SOURCE: "The Frankl Meaning," in Human Behavior: The News Magazine of the Social Sciences, Vol. 6, No. 7, July, 1977, pp. 56, 58-62.

[Cohen is an American journalist, freelance writer, filmmaker, and founder of Psychology News. In the following essay, he discusses Frankl's attempt to connect his understanding of the spiritual dimension of humanity with psychotherapy and, in particular, the logotherapeutic approach.]

The titles of Viktor Frankl's books—Man's Search for Meaning, The Doctor and the Soul, The Will to Meaning—made me expect a gloomy man who could be the hero of one of Bergman's bleaker films. Frankl lives in the heart of Vienna's medical district. The streets are narrow, quiet and a little dark. I pushed open the big heavy door of the block of flats where Frankl lives and found myself in a long, shabby hallway. My footsteps clanged on the stone floor. Certainly, it was going to be a somber interview.

But Frankl is far from a gloomy man. He bubbles with energy and good humor. He was delighted to see me, he said, and led me into a large light room that is his office. As I switched on my cassette, he smiled and said he would switch his on. He liked to have his own record of an interview and added, without a trace of embarrassment, that two American universities had asked him to record every interview he gives for their archives. He obviously enjoys recording himself for posterity.

Frankl also likes to be busy. He showed me photographs of him and his wife rock climbing. "Not bad still doing that at 70," he remarked and smiled. He enjoyed being photographed and, aware of what it takes to make good shots, slightly exaggerated his gestures while the photographer was there. The phone rang. A Swiss television station wanted to finalize arrangements for him to appear on a program. He was impressed by the way they had coaxed him to go on the air. He likes the idea of doing it. He almost seems to advertise the motto that a full life is a fulfilled life. He appears less contemplative than his books suggest.

Frankl was one of the first psychiatrists to treat patients as responsible human beings rather than superior machines that had a screw loose. In the end, even Freud expected to be able to pin a biochemical cause to every individual act. But from the 1920s, Frankl had patients who wanted something more than to be debugged of their hangups. Getting rid of their complexes did not suddenly make sense of their lives—they wanted to find meaning. Frankl alerted psychiatry and therapy to what could roughly be called the spiritual needs of humanity. The result is logotherapy, an approach that recognizes the fundamental need for meaning in a person's life.

One educated in Britain tends to suspect people who bandy about words like meaning. Only those who don't know what they're talking about dabble in such metaphysics. But it was surprising to find both that Frankl was humorous—even able to tell the odd joke about himself—and, also, that he did not hate science as so many of the existential gurus seem to do. Although logotherapy sounds weighty—translated literally, it means the therapy of meaning—there is often a lot of humor to it.

Given the confusion as to what life is really about now that the comfortable certainties of the past have gone, it isn't surprising that many people have found in Frankl something of a sage. He sees a desperate need for meaning all around and does not dismiss it as childish or as simply a stage that a person out-grows once he or she knows better. And Frankl believes that we need to develop the capacity for finding our personal raisons d'être.

"Meanings are inexhaustible. We need to develop our intuitive sense that allows us to smell out meanings hidden and dormant in life situations. This is very important today. Education should see as one of its main aims training people to be sensitive to the potential for meaning," he explains.

In developing logotherapy since the '20s, Frankl has made a number of enemies who attack both the man and his ideas. They often seize on the fact that Frankl can be a little vain. After speaking with him, I dined with some Freudians who rebuked me for having interviewed "their enemy." I shrugged that off as a passing gibe. But during dinner, I was told a number of malicious anecdotes.

It is not clear why some Freudians are so hostile to Frankl. He was never formally a Freudian analyst, even though he was born in Vienna. When he was three, Frankl decided to be a physician. His father had also wanted to be one, but money problems compelled him to work, first, as a stenographer in the Austrian Parliament and, then, as a civil servant in the Ministry of Social Work. "My father did more than encourage me to become a doctor; he wanted me to fulfill his dream," Frankl says. Frankl's parents were liberal Jews. He states, "No one ordered me to go to the synagogue," but he developed a feeling for the spiritual that he distinguished from the religious.

At 15, Frankl discovered psychoanalysis. As he was fascinated by both psychiatry and philosophy, psychoanalysis offered the perfect mix. Although he was still a schoolboy, Frankl went to university extension courses given by one of Freud's disciples, Hitchmann. "I also went to lectures by Paul Schilder, who spoke every Saturday evening for two hours in the university hospital." Schilder tried to apply psychoanalysis to the psychoses. Frankl added that the man was a genius but Frankl cannot resist also pointing out, and mimicking rather well, his squeaky high-pitched voice.

In 1922, Frankl read Freud's Beyond the Pleasure Principle. He liked the book enormously, not least because it fitted in with his own ideas. In 1919, when Frankl was 14, he had an intuitive-scientific vision—again spiritual rather than religious. "On the deck of a steamer in the Danube, I looked up at the stars and I arrived at the vision that nirvana is entropy seen from within. In entropy, all energy dissipates. There are no differences between things and so there is absolute equality and unity. I saw nirvana as being this lack of tension seen from within." Freud developed a thesis that was not dissimilar. All living things seek both pleasure and the release from tension that can only come with death. When we are a feast for the worms, we have no problems, no tension. Is it surprising that we should all tend toward the "tranquility of the inorganic state"?

Frankl began to send Freud articles from the literature that he thought might interest him. The two began to correspond. Freud was meticulous. "He answered each single letter, if only in the form of postcard, within 48 hours," Frankl says. Freud's courtesy to him—he knew, after all, that Frankl was only a schoolboy—touched Frankl. Once, Frankl enclosed a short essay with some ideas about the origins of such gestures as nodding and shaking the head. Freud suggested it be published and, at the tender age of 18, Frankl made his entrance into the literature in the International Journal of Psychoanalysis.

Toward the end of the correspondence, Freud suggested that Frankl visit Paul Federn, then the secretary of the Psychoanalytic Society, to discuss when Frankl should start his training analysis. Federn said he should first get his medical degree; the training analysis might interfere with his studies. Frankl accepted this advice, and ironically, it ultimately meant he would never have training analysis and would never formally become a Freudian—which may be why he found it so easy to be "disloyal" to Freud. By the time he was a physician, Frankl had become disenchanted with Freud.

Frankl felt that Freud, in his desire to be scientific, denied the rich spiritual side of humanity. Sex could not cause everything. Freud strained the importance of sex and denied the individual all final responsibility for his or her actions by explaining them away in subhuman terms.

Curiously, though, Frankl only met Freud once—later and by accident. "I saw an old man with a black stick with a silver handle beating the pavement and murmuring to himself, it seemed. I don't believe he was talking to himself but the pains in the jaw might give that impression." For the last 15 years of his life, Freud suffered an agonizing cancer of the jaw. Frankl followed the old man and saw him turn in Berg-gasse, the street on which Freud lived.

"I decided to introduce myself," Frankl recalls. "There was very little traffic, and he was in the middle of the street when I asked him if I had the honor to address Professor Freud. He said, 'Yes, I'm Freud.' I said, 'My name is Viktor Frankl.'" To which Freud responded by immediately quoting back Frankl's address. Frankl told him of a new book on the death instinct, which Freud asked him to review for Imago; but Frankl was already a member of Adler's individual psychology "school." He had to decline.

But Frankl also found Adler's "individual" school too narrow, just as Freud's had been. It seemed too dogmatic to explain everything in terms of power, of coping with a sense of inferiority. In the spring of 1927, two critics of Adler—Rudolph Allers and Oswald Schwarz—pointed out at a meeting that the whole of human behavior could not be explained in such narrow ways.

"Adler was there and challenged me to take a stand," Frankl remembers, "I had to agree with the critics but said I saw no need for them to resign from the Adlerian Society, since individual psychology ought to widen its horizons beyond the one power motive." Adler did not like that. Again the good mimic, Frankl acts out the ponderous way in which Adler tried to dismiss such criticisms. "From that moment on, Adler never spoke to me. When I approached the tables where the Adlerians sat at the Cafe Siller—the Freudians had a different cafe—Adler left. He never greeted me. I felt very hurt. I loved him and I admired him. I knew his weaknesses but I liked him."

In the next month, Frankl was repeatedly invited to resign from the Adlerian Society. He replied constantly that he saw no reason to. "Finally, Adler decreed I was no longer a member. He excommunicated me. It was embarrassing for me. But, in another way, it was beneficial perhaps because I no longer had to consider problems of loyalty."

At the age of 22, then, Frankl felt no need to cling to any particular psychological school—and in Vienna in the 1920s, each "master" demanded almost total loyalty.

While studying medicine, Frankl helped set up a number of youth counseling centers in different parts of Austria, Germany, Czechoslovakia and Hungary. Their main aim was to help young people who felt suicidal and to, literally, talk them into living. Talking at all hours to fellow students, he learned it is not enough for psychiatrists to cope with people's complexes, deliver them from their hangups and, then, declare them whole.

Often a patient suffers not from a complex but from feeling there is no point to life. The only help is for the person to find a meaning in his or her life. Sometimes, the meanings that Frankl found for suicidal patients seem trite, especially in a setting of apparent hopelessness. For instance, Frankl was imprisoned in a concentration camp during World War II, and while there he was visited by two other prisoners, a man and a woman who were close to suicide. Neither expected anything more from life. "I asked both my fellow prisoners whether the question was really what we expected from life. Was it not rather what life was expecting from us?" He suggested that the woman had a child abroad who was waiting for her and the man had a series of books that he had begun to publish but had not yet finished. Such meanings seem almost too simple—but Frankl records many cases in which pointing out even the simplest meanings or making it possible for a patient to find them did change lives.

Because of his experience with Freud, Adler and the youth centers, Frankl was permitted to act as a psychotherapist at the university hospital before he had qualified as a physician. "I learned to forget what I had learned from my great teachers, Freud and Adler. I tried to learn from my patients by learning to listen to my patients."

It is not just Frankl who makes meaning important. Frankl mentions several statistical studies showing that maybe one neurosis in five has, at its root, a feeling that life is meaningless. Neither psychoanalysis nor a technique like behavior therapy offers much help there. Recently, Frankl had a patient who had been to a behavior therapist. The therapist had tried to condition him to stop thinking the thought "Life is meaningless." Although Frankl approves of much in behavior therapy, he felt it was absurd here and insensitive to use such a mechanistic approach.

In the '20s, Frankl also became aware that many patients had learned to live very well with phobias and compulsions. "Again and again, I became aware of what in modern behavioristic language one would call the coping mechanisms that allowed patients to deal with anxieties and obsessions." During this period, Frankl hit on and developed his first original therapeutic technique—paradoxical intention.

"The essence of paradoxical intention is to get the patient to do or to wish to happen exactly what it is that he fears to do." He had a patient once who was scared that if he went out onto the street, he would have a heart attack and die. Eventually, Frankl told the patient that what he was to do was to go out, stand on the street corner and will himself to have the biggest heart attack ever. The patient did so and discovered that the more he tried to will on a heart attack, the more impossible it seemed. And his fear of having a heart attack disappeared. A second case: a young surgeon would always tremble when a superior entered the operating theater. Frankl told him that the next time a superior came in, the young surgeon had to try to tremble as hard as he could "to show what a good trembler" he was. "This quite took the wind out of the phobia," Frankl recalls, smiling.

Frankl admits that he stumbled onto the technique almost four decades ago out of intuition and impatience, rather than by research. "In a way, I felt it better to have an end to the horror than to have a horror without end with the patient subjected to constant, repetitive anxieties; so I said to the patient, tongue in cheek, 'For a change, let's try to have a heart attack,'" he explains.

Also, Frankl was reacting against psychoanalysis. "I sometimes had to deal with patients who had been through psychoanalysis and who had been induced to focus attention on their inner life, on their past, on their pathology, on their introspections. I felt the impulse to help man to break out of all this inner turmoil, the introspections and retrospections that were increasing their problems. And this paradoxical intention seemed to be a way."

Paradoxical intention uses what Frankl sees as a specifically human dimension, the ability to be self-detached. The patient can see how absurd the phobia is. Usually, a phobic patient avoids the situation that would bring on his or her phobia. The agoraphobic stays inside and, by staying inside, copes successfully with his or her fear of open spaces. But this very success strengthens the phobia. It's positive feedback. Next time round, the possibility of going out arouses even greater anxiety. Frankl explains, "As in behavior therapy, the principle is that what is at the root of phobias is the avoidance of fear-arousing situations. So you have to approach them directly." He sometimes points out that behavior therapy realized the value of this some 35 years later than he did.

But paradoxical intention not only confronts the patient with the feared situation, it mobilizes the specifically human ability to experience humor. Only human beings can be self-detached. Frankl claims—against a number of ethologists—that Homo sapiens is the only species that can laugh. But the point is not really whether some apes can, perhaps, laugh but that no one Frankl recognizes as an authority has yet suggested that an ape can see a joke, let alone a joke against himself. But, to be self-detached, one has to be able to see the funny side of oneself.

In a recent paper in Psychotherapy (Fall 1975), Frankl records many cases in which paradoxical intention was used by himself and often by other therapists. It is the technique, not the particular therapist, that succeeds. These case histories often highlight the use of humor. Linda T was an attractive 19-year-old student who had problems with her parents. She was very tense. She stuttered. Her therapist, Larry Ramirez, reports—and Frankl quotes him:

My natural reaction would have been to say, "Relax, it's all right." But from past experience I knew that asking her to relax would only increase her tension. Instead, I responded with just the opposite. "Linda, I want you to act as nervously as you can." "Okay," she said, "being nervous is easy for me." She started by clenching her fists together and shaking her hands as though they were trembling. "That's good," I said, "but try to be more nervous." The humor of the situation became obvious to her and she said, "I really was nervous but I can't be any longer. It's odd but the more I try to be tense, the less I'm able to be."

Paradoxical intention is not just dramatic but also effective. Linda T continued to feel less nervous and her stuttering decreased.

There are some remarkable cases. A doctor on Frankl's staff treated one 65-year-old woman who had suffered from a hand-washing compulsion for 60 years. Paradoxical intention cured her. A fellow logotherapist, Hans Gerz, is quoted by Frankl as having cured a woman who had a 24-year history of phobias. And Frankl tells many impressive cases of his own. But the only experimental study of logotherapy was one carried out in 1972 by W. Solyom and colleagues at the University of Montreal. They used paradoxical intention on patients who had had obsessive-compulsive disorders for between 4 1/2 and 25 years. For each patient they chose two compulsive thoughts. The therapist treated one of these symptoms by paradoxical intention and left the other untreated. In six weeks, patients reported a 50 percent drop in those compulsive thoughts that had had paradoxical intention applied. Since obsessions are notoriously hard to treat, these are impressive figures. No new obsessive symptoms welled up to take the place of those that had gone. But still that is only one experimental study that compared logotherapy and other therapies only indirectly. Tough-nosed researchers want more proof.

For Frankl, what is crucial is that patients, being human beings, live through their fear and see through their anxiety. They can laugh at themselves or, at least, take a detached view. The ironic insight, the paradox, is central. But for most behavior therapists, the humor that is so dear to Frankl is, at the very most, an embellishment.

Behavior therapists are less generous than Frankl would like to think. Isaac Marks of the Maudsley in a comprehensive review of therapies devotes one line to paradoxical intention. "Paradoxical intention is very similar to straight exposure in vivo." And, for behavior therapists, the reason paradoxical intention works has nothing to do with insight, ironic or otherwise. The patients are just given prolonged exposure to what they are phobic about and that deconditions their anxiety, since they are not gobbled by the cats or struck down by being in an open space.

For Frankl, people's ability to see themselves in this detached, ironic way goes with humanity's other unique gift—the capacity for self-transcendence. People can find a meaning, because they are capable of self-transcendence. "Self-transcendence means that human existence is directed to something or someone other than itself. Being human is to reach out for a meaning to fulfill. For example, in loving a person or serving a cause, we become ourselves in the best sense of the word. I maintain there is a motivation to find meaning." Humanity has a will-to-meaning.

Although Frankl was working toward this position already in the late 1920s, many people seem to think that he discovered meaning in the concentration camp. "People think I came out of Auschwitz with a brand-new psychotherapy. This is not the case."

After the Germans took over Vienna, Frankl explains, "I was called to the Gestapo offices and this officer examined me. But soon it seemed all camouflage. What he really wanted to squeeze out of me was whether and where there were still psychoanalysts and psychotherapists in Vienna." The Gestapo man asked how such people would treat agoraphobia; he said he had a friend who suffered from agoraphobia. "I realized, of course, that he was the person who suffered from agoraphobia and that he wanted to be treated. It was an instance of pure technique in therapy, because there could be no encounter between me and him. So, finally, I told him that if there were psychotherapists working in Vienna and if his friend went to see them, this would probably be what they would do." And Frankl told the Gestapo man how paradoxical intention would treat "his friend." The purely technical treatment may have succeeded, and it may explain why Frankl and his family were not deported to their first concentration camp until 1942—a full year after the encounter.

Frankl, his first wife and his parents were deported to the concentration camp at Terezin in Czechoslovakia. His father died there. In 1944, he was deported to Auschwitz and, from Auschwitz, to Dachau. "When I entered Auschwitz, I had hidden in the lining of my coat the full-length manuscript of what later became my first book, The Doctor and the Soul." This manuscript was a systematic presentation of logotherapy. He reiterates that Auschwitz did not inspire a new therapy.

Frankl believes that meanings can be found in unique life situations. "I am not talking about ultimate meaning. I grasped when I was 16 that I may one day find meaning either in a creative way—in work or doing a deed—or in an experiential way, in the way one experiences something or someone as good or true or beautiful. There is also a third way. If your situation is unchangeable, if you are suffering from an incurable disease, then you can find meaning by the way you live through it."

The camps taught Frankl much about all these ways to meaning. In extreme circumstances, those people who felt they had a reason, a goal, to survive were most likely to survive. They did not give up and die as did one inmate Frankl knew. This man dreamed that the war would end for him on March 30, 1945. At first, he was optimistic; then, as March dragged on, he began to despair. There seemed no end of the war in sight. On March 29th, he became delirious; on March 30th, he lost consciousness; on March 31st, he died. As in North Korean and Japanese prisoner-of-war camps, Frankl says, "those who were most oriented toward a meaning to fulfill in the future tended to survive."

In the concentration camps, however, it was not a question of surviving best, of not being broken by the experience; it was a question of not being sent to the gas chambers. Frankl has argued with Hannah Arendt and others who found fault with the Jews for not attacking the SS. Many people who had strong reasons to live "did not believe they were being marched to the gas chambers. Some laughed. And, second, they were powerless. To take action was unrealistic, and it would have been impossibly irresponsible."

The revenge taken would have been atrocious. Those who understood the situation and who were almost resigned to it, Frankl says sadly, managed by their attitude to find or to express a meaning. "Even if you are caught as a helpless victim in a hopeless situation, you may transcend that situation and turn a tragedy into a triumph on a human level by the attitude that you adopt and bear it with." At worst, the way you face your death can give meaning to your life.

Frankl cites the accounts about those who were exterminated in the concentration camps. "Once those people—including my own mother, by the way—had been crammed into the gas chambers and they saw the canisters of Cyclone B gas thrown into a crowd of naked people, they saw there was no help. Then they began to pray, saying the Shema Isreal, and surrendered themselves to what God had bestowed on them—the Communists singing the Marseillaise, the Christians saying the Our Father, the Jews saying Kaddish upon each other." Frankl confesses he was awed by the way in which many very simple, ordinary people met their death. "They were able to manifest their deepest humanity."

Frankl stresses the value of suffering. Most therapists, after all, try to make people as happy and well as they can be. For Frankl, suffering can be creative. Once, an old physician came to him, extremely depressed after the death of his wife. Theirs had been a very happy marriage. Frankl records; "'Tell me, what would have happened if you had died first and your wife had survived you?'

"'That would have been terrible,' he said. 'How my wife would have suffered.'

"'Well, you see,' I answered, 'your wife has been spared that, and it was you who spared her, though of course you must now pay by surviving and mourning her.'"

The change in perspective did not make the physician glow with happiness, but it did give him a feeling that there was some point, some meaning, to his suffering. And, as a result, he could handle it much better. Frankl believes that we need, at this time, to develop our capacity for finding meanings.

Frankl is a religious man. Some critics have suggested that he has done nothing more than import some religious ideas into psychiatry. He is accused of encouraging psychiatrists to comfort their patients with talk of ultimate meanings. Frankl denies this. He does not deny that religion concerns him—he feels therapists should not ignore or put down religion.

"Logotherapists," Frankl explains, "see in religion a human phenomenon we have to take into account. We have to consider the fact that so many people have become or remained religious. But that does not mean that you have to be religious to benefit from logotherapy or, indeed, to use it if you are a therapist." Frankl insists that when he speaks about logotherapy, he speaks as an authority, the founder of the technique. "Logotherapy is a technique, the application of a secular scientific approach. Religious psychiatrists should be content if it no longer indoctrinates people with the notion that religion is nothing but the compulsive neurosis of mankind and that God is nothing but our Father Image in the Sky. The result of all that is to block the spontaneous religious self-actualization of a patient who might be so inclined. Not even the Freudians deal with religion that way now."

And many people who are religious, Frankl finds, seek not just a meaning in the here and now of life but also "some overall meaning about life in general. This ultimate meaning may also be the target of motivation. I could speak, therefore, of a Will to Ultimate Meaning, and having recognized such a meaning means being religious in the widest sense of the word. As Einstein said, there are people content with nothing but such meanings." Whatever Frankl's personal beliefs, one of the reasons for his popularity is precisely that he pays attention to the fact that we hanker after meaning to make sense of our lives. He doesn't see it as a weakness or an immaturity, as Freud and the behaviorists did.

It is typical of the paradoxes of Frankl's position that this hankering after the religious does not make him antiscientific. "Frankly, I must admit that logotherapy has been developed on purely intuitive grounds by me, which is a personal strength, perhaps, but a scientific weakness," he admits. But he has been glad to see empirical psychologists and psychiatrists bother to look experimentally at his ideas. For example, James C. Crumbaugh and Leonard T. Maholick devised a Purpose in Life test (known as PIL) and tried it out on 1,151 subjects. They concluded that there was evidence of a noogenic neurosis, a neurosis caused by a lack of meaning in one's life. There have been other, similar tests. Equally, Frankl is glad to see some convergence between logotherapy and behavior therapy—an unlikely alliance of the spiritual and scientific. Certainly, Frankl displays none of the contempt and hostility toward behavior therapy that most Freudians do. And that is surely welcome change, especially if the behavior therapists will really reciprocate.

Through his career, Frankl has continued to develop insights that he had as a very young man. He was 22 when he broke both with Freud and with Adler because he distrusted the attempt to reduce humanity, to explain individuals away in mechanical terms and rob them totally of their freedom. Frankl sees his work as building upon a wide range of previous work, not overturning it. "Logotherapy," he contends, "has made a contribution by opening up the human dimension which shows that resources can be drawn on once people are aware that man is not just a mechanism, a being that seeks satisfaction of drives, instincts and needs. Beyond what can be explained in subhuman terms, there is specifically human motivation. Man can suffer deliberately for a cause. This is what eludes you if you restrict on a priori bias your research to, say, animals.

"This does not mean that man ceases to be a biochemical entity, but he is more than that. The noetic (the specifically human) dimension encompasses the psychic and somatic one. Freud, Adler, Pavlov, and Watson are not invalidated or to be dismissed, but logotherapy is the more inclusive dimension. Within their dimension, they may all have been right, but one cannot ignore the noetic dimension, because the collective neurosis today seems to be that people feel they are suffering empty and meaningless lives."

"And, in that sense, not in the sense of possessing some universal truth, logotherapy does appeal to the predicament of today's man." As he says that, Frankl positively radiates confidence. Despite his concern to have a much more humane psychiatry, he has kept what he feels is a hard-headed approach. He is critical of much humanistic psychiatry. He enjoys satirizing the pretensions of encounter groups, marathon encounter groups and nude marathon encounter groups as usually being sessions of "mutual monolog."

Frankl now spends his life commuting between Vienna and the United States, where he is a distinguished professor at the United States International University in San Diego, California. He is convinced that his work is influential in the United States, because it answers a desperate need for meaning. He recently received the UNIQUEST Albert Schweitzer Award for 1977, presented to him at the inauguration of the Viktor E. Frankl Library at the Graduate Theological Union in Berkeley, California.

As we finished our talk, Frankl showed me around the room in the flat that he has made his own personal archive. He takes an almost naive pleasure in the room. It has copies of almost everything he has written, of lectures he has given; of tapes he has made. Frankl has certainly carved out for himself a distinct place as one of the first psychiatrists to see the value of exploring both the spiritual and the humorous side of humanity. The contradiction fits him. He cares both about spirit and science, meaning and measurement. Perhaps his real contribution will turn out to be that he did not flinch from these contradictions but kept on trying to achieve an understanding of humanity and our needs that is not oversimplified.