould 
Book Reviews .................................................. 124 
*Papers read at the Sixth World Congress of Logotherapy in Buenos Aires, September 1987. 

A MEANING MODEL IN FAMILY TREATMENT 
James Lantz Mary Pegram 

As early as 1920 helping professionals have been thinking about the family as a unit of treatment attention.1 Since then, the central idea accepted by all family therapists is that interaction within the family is significant in all cultures for the understanding of mental health. In spite of this agreement, family therapists hold many conflicting ideas about the nature of family functioning and methods of treatment intervention. This article examines a few of the common family therapy models and argues for an alternative -the meaning model. 
The Biological Model 
In the biological model the family therapist points to the very small range of nondangerous human body temperature: 98.72 F. is the average for all human beings of all races and cultures worldwide. Even a slight variation of this safe body temperature can result in death or permanent brain damage. This fact helped some family therapists decide that the human family also needs to remain stable within a fairly narrow range of "safe" family functioning. From this followed the conclusion that any psychiatric problem in an individual family member was to be understood as an attempt of the family system to keep the family unit functioning within a safe, narrow range. From this perspective, a psychiatric problem of an individual also is a solution to a problem on the family level. In other words, the family system makes use of the individual problem to achieve homeostasis within a narrow range of safe family functioning. 
The biological model is extremely popular among family therapy practitioners. It is considered helpful for families in crisis and those who have somatic problems. Some family therapists also consider it helpful in the understanding and treatment of schizophrenia. 
The major problem with the biological model is that it docs not do an adequate job of helping the family therapist understand human change and selftranscendence. The biological model focuses upon the importance of stability and the danger of change. Variation is considered dangerous and intervention is primarily concerned with stability and safety at the expense of change. Thus, the potential for understanding human freedom and self-transcendence is minimized. 
The Mathematical Model 
In the mathematical model, cybernetic theory is used to discover and understand the circles and feedback loops in family interaction. The math model helps family practitioners observe the "snowballing" of family problems and understand how intervention can disrupt such snowballing processes before they become unmanageable. 
A police officer uses the math model in his work with domestic disputes. In the typical marital dispute he is called upon to "settle," he observes the "snowball" problem: the husband or the wife calls the spouse a "bad name" and the spouse then counters by calling the partner an even worse name. The name calling escalates and continues until someone is either physically hurt or killed. The police officer separates the couple as first step in intervention, to disrupt the snowballing effect. This "cools them out" and eventually they can be brought back together for a rational discussion and referral to a social agency for marital therapy. The police officer believes that his understanding of the feedback loop and the math model has literally saved his life and the lives of many angry clients. 
The mathematical model is also popular among family therapists. It is useful in short-term therapy and when working with explosive families and with those that "act out." Again the limitation of this model is its focus upon stability. It fails to adequately describe and understand consistent growth, change, and the process of human self-transcendence. 
The Organizational Model 
In the organizational model the family is viewed as a kind of company or business organization. The husband has a task, the wife has another and the kids have theirs. In a healthy family everyone does his or her task without interfering with that of other family members. If the wife doesn't do her task or tries to do the husband's job, family symptoms and problems are the logical result. The same is true the other way around. Similar problems arise if the children attempt to do the parents' jobs. In this model, family organization and structure are considered extremely important: problems occur whenever the correct organizational form of the family is disrupted by members who have either failed to do their job or who are trying to do someone else's. This particular model is useful with disorganized, chaotic, and many psychosomatic families. Its weakness is that it fails to adequately explain the tremendous variety of family organizational forms that work very well but would fail from an organizational point of view. This model, too, primarily focuses upon stability to the exclusion of an understanding of self-transcendence, variation, and change. 
The Meaning Model 
The meaning model is not used by many family therapy practitioners and never was particularly popular with them. 3 It sees the family as an important small social unit, extremely useful to its members in their attempts to discover, experience, and create meaning.3 The family is understood to be the individuals best -but not the only -hope and opportunity for the discovery and realization of meaning. If the individual members and the family as a group are unable to create a group atmosphere that encourages the discovery of meaning, the individual family members are in danger of experiencing what Frankl2 calls existential vacuum. This vacuum can be filled by either a developing sense of meaning or by the development of psychiatric symptoms such as anxiety, depression, substance abuse, and other forms of dysfunctional human behavior 
2,3_ In the meaning model the therapist challenges and confronts the meaningdiminishing family patterns which disrupt the family search for meaning, and encourages patterns that facilitate such search.3 In the meaning model family interactional patterns are only considered 
dysfunctional if they disrupt the families' ability or opportunity to discover, create, or experience meaning. 3 Family patterns are not evaluated in a general normative fashion because it is recognized that each family is unique and must 
discover its own meanings as well as its own methods of enhancing the family search for meaning. The therapeutic job is to facilitate the families' search for meaning, not to assign meaning or prescribe the right method of discovering meaning. This is not to say that family therapists would not have general ideas about what kinds of family pattern are more frequently useful to enhance the family's search for meaning. But they would also recognize that such ideas are 
general, and may or may not be relevant to the needs of the specific family.3 In this model, intervention is individualized in a phenomenological way to meet the unique needs of each family requesting help.3 
Such an attitude seems consistent with both an anthropological4 and existential2,3 understanding of human change and self-transcendence. It is consistent with anthropological findings documenting tremendous variation in the methods which families use in their search for meaning.4 And it is consistent with an existential perspective which believes in the human capacity for selftranscendence and change in reaction to a great variety of cultural, political, 
physical, and sociological stimuli .2,3 In clinical terms, the meaning model family therapist would agree with both existential and anthropological theorists who point out that human change and self-transcendence can be stimulated in a great variety of biopsychosocial situations. In such a family treatment model, change is viewed as common and normal as opposed to the dangerous, abnormal, 
and unusual.3 
The Future Family Therapy 
The meaning model offers the family treatment movement its greatest opportunity for evolution and growth. It is, at its core, concerned with the realization of human self-transcendence and change. The model consistently highlights the human potential for courage, freedom, change, and growth. The focus is upon human capacities and flexibility as opposed to a focus upon stability and danger-of-change which is found in the mathematical, organizational and biological models of family treatment intervention. 
JAMES LANTZ, Ph.D., and MARY PEGRAM, D.S.W., both teach social work practice at The Ohio State University, College ofSocial Work. Both are active as clinical and practice consultants to agencies and institutions in the Midwest Region. 
REFERENCES: 
1. 
Bremner, R.. American PhjlanthrQPy. Chicago, University of Chicago Press, 1960. 

2. 
Frankl, V., The Will to Meaninc; New York, New American Library, 1969. 

3. 
Lantz, J., An Introduction to Clinical Social Work Practice Springfield, Charles C. Thomas, 1987. 

4. 
Torrey, E., Witchdoctors and Psychiatrists. New York, Harper and Row, 1986. 


Dilemmas of Today -Logotherapy Proposals 
Joseph Fabry 
The dilemma of contemporary humanity can be summarized in one sentence: We are at the beginning of an unprecedented shift from a vertical to a horizontal society. From the time our ancestors ate mastodon meat, we received our guidelines for living from above: from gods, secular rulers, priests, teachers, the tribe eldest, the top of society. A vertical society. 
Within our life span this has begun to change. As Viktor Frankl put it, it is no longer enough to obey the Ten Commandments given by God, valid as they are. We have to try and follow the tens of thousand of commandments life gives us in the tens of thousands of moments of our existence. Guidelines from above still help but increasingly we have to listen to our own conscience, which may tell us to follow the guidelines from above, to modify them, even to ignore or oppose them. We are on the way to a horizontal society. 
This shift in world view from vertical to horizontal also changes the way we see ourselves. For thousands of years humans saw themselves as beings in search of God. Today they see themselves in search of themselves. Medieval men and women cried: "God, God, God, nothing but God." Our contemporaries, especially the young, call out "Me, me, me, nothing but me!" Some consequences of this attitude are alienation, anxiety, emptiness, resulting -as Frankl has pointed out -in violence, addiction, and suicide. 
According to Frankl, humans are beings in search of meaning, logos, traditionally translated as "the word of God." By translating "logos" as "meaning" Frankl gives it a horizontal interpretation. Meaning exists everywhere, whether we believe it or not. The first axiom of logotherapy is: Life has meaning, under all circumstances, to the last breath. "Meaning, meaning, meaning, nothing but meaning!" 
His second axiom is that we all have an innate "will to meaning," our strongest motivation for living and acting. We have an intrinsic longing to be part of a whole, be connected, be a thread in the fabric of life, to belong, to perceive order behind apparent chaos. This order can be seen in religious or in secular terms, as nature, science, harmony, the ecosystem, in a vertical as well as in a horizontal direction. 
His third axiom is the most revolutionary. We have the freedom to find meaning, under all circumstances. This is inconceivable in a vertical society where meaning is given from above. You can resist it but you will feel guilty. The vertical society works through guilt 
Obviously we are not always free to change a meaningless situation. But we are always free to change attitudes in situations that cannot be changed. We can find a meaningful attitude in a meaningless situation. 
Freedom Misapplied 
Most of our contemporary dilemmas are caused because this third axiom of freedom is widely misunderstood and misapplied. Frankl does not say we are free to do what we like. He says we are free to find meaning. He doesn't say we have to give our lives meaning. He says we have to find it. Meaning is contained in our relationship with others, being part of the human community. Each of us goes through life, birth to death, and every moment, every situation, offers a meaniIJ.g to which we can respond. Freedom means we are able to respond to the meanings of the moment, to be response-able. 
Frankl said again and again: freedom without responsibility leads not to meaning but chaos, to meaninglessness. And here lies the crux of our dilemma: We have more freedom by far than our ancestors could imagine. Science and technology provide us with freedom that comes with leisure and affluence. In the West, we have gained many freedoms from : Freedom from hunger, cold, poverty. Yet, no paradise has arrived. The boredom, emptiness, and existential frustration, that characterize the idle rich on top, are now widespread. The existential vacuum, too, has become horizontal. 
To find fulfillment, however, more is necessary than freedom from physical hunger. We have to satisfy our hunger of the spirit. We must feel free to find meaning. Frankl puts it this way: "We now have enough to live on, but we don't know what to live for. " Meaning comes from having a task to fulfill, a person to love, a cause to support, a responsibility to meet. Freedom without responsibility is meaningless arbitrariness, and leaves us empty. 
In a vertical society, responsibility is dictated from above, and provides those who believe in the value of the vertical society with a sense of meaning. This is no longer true for a society that can impeach a president, question church dogma, rebel against parents and teachers, strike against bosses, and fight the discrimination of a white, male-oriented culture. Father no longer knows best, but if we reject the responsibility given by father, and do not replace it with a responsibleness of our own, the result is not the Oedipus complex, as Freud maintained, but the existential vacuum. 
The first amendment proclaims freedom of speech, assembly, press, and religion. But, as Justice Oliver Holmes pointed out many years ago, freedom of speech does not include shouting "fire" in a crowded theater. Neither does freedom of assembly include incitement to violence, nor freedom of the press slander and pornography, or freedom of religion a cult-like dependency. 
Today's Dilemmas 
This is the dilemma of our times: We tend to reject responsibility from above, but have not learned to assume responsibleness from within. We have no tradition to listen to and follow the faint voice of conscience, especially when it says "no" to traditional vertical values. 
The three greatest dangers today are atomic war, pollution, and overpopulation. All three are created by freedom applied irresponsibly. Superpowers produce superweapons because science and technology have given them the freedom to produce them. They will be abolished only when enough people, listening to their personal conscience, will insist that global suicide is no path to a meaningful life. There is no precedent for this. National conflicts have always been decided by war, and war has always been declared by the top of the political pyramid. 
Pollution. Ecological destruction is possible because industrial leaders have the ability and freedom to create affluence at the price of poisoning or using up our resources. The top values are profits, power, the pleasurable life, not the meaningful life. Government guidelines arc restricted to preventing immediate disaster. No responsibility is shown for the welfare, even the survival, of future generations. Again hope lies in the conscience of increasing numbers who listen to the voice within. 
Finally, overpopulation. We arc free to give birth and control birth. But values have changed, even reversed. In an underpopulated world with a high child mortality, the King needed soldiers, and a father needed children to support him in old age. The Church supported this value system. In our overcrowded world it takes courage for women, and men too, to say "no" to taboos from above. 
Freedom without responsibility also causes personal dilemmas. The family is in trouble because its members feel free to "self-actualize" without sufficient consideration toward other family members. Most work has lost its meaning because employers and employees feel free to fire, quit, change jobs, compete, with little responsibility toward others. In the past, working hours were long and leisure short. It made sense to seek rest and pleasure. Now, we don't know what to do with our long evenings, weekends, and vacations. Frankl speaks of a "Sunday neurosis" which drives people to directly pursue pleasure through gambling, sex, and drugs. The mass media offer pleasure-oriented programs, expanding a meaningless wasteland of thrills. 
People are free to "do their own thing," without concern for others, that is, without responsibility. They blare loud music through open windows, litter beaches, spray slogans on walls, drive under the influence of alcohol, snatch handbags, rob gas stations to support their drug habits, and terrorize neighborhoods. This is freedom without responsibility. 
Logotherapy's Solution 
Logotherapy proposes remedies, not because freedom without responsibility is immoral, but because it is unhealthy. Fifty years of logotherapy research has shown that an ignored or repressed will to meaning leads to inner emptiness resulting in neuroses, depressions, addiction, suicide. Logotherapy offers methods to overcome such crises and, far more important, offers a philosophy of life that prevents existential crises, and helps people face them when they do occur. 
Logotherapy proposes "education to responsibility." Frankl's ideas of education are revolutionary, literally. They turn the educational system around, from a vertical pouring of information from teacher to student, to a horizontal orientation where both teachers and students cultivate values, commitment, and personal responsibility. The principal method of logotherapy is the "Socratic dialogue." Socrates was the first horizontalist in education. For him, the teacher was not above, pouring facts into the student below. The teacher, with special skills and insights, helped the students become aware of their own skills and insights deep within themselves. 
Logotherapy believes that human beings have a reservoir of resources within, and the therapist-teacher must help clients make use of them, to find meaning. Meanings must be found by each person, horizontally, in response to the specific demands of life. Teachers can transmit values, which Frankl defines as "universal meanings." Personal meanings cannot be given, only taught by example. 
Proposal One: Meaning 
This means that every one is a teacher. And also a lifelong student. What is our curriculum? The writings of Viktor Frankl and his followers make good textbooks, to read and to live out. 
The remedies are based on the three logotherapeutic axioms. The first axiom, that life has meaning under all circumstances, has come under attack from many sides. 
One is the attack from nihilism, the denial that life has meaning. What does logotherapy propose as counter measures? We can make people aware of their deep unconscious belief in a basic meaning in life, and help remove the psychological, mental, and sociological blocks that hinder access to the resources of the spirit. We can draw our clients' attention to moments when life made sense and they felt part of a whole. As Frankl says, meaning may be temporarily obscured like the sun by clouds but we know it exists behind the clouds and will break through again. 
We can counteract nihilistic trends in our children, students, friends, and neighbors by living the meaningful life as we see it, and thus affirm fundamental human needs in danger of being lost in a nihilistic society, such as the need for reliable relationship, self-esteem, and a sense of belonging. 
A second attack on life's meaningfulness comes from "pan-determinism," the belief that we are completely determined by forces beyond our control. Modem, scientific, and therefore "rational" theories, such as those of Gregor Mendel, Karl Marx, and Sigmund Freud tell us that we are determined by our genetic make-up, our social environment, our psychological drives. Existentialism, including Viktor Frankl, is a healthy reaction to this belief of being a helpless victim. Logotherapy stressed the specifically human dimension of the spirit where we can take a stand against determining influences. Logotherapeutic literature is full o examples of how ordinary people rose above their limitations and used th "defiant power of the human spirit" to become masters rather than victims o genetic defects, damaging environment, or childhood traumas. 
A third attack on our basic belief in a meaningful life comes from a spreadin reductionism that denies the specifically human dimension of which meanin orientation is the centerpiece. Reductionist thinking sees humans as nothing bu animals that can be trained, or machines to be manipulated. Human values ar replaced by machine values -cost efficiency, productivity, replaceability predictability, measurability. We cannot find meaning in family or friendship i we judge human beings by their usefulness. People, then, have a price tag bu no worth, not even self-worth. Human values, not being measurable, ar becoming suspect. Our educational system is proud of being value-free. 
Logotherapy draws attention to the specifically human qualities that cannot b measured, analyzed, or repeated in laboratory experiments: the resources of th human spirit -freedom to choose, responsibility, orientation toward tasks an purposes, creativity, imagination, idealism, insight, faith, love beyond th physical, conscience beyond the superego, a sense of humor, self-transcendenc and -most of all -our will to meaning. 
Proposal Two: Will 
And here we have arrived at the second axiom of logotherapy which propose solutions to contemporary dilemmas. Logotherapy places the "will to meaning as our main motivation for living. 
We, especially in the affluent West, live in societies greatly motivated b pleasure and power. It is no longer the examined life, but the pleasurable lif that's worth living. Our role models are the beautiful people in the mass medi advertisings who drink, eat, make love, take dream vacations, and live i Hollywood homes full of labor-saving gadgets. Our young grow up in the unshakable belief that they have the inalienable right, not just to the pursuit of happiness, but to happiness presented on a platter. They expect good breaks, pleasurable experiences, good health, a sex life with guaranteed orgasms. If these things don't happen, they sulk, become neurotic, depressed, suicidal. 
This hedonistic attitude is reinforced by a doomsday anxiety of impending universal destruction. Why spend time searching for meaning when all will end in atomic cataclysm? Let's have fun while we can. 
Logotherapy's assumptions are different: life does not owe us pleasure, it offers us meanings, moment by moment. If we respond to these meaning offerings, pleasure comes as a by-product. It eludes us if we chase after it. Frankl mentions sex as illustration. If attention is focussed on the pleasure of orgasm, the relationship will not be fulfilling, and excessive attention to the sex act may lead to sexual dysfunction. Sexual pleasure comes as the by-product of a meaningful human relationship. 
Gambling is another illustration. Logotherapy surveys show that people in gambling casinos score low in meaning. They try to find meaning directly through the "pleasure" of gambling, and are frustrated. 
A power-driven society faces even greater dangers. Power struggles cause conflict, in families as well as among nations. It's husband against wife, industry against labor, one political party against the other, the executive branch against the legislative, Capitalism against Communism, rich against poor, white against black, male against female. In an overpopulated world armed with atomic weapons, power as motivating force threatens the survival of the human race. 
Logotherapy does not deny that pleasure and power are effective, even desirable motivators but maintains that the will to meaning is basic. It helps us find meaning in life, to make meaningful choices. And it helps us to act according to our decisions. 
In the phrase "will to meaning," "will " is as important as "meaning. " As long as we are motivated by pleasure and power we remain on the psychological level, we are driven . Logotherapy dares to enter the dimension of the human spirit where we have the will to decide in each instance whether it is meaningful to follow the pleasure principle and what to do with our power drives. The "defiant power of the human spirit" is not vertical power from some outside authority, but the horizontal power of our own will. It is the task of the logotherapist to make us aware that we have this will, to strengthen it, and to remove blocks where they exist. 
Frankl describes one of our contemporary dilemmas when he says that, unlike animals, we no longer have the instincts that tell us what we must do. Unlike past generations we no longer have firm traditional values to tell us what we should do. We therefore often do not even know what we want to do, and either do what others do, which leads to conformism, or what others want us to do, which is submission to authoritarianism. 
Our inability to know what we want to do leads to many contemporary dilemmas: the insecurity of parents bringing up children; peer pressure leading to addiction, violence, promiscuity; advertisement pressure for pleasure at any cost; the competitive spirit for power and prestige; to "keep up with the Jones;" the "everybody does it" argument for early sex, adultery, divorce; the attraction of cults; the tendency to find shortcuts for every ill, and the development of depressions if shortcuts don't work. 
Logotherapy proposes that we become aware of our will to meaning, that enables us to act beyond instincts, conformism, and authoritarianism, to have the freedom of our own choices. 
Proposal Three: Freedom 
The third logothcrapcutic axiom that proposes solutions to many dilemmas is the assumption that we have the freedom to find meaning under all conditions. 
This is a daring assumption because we know that freedom is often denied to us by forces beyond our control. We also know that freedom may lead to meaningless chaos. Freedom is the danger and the challenge in our shifting from a vertical to a horizontal society. 
In a vertical society freedom is restricted within defined limits, within which people find meaning. The slaves of antiquity, the women in a harem led severely limited but meaningful lives as they saw it. 
The fight for political freedom started with the French and American revolutions, and continued through the struggle for independence of the colonial states after World War II. The fight for social-economic freedom goes back to the Americal Civil War, and continued through the civil rights movement, the labor union movement and the struggles for equality by many groups -minorities, women, children, the aged, homosexuals, advocates for animal rights. 
These wars for freedom have yet to be won on all fronts but problems are already apparent. When I went to the University in Vienna almost 60 years ago, students had a choice of four disciplines: medicine, law, philosophy, and theology. Students entering college today are free to choose from a thick catalogue of disciplines, many not even imagined in the thirties. Only two generations ago, people had limited choices as to careers, and usually had to stick with early choices. Today, they are free to change careers several times. Similarly, they are much freer than their grandparents to choose partners (married or unmarried), relationships, residences, jobs, church affiliations, sex preferences, even sex identification. 
A plethora of freedoms is not an unmixed blessing resulting in what Frankl predicted: uncertainty of what we really want to do, veering toward conformism or authoritarianism. Most of the newly liberated countries live under dictatorships. Many newly liberated individuals tum to cults and dogmatic creeds, gurus and quick healers, submit to the role models of the mass media, or exchange freedom for chemical dependency. Or, tom by conflicts of values and conscience, they develop noogenic neuroses and depressions. 
Logotherapy's proposal is contained in a symbolism Frankl has often mentioned in his speeches in the United States. We should balance, he says, our Statue of Liberty on the East Coast with a Statue of Responsibility on the West Coast. Freedom leads to meaning, wholeness, and health only when balanced by responsibility. In a horizontal society, our actions must respond to meaning offerings within a community greater than ourselves -family, friends, colleagues, fellow citizens, and people who will be affected by our actions, people we don't know, or haven't even been born. 
Our traditions have not prepared us to think in such self-transcendent terms. The computer prints out more choices than our brain can register but the responsibility of selecting must be made by personal conscience. 
Logotherapy's prescription says: We are always free but not always responsible. It distinguishes between areas of freedom and areas of fate. 
In the areas of freedom we are free and responsible. In the areas of fate, where a meaningless situation cannot be changed, we are still free to find a meaningful attitude toward toward the unchangeable situation, though we are not responsible. 
This distinction has important therapeutic consequences. If we feel responsible where we have no control, the result is frustration, despair, guilt. If we don't feel responsible where we do have control, the result is the existential vacuum which we try to fill with thrills and drugs, and which opens us to noogenic neurosis. 
The area of fate lies in physical, psychological, often social conditions. The area of freedom lies in the dimension of spirit. 
Frankl once told an overweight woman whose obesity was uncontrollable because of a gland malfunction: "You are not responsible for your obesity. Your body docs this to you, beyond your control. But you are responsible how you live as a woman whose body forces her to be overweight. Many activities are beyond your reach. But you can lead a meaningful life within your limitations." 
In all cases of fate the attention of people must be dereflected from the conditions over which they have no control and are not responsible, to conditions over which they do have control and therefore can assume responsibility. They have the freedom to change a situation where this is possible, or to change their attitude where fate must be accepted. The events of our past are always fate. Whether we are crushed by them, or take them as challenges or learning experiences, is within our area of freedom and responsibility. 
It has become fashionable to blame the past, environment, society, physical defects, psychological forces for present failure and misconduct. A violent highschool student is excused because of jungle-like home conditions, an alcoholic because of his genetic make-up, a wife beater because of his aggressive character. True, we have no control over our childhood environment, our genes, or aggresive drives. Yet we have areas of freedom -they may be small or blocked by physical or psychological obstacles, but logotherapists will make their clients aware that areas of freedom exist, and blocks can be removed. The violent student is made to see that it is his task not to pass on the dog-eat-dog attitude of his childhood to his own children but rather to break the chain; the alcoholic is helped to realize that, although she has no control over her genetic make-up, it is her responsibility not to take that dangerous first drink; and the wife beater, while not responsible for his aggressive impulses, is responsible for what he does with them. Logotherapists may have to work with traditional psychotherapists and medical doctors to remove psychic or physical blocks to the human spirit where free decisions are made, Their aim is to make patients aware that there is an area, however limited, where they do have responsibility. 
To rob people of responsibility in their areas of freedom has become a social dilemma. In vertical societies the harm was in the opposite direction: people were made to feel responsible, and guilty, in areas of "fate" for physical defects, psychological impulses, and the sins of others, going back to Adam and Eve. 
In emerging horizontal societies we do people an injustice by not holding them responsible in their areas of freedom because we rob them of their essence as human beings. We don't do favors to misbehaving children when we let them place the exclusive blame on parents; nor to criminals when we acquit them as helpless victims of blind forces and drives; nor to addicts allowed to justify 
11 
addiction due entirely to genes or social conditions. Such excuses are insults to their humanness. 
Antidote to Scientism 
In sum: many of our contemporary dilemmas result from a shift to a horizontal society where decision making is increasingly transferred to the individual. The philosophy of logotherapy, with its emphasis on unique individuals making meaningful choices and taking meaningful attitudes, is an antidote to the power forces of scientism. 
Humans are seen as beings in search of meaning which cannot be objectively measured, only existentially lived.Each person becomes a life-long teacher as well as student in finding responses to the demands of life and each jewelled moment. 
Logotherapy directs us toward living life in response to meaning demands: 
In an increasingly materialistic world, logotherapy helps us resist the forces that make our search for meaning seem hopeless (nihilism), futile (pandeterminism), or manipulable (reductionism). 
In a hedonistic and competive world, it helps us resist the forces that place pleasure and power over human values. 
In a world that demands personal responsibility, it helps us resist the forces that lead to conformity or authoritarianism and helps us distinguish our areas of freedom, where we are responsible, and the areas of fate where we are not. 
It may seem that these logotherapeutic proposals are valid only in the affluent West. The Communist world is still a vertical society with responsibility largely dictated from the top, and personal freedom limited. In the Third World, and parts of the West, meaning is still found in physical survival. But in our shrinking universe the earth has become a global village. We have seen pictures of our earth, a small orb floating in space revealing the meaning of interconnectedness. Logotherapeutic research has shown that the question of meaning has become a dilemma also in Communist and Third Worlds. There is no curtain between vertical and horizontal societies or between affluence and developing worlds. Meaning is a universal human goal, not reserved for the affluent West. Elisabeth Lukas reports existential vacuum, noogenic neuroses and depressions to be on the rise in the affluent West. Frankl recommends supplementing the emphasis on freedom in the West by an emphasis on responsibility in the East, to form societies where both are balanced. He proposed a solution to the meaning crisis in the First World and the hunger crisis in the Third. "To the extent," he said, "to which the First World sees its task in fighting hunger in the Third World, it helps itself to overcome its own meaning crisis: We give them bread, they give us meaning -not a bad bargain.''1 
JOSEPH FABRY is director of publications of the Institute of Logotherapy, Berkeley, and editor ofthe International Forum for Logotherapy. 
REFERENCE: l.Viktor E. Frankl. "The Meaning Crisis in the First World and Hunger in the Third World.'' The International Forum for Logotherapy, 1(1), 1984. 
Logomedicine: A Doctor-Patient Partnership 
Edward Lazar 
Wellness, the optimum quality of health possible, is an ongoing process requiring awareness, choices, and decision making. Health care must consider the total person's way of life and entails an interrelationship between patient and physician that I call "logomedicine" -a doctor-patient relationship in which each assumes responsibilities. Physicians are adjuncts to the patient and the patient, rather than the doctor, is the primary person responsible for maintaining health. 
Logomedicine combines medical technology with the art of medicine. During the past two decades medical technology has made great strides while the art of medicine has not made significant advances and may even have regressed. 
The art of medicine requires the physician to view the patient as a three-dimensional unique individual of body, mind, and spirit, with certain feelings, thoughts, attitudes, interpersonal relationships, hopes and expectations, and not merely as a carrier of disease or a body afflicted with illness. Medical technology tends to dehumanize the patient, and while there have always been physicians practicing "logomedicine," it is the philosophy behind Frankl's logotherapy that acts to rehumanize psychotherapy and medicine as a whole. 
Ethical Values 
In the medical profession, the Hippocratic Oath stood for 2,500 years as testimony to the need and concern for guidance toward "right" action. But now the ethical values of the Oath are being challenged because it does not recognize the patient's point of view.5 
It is not necessary that the ethical values for the physician be changed, challenged, or criticized. As Frankl puts it, we are responsible for "what we do, whom we love, and how we suffer. "2 As early as the twelfth century, Maimonides and other codifiers of law obligated the physicians not only to use their medical skill but let patients care for their own health and lives.7 Logotherapy follows that tradition. Frankl distinguishes between responsibility and responsibleness. Responsibility is the acceptance of values imposed by outside authorities, while responsibleness results from inner discipline and free choice. 2,3,4 
Patients often accept blindly the word of the physician, others resist all authority, including the doctor's. We need to move to a position somewhere between responsibility and responsibleness. For optimum health care, doctor and patient have to have a satisfactory working partnership, which sets the proper proportions of responsibility and responsibleness for each. 
Studies reveal that most patients play a passive role, leaving physicians to make the decisions. But surveys also report that a large number of patients prefer more information about their illness than they receive, and that clinicians underestimate patient preferences when therapy is discussed. 6,9 
The Uninformed Patient 
Dr. Walter C. Alvarez spoke for many concerned physicians when he stated: "The uninformed patient may have traveled from doctor to doctor and spent considerable time and money, while getting little or no relief. How can this be possible? Because, with little knowledge of the structure of the body and a lack of understanding of medical terms [the patients] told the story of their illness with so few details and such lack of accuracy that the doctor could not guess what was wrong. As a result, often the diagnosis and the treatment were for the wrong disease and therefore did no good and may, in fact, even have done harm."1 
The patients need to know the history, methods of treatment, and as many details about their ailment as possible so the problem can be discussed intelligently. An informed patient reduces risk. 
Doctors are as different from one another as are their patients. Their expertise in healing is partly science, partly art. In choosing a doctor for specific needs, patients have the responsibility to look for one with the best mix of science and art. 
Two important elements in a doctor's qualifications are competence and compassion. Lacking compassion, a doctor is not able to heal effectively at all levels. On the other hand, understanding and compassion often work "miracles" where other therapies fall short. 
The Doctor's Qualifications 
Members of the medical profession need to consider the following: 
1. 
Are you well informed, current with the latest medicines, technology, and diseases? Do you keep records? 

2. 
Are you understanding and compassionate? Do patients feel at ease and secure in your presence? Do you make them feel comfortable enough to ask and answer questions honestly? 

3. 
Do you respect the patients' confidentiality? 

4. 
Are you always honest with the patients? Are you not afraid to say: "I don't know but I'll try to find the answer"? 

5. 
Do you see your patients promptly, or are they kept waiting unnecessarily? 

6. 
Do you communicate in a language they readily understand? 

7. 
Do you give them your undivided attention and all the time necessary? Do you take time to explain? 

8. 
Do you practice a holistic medicine, concerned with the total individual, the patients' psychological and spiritual as well as physical wellbeing? 


Informing the patient is not always a matter of a simple statement. After having diagnosed a fatal disease, the doctor is confronted with the question whether the patient should be told the nature of the illness and the prognosis. At what stage of the illness should this be done? Who has the responsibility of informing the patient -the physician, the next of kin, or both? The minister, priest, or rabbi? It is important for the doctor to know the patient as it is for the doctor to know the disease. 
Divided Responsibilities 
The primary physician and the patient are the most important members of the medical care team. The patient is the focal point of the team and must, at some time, assume responsibility. Apathy in patients, for whatever reason, delays and may even prevent recovery. 
Patients are responsible, most significantly, to communicate openly and honestly. They must make their feelings known and answer truthfully all questions asked by the physician and staff. If the patients do not comprehend what they are being told or asked, they must make this known. In addition, they are responsible for exploring, with the physician, alternative treatments, or no treatment, and the consequences thereof. The physician is not to sit in judgment but to offer options. Their final choice is the patient's. 
The importance of the patients' attitude toward their illness is illustrated in the following case history. 
Jerry and Bill had virtually identical diagnoses of lung cancer, which had spread to the brain. The day he received the diagnosis, Jerry resigned from life. He quit his job and, after taking care of his financial affairs, settled in front of the television set, staring blankly hour after hour. Within 24 hours he was experiencing severe pain and lack of energy. No one could get him interested in much of anything. He showed no response to radiation therapy, and within three month was dead. 
Bill's response to the diagnosis was different. He took the illness as a time to review the priorities of his life. As a traveling sales manager he had been constantly on the go and, he said, had "never taken time to see the trees." Although he continued working, he rearranged his schedule so that he could take more time to do things he enjoyed. At the clinic, he participated actively in the therapy · group. He responded favorably to radiation therapy and became virtually symptom free. All the while he remained active. 
Both patients, with the same diagnosis, received the same treatment. Yet Bill outlived Jerry by more than a year and considerably outlived the medical prognosis. Furthermore, the quality of Bill's life was quite different: he was involved in life, active, enjoying family and friends. 8,p.15-16 
A logotherapist would perceive Bill as a responsible person who lived his life with meaning. Jerry, in contrast, lived and died in a self-made existential vacuum filled with anxiety and depression. 
To summarize: physicians can cure only sometimes. More often they can relieve pain, and always give comfort and hope. In cases of chronic or incurable disease, the doctor can teach patients how to cope and live more comfortably with the illness. 
Logomedicine is a workable partnership of doctor and patient based on mutual trust and respect. Each partner supports the efforts of the other, in order for the patient to achieve the best possible health. In logomedicine physicians view themselves as adjuncts of their patients who are primarily responsible for maintaining their health. 
EDWARD LAZAR, Ph.D. is a medical-care psychologist in Chicago and facilitator in support groups whose participants have a 
life-threatening illness. 
REFERENCES: 
1. 
Alvarez, W.C. Help Your Doctor Help You. Millbrae, CA, Celestial Arts, L976. 

2. 
Fabry, J.B. The Pursuit of Meaning. New York, Harper & Row, 1980. 

3. 
Frankl, V.E. Psychotherapy and Existentialism. New York, Simon and Schuster, 


1967. 4..The Unconscjous God. New York, Simon and Schuster, 1975. 
5. 
Holleb, A.I. and M. Braun. "Ethical Issues and the Cancer Patient." Ca 36(2), 83-84. 

6. 
Lazar, E."Suggested Approaches for an Optimum Care and Rehabilitation Program for the Cardiac Patient". Ann Arbor, University Microfilms International, 1984. 

7. 
Rosner F. Modern Medicine and Jewish Ethics. New York, Yeshiva University Press, 1986. 

8. 
Simonton, O.C., S. Mathew-Simonton, and J. Creighton. Getting Well Again. Los Angeles, J.P.Tarcher, 1978. 

9. 
Strull, W.M., B. Lo, and G. Charles."Do Patients Want to Participate in Medical Decision Making?" Jama 251_(2 l ), 2990-94, 1984. 


ETHOLOGICAL EXISTENTIALISM FOR SUBSTANCE ABUSE 

Harold D. Rosenheim 
Treatment approaches to chemical dependency have remained remarkably stable. Yet, some intriguing ideas have developed viewing chemical dependency as a reflection of broad societal and mental health problems, and not merely as a specialized area of dysfunction. Acceptance of a new philosophy can stimulate change in procedure. Even existing methods can become effective when seen through a different philosophical lens. 
Philosophy 
Abusing alcohol and mind-altering drugs is a free decision within genetic limitations. In this sense, chemical dependency is a general psychological and emotional dysfunction, and no more a disease than behaviors resulting from anxiety, fear, obsession, or depression. It is a consequence of poor life choices to which certain individuals are predisposed. This would mean that if attention is paid to the substance abusers' existential opportunities, and their instinctual pressures are explored, motivated individuals may be able to transcend limitations, revise fundamental decisions, and alter life styles in which substance abuse is central. 
Ethological Existentialism is a philosophy based on uniquely human freedom and consciousness, recognizing evolutionary-based limitations and dispositions. The two schools of thought in this synthesis are ethology and existentialism. 
Ethology 
Ethology originated in Europe and received its most popular introduction through Lorenz.1 4 Since then research has had serious implications for personality development1 and psychopathology_l 9 Ethology rests on the assumption that behavior is no less a function of evolving pressures than morphology. 
Ethological research has clarified the issue of instincts. It has contributed immensely to the understanding of open versus closed instincts, innate releasing mechanisms, dominance hierarchies, displacement, and perhaps the most widely known phenomenon -territoriality. These processes arc based on a complex view of instinct in which predispositions and species-wide needs dramatically limit the range of behaviors available to an organism in a particular situation. The limitations range from complete (closed instinct) as seen in much insect behavior, to minimal (open instinct) as seen in birds learning specific songs, and some human aggression. In all cases the particular instinct is associated with useful adaptiveness developed during long evolutionary periods. While the question of the object of the adaptiveness (gene, individual, or group) is far from resolved, all ethologists explain behavior as the outcome of competition for the most survival-oriented strategy. 
Specific applications to human psychopathology have their beginning with Price19 who explained how depression, anxiety, irritability, and dysphoric mood 
problems could be seen as by-products of the evolutionary adaptive development of a dominance hierarchy. A 1977 collection of articles dealt with ethological analysis and application to personality theory and psychopathology. IS Ethology also was used in analyzing manic-depressive disorders 10 and in understanding antisocial behavior.16 
Much of human ethology remains theory and lacks rigid research-oriented support. Yet, it has opened doors to understanding problems that have not responded to other disciplinary approaches. Field observation, clinical experience, and comparative research have supported ethological hypotheses. At the least, ethology provides a major conceptual tool in understanding personality, psychopathology (in the full sense of cognitive, emotional, and behavioral 
problems including substance abuse) and even human nature. 1 
Logotherapy 
Logotherapy has been called the most clinically oriented existential philosophy. Frankl 4 ,5,6 views meaning as the major unitary principle in 
understanding human personality and demonstrates its tremendous impact on affect and behavior. He does not reject the major existing theories but views his efforts as integrating.8 He maintains that the ability to discover meaning in 
various life situations uniquely defines human psychology. He has developed a secular understanding of spirituality (noos) and has examined the specific nature of problems not arising from unconscious conflicts and past events but from problems in discovering meaning. Logotherapy is primarily concerned with failures in the "will to meaning" and thus with existential problems. Prolonged difficulties can lead to existential frustration and, in turn, to symptoms that include depression and substance abuse. When the symptoms are the result of an existential (noogenic) neurosis, conventional psychotherapy is not helpful, even counterproductive. In these situations the therapeutic task is to assist patients in finding meaning within their own life context. Some of Frankl's procedures (e.g. dereflection, paradoxical intention) have been adopted by other schools, but the hallmark of logotherapy is Socratic dialogue. 
Although Frankl does not follow a tradition of pure phenomenology, his work is closely connected with formal philosophy.12 His failure to become better recognized in mainstream psychiatry and clinical psychology may lie in their 
disregard of their philosophical roots. This situation seems to be changing, judging from the number of publications seeking the philosophical underpinnings of psychotherapeutic endeavors.2,21 In any event it is clear that some popular clinical therapies are indebted to Frankl. In particular, cognitive-based therapies 
have accepted Frankl's ideas of the primacy of mind (thinking) over affect. 
Frankl's most unique concept and the most difficult to apply, is his view of spirituality. Although he has repeatedly elaborated on the noos, and his commentators have attempted clarification, one is still confused over how to identify and deal with the noos. Significant help is gained from Gittelsohn's attempt to help children understand "God" through concrete representation of "raw materials," as he calls it. Gittelsohn's listing of attributes that define God could serve as illustrating Frankl's noos: 11 
1. 
An appreciation of beauty and order in nature. 

2. 
A sense of wonder, mystery, and awe toward the world and human life. 

3. 
Confidence and trust in the universe. 

4. 
The experience of friendship and love. 

5. 
An understanding of and a feeling for the relationship of human beings to the rest of nature, especially to other forms of life. 

6. 
A perception of our ethical capacities. 

7. 
A perception of the spiritual aspects of human experience -those capacities by which we rise above momentary self-concern, most especially our ability to create and appreciate truth, beauty, and moral goodness. 


Frankl's noos is the vehicle by which limitations imposed by environment and instincts can be transcended; it therefore constitutes the potential for balancing our ethological barriers with existential freedom. The recognition that humans are capable of responding non-mechanistically differentiates Frankl's 
theories from psychoanalysis8 and clearly separates his views from ethology. At the unconscious level the ethological concept of instinct is biological, determined, and species-oriented, while Frankl's unconscious spiritual dimension offers ethical, individual possibilities, and self-freedom. The conscious expression of both instincts and spirituality reflects the unconscious determinants (instincts) and choices (ethics) which are unconsciously selected for conscious experience. Human ethology and existential analysis must be confined to consciousness and settle for indirect understanding of the more influential unconscious. 
Conceptual Linkage: Ethological Existentialism 
Human ethology is a psychology of limitations. Existentialism is a psychology of opportunity and responsibility to challenge and transcend these limitations. Ethological existentialism uses ethology to understand instinctual pressures while incorporating Frankl's existentialism which helps in the search for meaning to overcome malfunctioning instincts. It is necessary to know one's limits before seeking to transcend them. Similarly, it is necessary to have meaning before transcendence is possible. 
An example of this conceptual linkage: When President Reagan was shot in 1981, the videotape showed a secret service agent who engaged in a remarkably protective behavior. In the midst of gunfire when the reflex or disposition would be to duck, this agent stood in a wide stance, extended his arms, and diligently searched for the source of the terrifying destruction. He maintained this behavior until wounded himself. For whatever reason (training, commitment to his role, personal loyalty, altruism), this agent found such meaning in his task of the moment that he defied his ethology. 
Many other examples from personal experiences and history demonstrate the parameters of ethology but also the human quality of defying those parameters. Some of these examples are in Frankl's writings. He describes how select individuals in the death camps refused to abide by rules of dominance hierarchies, aggressive competition for survival, displacement, and instinctual reduction to 
primitive needs at the cost of ethical or moral commitments.6 It must be remembered that instinctual pressures can be overcome by taking a unique attitude when the negative condition cannot be changed. 12 There have been several formal efforts to unify ethology and existential concepts. Frankl sees no unworkable contradictions between his and Lorenz' positions.7 Hefner discusses the underlying unity of the theological-ethical and 
ethological domains.20 Walsh and Peterson advocate a pluralistic approach in laying the groundwork for a synthesis of widely varying philosophies.21 
Ethological Existentialism and Substance Abuse 
While any individual can decide to consume a conscious-altering substance, certain categories of people are more likely to make this decision. Abuse may be a conscious decision but also the result of psychopharmacology, unique personality, or psychopathology. Yet the initial decision to use the substance and the choices associated with abuse are existential problems. The predisposition toward abuse is an ethological issue. 
Ethologically, any psychological characteristic varying from the "social normal" is viewed as an aberration of normal, instinctual, social-control processes. Thus, Price views depression, anxiety, schizophrenia, and cyclothymic disorders as a result of excessive behaviors normally linked to stabilizing a dominance hierarchy .19 For example, in a well-functioning dominance hierarchy, those higher in status tend to be irritable toward those lower, while those lower tend to be anxious when confronted with higher-status persons. Changes in hierarchical placement result in euphoria as one moves up, and in depression when one moves lower in status. This is viewed as functional and the result of natural selection toward social stability. "Knowing one's place" maintains stable group cooperation; depression resulting from lowering of status insures minimal disruption when there is contention over status -a depressed decliner is not likely to continue the struggle. Gardner uses this model in his ethology of manic
depressives.10 Frye views substance abuse as "a vestige of evolution."9,p.3 l Oetting and Beauvais see a small but critical subset of adolescents setting conditions, values, and meanings for drug use. This essentially is the ethological notion of a dominance hierarchy. "When considering all socialization characteristics, 95% of the predictable variance in drug use can be accounted for by the influence ofpeers."18, p.20 
Ethological existentialism can serve to generate a new type of validating research that would not be likely in the context of a disease model. Clinically oriented research is also stimulated. And it is also possible to develop new treatment programs with no major changes in existing approaches. The inpatient program outlined below should be viewed as additional interventions. 
Inpatient Programming 
Because factors increasing dominance hierarchy behaviors aggravate psychological problems, and those decreasing this behavior can relieve such difficulties, inpatient programming should capitalize on ward-management 
procedures to insure proper modulation. Using Price's list, l 9 a set of wardmanagement procedures can be suggested to decrease hierarchy behaviors: Minimize competitiveness. For example, bedrooms should be equally attractive. 
A void overcrowding. 
Make leadership clear, nonambiguous, authoritative. This applies to staff, patients, or a formalized combination. 
Arrange intense programming , with minimal free time. 
Have staff control all social activities and chores. 
Foster discovery of meaning through noogenic issues (e.g. "a higher power") 
and through significant involvement with others. 
In addition to general ward milieu, groups can be used to analyze and discuss hierarchial behavior. Fry analyzed a therapeutic residential treatment program through an ethological perspective.9 It is now possible to offer patients practical self-help ethology, including such phenomena as innate releasing mechanisms, territoriality, displacement, and investment strategy. Weisfeld describes how 
ethological understanding in itself can be therapeutic.22 
Learning observable and specific behaviors that are "built in" could help patients introspect on their own instinctual pressures and effectively define the target of transcendence. Ethological education is offered instead of a general, inflated, and fundamentally incomprehensible command to "transcend yourself." 
The addition of meaning-analysis groups and the teaching of logotherapy can help patients balance their understanding of limits, determinism, and pathological predisposition with awareness of their freedom to transcend such barriers. Such interventions can complement group therapy by helping patients perceive that improved interpersonal functioning can enable them to have an "encounter." Crumbaugh et al. describe an encounter as an intimate psychological relationship 
which demonstrates the power of meaning through involvement with others.3 This is consistent with a major tenet of Sullivan's interpersonal theory that through such a process patients can maximize their positive freedoms and 
responsibilities. 20 
Conclusion 
A synthesis of ethology and existentialism can have clinical application in chemical dependency. All standard components of treatment programs arc consistent with an effective plan based on such a synthesis. This includes AA, and medical, nursing, and activities therapies. Should this synthesis prove effective, health-care providers might wish to integrate their own approaches with ethological existentialism. For instance, traditional history taking and review could be amplified by a major emphasis on subjectivism. The patients' own views of their histories and their revised perception after treatment could constitute an extremely therapeutic variation to current practice. Novey describes a new approach to patient history that is exactly the kind of modification 
discussed here. 17 The use of written communication and bibliotherapy as useful adjuncts to therapy is particularly applicable to existential analysis and promotes ethological insight. At a minimum, ethological existentialism enriches any school of thought, system of psychotherapy, and personality theory with a philosophy that casts all views in a new light. 
Ethological existentialism is a synthesis and not a replacement for current approaches in mental health. In particularly serious psychiatric disorders (whether in connection with substance abuse or a separate problem) the full range of analytic, interpersonal, behavioral, and psychopharmacological treatment is mandatory. Such approaches are essential before a patient is receptive to the new ideas proposed in this article. 
HAROLD D. ROSENHEIM, Maj, USAF, BSC is chief, Mental Health Clinic, USAF Hospital, Grand Forks Air Force Base, North Dakota. 
REFERENCES: 
1. Buss,D.M. "Evolutionary Biology and Personality Psychology," American Psychologist, 12...1984. 
2. Chessick, R.D. "Heidegger for Psychotherapists." Am.J. of Psychotherapy, XL.. 1986. 
3. Crumbaugh, J.C.. W.W.Wood, and W.C.Wood. Logotherapy: New Help for Problem Drinkers. Chicago, Nelson-Hall. 1980. 
4. Fabry, J.B. The Pursuit of Meaning. New York, Harper and Row, 1980 
5. Frankl, V.E. The Doctor and the Soul. New York, Alfred Knopf, 1955. 
6. ____. Man's Search for Meanini.:, New York, Washington Square Press. 1984. 
7. ____. Videotaped Interview. 1984. 
8. ____. The Unconscious God. New York,Washington Square Press. 1985. 
9. Frye,R.V. "The Therapeutic Community." J. of Psychoactive Drugs,12. 1984. 
10. Gardner, R. "Mechanism in Manic-Depressive Disorders." Archives of General Psychiatry, 12... 1982. 
11. Gittelsohn, R.B."Nurturing a Belief in God." Reconstructionist, LL. 1986. 
12. Gould, W.B. "The Kantian Dimension in Frankl's Thoughts." In ,Proceedjni:s of the Fifth World Congress of Loi:otherapy. Berkeley, Institute of Logotherapy Press. 1986. 
13. Hefner, P. "Sociology, Ethics, and Theology." Zygon, 12.. 1984. 
14. Lorenz, K. On Aggression. New York, Hartcourt, Brace, and World. 1967. 
15. McGuire, M.T. and L.A. Fairbanks. Ethological Psychiatzy. New York, Grune and Stratton, 1977. 
16. MacMillan, J. and L. Kofoed. "Sociobiology and Antisocial Personality. J. of Nervous and Mental Disase, 172. 1984. 
17. Novey, S. The Second Look: The Reconstruction of Personal History jn Psychiatry and Psychoanalysis. New York, Int'l Universities Press, 1985. 
18. Oetting, E.R. and F. Beauvais. "Peer Ouster Theory: Drugs and the Adolescent." J. of Counseling and Development,..§i_ 1986. 
19. Price, J. "The Dominance Hierarchy and the Evolution of Mental Illness."Lancet, l,. 1967. 
20. Sullivan, H.S. The Interpersonal Theory of Psychiatry. New York, W.W. Norton. 1953. 
21. Walsh, B.W. and L.E. Peterson. "Philosophical Foundations of Psychological Theories." Psychotherapy, ll-1985. 
22. Weisfeldt, G.E. In McGuire and Fairbanks (see Reference 15). 
The Secular Character of Logotherapy 
Stephen S. Kalmar 
In all his writings Viktor Frankl takes great pain to separate logotherapy from religion. Here are some samples: 
The goal of psychotherapy, of psychiatry, and, quite generally, of medicine, is health. The goal of religion, however, is something essentially different: salvation.2, p.32/33 The function of the psychiatrist cannot be distinguished sharply enough from the mission of the clergy.4,p.73 
Whoever tries to make psychotherapy into an ancilla theologiae, a servant to theology, not only robs it of the dignity of an autonomous science but also takes away the potential value it might have for religion. Any fusion of the respective goal of religion and 
psychiatry must result in con-fusion_4, p.75 
Logotherapy, as a secular theory and medical practice, must restrict itself to factual statements, leaving to the patient the decision as to how to understand his own being-responsible; whether along the lines of religious beliefs or agnostic convictions.2,p13 
Just as dignity of man is based on his freedom--to the extent that he may even say no to God--likewise, the dignity of a science is based on that unconditional freedom which guarantees its independent search for truth.4,P-75 
If, then, it should be construed that medical ministry is being offered as a surrogate for religion, we can only say that nothing could be further from our intention. When we practice logotherapy or existential analysis, we are medical men and wish to remain so. We 
have no thought of competing with the clergy_3,p271 
I personally doubt whether, within religion, truth can ever be distinguished from untruth by evidence which is universally acceptable to man.2,p,l3 
Psychotherapy has to refrain from setting any preconceived goals along religious lines... by its very nature [it] is not and never can be religiously oriented.4,p.76 
As to religion, I have to stress [that] logotherapy is therapy, a psychotherapy, a psychiatric method of treatment -even in the hands of non-psychiatrists. As such it is a "secular approach." Logotherapy is applicable for every patient, religious and nonreligious. It remains applicable in the hands of every therapist, the agnostic as well as the 
believing.5,P-14(Author's translation.). 
In spite of these and similar statements, logotherapy is accused by some, and praised by others, for introducing religion into psychiatry. Logotherapy has strong appeal for religious persons and is being discovered by a growing number of religious leaders. When logotherapy speaks of a search for meaning and of finding meaning in life, religious persons often understand this as searching for God and finding God. Religiously oriented universities, especially Catholic universities the world over, are introducing logotherapy in their course programs, and many of them have bestowed their highest honors to Frankl. 
Despite Frankl's clear position in this regard, the secular character of logotherapy is seldom stressed in articles and lectures. What is emphasized is the similarity of Judaic, Christian, Moslem, and even Buddhist thought with Frankl's personal religiosity, as backed by Frankl's many statements about religion. 
It is of the first importance to rediscover that in Frankl's own view logotherapy is a secular discipline and should remain so. In the United States, and in many other countries, there is a strict constitutional separation of secular affairs and religious activities, and religion is excluded from their educational institutions, legislation, and politics. Therefore, if logotherapy is considered not a secular discipline, but based on religious views, this may well contribute to the resistance of state-supported universities and colleges in not accepting logotherapy in their curricula; it also explains why it is so widely supported by religious institutions. 
In Frankl's views, quoted above, religious persons can use logotherapy in their lives and in their relations with others, and incorporating logotherapeutic concepts into their religion. But any attempt to go the other way, and incorporate religion into logotherapy would be a disservice to logotherapy, because it would eliminate it as an independent field in human research. If logotherapy is ever taken over by religion it would lose its usefulness for nonreligious patients and nonreligious psychiatrists. It would become indoctrination. Logotherapy and religion must stay apart. (I am not discussing here "Logo-Philosophy" and its relation toward religion.) 
Frankl is aware that his thoughts about the human dimension of the spirit could be mistaken as religious in nature. That is not his intention. In German there is a clear distinction between geistig and geistlich, the latter, but not the first, having religious connotations. Both are rendered in English as "spiritual." Frankl puts logotherapy into the geistige (nonreligious) sphere of scholastic systems. Because the words spirit and spirituality have religious connotations, Frankl prefers to call the geistige dimension the noo-sphere, to avoid a religious interpretation. For Frankl, Logotherapy belongs to the Geisteswissenschaften , secular disciplines. 
The search for meaning and the will to meaning is as important to nonreligious as to religious persons. Finding meaning is a personal matter and a personal, unique choice. This freedom of choice is a main tenet of logotherapy. Frankl warns that dogmatic religious systems could endanger this freedom, the main characteristic separating humans from their animalistic forbears. Truly religious persons allow others to choose what is meaningful to them, even if it is different from their own religion, even if it is a religion without a God figure, and even if such personal meaning is found outside religion, in one's conscience and in the moral values of agnostic or atheistic world views. The need for finding meaningful values as guides through life exist for religious as well as nonreligious persons. Freud's view -that animals cannot be asked about their meaning in life, therefore the human animal should not be asked such a question either -is no longer accepted. Whether such meaning exists in the world, given by a divine power (as religious persons believe) or whether meaning exists, without divine intervention, or does not exist but has to be created (as the nonreligious believe) is not really important. Without meaningful values chaos and the existential vacuum result. 
No arguments will bring religious persons to forsake their belief in a meaning through divinity, and no religious evidence will convince the nonreligious to give up their secular explanations of the meaning in life. Nor will the nonreligious be impressed by statements that deep inside we "know" of God, that our longing for God proves His existence, or that our feelings and subconscience tell us of Him and, therefore, cognitive arguments are unnecessary. The position remains: Reason on one side, faith on the other. As Teilhard de Chardin expresses it: 
After two centuries of passionate struggles, neither science nor 
faith has succeeded in discrediting its adversary. On the contrary, it 
becomes obvious that neither can develop normally without the 
other. The reason is simple: the same life animates both.6,p.3 l l 
His views are based on two assumptions: 
The pre-eminent significance of man in nature and the organic 
nature of mankind; these are two assumptions that one may start by 
trying to reject, but without accepting them I do not sec how it is 
possible to give a full and coherent account of the phenomenon of 
man. 6,p.311 
Psychiatry in general and logotherapy in particular, are secular disciplines of human research, and must stay out of this dispute about religion. As Martin Buber says in his criticism of C. G. Jung: "... a psychologist as such has no right to declare what exists beyond the psychic and what does not. .. 
n2,p.134 
The defined goal of psychiatry and logotherapy is to research and improve human understanding and to help individuals understand themselves better, so that they can better solve their personal problems and their relations to others. Psychological theories are not based on faith -they can be proved wrong, often were proved wrong and had to be amended or abandoned as new research warranted. This distinction from religion must be preserved for the sake of logotherapy's independence and scholastic future. The need to separate religion from psychotherapy was never as great, acute and important as in our times. Contrary to the hopes of many, religious dogmatism, fanatism, and religious wars have not been overcome. Religious fanaticism still leads to the most cruel actions and wars, "justified" by religious dogmas. As in many countries, religious forces in the United States try to increase their power in fields that have been kept separated from religion, such as public education, jurisprudence, politics, and medicine. Individual logotherapists are entitled to their own religious views in such fields, for example, in questions of prayer and religious education in public schools;religious rules for marriage and divorce; preferential status for specific religions and races; individual decision-making about abortion; one's own choice about postponing one's death by exclusively technical means, and others. But when logotherapists make religious statements in such matters, they need to make it clear that these are personal views, not positions of logotherapy. 
Frankl wishes to keep religion and logotherapy separate. This separation needs to be stressed by logotherapists, to strengthen its recognition as a true secular psychiatry that is of important now and in the future. By emphasizing the secular character of logotherapy, it would find greater acceptance by nonparochial educational institutions in the United States and elsewhere. This is true of countries where religion, in many forms, is accepted, and also in those where religious activitis are severely restricted, as in Communist nations. Logotherapy, as a truly secular psychiatry, clearly distinct from religion, could find wider acceptance East and West, and help millions in their search for meaning, freedom, and individual responsibility. 
STEPHEN S. KALMAR is vice-president of the Board of the Institute of Logotherapy, Berkeley. 
REFERFNCES 
1. 
Martin Buber. Eclipse of God. New York, Harper Torchbooks, 1957. 

2. 
Frankl, V.E. Psychotherapy and Existentialism. New York, Washington Square Press, 1985. 

3. 
___. The Doctor and the Soul. New York, Vintage Books, 1973. 4 ___. The Unconscious God. New York, Washington Square Press, 1985. 


5. 
Kreutzer, Franz. Im Anfang war der Sinn. Vienna, Franz Deutike, 1982. 

6. 
Teilhard de Chardin. The Phenomenon of Man. New York, Harper,8 1966. 


Logotherapy and African-Oriented Therapy 
Charles Okechukwu lwundu 
The typical African-oriented therapy is "network therapy." It is well-defined and exercises a major role in African society today. 
Network therapy in the African context can be regarded as a group therapy in the European-American sense of psychology. Differences exist: group therapy views individuals in groups irrespective of previous acquaintance, such as friends or kinsmen. In non-western cultures the group is essentially close-knit, tribal. 
P. Zimbardo states: "Among the Navaho and African cultures, healing is a matter that always takes place in a social setting and involves the sick person's beliefs, family, work and life environment. The African use of group support in therapy is now being expanded into a procedure called network therapy. The patient's 
entire network ofrelatives, co-workers and friends are involved in the trcatment."5 The African form therefore contrasts with the European which emphasizes individuality, uniqueness, competition, independence, survival of the fittest, mastery over nature, and personal responsibility for success and failure. In contrast, Zimbardo views the African version as emphasizing groupness, sameness, commonality, co-operation, interdependence, tribal survival, unity with nature, and collective responsibility. Fundamental differences in philosophies and basic belief systems underlie the ways in which people become mentally ill and the paths available to mental health. 
Zimbardo maintains that therapy for mental illness is neither as swift or sure when it follows an isolated path as when the way is social. To help re-establish the powerful bonds of human connection, the ultimate therapy would include someone who cares enough about the person. In that network of mutual concern, says Zimbardo, people are more united in their common journey through life, and are strengthened against the fears, frustrations and failures which await them. No man or woman should ever have to be an island separate unto themselves: in isolation there is madness, in community, reinforcement. My own view and that of some psychiatrists in Nigeria is that psycho-sociological factors dormantly active can trigger maladjustment and that those with such illnesses have no need of a psychiatrist: their society offers them opportunities to share problems with relations or parents. This view is also held by Professor T. Assuni, Department of Psychiatry, University of Lagos. When I asked him how he felt about patients who go to psychiatric hospitals and discover that they do not have pure psychiatric problems but are existentially disturbed, his answer was succinct and inclusive, but seems pessimistic to me.* (*In Nigeria the patient is never considered psychologically sick once he enters a psychiatric hospital, though the society considers him mad even after leaving the place.) 
Professor Assuni stressed that Psychiatry in Nigeria is quite different from the European-American. In his view, Western psychiatry covers psychosocial problems, cultural problems, and adaptations which Nigerians do not regard as psychiatric illnesses but as social problems which the social network supports and rituals and morals can handle. In the West, people have lost the network, they are individualistic and materialistic. These patients have no parents to talk to, they don't think parents will understand them and therefore consult a psychoanalyst or psychiatrist. In Nigeria, those who come for psychiatric treatment have something wrong with them. Behavior is disordered or they exhibit a variety of symptoms. Professor Assuni insisted there is no one under psychiatric treatment in Nigeria who does not have pathological problems. If the problems were sociological, rituals would have coped with them and by the time patients came to a psychiatric hospital adjustments would have been made.** (**From a personal taped interview with Professor Assuni.) 
I do not agree with Professor Assuni, and one example will have to suffice, a typical incident in one of the neighboring villages of my town. Mr. X, after the civil war in Nigeria, returned to find his wife who had already given him three children, pregnant. He had hoped to meet family and parents in good health, instead he saw his wife with a pregnancy he was not responsible for. He could not believe his eyes. Could that be his wife or another person? He asked his mother and his wife what happened. Both said that it was an accident and th work of the devil. Could this be true? "What have you been doing since th incident took place?" he asked his wife. "Waiting for whom? You thought would die in the war? Before I undress, begone! What a shame for me, popul and respected among my people! How could such a thing happen to me? Thi can't be me. It is impossible!" 
The wife fled for her life to her home town, and allowed him time to recove from the shock, but he became increasingly devastated and dejected. The worl seemed unreal. Friends and relatives came to offer consolation in the form o advice (typical network therapy), yet his condition remained precarious. H developed mental confusion which led to unnecessary embarrassment to thos around him. He was handcuffed and sent to the psychiatric hospital. Diagnosi was that he was neither mentally deranged nor pathologically ill, rather he ha suffered a psychological defeat arising from severe depression. He was given anti depressants and returned home apparently cured. Unfortunately, there was n follow-up or aftercare therapy (== logotherapy), and the illness recurred Fortunately, Mr. X was referred to a priest who appealed to the forces of the spiri through psychology and Bible. Now Mr. X is fully recovered, has resumed hi business, got a new wife, and lives a decent life. 
I believe Professor Assuni is one of the medical practitioners in Nigeria wh look at people from the viewpoint of a machine that needs repair, and who tend t forget that consolation or comfort and human relationship is worth more at time than drugs or medicines. This points to a change in handling the psychologicall unstable. With Mr. X, psychiatry should not have been tried first, because hi problem was less than psychiatric. What he needed was a consolatory therap (Iogotherapy) to see life in a different perspective instead of the purely negativ way he was seeing it. His problem resulted from not seeing meaning in lif beyond or in spite of what happened to him. We therefore propose counselor therapist intervention for this form of illness. The guiding philosophy of th counselor-therapist which this example illustrates lies in the popular adage prevention is better than cure. 
Let us see how logotherapy can "transcend" network therapy (transcend in th sense of illuminating or making perfect.) Reiterating the case of the traditiona African world view based on old beliefs, B. Eboh cites Obiechina: "Traditiona life in precolonial Africa subsisted in the collective solidarity of people wh shared common customs and beliefs and an identical world view, were linked by blood or marriage, and were -by the close-knit nature of their social relationship deeply involved in one another's personal lives. We find that the value which sustains society is collective responsibility, the responsibility of the group for the lives and well-being of the members. In both personal and social relationships, everything that disrupts the orderly life of individuals must be removed or set right. The group and its interests always take precedence over the 
individual apd self interest." 1 These words symbolize the social interaction at village level; i.e., the sharing of each others' problems as is customary in Iboland. The Ibos are known for social awareness and solidarity. Isolated living in lboland normally attracts criticism, and that is why network support or therapy is central to their culture. Its disadvantage lies in its direct and institutionalized advice which logotherapy transcends. Another failing is that group leaders are seldom involved. Most people giving advice have no knowledge of human dynamics, no training in psychology, even less in psychotherapy. No wonder the bereaved person does not respond to the treatment. The advisors do not understand the patients since they cannot help them find meaning or solutions. In severe cases, such as impotence, the African may feel so ashamed that he cannot confide in anyone, and may die in silence. 
Failure of network support opens the way to logotherapy. Clients or patients should be referred to the logotherapist who can initiate them into network therapy after a well concluded individual therapy. Devastated and confused persons do not need network "multitude visiting consolation" until they have fould their identity. In their depression, they do not see anybody outside themselves. Group or network comes in as follow-up therapy -a step toward meaning orientation. In minor depressions and maladjustments, the logotherapist can participate as leader or facilitator in network therapy. F. Giardini states: "The person in need can at first hope to get some assistance from his family or from his closest friend. But if they also fall short, then the only chance left is to seek a professional counselor 
(logotherapist). "2 
U. Meshoulam3 confirms: " ... the moment personal problems are regarded as not necessarily medical or psychological, permission is given to consider resources of care even beyond the counseling professions. Herc the client's relatives, family, the family lawyer, his teachers, counselors, peers, his students and his doctor, may be better equipped to assist in spiritual and philosophical difficulties. Here logotherapy and network therapy combine. All people involved are possible providers of noetic care or "care-givers." The non-professionals (network support) and the care-givers (logotherapy), providers of noetic care, are not biased by psychological theories and medical approach. This does not mean that theoretical orientation is identical with bias, rather, that common sense and a sound philosophy of life are in some situations more essential than professional expertise in helping those in noetic plight. "Frankl cautions," says Meshoulam, "that traditionally the physician is not prepared to cope with the existential vacuum in any but medical terms and thus sees the problems as something pathological. Since noetic problems are often non-pathological, the medical 
approach of the psychiatrist may be disadvantageous.3 This also provides a proper answer to Professor Assuni on psychiatrists and mental problems; that is, not all who go to psychiatrists are mentally sick. 
Meshoulam leans toward network support and then corrects himself. Cordial encounter, especially on a truly human dimension (network), rather than psychological instruction and insight, encourages the clients to find and actualize meanings, whereas the mental-health professional tends to establish an expert~ patient relationship which can impede the development of an amiable and egalitarian tie. The non-professionals are more likely to develop friendship-like relationships because they are perceived, and perceive themselves, as less than au,thority figures. They are also more readily accepted by clients as equals in 
social status and moral values; friendships ensue more easily with one's equal.4 This view, however, cannot be fully valid at a deep therapeutic level, and that is why logotherapeutic cooperation is needed. A suffering client does not always need pity nor (misuse of) empathy that may lead to immoral friendship. The encounter logotherapy advocates is an existential love meeting; that is, an I-Thou relationship, not beer-or-coffee-drinking chumminess. Thus Meshoulam ends: "The physician (=logotherapist) is without doubt the natural source of support and consultation for the disabled and incurable, concerned not only with the disease but also with the patient's attitude toward it, and it is in this way that assistance 
fits his needs.3 
F. Giardini cites Jung in close support: "One cannot expect from the community ... a real and fundamental change in individuals whether for good or for bad. Such changes can come only from the personal encounter between man and man, but not from communistic or Christian baptism en masse. which do not touch the inner man." 
In sum, the therapy of "man-to-man," touching the inner person, is exactly what logotherapy advocates. The network lacks psychological knowledge and their counseling often fails the suffering person. jR. Mitchell adds the finishing touch: "We are all capable of helping each other in this sense, but the difference between a good friend and a professional worker is the professional's ability to be both involved and objective at the same. He is as much involved in the relationship as a good friend but, in addition, can stand back and see what is happening in objective terms -this is wi,at the American psychiatrist Harry Stack Sullivan called "participant observation."4 The collaboration of network therapy and logotherapy are indispensable for good results. 
CHARLES OKECHUKWU IWUNDU is research doctoral candidate in Logotherapy, Department of Educational Psychology, Pontifical University, Antonianum, Rome, Italy. 
REFERENCES: 
1. 
Eboh, B. N. The structure of Igbo Logic in Dispute Settlement in Igboland. Rome, Publ. Thesis, PUB, 1983. 

2. 
Giardini, F. Humanistic Counseling. Rome, Pont. University, St. Thomas 1985. 

3. 
Meshoulam U. "The Community Mental Health Movement." in J. Fabry e al, eds. Logotherapy in Action, New York, Jason Aronson, 1979. 

4. 
Mitchell R. Depression, London, Penguin Books, 1975. 

5. 
Zimbardo P. Psychology and Life Ill., Foresman and Co., 1979. 


Egocentricity and Two Conceptual Approaches to Meaning in Life 
Joseph T. Mccann and Mary Kay Biaggio 
According to Frankl,5,7 an individual's search for meaning is a basic motivation. When meaning or purpose in life cannot be found, and a person feels bored and empty, the results may be depression, anxiety, even suicide.6 At the core of a person's pursuit of meaning is self-transcendence -a going beyond self-interest or selfcentered needs to find meaning in relationships with others or in creative work.4 As such, self-transcendence is crucial in assuring truly satisfying interpersonal relationships. 
Another approach to meaning is self-actualization.9, 1 0 According to Yalom,20 self-actualization may be seen as a specific type of meaning in which one is motivated to realize an innate determined potential for self-growth. This position is incompatible with Frankl's view in that self-actualization is concerned with the 
self whereas self-transcendence reflects socially oriented motives. Frankl views self-actualization as the goal of life only if one has been unable to find self-transcendent meanings.4 Although Maslow8 agrees that self-actualization must not be sought 
selfishly, directly, or for personal achievement, there appear to be basic differences between Maslow and Frankl in their views of optimal psychological functioning. 
These basic theoretical approaches to meaning are explored by researchers l 4 who state that Frankl views the person as an open system that is "other-oriented" whereas Maslow views the person as a closed system which strives for actualization of the self. However, these authors contend that Maslow and Frankl describe the same "fully functioning" individual despite theoretical differences. Their argument, however, is not well supported by their results. Although self-transcendence was moderately correlated with the degree to which past experiences are used to attain future goals, no significant correlations were found between self-transcendence and several other aspects of self-actualization. To summarize: it has been argued that Maslow is describing the 
self-actualized person as functioning relatively independent of environmental influences whereas Frankl views the individual as open to experiences beyond the self, l 4, 20 and that self-actualizing may raise the level of egocentricity which can interfere with attaining satisfying interpersonal relationships. 1 9 If these theoretical differences between Frankl and Maslow are valid, there 
should be no relationship between the inner directedness scale of the Personal Orientation Inventory (POI) and measure of selftranscendence such as the PIL. The results from previous research point to the absence of such a relationship. 
One might hypothesize that if self-actualization raises the level of egocentricity, then individuals high in self-transcendent strivings will exhibit less egocentricity. The present investigation aims at examining this hypothesis. More specifically, it is anticipated that: 1. there will be a negative relationship between purpose in life and egocentric tendencies; 2. there will be a pos1t1ve relationship between self-actualization and egocentric tendencies; and 3. there will be no relationship between purpose in life and self-actualizatioon. 
Method 
Participants were 48 staff members of a midwestern state university and their spouses. The couples were participating in a larger study on meaning and sexual satisfaction. 11 The 48 predominantly white married couples responded to a letter requesting participation in a psychology experiment. The mean age for males was 43.77 (SD =10.75) years and for females 40.83 
(S D=9.97) years. The modal level of education was a high-school degree (n.=24 for the 96 subjects; 21 had completed a master's degree, and four had a doctorate; the remainder had completed varying levels of these degrees. 
The Purpose-in-Life (PIL) test is a 20-item, 7-point Likert scale,3 which assesses the degree in which an individual reports a sense of meaning as defined by Frankl. The Personal Orientation Inventory (POI) by Shostrom1 6 measures values and behaviors that define the self-actualized person. It is a 150-item forced-choice test consisting of 12 scales. Two major scales are of primary concern: time competence (POI-Tc) and inner directedness (POI-I). Time competence refers to the degree to which one is present-oriented and is able to adequately integrate past, present, and future aspects of one's life situation. 
Inner directedness refers to whether the psychological reaction tendencies of the individual are basically directed toward others or the self.15 , 16 
The Selfism Scale by Phares and Erskine1 3 measures an individual's tendency to view life events in an egocentric manner. It is a 40-item, 5-point Likert scale. Twelve of the items are designed to disguise the purpose of the scale, leaving 28 selfism i terns included in the final scoring. 
The Crowne-Marlow Social Desirability Scale (CMSD) measures social desirability response sets in the responses to psychological 
questionnaires. It contains 33 true-false items. 1 It was included to control for social desirability response sets to the instruments used in the present study. Although the Selfism Scale does not appear to be influenced by social desirability, the PIL and POI have been shown to be susceptible. 
All subjects filled out a demographic information sheet and were administered the PIL, POI, Selfism Scale, and CMSD. 
Results 
Table 1 presents a matrix of Pearson correlation coefficients for the measures. PIL scores were negatively correlated with Selfism scores, suggesting that individuals finding life more meaningful tended to view life situations less egocentrically than those finding less purpose in life. Given the highly significant correlation between the PIL and CMSD, higher PIL scores tend to represent a desire to present oneself in a socially favorable light. When variance due to CMSD scores were partialled out in a partial correlation analysis, the coefficient between PIL and Selfism values was -.13 (Il.=10). While these results tend to support the first hypothesis (that purpose in life is negatively related to selfism), the strength of this relationship depends, in part, upon social desirability characteristics of the individuals' responses. 
Table 1. Correlation Matrix of Personality Variables 
Variable 2 3 4 5 
1. PIL -.18 * .09 .26** .39*** 
2. Selfism .00 -.16 .16 
3. POI-I .57*** -.08 
4. POI-Tc .05 
5. CMSD 
*n.<.05 
***n.=<.001 
Self-actualization was not related to egocentnc1ty as evidenced by the lack of a statistically significant correlation between POI and Selfism scores. POI-I scores were not correlated with either PIL or Sclfism scores, suggesting that self-transcendence and egocentricity do not appear to vary as a function of an individual's tendency to respond to internal motivations rather than environmental influences. A significant correlation between POI-Tc scores and PIL supports the tendency for individuals who report life to be meaningful to live more fully in the "here-and'now." They are less burdened by past guilt and resentment, and have realistic goals which are meaningful in their present life. This relationship was statistically significant for females (r.=.46, ll<.001) but not males (r.=.01, l!.=.001). Together these results refute the hypothesis that self-actualization would correlate positively with egocentnc1ty. However, the obtained results were consistent with the third hypothesis that there would be no relationship between purpose in life and inner-directedness aspects · of self-actualization. 
Table 2. Multiple Analysis of Purpose in Life Scores as the Dependent Variable 
Variables R Square RSQ Change 
df E 
CMSD  .133  .133  
4+86  11.47***  
POI-Tc  .186  .052  4+86  
4.40*  
Selfism  .194  .008  4+86  
.81  
POI-I  .197  .002  
4+86  .28  

*n.<.05 ***n.,.001 
The most interesting set of relationships was obtained between CMSD, POI-Tc, PIL, and Selfism scores. That is, time competence aspects of self-actualization and purpose in life share a similar relationship with egocentnclty. POI-Tc scores correlate significantly in a negative direction with Selfism scores, with a partial correlation coefficient of -.18(1!.<,05) when both CMSD and POI-I were partialled out. Of all personality measures, POI-Tc and CMSD scores were the best overall predictors of PIL scores in a multiple analysis (see Table 2). 
Discussion 
The findings suggest that purpose in life and self-actualization are similar constructs. Individuals who have a purpose appear to meaningfully integrate past and present experiences to achieve future goals. Thus there is validity to the claim that Frankl and 
1 4
Maslow are describing the same fully functioning person. However, because purpose in life was not related in any way with inner directedness aspects of self-actualization, the results support some inherent difference between Frankl's and Maslow's views of ideal functioning. A high degree of purpose does not necessarily mean that the person will respond to his or her own set of motivations. This does not imply, however, that self-actualized persons who are inner-directed cannot have purpose in life. Those responding to their own needs and values may lack selftranscendence, but in no way does this imply that they lack meaning in life (Frankl, personal communication). Therefore, selfactualization might be achieved through two different modes: some people may achieve it through primary egocentric, self-centered means; others through self-transcendence. 
This explanation becomes clearer upon further examination of the results. Purpose in life was negatively correlated with egocentricity, while inner-directedness was not. One could therefore speculate that people who see purpose in life are inherently less egocentric and more self-transcendent. While the relationship between PIL and Selfism scores was moderate, this could be expected because the PIL items assess mainly the degree of meaning rather than the content or self-transcending nature of meaning. Nevertheless, the results suggest that self-transcendence is related to high levels of purpose in life. 
Overall, these observations are consistent with Frankl's explicit statements on the importance of self-transcendence in the search for meaning. Maslow, on the other hand, finds selftranscendence important also but not as a major component of his theory of motivation. Thus, while purpose in life and selfactualization may be similar in part, they remain different as to the relative importance of finding meaning through causes, persons, or life work that lies outside the person's self-interest. 
These results do not support the contention1 9 that selfactualization raises the level of self-centcrcdness. While it is possible that self-actualized persons may be egocentric, this tendency docs not appear to be related to an inherent trend in selfactualizing behavior. It may, instead, be due to a person's value system and life experiences that define whether he or she is self-or other-directed. 
Because CMSD scores were the most significant predictor of purpose in life, these results support Crumbaugh and Maholick's caution3 and Valom's20 criticism that PIL is highly susceptible to social desirability response bias. But the interpretation of social 
desirability scores is controversial• 17 Specifically, it is not known whether social desirability scales assess a personality characteristic or a response style during testing. Therefore it can be argued that a high degree of purpose in life may reflect a person's desire to present a virtue which is adaptive in social situations. It can also be argued that PIL is a transparent instrument that loses accuracy in testing situations where individuals wish to impress the researcher. The controversy needs further investigation. 
Additional research should also examine the possibility that self-actualizing individuals might explore their needs in two different domains of life experiences. If self-actualizing behavior directs the person toward either self-transcendent or nonselftranscendent life goals, further comparisons could be made between the theories of Frankl and Maslow. Such research should address two major limitations of the present investigation. First, the correlations obtained here might be a product of item overlap.1 2 The item content of each of the measures addresses different personality constructs: PIL assesses degree of life satisfaction, the Selfism scale addresses egocentricity, and POI responsitivity to internal motivations. Additional criterion measures should be applied to overcome the limitations inherent in sole reliance on self-report measures. Second, the sample represents only a small percentage of those contacted (13.75% of couples sampled) and may represent a more curious group of individuals. Also, the results may reflect the relationship between egocentricity and meaning only for married individuals. Further research on other populations is necessary. 
JOSEPH T. McCANN, Psy.D. is associate psychologist for Genesee County Mental Health Services, Batavia, New York. MARY KAY BIAGGIO, Ph.D. is professor and director of clinical training at the Oregon Graduate School of Professional Psychology, Pacific University, Forest Grove, Oregon. 
REFERENCES: 
1. Crowne, D. P. and D. Marlow. The Approval Motive: Studies in 
Evaluative Dependence. New York, Wiley, 1964. 
2. 
Crumbaugh, J. C. "Cross-validation of Purpose-in-Life Test based on Frankl's Concepts." J. of Individual Psychology, 24, 1968. 

3. 
______ and L. T. Maholick. "Manual of Instruction for 


the PIL Test." Murfreesboro, TN, Psychometric Affiliates, 1969. 
4. 
Frankl, V. E. "Self-Transcendence as a Human Phenomenon." J. of Humanistic Psychology, Q.., 1966. 

5. 
____ The Will to Meanini;. New York, The American Library, 1969. 

6. 
____ "The Feeling of Meaninglessness: A Challenge to 


Psychotherapy." Am. J. of Psychoanalysis, ll, 1972. 
7. 
Man"s Search for Meaning. New York, Simon & Schuster, 1984. 

8. 
Maslow, A. H. "Comments on Dr. Frankl's Paper." J. of Humanistic Psychology," .6.., 1966. 

9. 
____ . Toward a Psychology of Being. Princeton, Van Nostr and Reinhold Company, 1967. 

10. 
__________. A Theory of Metamotivation. In Chiang and 


Maslow, eds., The Healthy Personality: Readings, New York, Van Nostr and Reinhold Company, 1969. 
11. McCann, J.T. and M. K. Biaggio. "Sexual Satisfaction in Marriage 
as a Function of Meaning in Life." Archives of Sexual Behavior (in press). 
12. 
Nicholls, J.G., B.G. Licht and R.A. Pearl. "Some Dangers of Using Personality Questionnaires to Study Personality." Psychological Bulletin, 21.., 1982. 

13. 
Phares, W.J. and N. Erskine. "The Measurements of Selfism." 


Educational and Psychological Measurement, 24, 1964 
14. Phillips, W.M., J.T. Watkins and JG. Noll. "Self-Actualization, 
Self-Transcendence, and Personal Philosophy," li(Jl, 1974. 
15. 
Shostrom, E.L. "An Inventory for the Measurement for SelfActualization." Educational and Psychological Measurement, 24, 1964. 

16. 
___________ "Manual: Personal Orientation Inventory." 


Educational and Industrial Testing Service, 1966. 
17. Tanaka-Matsumi, J. and V .A. Kameoka. "Reliabilities and Concurrent Validities of Popular Self-Report Measures of Depression, Anxiety, and Social Desirability." J. 
of Humanistic Psychology, .5.±. 1986. 
18. Warehime, R.G. and M.L. Foulds. "Social Desirability Response 
Sets and Measure of Self-Actualization." J. of Humanistic Psychology, llill, 1973. 
19. Waterman, C.K., E. Chiauzzi, and M. Gruenbaum. "The Relationship between Sexual Enjoyment and 
Actualization of Self and Sexual Partner." J. of Sex Research, li., 1979, 
20. Yalom, I.D. Existential Psychotherapy. New York, Basic Books, 1980. 

Listen to Life: A Tribute to Joe Through Logotherapy 
Carol Crosby 
Husband Joe 
Viktor Frankl's logotherapy has had a profound impact in my life. His writings proved my worst fears to be wrong. Life was worth living, even amidst a hollow, meaningless existence. 
Illness changes our lives. I learned this during the first month of my marriage when my husband Joe suffered many injuries from a serious fall. Complications from the accident eventually resulted in his permanent disability, both mentally and physically. My nursing background enabled me to cope with Joe's physical condition but his personality change from a subsequent stroke left me with a violent tempered, childish man. My life of 24 years was suddenly submerged into a bizarre way of living. I felt trapped with a stranger who had more problems than I ever anticipated. 
Our lives grew apart. My love for Joe slowly became a distant fantasy. As the years progressed, stress caused us to be detached from the world and each other. Friends stopped calling and we were left to fight our own battles. I remained faithful but felt cheated -no children and in many ways no husband. 
Ten years later my depressions peaked. Our life consisted of constant frustration. My dilemma was whether to continue to stay with the husband I no longer loved or abandon a severely ill man. I couldn't cope because I could not decide. My burden was heavy and the future looked grim. My thoughts focused on me, how to satisfy my needs in this impoverished existence. Hyperreflection only increased my desperation. 
Over the next four years I counseled with ministers, priests, psychiatrists, psychologists, social workers and others, but my confusion only deepened. Their focus was on relieving my suffering, not on facing but on avoiding pain, and to concentrate on happiness. I felt guilty when I would hear, "Don't you think God wants you to be happy?" 
Every answer was the same: leave Joe to preserve your sanity. But there was still part of me that knew that this was not the solution, at least not for me. They told me that, above all else, I must take care of myself. Every time I left an appointment, I was more unhappy and ashamed of my suffering. I allowed the consultants to make my decisions for me, believing I was too weak to think for myself. 
Divorce papers were served to my very ill husband lying in his hospital bed. It was like committing a crime. 
The impact of a book 
One summer day, a friend gave me Frankl's Man's Search for Meaning, describing his fight for life in Auschwitz. I felt a personal closeness to Frankl. It was as if I was in my own Auschwitz. Even though there was no comparison in circumstance, I too was confined within my own limitations, incapable of using my freedom. I read how Frankl struggled through the worst conditions known to humans and maintained his will to live. 
I read about the millions in Auschwitz who perished, robbed of all choice, and those who, by their own choice, ran into the electric wire. Then there were those with reasons to survive, who rose above the torment. I wanted to learn the source of this passionate desire for life. The answer was their attitude toward their suffering. Frankl profoundly convinced me there was meaning in my suffering, even if I didn't know what it was at that moment. "Suffering ceases to be suffering in some way at the moment it finds a meaning, such as the meaning of a sacrifice."1 Frankl's courage and strength filled my spirit. After 14 years of floundering, this little book gave me reasons to go on, and my heart was full of gratitude. I knew there was a meaning in all this suffering and my conscience would guide me to find it. 
I was in awe of Frankl's never-wavering will to live, amidst such horror. Even though he seemed worlds away, I wanted to express my thankfulness for his words of hope. I wanted him to know how deeply his perseverance affected me. 
Ten days later I received a response. It read, "Your words came from your heart, and therefore they reached and touched my heart. I am proud of your letter, it gives me courage to continue my work." I felt deeply inspired. 
Frankl referred me to his personal friend, Melvin Kimble, professor of pastoral theology and ministry, who had studied logotherapy in Vienna -a logotherapist only ten minutes from my home! 
I was greeted by a warm, gentle man. During the next two hours my recovery began. Contrary to my earlier experiences with therapists, I felt sincere, not casual sympathy. Our discussion centered on Joe, where it should have been long ago. Kimble helped me face my problem, not run away from it. He spoke about values, responsibility, conscience, and meaning. My exhausted mind awakened -finally this was where I would find my answers. He explained I had the freedom, strength, and right to choose the attitude I wished toward my problem. My thoughts turned to Joe as a suffering human being instead of what he could or could not do for me. I saw that self-concern was not what I needed. Nor did I need to be "cured"; I needed to understand. 
We talked about giving. Was it genuine or an act of obligation, and was this fair to Joe? I couldn't tolerate the feeling that all my serving may be tarnished and hypocritical. My controlling character was being questioned and I wanted to avoid the subject I thought of all the years of devastating turmoil. If my giving to Joe was only a selfish, resentful duty, this was obviously not a genuine act. It wasn't what I wanted to be. My lack of love for Joe had left a lonely emptiness. I had tried my best but now couldn't help wondering if my efforts had been an injustice to him. After all, he had the right to the best possible care. Maybe he was the one who had been cheated. 
Kimble encouraged me to search my conscience and sort out my values. My faith was fragile. I thought God spoke to others but ignored me. My hundreds of prayers for Joe's recovery had not been answered my way, so I felt I didn't count. I knew that God was with me through it all but was waiting for me to listen: listen to life. I became conscious of my responsibility to make my own decisions by listening to my "self." 
My conscience guided me to new awareness of wanting to improve my inner value. Perhaps one way to start was to ask for Joe's forgiveness, as well as my own. Much of my problem had been a conflict of my own values, which were strongly influenced by society's values. My new answers started to make sense. 
Quietly, I sat at Joe's bedside and awkwardly told him I wanted to try again. We held each other close, our tears flowed freely, we felt the relief of a long awaited decision. We had invested too much pain, and our bond of suffering was too strong to break. After 14 years of fighting life itself, there began a transformation of total acceptance. My decision to stay with Joe never changed. This was my challenge: what did life expect of me? Meaning was emerging but our situation didn't change. I changed. 
Logotherapy taught me that pain was a necessary part of life, but we needed meaning in that pain to endure it. I began to see the true values of life through the raw struggle to survive. No pretense, no reason to impress the neighbors. My mission was to give Joe a fuller life. I became aware of the immense importance of moments I used to take for granted. 
During the next eight months Joe spent weeks of hospitalization in an isolation-intensive care unit. After three heart attacks, two cardiac arrests in a body riddled with staph infection, he acquired the name "miracle man." To the astonishment of everyone, Joe recovered enough to come home, where he so wanted to be. 
My love for Joe returned as an experiential value. My needs were no longer important because I had found a strong purpose. This time my giving was sincere and tender. He knew it, and that's what counted. I remembered the healthy, handsome Air Force veteran I had married, and now I saw the frail human being whom I carefully fed ounces of food. I knew his every need, almost his every thought. I studied his will to live and was proud to be part of his life. My husband and closest friend died peacefully at home, March 3, 1975. My meaning had been found through Joe's suffering and his struggle to live. "Life holds a meaning for each and every individual and, even more, it retains this meaning literally to the last breath."2 
Joe had shown me part of life I would never have known otherwise. I learned that sufferers live in a different dimension. This dimension is reserved solely for the very special, for those who set an example for others, representing a higher tolerance and valor. It is imperative that they know that courage and strife have a place of honor in our lives. Suffering is what we envy the least but admire the most. 
Our society discounts suffering because it's easier to pretend it doesn't exist. Thus, we are made to feel guilty when we suffer. But suffering people want the chance to be heard and the hope to be understood. Psychologists often tell us that we are born to win, that we are here solely for enjoyment, and to satisfy our own needs. But what if we are faced with an incurable disease, wrestling with a divorce, grieving a personal loss, or find ourselves in a situation we cannot change? Logotherapy's answer is positive: "To subtract trouble, death, fate, and suffering from life would be stripping life of its form and shape. Only under the hammer blows of fate, in the white heat of suffering, does life gain shape and form. "3 
I found meaning in my burden, and learned to listen to my conscience. This was a fulfilling experience, for every meaning we miss is lost forever. 
CAROL CROSBY is a medical review analyst with a National Health Carrier, St. Paul, Minnesota. 
REFERENCES: 
1. 
Frankl, Viktor. Man's Search for Meaning, Boston, Beacon Press, 1959. Paperback, New York, Pocket Books, 1977, page 179. 

2. 
____. The Will to Meaning. New York, World Puhl.Company, 1969, page ix. 

3. 
____. The Doctor and the Soul. New York, Knopf, 1965. page lll. 


A CRITIQUE OF LOGOTHERAPY AS 
A PERSONALITY THEORY 
Robert F. Massey 
Similarities and Differences 
The similarities and differences between the 32 personality theories and logotherapy are surveyed in a previous article.39 Their various viewpoints depend on the perspective of its originator. 34 They articulate six principal clusters of 
considerations for a holistic model: physical/constitutional variables; psychological processes; social/cultural influences and interactions; specifically human (noological) capacities; developmental progression of personality and orientation to crucial times in the life cycle; and distinctions between normal and 
abnormal behaviors. 34 This is how Frankl deals with these six dimensions. 
1) Physical/constitutional variables. Frankl acknowledges the somatic dimension and the determining influences of biological conditions. He objects to the "nothing but" explanations of reductionistic biologism, a person is more than "an automaton of reflexes, a bundle of drives.16,p l23 He "developed the first tranquilizing drug on the Continent" l 7, P 28 and applied electroshock treatments and performed lobotomies--all procedures addressing physiological issues. Attention to somatic concerns, as in neurological examinations, requires focusing on only one dimension which, however, is only part of "the full dimensionality of reality"l6, P 140 for human beings. For example, "the organic factor ... provides no more than a mere inclination to anxiety." l 6, P 103 Frankl, therefore, recommends to deal with the several dimensions making up the anthropological unity of a person. 
Frankl confines himself to mentioning reflexes and drives in examining somatic factors. He18 discusses the "bodily appearance," the "sexual element," in relation to love. He18 sees biochemistry and heredity important in the etiology 
of psychoses but not of neuroses. 
2) Psychological processes. Frankl states that psychic conditions can be determining but eschews psychologism which treats a human as '"nothing but' .. . a psychic mechanism." 16, p.123 In the psychological dimension, he refers to psychological complexes and traumata, to aggressive impulses and guilt feelings, and to learning and conditioning as underlying psychogenic neuroses. He views 
He18
traumata not as causing neuroses but as providing the contents for them. sees the eroticism of love as being involved with the psychic structure of another person. He elaborates little on psychological processes in human functioning or on the psychogenic aspects of neuroses, except for his remarks on anticipatory 
anxiety.47 
3) Social/cultural influences and interactions. Frankl mainly refers to the social dimension of persons in noting that "encounter with others" l6, p. 14 serves as an avenue to meaning. He considers "the relationship between patient and ... doctor ... the crucial agency in psychotherapy." 16,p. 144 He approaches interpersonal processes and love "in the light of existential meaning." l8, P 132 
Thus he defines love as "living the experience of another in all ... uniqueness and singularity." l8, p. 132 In the interactions of persons, too, Frankl focuses on relationships as pathways to meaning. He acknowledges sociological conditions, yet does not consider them determining: a person "always remains free to take a stand ... to choose ... [an] attitude toward them." 16, P 3 He rejects sociologism--which he characterizes as regarding a person as "simply a product of economic environment."16, p.l32 "Sociological laws ... cannot affect ... [a person] without first passing through a zone of individual freedom." 18, p.9l Frankl17 recognizes sociogenic neuroses. However, in discussing his second law of dimensional ontology, he mentions somatogenic, psychogenic, and noogenic neuroses but omits sociogenic ones. He sees 
iatrogenic neuroses as sociogenic. Primarily, he18 regards sociogenic neuroses as the mass feeling of meaninglessness generated by the dissolution of traditional values. In speaking of "the collective neuroses of the present day," Frankt16 depicts the symptoms in individually oriented terms (fatalist attitudes toward life, conformist thinking, and denying the personalities of others). 
4) Specifically human {noologican capacities. Frankl accents the specifically human capacities in describing noetic phenomena and the noological dimension. Though he renounces "noologism"--a one-sided, monistic spiritualism--he concentrates on the specifically human features of personality. The noetic is "the characteristic and constitutive dimension of human existence." l6,p 157 He repeatedly defines and illustrates with case examples the specifically human phenomenon of self-transcendence; the will to meaning; the capacities to discover meaning through creative, experiential, and attitudinal values; freedom of the will; self-consciousness; conscience; and self-distancing. He attributes the specifically human phenomena to the noological dimension. His logotherapeutic techniques are based on noetic capabilities. 
Noogenic neuroses stem from collisions between different values or from existential frustration of the will to meaning. This leaves the individual's groping for ultimate meaning and the meanings of the moment unrewarded. While Frankl extols the creative and experiential values, which other personality theorists also have dealt with, he deems the attitudinal values, which logotherapy 
specifically introduces, as "the noblest appreciation of meaning." 17, P 70 
5) Developmental considerations. Frankl has not postulated stages in personality development. He implies development in four instances: when a person engages in an attitudinal value in cases of incurable disease, inerasable guilt, and inevitable death. The fourth personality development occurs when a person moves from physical attraction to erotic involvement to loving the spiritual core of another in sexualized love. 
Frankl's orientation to time centers on the present. He is concerned with the current pursuit of meaning and the choices made in the now. The past can be transcended by a present decision. The future is also important because it offers a horizon that beckons to new meanings. 
6) Differentiating normal and abnormal. Frankl distinguishes between norinal and abnormal behavior mostly on the basis of noodynamics. He recognizes biogenic disturbances in psychoses, psychogenic factors in neuroses, and 
sociogenic influences in the existential vacuum. He is primarily concerned with the differences between following the will to meaning versus experiencing frustration in the will to meaning. When persons are motivated to fulfill their unique meanings, happiness and success ensue. Even in unalterable circumstances, they can exercise the freedom to take a positive attitude and discover personal meanings. Pathology results when they shirk the responsibility to respond to meanings unique to themselves. Succumbing to the apathy of an existential vacuum diminishes human development and increases the risk of damaging results. So do the collective neuroses of purposelessness, fatalism, conformism, or fanaticism. The two most prominent therapeutic techniques specific to logotherapy elicit the capacity underdeveloped in neurotics--selftranscendence: Through "paradoxical intention," clients (e.g., obsessive/compulsives or phobics) are invited to transcend themselves through humor. In "dereflection," hyperreflecting persons (e.g., those with sexual dysfunction) arc directed to transcend themselves through focusing on a partner. 
Frankl has most in common with theorists concentrating on the specifically human aspects of personality. He accents the self-transcendence of persons who arc motivated to use consciousness, freedom, and responsibility in searching for unique meanings. He regards biological explanations for personality functions as reductionistic. He does not subscribe to environmental control of behavior and shies away from considering social processes in personality development. 
Frankl vis-a-vis Freud, Adler, Jung. 
Though he retains the hierarchy of unconscious, preconscious, and conscious strata of human functioning, Frankl l 8 disagrees with the psychoanalytic approach. He contrasts his height psychology with Freud's l 9 reductionistic depth psychology. Frankl cannot be considered a neo-Freudian. 

Though he distances himself from Adler around the issues of the "will to power" vs. the "will to meaning" and whether values are created or discovered, Frankl shares a number of similarities with AdlerI. They both espouse a "psychology of use, not possession" --what matters most are not our endowments or circumstances, but what action or attitude we take. Both Adler and Frankl view humans as capable of being active and creative rather than as intrinsically passive and reactive to drives or situations. However, Frankl's fundamental concentration on noodynamics and his sparse attention to social processes do not lead to classifying him as a neo-Adlerian. 
Though Frankl disputes Jung's25,26,27,28 notion of archetypes as embodying spiritual realities within persons, in contrast to discovering them from without through self-transcendence, the two theorists have common themes. Each accents distinctively personal development either through individuation or through discovering unique meanings. Both emphasize the importance of spiritual issues and the problems that arise when this dimension is neglected or denied. Both consider spiritual concerns intrinsic to human nature and an essential aspect of personality theory. Arnold and Gasson concluded, "Only two major psychotherapists, Jung and Frankl, paid attention to the human spirit and human 
aspirations"7, p.51 Both theorists point to the dynamics and results of crises in values. For Jung, the midlife crisis revolves around values. Both focus on "the meaning and purpose ... of life.24, p.110 Both speak of a unity of multiplicity. Jung observes the union of opposites of archetypes and personality-type functions and the emergence of a unified self through transcendence; Frankl advocates dimensional anthropology. Both oppose reductionism. Both suggest including the insights of Freud and Adler in a more encompassing framework. Both deal with the tension of opposites (Jung in consciousness and unconsciousness and in opposing archetypes; Frankl regarding subjectivity and objectivity). The future is important to both--for Jung as an opportunity for becoming, for Frankl as an arena for discovering new meanings. In the sense that Frankl incorporates into logotherapy so many of these themes that mainly Jung previously articulated 
(much as the neo-Adlerians6,35,36 reintroduced Adlerian motifs), Frankl might be considered a "neo-Jungian." 
Dimensional Anthropology 
With his model of "dimensional anthropology and ontology," Frankl17 offers a paradigm for evaluating the completeness of a personality theory. He proposes that a holistic theory must adequately address each dimension of human functioning and acknowledge the unity of a person who integrates the dimensions 
into the total being. For Frankl6 anthropological unity is supported by a multidimensional concept of persons. He often speaks of three layers--"a physical-psychic-spiritual totality,"14, p.133 and the "somatic, psychic, noetic modes of being." 17, p.22 Frankl prefers speaking of dimensions rather than layers of human existence, to emphasize that these aspects are not separable layers but 
"dimensions of one and the same being."16, P 137 He views persons as "subject to biological, psychological, and sociological conditions," 19, p.47 which can be determining, but they have a noological dimension, where they take a stand. In analyzing the dynamics of personality as a whole Nuttin43 lists three main levels of human activity--l)psycho-physiological, 2) psycho-social, and 3) psycho-spiritual. The crucial difference is that Frankl views the "psychic layer" as a dimension of human existence; Nuttin, on the other hand, develops his theory from the point of view of an individual's psychological experience of the 
three levels of human activity. When we realize that the two theorists speak from different perspectives, we can conclude that there is no inherent contradiction in their formulations. Van Kaam5 1 points out that in studying the anthropological 
wholeness of persons, psychologies tend to study human existence from one of three perspectives: the subjective, experiential aspect; the objective, measurable profile; or the situational context. Frankl is describing human functioning from the "outside" or "observed, objective" perspective, while Nuttin bases his explanations on the "inside" or "subjective, experienced" perspective. The two are dealing from different vantage points on the same processes. The juxtaposing of different perspectives accounts for some of the variance in how personality theorists proceed in their analyses and arrive at their conclusions. 
Frankl emphasizes "the anthropological unity and wholeness of a human being," l6, p. 136 and concentrates on the noological dimension. While noting that "each of ... [the] schools [of psychotherapy] has made a valuable contribution,"16, p.l7 Frankl accents his perspective by concluding, "Their real 
significance and value become visible only if we place them in a higher, more inclusive dimension, within the human dimension." 18, p.17 To avoid reductionism and preserve the integrity of a higher, "more inclusive and more encompassing dimension," 17,p.Z6 logotherapy presumes but does not detail processes in the psychological and physiological dimensions. It tends to underplay the social dimension. The contrast between logotherapy and other approaches is exemplified by how various theorists deal with values. Many of them examine experiential valuing: 
Freud (regarding psychosexual impulses), Jung (the emerging self), Rogers (organismic processes and relationships), Maslow (deficiency and being needs), Allport (awareness of self), Boss (illuminating and disclosing meanings), and the phenomenologists (on multiple topics). A host of other theorists explore creative valuing: Adler (choosing a style of life), Horney (using interpersonal movement), Erikson (forming an identity), Fromm (constructing social character), Allport (engaging an in propriate striving and an ought conscience), Berne (deciding on a script), Lewin (setting goals), Rotter (developing expectancies), Binswanger (exercising freedom), and May (employing courage, creativity, power, love, and will). Only logothcrapy stresses attitudinal valuing. 
Complementing Logotherapy with Other Approaches 
Frankl states that "logotherapy . . . is open to cooperation with other approaches to psychotherapy" I 8, P-141 and decries that "the lack of an opportunity to compare one school with another accounts for much of the proselytizing among psychiatric sectarians." l7, p. l33 He sees "logothcrapy as a supplement rather than a substitute for psychotherapy.1117, p. 14 To fulfill the criteria of Frankl's dimensional ontology, logotherapy requires supplementation, especially in four areas: attention to developmental processes; increased understanding of social/contextual dynamics; greater detailing of the interlinkage of persons; and more balance of the subjective and objective. 
Developmental processes. Frankl does not discuss children and their development. He does not describe stages of development as do Freud, Jung, Sullivan, Erikson, Allport, and Berne. Frankl's penchant for articulating general principles, which may operate universally and not according to developmental stages, parallels the approaches of behaviorists and social-learning theorists. Bimbaum9 notes the contrast between Adler, who emphasized education and the formation of a child, and Frankl, who has highlighted termination, suffering, and dying. Whether responding to meaning is modulated by life cycle changes merits researching. The pursuit and discovery of meaning may not proceed in predictable stages, but the influence of developmental capacities on responding to meaning needs to be investigated. Is the seeking of meaning a specifically adult activity, or does it emerge in adolescence with the development of the capacity for abstract thinking, or are there ways in which children display this capacity? As a person grows and various abilities evolve, the capacities to discover meaning may be affected. Such coniderations are held important by Elkind and Piaget for cognitiveIO and affective developmenr45,46, by Kohlberg29 for the development 
of moral judgment, and by Bloom30 for affective development and valuing. 
A comprehensive psychology should examine what physiological, psychological, and social abilities are needed for the search of meaning. What capabilities for social-cognitive understanding50 and for empathy22 need to be developed to practice a love in which the partners recognize meaning? Raskob credits Frankl for his "contention that childhood experiences do not completely determine a person's later life," and for his plea to take "childhood psychogenic factors seriously.47, PP lll-ll2 
Social/contextual dynamics. Frankl alludes to the social context of personality processes but does not draw out many of the implications. He notes the importance "in psychology to view the phenomena 'in a context.17 ,p.40 
Although he acknowledges that "everywhere the individual appears to us embedded in the social nexus,"18, p. 91 his emphases on avoiding social determinism and conformism and on protecting "values ... [as] the private preserve of the individual'' 18, P-92 lead him to highlight personal experiences and to leave social variables unexplicatcd. From Frankl's perspective, work (through which an individual faces "the problem of reaching an 'active' settlement with the social environment")18, p.92 and concentration camps (where persons run up against "a more or less unalterable element which opposes the human will)" l8, P-92 serve to actualize values and discover meaning rather than social-psychological interconnections between personalities and social structures. For instance, Frankl discusses "unemployment neurosis" but not the social psychology of how unemployment develops and is handled in society. He writes about the character 
changes and attitudinal values of inmates of concentration camps21 but not about the social psychology of power that sustains such structures.23,40 
Logotherapy's spotlight on the individual is apparent also in depicting a sociogenic neurosis as a personal feeling of meaninglessness or the experience of an existential vacuum.17,18 "Collective" neuroses are examined as symptomatic 
attitudes and types of thinking without analyzing their social-psychological contexts. Logotherapy needs supplementation in explaining contextual influences on personality. Insights can be drawn from Adler, Berne, and Laing (on family dynamics), Sullivan, Horney, and Rogers (on interpersonal processes), Erikson (on cultural influences), Lewin, Maslow, and Boss (on the impact of institutions), and Allport (on intergroup relations). A good starting point for supplementing logotherapy regarding contextual variables would be an integration of Frankl and Fromm. Both consider self-consciousness, responsibility, freedom, transcendence, and values, with a frame of reference and orientation, basic to human existence. Fromm's20 "historical dichotomies" deal with "creative values" and his "existential dichotomies" with "attitudinal values...21 Additionally, Fromm stresses the specifically human needs for rootedness and relatedness and the social/historical/political/economic contexts of identity21 . Frankl claims that other approaches "are not nullified by logotherapy but rather overarched by it 17 P-26, italics added_ In the area of social dynamics and interlinkage of a person (see below) logotherapy so overarches other more socially oriented perspectives 
that it loses sight of them and can use further butresses to remain more comprehensively grounded in all the dimensions. Interlinkage of Persons. Frankl touches on the interconnectedness of persons 
but does not pursue all the ramifications. In speaking of interpersonal encounter and dialogue, he18 concentrates on discussing the "intentional referent" of the communication without thoroughly exploring the interpersonal processes. He equates "relating to something, or someone, other than oneself, be it a meaning to fulfill, or human beings to encounter," l8, p. 47 as ways to demonstrate the self-transcendent quality of human existence. The stress on the noological dimension obscures the social dimension. Frankl characterizes Binswanger's daseinanalysis as "ontologizing Alfred Adler's tenet of tendentious apperception" 16, p.114 and as "the a priori structure of Daseingestalten ... [as] the specific mode of being-in-the-world which corresponds to a specific subjective mode of experiencing the world_ 16, P-134 This circumvents the interconnection 
between persons and contexts connoted by the concept of being-in-the-world as a holistic process. Frankl's spotlighting an objectively given world distracts from an appreciation of the dynamic interlinkage and reciprocity between persons bound 
together in social systems. In his remarks on love, he 14 focuses on the uniqueness of the partners and on the meaning of love rather than on the interaction between the lovers. Logotherapy highlights the spiritual heteronomy of self-transcendent persons while leaving the social heteronomy of interacting partners unexplored4,5. 
A personality theory that adequately attends to the social dimension must explicate both the social context of human development and the dynamic interconnections of persons in social systems. The essence of this theme is that persons in systems are interconnected through the interdependent processes of 
interperception, interexperience, and interaction. 32 This understanding is helpful in treating couples and families. "A holistic, synthesizing perspective on systems elucidates the gestalt of farnilies--persons--dynamically~interdependent-incontext. Persons -in-context create and are structured by a system _38, p. 30 
Some of Frankl's ideas could lead to supplementing logotherapy on the social dimension. Frankl's contention that "the ego can become an ego only through a 
Thou," 17, p.12 echoes Mead's social psychological description of the development of self.41 Frankl's17,l8 depiction of the cycle of feedback mechanisms in the intertwining of anxiety, phobias, and symptoms implies "circular causality."52 Frankl also recognizes dimensional interaction as in "a feedback mechanism between the primary somatic condition and the secondary psychic reaction." 16, p.76 The fact that Frankl developed paradoxical intention, which family systems therapists have adapted, 36,44 is balanced by logotherapy's receiving from systems thinkers a more comprehensive understanding of socialinteraction processes. Logotherapy's conceptualization of how persons are bound together by the interactions in the social dimension, can be supplemented by other theorists: by Adlerl (who elaborates on the dynamics of inferiority, superiority, and social interest both interpersonally and in social structures); by Jung 25,28,42 (with his focus on the transpersonal unconscious whose contents retain the spiritual heritage of human evolution and interlink persons as they proceed through the common human life cycle); by Angyal,5 (with his stress on the biospheric dynamics of heteronomy as well as autonomy); by Laing 31, P· 66 (who explores the '"psychosocial interior' of the family"); by Erikson11 (who 
points out the reciprocal interconnections between the generations as the life cycle unfolds); and by Berne8 (who analyzed moment-to-moment patterns of interaction and transgenerational influences and responses). Balanced understanding of subjective and objective. Frankl juxtaposes remarks about subjectivity and objectivity. He both uses a phenomenological approach and insists upon objective existence. He proposes that "the logotherapist's ... work is based on empirical, i.e., phenomenological ... analysis of the simple P-69
[person] in the street's experience of the valuing process." 17, He characterizes phenomenology as the way persons understand themselves and interpret their own existence. Frankl notes that the immediate data of experience, analyzed phenomenologically, and the "concrete meaning of personal existence," 
change from person to person, "from day to day, from hour to hour.1116, P-57 Yet our understanding of human existence is complete only when we realize that each person's "cognitive act ... is based upon the polar tension between the subject and the object." 16, p.48 . While a person "can only make a subjective selection from the full spectrum of the world, nevertheless, [the individual] is always making a subjective selection from an objective world."16 p. 49, italics added. Because of the capacity for self-transcendence and the intentionality of consciousness, Frankl considers "the main characteristic of any subject ... [as being] always related to objects ... the intentional referents' to which ... cognitive acts reach out."18, PP 75-76 He asserts "that values are necessarily more than the mere self-expression of the subject,"16, p.64 which signifies that values, like meanings, are "objective." Frankl paints subjectivism and relativism as fallacious because "self-transcendence is the essence of existence.1117, p.50 He 
emphasizes what is experienced over the experiencing processes. 
Frankl's use of the term "objective" needs clarification. He stresses that objectivity connotes "a sphere beyond ... and above [persons]."16, p.64 The objective realm can thus place demands and obligations on individuals. Possible confusion arises because Frankl proclaims himself a phenome-nologist whereas objectivity is accentuated more by behaviorists and experimentalists in the Aristotelean and Lockean empirical traditions. They focus on categories, expected averages, sense information, reactions to external stimulation, and molecular units, and view intellect as an effect of sensory information. Frankl fits more into the thinking of Galileo (who spotlights concrete individual cases, internal organization, and unique events), Leibnitz (who sees the organism as selfpropelled and as actively thinking), and Kant (who emphasizes the organismic 
dynamics of the capacities for valuing and choosing);3,33,49 Allers2 distinguishes two uses of the term "objective--reality independent of persons, and any referent of a mental state. Empirical science relies on the first usage. To avoid confusion between the two connotations, Allers refers to the second usage as "transsubjective." 
Frankl is philosophically more of a "rationalist" (who concentrates on the specifically human subjective capacities of finding meaning) than either a "positivist" (who focuses on the biochemical processes that humans and other organisms have in common rather than on their fundamental differences) or an "existentialist" (who approaches an individual as an entity who cannnot live 
without conscious involvement with an environment).51 Logotherapy is more compatible with theories which elaborate on the active capacities of persons as subjects, yet Frankl insists on the objective dimension of reality. Unlike Nuttin,43 who describes human development from the experiential perspective, 
Frankl'sl6,17 dimensional anthropology portrays human functioning from an objective viewpoint. There are clues for exiting this quandary in Frankl's writings: 
1) Frankl "defines values as those meaning universals which crys-tallize in the typical situations a society or even humanity has to face." 17, p. 56 
2) "There are no absolute values, namely, values which are inde-pendent of an evaluating will. And therefore the value of life cannot be proven, but only accepted ... Thus we can prove that values cannot be proven, only "wanted," but 
also that everyone wants them." 12, p. 251 
3) "Conscience is creative ...Conscience may well start a revolution, in that what is at first a unique meaning may become a universal value . . Values evolve. " 17, p.63 
4) Though he states that a human is not "capable of bridging ... the gap between subjectivity and objectivity," Frankl specifies that "love--the very paradigm of human self-transcendence and coexistence--may bridge existences but cannot merge them."16, p.135 
5) Frankl borrows Aller's 2-concept "trans-subjective" to describe the realm in which self-transcendence occurs. Frankl states, "I have no objection to replacing the term 'objective' with the more cautious term 'trans-subjective' ... [to] speak of things or meanings ... This trans-subjectivism has really been presupposed 
all along whenever we spoke of self-transcendence." 17, p.60 
These five statements all allude to social-psychological processes. They suggest that "objective" may not mean a concrete object, such as a Rosetta stone that dictates how to interpret meaning, or something that is visibly observable and tactilely measurable, as logical positivists would demand for experimental results. The key to reconciling logotherapy's potential separation of the subjective and the objective perspective lies in van Kaam's explication of "intersubjective validation 5l,pl72 and Roger's "intersubjective verification." 48, P· 219 . The main idea is that psychology, in striving for recognition as a science, appropriated the canons of physical sciences. Emulating the physical sciences emphasized the positivist's stress on "objective," measurable behavior at the expense of analyzing the rationalist's emphasis on subjective intentionality and the existentialist's focus on the situational context of intentional behavior. A comprehensive psychology should encompass all three approaches. Frankl refuses to separate subjectivity and objectivity and thereby preserves these two essential perspectives on human existence. However, in de-emphasizing the situationalcontextual perspective, he leaves the nature of human objectivity vague. 
A human science, when speaking of objective reality with its demands, does not necessarily mean a tangible entity as physical science studies. Rather, what seems objective, i.e. "more than the mere self-expression of the subject ... and stems from a sphere beyond ... and above [the individual]," 16,p.64 may be "a 
unique meaning ... [which has] become a universal value." 17, p.63 This occurs through the social psychological processes of adhering to hierarchies of culturally preserved values. Science develops as persons seek agreement on the nature and processes of reality by collaborating in ways which reduce and overcome biases. Science presents "intersubjective" but accurate (frequently termed "objective") observations. Frankl emphasizes the objective aspect of reality to prevent "eroding idealism and enthusiasm ... endangered by the prevalent subjectivism and relativism." 17, p.52 However, by sidelining exploration of social psychological processes, Frankl leaves underdeveloped a fuller understanding of the construction and power of systems which facilitate or impede the discovery of experiential and creative values.40 The subjective, objective, and situational profiles of human existence cannot be merged, but need to be bridged by the social psychological processes of persons as they pursue, grasp, and live meanings and values. 
Frankl is unique among personality theorists because he has developed a "differential psychology" and offered a model for a "comprehensive psychology" through his dimensional anthropology. As a differential psychology, logotherapy accents the noetic dimension. Differential psychologies require continuous integration into a comprehensive psychology that incorporates each perspective without distorting any of them. Comprehensive psychology reflects the integrity of the panorama of diverse multidimensional personalities as experienced. In his eloquent eagemesss to establish the distinctiveness of his approach, Frankl sometimes sidesteps full consideration of dimensions other than the noological, particularly social/cultural processes. The brief treatments and catch phrases by which Frankl contrasts logotherapy from other approaches (e.g., "will to pleasure" in referring to Freud and "will to power" in regard to Adler, that 
Frankl17, by his own admission, has devised), need not be used to oversimplify the ideas of other personality theorists. Rather, they better serve dimensional anthropology when they are taken as brief glimpses of the variegated insights which complement logotherapy as we seek an increasingly comprehensive exploration of the confluence and coherence of dimensions in the dynamically integrated unities of persons-living-in-contexts. 
ROBERT F.MASSEY, Ph.D.is visiting professor of counseling and marriage and family counseling at Queens College, New York, and a licensed psychologist and a marriage and family therapist in New Jersey. This article is the second part of his essay on Frankl in the Context of Personality Theorists.The first part was published in the Fall/Winter 1987 issue of The International Forum for Logotherapy. 
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52 
Summary of Comparisons between 
Logotherapy and Other Personality Theorie 
Ilu:urisl Similarities lli[CftfD!.:fS
Freud Both recognize unconscious. 
Adler Each person unique, can exercise courage, engages in value process to find meaning in life. 
Jung Each person unique and capable of spirituality. Propose superordinant synthesis. Oppose reductionism. Empasize future. Highlight values. Acknowledge tension of opposites. 
Sullivan Essential similartty of all humans. 
Horney Be true to self; alienation if not. Specialize in neurosis. 
Erikson Integrity of self. Conscience, ethics important. 
Fromm Specifically human needs, 
freedom, responsibility. 
Happiness and fulfillment 
are by-products. 
Dollard Learning of symptoms in & Miller sychogenic neuroses. Skinner Reinforcing of symptoms 
Bandura Cognitive capacities. 
Rotter Intentionality and goaldirectedness of behavior. 
Wolpe Interest in dynamics of psychogenic neuroses. 
Physiologcal emphasis stages of development vs. nonreductionistic'height psychology." 
Social emphasis vs. noological emphasis. 
Individuation through union of from within vs. fulfilling of life external to self. 
Psychological needs and stages interpersonal emphasis vs. stress on noetic. 
Interpersonal/cultural emphasis vs existential/noological concerns. 
Psychosocial stages, organ modes and modalities, social/cultural context of identity vs. will to meaning. 
Interaction of character and social structures.source of ethical norms in human nature vs. responding to self-transcending values. 
Verifying psychoanalytic concepts vs. disputing their adequacy. Environmental control vs. nonpandeterministic, realistic free-dam of will. 
Social emphasis, reciprocal interaction of cognitive, behavioral and situational determinants vs. attitudinal values. 
Emphasis on personal preference vs.demands of meaningful reality. 
Relaxation in systematic desensiti-Ration based on neurological principies vs.counteracting hyperreflection by dereflection and intensification in paradoxical intention based on noological capacities. 
Allport  Persons intentional, unique, conscious, unified, free. Addresses unifying philosophy of life, conscience, religious orientation.  
Rogers  Desirability of warm encounter in therapy.  
Maslow  Human growth and fulfill-men!, higher human nature, search for meaning.  
Lewin  Human intentionality  
Berne  Choice (decide on autonomy or pathology in scripting or seek meaning or succumb to existential vacuum).  
Laing  Human cognitive capacities.  
Angyal  Humans seek individual fulfillment and open to outside reality.  
Binswanger  Humans capable of freedom, responsibility, spirituality, and taking stands.  
Boss  Responsible for using time, space, bodiliness, relations ships.  
May  Human capable of consciousness, intentionality, conscience, courage, and meaninglessness.  

Stages of development of sell, interdependence of personality and social structure vs. existential analysis. 
Focus on subjective processes.self actualization,facilitative conditions vs. self-transcendent meaning fulfillment 
Social structures support or impede human fulfillment, synergistic interconnection of persons vs. attitudinal values. 
Contextual influences on psychological position in life-space vs.selftranscendence and noodynamics. 
Social context of personality, highlight interpersonal transactions vs. stress noetics. 
Family context of self, power of system on personality processes vs. freedom of will. 
Interrelationship of person and environment vs. discover meaning through self-transcendence. 
Being-in-the-world, human existence before split into subject and object, person's experiencing vs. observer's view of human functioning. 
Dasein illuminates and discloses meaning;symptoms as disturbances in relationships; codetermination of motivation by choice, past, constitution, significant others vs. meaning beckons; existential vacuum. 
Striving for self-esteem, significance, power vs. search for meaning. 
Childlike Adults and Meaning In Life 
Paul Welter 

Adults are often condescending in the education of the young. We take the attitude that children need to learn, and adults know how to live, what to teach the children, and other things equally as difficult to demonstrate. Of course, adults have responsibilities to teach children. But they also have the opportunity to learn from them. 
Even our language has some bias. The word "infantile" has a negative connotation. But some of children's traits are desirable, 
such  as  persistence,  humor,  and  great  personal  strength.  Infants  
and  little  children  survived  many  days  in  the  ruins  of  the  
September  1985  Mexico  City earthquake.  

Children are often given negative labels for behavior that could be interpreted positively. "For example, some children need to be viewed not as tattletales but as justice seekers, because they are motivated by a strong sense of justice. We thus correctly see the child as acting morally rather than immorally. ,.5 ,pp .131-13 2 It seems incongruous that we punish children for being tattletales, and then reward adults for being "crimestoppers." 
Learning from Children 
For the past six years I have tried to learn from children, and to discover what other adults have learned from them. I have collected more than 1100 stories of what adults have learned from children -their appreciation for values, meanings, and beauty. The following story is an example of this kind of learning: 
Our youngest child is three and a half. Three days a week, she must get up at 7:00 a.m., dress, cat breakfast, find her coat, mittens, and hat, gather a doll or "take along" --amid four other people in the household doing their own things. As we walked out the door one busy morning, she stopped, looked up at the sky, and said, "It's a pretty day, Mom." My day began "pretty" and I know I was a neater person to be 
around bccausc--it was a "pretty" day!6,p.46 This mother learned from her young daughter to take time to enjoy the beauty around her. 
Becoming Childlike 
Ashley Montagu stated that childlikeness, "its significance and its ramifications for the future of each of us and of humanity in 
general are so staggering that an understanding of it should be a part of everyone's equipment. Yet as a scientific principle it 1s known only to a few scientists"3,p. l He further stated, "We begin to see that the goal of life is to die young--as late as possible."3,P · 6 Montagu's theoretical basis for the importance of childlikeness is biological, but it has psychological and social implications. "The retention of juvenile physical traits is one of the major qualities 
that differentiate human beings from other animals..."3,p.2 He believes that if we can build behavioral patterns to go with these physical traits, humans can perhaps become "the kinds of creatures their heritage intends them to be--that is, youthful all the days of our lives."3,P-2 
TABLE 1. CHILDLIKE ADULT INVENTORY 
The characteristics on the right below may be seen in many children, especially young 
children. Not all of those qualities on the left are always bad, and not all of those on the 
right are always good. In the range between the two qualities for each item below, 
please circle the number that most accurately describes your behavior the past few 
months. Then place an S by three of those qualities in the right column which are your 
strengths~ and a G by three of those qualities in the right column which you want to 
target for growth. 
I.Sedentary 2 3 4 5 6 7 Active 2.Timid 2 3 4 5 6 7 Challenges fear 3.No longer 
creates 2 3 4 5 6 7 Creative 4.Rigid 2 3 4 5 6 7 Flexible 5.Holds grudge 2 3 4 5 6 7 Forgives rapidly 
6. Unfriendly 2 3 4 5 6 7 Friendly 7 .Dishonest 2 3 4 5 6 7 Honest 
8. Grim 2 3 4 5 6 7 Sense of humor 
9.Satisfied "Thirstly to with present 2 3 4 5 6 7 learn'* 
10.Loves but does 
not express it 2 3 4 5 6 7 Expresses love 1!.Bottles up Expresses grief sad feeling 2 3 4 5 6 7 spontaneously 12.Unable or un
willing to play 2 3 4 5 6 7 Playful 13.Stressed 2 3 4 5 6 7 Relaxed 14.Unable to 
bounce back from traumas 2 3 4 5 6 7 Resilient 15.Focused on Sensitive to 
self only 2 3 4 5 6 7 others 16.Nontouching 2 3 4 5 6 7 Touches 17.Suspicious 2 3 4 5 6 7 Trusting 18.Rushed, im
patient 2 3 4 5 6 7 Unhurried 19.Protective 2 3 4 5 6 7 Vulnerable 20.Unaware of Has sense of wonders 2 3 4 5 6 7 wonder 
How do we go about dying young "as late as possible" -what does it mean to grow into childlikeness? I agree that childlikeness differs from adulthood biologically, with psychological and social implications. But an important additional difference is the spiritual dimension. Jesus called attention to this spiritual quality 
in children: "I tell you the truth, unless you change and become like little children, you will never enter the kingdom of heaven."4 ,P-13 
I have constructed a Childlike Adult Inventory (CAI), shown in Table 1. The 20 categories have an empirical base in the stories I collected about what adults had learned from children. Montagu 
provided a theoretical base. He listed 26 childlike traits.3,PP· 129193 
Thirteen of these traits are identical, or nearly so, with qualities on the CAI, and several others are similar. 
Childlikeness and Meaning 
To explore the connections between childlikeness in adults and meaning, 338 college students were tested using the CAI and the Purpose In Life (PIL) test -103 males and 235 females. Nearly all the 209 education students in the study were undergraduates. Most of the 129 participating counseling students were graduates. 
The means on the CAI ranged from 101.0 for the males to 103.2 for the females and the counseling students. The overall mean was 
102.5. The means for the PIL ranged from 106.7 for the males to 
111.0 for the counseling students. The overall PIL mean was 109.2. The correlation between the CAI scores and PIL scores was found to be significant (p<0.001). 
TABLE 2. CAI QUALITIES MOST HIGHLYRELATED TO THE PIL 
Correlation Ranking Quality Coefricienl 
1. Resilient .39*** 
2. Expresses grief .35•·· 
spontaneously 3. Relaxed .34*** 
4. Expresses lov e .31••· 
5.' Challenges fear .30••· ·••(p<.001) 
The students were given the opportunity to briefly respond to the question, "What is my purpose in life?" or, "What does life expect of me?" Of the 338 students, 109 wrote a response. These were done anonymously. The written responses to the item were judged to be altruistic, self-centered, or ambiguous/confused. 
Here is an example of an altruistic response: "Life expects me to do my best. This means I need to take responsibility for my actions, however imperfect they may be. Furthermore, life enjoins me to encourage others to grow to be their personal best." 
An example of a response judged to be self-centered: "My purpose in life is to be able to make someone notice me by something I have done. Maybe I will invent something or do something so everyone will remember me." 
Of the 109 written reports, 56 were judged to be altruistic and 
23 self-centered. Thirty were discarded as confused, ambivalent, or ambiguous. Altruistic students obtained a higher mean score than self-centered students on both the CAI and PIL. The difference was not statistically significant (p>.05) on the PIL, but was statistically significant on the CAI (p<0.05). The altruistic students had a CAI mean score of 106.9 compared to the self-centered CAI mean score of 101.3, more than 5 1/2 points lower. 
Participants were asked to note on the CAI three qualities they saw as their strengths. Both men and women most frequently reported the same #1 and #3 strengths: "Friendly" and "Sensitive to others." Men reported "Sense of humor" as their #2 strength while women reported "Honest" as their second strength. 
Participants also reported CAI qualities they wanted to target for growth. Males and females were unanimous in their choices: first was "active"; second, "relaxed"; and third, "unhurried." 
The study indicates that childlike adults have greater purpose in life than non-childlike adults. This finding tends to support my own intuitive judgment that childlike adults have a zest for life that indicates they find life meaningful. 
These findings provide some hope that people may find greater purpose in life by becoming more childlike. My own observations suggest that the best way of "growing young" is to spend time with little children, or with childlike adults. I have studied 20 childlike adults in depth, whose ages range from 24 to 97. Their scores on the CAI range from 115 to 125, compared to the overall mean of 102.5 for the entire group reported in this study. There is a youthfulness that is apparent in these adults. For example, a 96 year old woman had been in a wheelchair for 85 years because of polio. Her body was twisted because of the ravages of the disease. Yet her skin felt young to the touch. She never complained. Her life appeared to be charged with meaning. She had always earned her own living as a seamstress. And she gave her friends gifts -clothes, afghans, pillows -all her own creations. She lived out what Frankl wrote about meaning: "According to logotherapy, we can discover this meaning in life in three different ways: (1) by doing a deed; (2) by experiencing a value; and (3) by suffering."2,P-176 She had found meaning through her activities, lived out the value of love every day, and took a courageous stance toward her suffering. She attacked her partial immobility head on, by using what remained mobile -her fingers and hands -to earn her living, and to create gifts for others. 
Some childlike qualities appear to be more highly associated with purpose in life than others. They are listed in Table 2 as "resilient," "expresses grief spontaneously," "relaxes," "expresses love," and "challenges fear" (courage). Examples of these traits are everywhere. Charlie Brown is resilient -his team may have lost every game, but "just wait 'til next year." Children cry whenever they are grieved, until they are taught not to. They are usually relaxed, and express love by hugs or verbally. They challenge their fears, such as the fear of falling -they walk and climb before they have achieved balance. Probably most adults would grow in excitement and meaning if they could release these latent traits. 
It was expected that participants judged as altruistic would show more purpose in life than those judged to be self-centered. The difference, however, was not statistically significant. It was also expected that "altruistic" participants would score higher on the CAI than "self-centered" participants. The difference here was statistically significant, indicating that the altruistic students were also more childlike. Altruism is quite similar to Frankl's important concept of self-transcendence. Both are action-oriented. They require an unselfish reaching out to meet the needs of others. Perhaps self-transcendence is a childlike quality. 
Both men and women participants agreed on their three targets for growth in the area of childlike qualities -physically active, relaxed, and unhurried. There is a wistfulness about the similarity of these three growth targets. Is it a function of college life, or simply a function of life itself, that people want to move away from a sedentary life style, but at the same time time relax and slow down? This apparent paradox of desires may be explained by Frankl 's distinction between the healthy noetic stress of self-chosen meaningful activities, and the unhealthy psychological or physical stress to which we are driven. Children are good models for us here, too. They are intensely active, but in many ways relaxed and unhurried. Perhaps children and childlike adults can also serve as models for us in other ways, as we seek greater meaning in life. 
PAUL WELTER, Ph.D., is professor of counseling and school psvchology at Kearney State College, Kearney, Nebraska. 
REFERENCES: 
1. 
Crumbaugh, J.C. & L.T. Maholick, Purpose-in-Life Test, Psychosometric Affiliates, Murfreesboro, TN, 1976. 

2. 
Frankl, V.E. Man's Search for Meaning, Pocket Books, 1963. 

3. 
Montagu, A. Growing Young. New York, McGraw-Hill, 1981. 

4. 
New Int'! Version of the Bible. Grand Rapids, Zondervan, 1978. 

5. 
Welter, P. Counseling and the Search for Meaning. Waco,TX, World Books, 1987. 

6. 
___. Learning from Children. Wheaton, IL, Tyndale, 1984. 


The International Forum for 
LOGOTHERAPY 
JOURNAL OF SEARCH FOR l\1EANING