[Rowland is an American reporter, editor, and author of Hurt and Healing (1969). In the following essay, he examines Frankl's notion of the "will to meaning" as an essential supplementary element in modern depth psychology.]

Two elderly psychiatrists sat together at the round dining table opposite a young psychiatrist and a Methodist chaplain in his middle years. Between the two pairs sat two newsmen, Murray Ilson of the New York Times and myself. The subject was the meaning of human life, and the place of this question in psychiatry.

"The question has no place in psychiatry," one of the older psychiatrists said flatly. "It is a philosophical question." He nodded toward the head table in the ballroom, indicating the man who was to speak: Viktor E. Frankl of Vienna. Dr. Frankl has pioneered the psychiatric approach known as logotherapy, which stresses man's "will to meaning"; as a prisoner in a Nazi death camp during World War II he was able to test his existential psychiatry existentially. On this occasion he was about to address the annual meeting of the Academy of Religion and Mental Health.

"What Frankl says is very inspiring," the older psychiatrist continued. "It reminds me somewhat of an address that Paul Tillich gave at one of our meetings. We psychiatrists could scarcely understand him—he was talking on another level—though he was quite inspiring also. But these questions of meaning and purpose in life have no part in psychiatry."

At this point I challenged him: "I'm not trying to tell you about your profession. I take a flat pragmatic approach. If something is necessary for the healing—for the rejuvenation—of a person, then it must be included by the healer. I don't care what label it wears. In my own experience psychotherapy does a fine job of removing blocks, like surgery does in removing tumors. But such removal also increases the inner vacuum. And that vacuum has to be filled, and filled with the right things, or the result will be dependency and weakness. For instance, if the patient doesn't actualize his drive to love, then it will come back to him like a boomerang, in the form of anxiety—as an anxious desire to be loved. The same applies to actualizing faith and meaning. You or the clergy can put these in any category you like. But they are deep human needs, and they've got to be filled or the counselee is in trouble."

"I agree with you," the young psychiatrist said, leaning forward in his chair. "I've become a very theological psychiatrist. I've had to, in order to heal people."

"No," said the older psychiatrist. "Such concepts have no place in psychiatry."

"Yes," said the younger psychiatrist. "You've got to use the concepts that work."

For a few minutes the two men tried to discuss the issue. But the older doctor spoke in terms of the function of different brain segments in neuroses, while the other spoke about the need to love and the energy of being. Quickly it became apparent that they could scarcely discuss the issue at all, so different were their views of human nature and their categories.

"All this is great material for a sermon," the clergyman commented, and inquired further into the psychiatric mechanisms involved in redemption. The younger psychiatrist could talk with him from a professional standpoint and I could converse on the basis of experience. The other two psychiatrists could not really discuss the issue. The table conversation divided in half.

This development seemed to symbolize the academy's annual meeting fairly well. The much touted chasm between religion and psychiatry did not seem appreciable. Instead, the major chasm seemed to be between those who took a methodological and mechanistic approach and those who took an existential approach, with special emphasis on the question of life's meaning. On this basis, dealing with the practical question of what a person needs to be whole and rejuvenated, clergy and psychiatrists were able to talk fruitfully. A number of participants agreed with a leading psychiatrist who declared: "Dr. Frankl's address was very interesting and inspiring. But it doesn't help us with the people at state hospital." Dr. Frankl's approach received support, however, from a number of other leaders in the field of psychotherapy—Rollo May, for one.

Dr. Frankl called for a new "height psychology," utilizing man's "will to meaning," to supplement traditional depth psychology. He assailed the "pandeterminism which is so pervasive in psychology"; the view that the patient's actions are determined, he said, "plays into the hands of the patient's fatalism, thus reinforcing the latter's neurosis." He supported his discussion with examples of how logotherapy has effected cures, even in some apparently hopeless cases, by mobilizing the patient's will to meaning and capacity for free choice.

Stressing the importance of this view in modern psychiatry, he asserted: "Ever more frequently psychoanalysts report that they are confronted with a new type of neurosis characterized by loss of interest and by lack of initiative. They complain that in such cases conventional psychoanalysis is not effective." In a survey made at the University of Vienna where he teaches he found that 40 per cent of the European students were afflicted with this "existential vacuum," compared with 81 per cent of the American students. "From these percentages we must not draw the conclusion that the existential vacuum is predominantly an American disease, but rather that it is apparently a concomitant of industrialization." He did not, however, explain why the problem of unmeaning was less common among students from highly industrialized countries in Europe.

Dr. Frankl went on to say that "rather than being a 'secondary rationalization' of instinctual drives, the striving to find a meaning in life is a primary motivational force in man." He could not agree, he asserted, with the Freudian thinking that gives primacy to the desire for pleasure. "Logotherapy regards the will to pleasure as a secondary matter," he said during a panel discussion. "Pleasure comes largely as a by-product, not as a result of direct striving—which tends to increase anxiety. This is typically the case in sexual neuroses. We find a forced striving for erection or orgasm, which simply increases the anxiety syndrome. The neurosis feeds on itself."

Picking up this point in conversation with Dr. Frankl, I asked him whether "will to meaning" is the proper term to describe a sound approach to the sexual: "Isn't there also a will to love, which may be sexually directed, and a will to have faith in something?" He agreed, though he gave centrality to the will to meaning. I also challenged his assertion that immortal life would deprive the present of its meaning and significance. "Some people," I suggested, "feel that death deprives life of its meaning. On the other hand, my belief in the eternal life of personal being throws me back completely on the present moment."

"I would put it more strongly than that," the young psychiatrist commented regarding the same suggestion in another context. "When a patient realizes a belief in personal immortality, it creates something like a state of emergency in the present. If 'now' goes on forever, then the only time they have is right now."

Dr. Frankl affably conceded the point but insisted that "if immortal life does not deprive the present of meaning, then neither does death." I quite readily agreed.

This was the kind of conversation one found repeatedly in the corridors of the Biltmore hotel at the academy's annual meeting. And despite the various objections to Dr. Frankl's emphasis, the stress on life's meaning seemed to provide the major note of the conference.

In a panel dealing with the psychological aspects of confrontation with the prospect of mass death, one psychiatrist took a technical approach in discussing the common reactions of apathy, anxiety and escapism. But he urged that Americans can cope with the problem realistically only if they recover a strong awareness of the meaning and values to be found in life.