Man's Search for Meaning.

Psychiatrist Viktor Frankl’s memoir has riveted generations of readers with its descriptions of life in Nazi death camps and its lessons for spiritual survival. Between 1942 and 1945 Frankl labored in four different camps, including Auschwitz, while his parents, brother, and pregnant wife perished. Based on his own experience and the experiences of those he treated in his practice, Frankl argues that we cannot avoid suffering but we can choose how to cope with it, find meaning in it, and move forward with renewed purpose. Frankl’s theory—known as logotherapy, from the Greek word logos (“meaning”)—holds that our primary drive in life is not pleasure, as Freud maintained, but the discovery and pursuit of what we personally find meaningful.

At the time of Frankl’s death in 1997, Man’s Search for Meaning had sold more than 10 million copies in twenty-four languages. A 1991 reader survey by the Library of Congress and the Book-of-the-Month Club that asked readers to name a “book that made a difference in your life” found Man’s Search for Meaning among the ten most influential books in America.

Some penetrating insights from Victor E. Frankl’s “Man’s Search for Meaning“…

Excerpt from the preface:

In the concentration camp every circumstance conspires to make the prisoner lose his hold. All the familiar goals in life are snatched away. What alone remains is “the last of human freedoms” – the ability to “choose one’s attitude in a given set of circumstances.” This ultimate freedom, recognised by the ancient Stoics as well as by modern existentialists, takes on vivid significance in Frankl’s story. The prisoners were only average men, but some, at least, by choosing to be “worthy of their suffering” proved man’s capacity to rise above his outward fate.

As a psychotherapist, the author, of course, wants to know how men can be helped to achieve this distinctively human capacity. How can one awaken in a patient the feeling that he is responsible to live for something, however grim his circumstances may be? Frankl gives us a moving account of one collective therapeutic session he held with his fellow prisoners.

Unlike many European existentialists, Frankl is neither pessimistic nor antireligious. On the contrary, for a writer who faces fully the ubiquity of suffering and the forces of evil, he takes a surprisingly hopeful view of man’s capacity to transcend his predicament and discover an adequate guiding truth.

On Spiritual freedom:

“…There are two races of men in this world, but only these two – the “race” of the decent man and the “race” of the indecent man. Both are found everywhere; they penetrate into all groups of society.”

And there were always choices to make. Every day, every hour, offered the opportunity to make a decision, a decision which determined whether you would or would not submit to those powers which threatened to rob you of your very self, your inner freedom; which determined whether or not you would become the plaything of circumstance, renouncing freedom and dignity to become moulded into the form of the typical inmate.

Seen from this point of view, the mental reactions of the inmates of a concentration camp must seem more to us than the mere expression of certain physical and sociological conditions. Even though conditions such as lack of sleep, insufficient food and various mental stresses may suggest that the inmates were bound to react in certain ways, in the final analysis it becomes clear that the sort of person the prisoner became was the result of an inner decision, and not the result of camp influences alone. Fundementally, therefore, any man can, even under such circumstances, decide what shall become of him – mentally and spiritually. He may retain his human dignity even in a concentration camp. Dostoevski said once, “There is only one thing that I dread: not to be worthy of my sufferings.” These words frequently came to my mind after I became aquainted with those martyrs whose behaviour in camp, whose suffering and death, bore witness to the fact that the last inner freedom cannot be lost. It can be said that they were worthy of their sufferings; the way they bore their suffering was a genuine inner achievement. It is this spiritual freedom – which cannot be taken away – that makes life meaningful and purposeful.

On fear and the cure:

A realistic fear, such as fear of death, cannot be tranquilized away by is psychodynamic interpretation; on the other hand, a neurotic fear, such as agoraphobia, cannot be cured by philosophical understanding. However, logotherapy has developed a special technique to handle such case, too. To understand what is going on whenever this technique is used, we take a starting point to a condition which is frequently observed in neurotic individuals, namely, anticipatory anxiety. It is characteristic of this fear that it produces precisely that of which the patient is afraid. An individual, for example, who is afraid of blushing when he enters a large room and faces many people will actually be more prone to blush under these circumstances. In this context, one might amend the saying “The wish is father to the thought” to “The fear is mother of the event.”

Ironically enough, in the same way that fear brings to pass what one is afraid of, likewise a forced intention makes impossible what one forcibly wishes. This excessive intention, or “hyper-intention”, as I call it, can be observed particularly in cases of sexual neurosis. The more a man tries to demonstrate his sexual potency or a woman her ability to experience orgasm, the less they are able to succeed. Pleasure is, and must remain, a side-effect of by-product, and is destroyed or spoiled to the degree to which it is made a goal in itself.

In addition to excessive intention as described above, excessive attention, or “hyper-reflection” as it is called in logotherapy, may also be pathogenic (that is, lead to sickness). The following clinical report will indicate what I mean: A young woman came to me complaining of being frigid. The case history showed that in her childhood she had been sexually abused by her father. However, it had not been this traumatic experience in itself which had eventuated in her sexual neurosis, as could easily be evidenced. For it turned out that, through reading popular psychoanalytic literature, the patient had lived constantly with the fearful expectation of the toll which her traumatic experience would someday take. This anticipatory anxiety resulted both in excessive intention to confirm her femininity and excessive attention centred upon herself rather than upon her partner. This was enough to incapacitate the patient for the peak experience of sexual pleasure, since the orgasm was made an object of intention, and an object of attention as well, instead of remaining an unintended effect of unreflected dedication and surrender to the partner.

After undergoing short-term logotherapy, the patient’s excessive attention and intention of her ability to experience orgasm had been “dereflected” to introduce another logotherapeutic term. When her attention was refocused toward the proper object, i.e., the partner, orgasm established itself spontaneously.

Logotherapy bases its technique called “paradoxical intention” on the twofold fact that fear brings about that which one is afraid of, and that hyper-intention makes impossible what one wishes. In German I described paradoxical intention as early as 1939. In this approach the phobic patient is invited to intend, even if only for a moment, precisely that which he fears.

Let me recall a case. A young physician consulted me because of his fear of perspiring. Whenever he expected an outbreak fo perspiration, this anticipatory anxiety was enough to precipitate excessive sweating. In order to cut this circle formation I advised the patient, in the event that sweating should recur, to resolve deliberately to show people how much he could sweat. A week later he returned to report that whenever he met anyone who triggered his anticipatory anxiety, he said to himself, “I only sweated out a quart before, but now I am going to pour at least then quarts!” The result was that, after suffering from his phobia for four years, he was able, after a single session, to free himself permanently of it within one week.

The reader will note that this procedure consists of a reversal of the patient’s attitude, inasmuch as his fear is replaced by a paradoxical wish. By this treatment, the wind is taken out of the sails of the anxiety.

Such a procedure however, must make sure of the specifically human capacity for self-detachment inherent in a sense of humour. this basic capacity to detach one from oneself is actualized whenever the logotherapeutic technique called paradoxical intention is applied. At the same time, the patient is enabled to put himself at a distance from his own neurosis. “The neurotic who learns to laugh at himself may be on the way to self-management: perhaps to cure.”

A few more case reports may serve to clarity this method further. The following patient was a bookkeeper who had been treated by many doctors and in several clinics without any therapeutic success. When he was admitted to my hospital department, he was in extreme despair, confessing that he was close to suicide. For some years, he had suffered from a writer’s cramp which had recently become so severe that he was in danger of losing his job. Therefore, only immediate short-term therapy could alleviate the situation. In starting treatment, Dr. Eva Kozdera recommended to the patient that he do just the opposite of what he usually had done; namely, instead of trying to write as neatly and legitimately as possible, to write with the worst possible scrawl. He was advised to say to himself, “Now I will show these people what a good scribbler I am!” And at the moment in which he deliberately tried to scribble, he was unable to do so. “I tried to scrawl but simply could not do it,” he said the next day. Within forty-eight hours the patient was in this way freed from his writer’s cramp, and remained free for the observation period after he had been treated. He is a happy man again and fully able to work.

A similar case, dealing, however, with speaking rather than writing, was related to me by a colleague in the Laryngological Department of the Hospital. it was the most severe case of stuttering he had come across in his many years of practice. Never in his life, as far as the stutterer could remember, had he been free from his speech trouble, even for a moment, except once. This happened when he was twelve years old and had hooked a ride on a streetcar. When caught by the conductor, he thought that the only way to escape would be to elicit his sympathy, and so he tried to demonstrate that he was just a poor stuttering boy. At that moment, when he tried to stutter, he was unable to do it. Without meaning to, he had practiced paradoxical intention, though not for therapeutic purposes.

Paradoxical intention can also be applied in cases of sleep disturbances. The fear of sleeplessness results in a hyper-intention to fall asleep, which, in turn, incapacitates the patient to do so. To overcome this particular fear, I usually advice the patient to not try to sleep but rather try to do just the opposite, that is, to stay awake as long as possible. In other words, the hyper-intention to fall asleep, arising from the anticipatory anxiety of not being able to do so, must be replaced by the paradoxical intention not to fall asleep, which soon will be followed by sleep.

Paradoxical intention is no panacea. Yet it lends itself as a useful tool in treating obsessive-compulsive and phobic conditions, especially in cases with underlying anticipatory anxiety. Moreover, it is a short-term therapeutic device. However, one should not conclude that such a short-term therapy necessarily results in only temporary therapeutic effects. In my files there is, for instance, the case report of a patient to whom paradoxical intention was administered more than twenty years ago; the therapeutic effects prove to be, nevertheless, a permanent one.

One of the most remarkable facts is that paradoxical intention is effective regardless of the etiological basis of the case concerned. This confirms a statement: Although traditional psychotherapy has insisted that the therapeutic practices have to be based on findings on etiology, it is possible that certain factors might cause neuroses during early childhood and that entirely different factors might relieve neuroses during adulthood.

As soon as the patient stops fighting his obsessions and instead tries to ridicule them by dealing with them in an ironical way – by applying paradoxical intention – the vicious circle is cut, the symptom diminishes and finally atrophies. In the fortunate case where there is no existential vacuum which invites and elicits the symptom, the patient will not only  succeed in ridiculing his neurotic fear but finally will succeed in completely ignoring it.

As we see, anticipatory anxiety has to be counteracted by paradoxical intention; hyper-intention as well as hyper-reflection have to be counteracted by dereflection. Dereflection, however, ultimately is not possible except by the patients orientation toward his specific vocation and mission in life.

It is not the neurotic’s self-concern, whether pity or contempt, which breaks the circle formation: the cue to cure is self-trancendence!

I recommend this little book heartily, for it is a gem of dramatic narrative, focused upon the deepest of human problems. It has literary and philosophical merit and provides a compelling introduction to a very significant psychological movement.

~ by revolutionwithin on March 22, 2010.