It is obvious that in noögenic cases the appropriate and adequate therapy is not psychotherapy in general but rather logotherapy; a therapy, that is, which dares to enter the specifically human dimension.
Let me quote the following instance: A high-ranking American diplomat came to my offce in Vienna in order to continue psychoanalytic treatment which he had begun five years previously with an analyst in New York. At the outset I asked him why he thought he should be analyzed, why his analysis had been started in the first place. It turned out that the patient was discontented with his career and found it most diffcult to comply with American foreign policy. His analyst, however, had told him again and again that he should try to reconcile himself with his father; because the government of the U.S. as well as his superiors were “nothing but” father images and, consequently, his dissatisfaction with his job was due to the hatred he unconsciously harbored toward his father. Through an analysis lasting five years, the patient had been prompted more and more to accept his analyst’s interpretations until he finally was unable to see the forest of reality for the trees of symbols and images. After a few interviews, it was clear that his will to meaning was frustrated by his vocation, and he actually longed to be engaged in some other kind of work. As there was no reason for not giving up his profession and embarking on a different one, he did so, with most gratifying results. He has remained contented in this new occupation for over five years, as he recently reported. I doubt that, in this case, I was dealing with a neurotic condition at all, and that is why I thought that he did not need any psychotherapy, nor even logotherapy, for the simple reason that he was not actually a patient. Not every conflict is necessarily neurotic; some amount of conflict is normal and healthy. In a similar sense suffering is not always a pathological phenomenon; rather than being a symptom of neurosis, suffering may well be a human achievement, especially if the suffering grows out of existential frustration. I would strictly deny that one’s search for a meaning to his existence, or even his doubt of it, in every case is derived from, or results in, any disease. Existential frustration is in itself neither pathologi- cal nor pathogenic. A man’s concern, even his despair, over the worthwhileness of life is an existential distress but by no means a mental disease. It may well be that interpreting the first in terms of the latter motivates a doctor to bury his patient’s existential despair under a heap of tranquilizing drugs. It is his task, rather, to pilot the patient through his existential crises of growth and development.
Logotherapy regards its assignment as that of assisting the patient to find meaning in his life. Inasmuch as logotherapy makes him aware of the hidden logos of his existence, it is an analytical process. To this extent, logotherapy resembles psychoanalysis. However, in logotherapy’s attempt to make something conscious again it does not restrict its activity to instinctual facts within the individual’s unconscious but also cares for existential realities, such as the potential meaning of his existence to be fulfilled as well as his will to meaning. Any analysis, however, even when it refrains from including the noölogical dimension in its therapeutic process, tries to make the patient aware of what he actually longs for in the depth of his being. Logotherapy deviates from psychoanalysis insofar as it considers man a being whose main concern consists in fulfilling a meaning, rather than in the mere gratification and satisfaction of drives and instincts, or in merely reconciling the conflicting claims of id, ego and superego, or in the mere adaptation and adjustment to society and environment.
Noö-Dynamics
To be sure, man’s search for meaning may arouse inner tension rather than inner equilibrium. However, precisely such tension is an indispensable prerequisite of mental health. There is nothing in the world, I venture to say, that would so effectively help one to survive even the worst conditions as the knowledge that there is a meaning in one’s life. There is much wisdom in the words of Nietzsche: “He who has a why to live for can bear almost any how.” I can see in these words a motto which holds true for any psychotherapy. In the Nazi concentration camps, one could have witnessed that those who knew that there was a task waiting for them to fulfill were most apt to survive. The same conclusion has since been reached by other authors of books on concentration camps, and also by psychiatric investigations into Japanese, North Korean and North Vietnamese prisoner-of-war camps.
As for myself, when I was taken to the concentration camp of Auschwitz, a manuscript of mine ready for publication was confiscated.1 Certainly, my deep desire to write this manuscript anew helped me to survive the rigors of the camps I was in. For instance, when in a camp in Bavaria I fell ill with typhus fever, I jotted down on little scraps of paper many notes intended to enable me to rewrite the manuscript, should I live to the day of liberation. I am sure that this reconstruction of my lost manuscript in the dark barracks of a Bavarian concentration camp assisted me in overcoming the danger of cardiovascular collapse.
Thus it can be seen that mental health is based on a certain degree of tension, the tension between what one has already achieved and what one still ought to accomplish, or the gap between what one is and what one should become. Such a tension is inherent in the human being and therefore is indispensable to mental well-being. We should not, then, be hesitant about challenging man with a potential meaning for him to fulfill. It is only thus that we evoke his will to meaning from its state of latency. I consider it a dangerous misconception of mental hygiene to assume that what man needs in the first place is equilibrium or, as it is called in biology, “homeostasis,” i.e., a tensionless state. What man actually needs is not a tensionless state but rather the striving and struggling for a worthwhile goal, a freely chosen task. What he needs is not the discharge of tension at any cost but the call of a potential meaning waiting to be fulfilled by him. What man needs is not homeostasis but what I call “noö- dynamics,” i.e., the existential dynamics in a polar field of tension where one pole is represented by a meaning that is to be fulfilled and the other pole by the man who has to fulfill it. And one should not think that this holds true only for normal conditions; in neurotic individuals, it is even more valid. If architects want to strengthen a decrepit arch, they increase the load which is laid upon it, for thereby the parts are joined more firmly together. So if therapists wish to foster their patients’ mental health, they should not be afraid to create a sound amount of tension through a reorientation toward the meaning of one’s life.
Having shown the beneficial impact of meaning orientation, I turn to the detrimental influence of that feeling of which so many patients complain today, namely, the feeling of the total and ultimate meaninglessness of their lives. They lack the awareness of a meaning worth living for. They are haunted by the experience of their inner emptiness, a void within themselves; they are caught in that situation which I have called the “existential vacuum.”
The Existential Vacuum
The existential vacuum is a widespread phenomenon of the twentieth century. This is understandable; it may be due to a twofold loss which man has had to undergo since he became a truly human being. At the beginning of human history, man lost some of the basic animal instincts in which an animal’s behavior is imbedded and by which it is secured. Such security, like Paradise, is closed to man forever; man has to make choices. In addition to this, however, man has suffered another loss in his more recent development inasmuch as the traditions which buttressed his behavior are now rapidly diminishing. No instinct tells him what he has to do, and no tradition tells him what he ought to do; sometimes he does not even know what he wishes to do. Instead, he either wishes to do what other people do (conformism) or he does what other people wish him to do (totalitarianism).
A statistical survey recently revealed that among my European students, 25 percent showed a more-or-less marked degree of existential vacuum. Among my American students it was not 25 but 60 percent.
The existential vacuum manifests itself mainly in a state of boredom. Now we can understand Schopenhauer when he said th
at mankind was apparently doomed to vacillate eternally between the two extremes of distress and boredom. In actual fact, boredom is now causing, and certainly bringing to psychiatrists, more problems to solve than distress. And these problems are growing increasingly crucial, for progressive automation will probably lead to an enormous increase in the leisure hours available to the average worker. The pity of it is that many of these will not know what to do with all their newly acquired free time.
Let us consider, for instance, “Sunday neurosis,” that kind of depression which afflicts people who become aware of the lack of content in their lives when the rush of the busy week is over and the void within themselves becomes manifest. Not a few cases of suicide can be traced back to this existential vacuum. Such widespread phenomena as depression, aggression and addiction are not understandable unless we recognize the existential vacuum underlying them. This is also true of the crises of pensioners and aging people.
Moreover, there are various masks and guises under which the existential vacuum appears. Sometimes the frustrated will to meaning is vicariously compensated for by a will to power, including the most primitive form of the will to power, the will to money. In other cases, the place of frustrated will to meaning is taken by the will to pleasure. That is why existential frustration often eventuates in sexual compensation. We can observe in such cases that the sexual libido becomes rampant in the existential vacuum.
An analogous event occurs in neurotic cases. There are certain types of feedback mechanisms and vicious-circle formations which I will touch upon later. One can observe again and again, however, that this symptomatology has invaded an existential vacuum wherein it then continues to flourish. In such patients, what we have to deal with is not a noögenic neurosis. However, we will never succeed in having the patient overcome his condition if we have not supplemented the psychotherapeutic treatment with logotherapy. For by filling the existential vacuum, the patient will be prevented from suffering further relapses. Therefore, logotherapy is indicated not only in noögenic cases, as pointed out above, but also in psychogenic cases, and sometimes even the somatogenic (pseudo-) neuroses. Viewed in this light, a statement once made by Magda B. Arnold is justified: “Every therapy must in some way, no matter how restricted, also be logotherapy.”2
Let us now consider what we can do if a patient asks what the meaning of his life is.
The Meaning of Life
I doubt whether a doctor can answer this question in general terms. For the meaning of life differs from man to man, from day to day and from hour to hour. What matters, therefore, is not the meaning of life in general but rather the specific meaning of a person’s life at a given moment. To put the question in general terms would be comparable to the question posed to a chess champion: “Tell me, Master, what is the best move in the world?” There simply is no such thing as the best or even a good move apart from a particular situation in a game and the particular personality of one’s opponent. The same holds for human existence. One should not search for an abstract meaning of life. Everyone has his own specific vocation or mission in life to carry out a concrete assignment which demands fulfillment. Therein he cannot be replaced, nor can his life be repeated. Thus, everyone’s task is as unique as is his specific opportunity to implement it.
As each situation in life represents a challenge to man and presents a problem for him to solve, the question of the meaning of life may actually be reversed. Ultimately, man should not ask what the meaning of his life is, but rather he must recognize that it is he who is asked. In a word, each man is questioned by life; and he can only answer to life by answering for his own life; to life he can only respond by being responsible. Thus, logotherapy sees in responsibleness the very essence of human existence.
The Essence of Existence
This emphasis on responsibleness is reflected in the categorical imperative of logotherapy, which is: “Live as if you were living already for the second time and as if you had acted the first time as wrongly as you are about to act now!” It seems to me that there is nothing which would stimulate a man’s sense of responsibleness more than this maxim, which invites him to imagine first that the present is past and, second, that the past may yet be changed and amended. Such a precept confronts him with life’s finiteness as well as the finality of what he makes out of both his life and himself.
Logotherapy tries to make the patient fully aware of his own responsibleness; therefore, it must leave to him the option for what, to what, or to whom he understands himself to be responsible. That is why a logotherapist is the least tempted of all psychotherapists to impose value judgments on his patients, for he will never permit the patient to pass to the doctor the responsibility of judging.
It is, therefore, up to the patient to decide whether he should interpret his life task as being responsible to society or to his own conscience. There are people, however, who do not interpret their own lives merely in terms of a task assigned to them but also in terms of the taskmaster who has assigned it to them.
Logotherapy is neither teaching nor preaching. It is as far removed from logical reasoning as it is from moral exhortation. To put it figuratively, the role played by a logotherapist is that of an eye specialist rather than that of a painter. A painter tries to convey to us a picture of the world as he sees it; an ophthalmologist tries to enable us to see the world as it really is. The logotherapist’s role consists of widening and broadening the visual field of the patient so that the whole spectrum of potential meaning becomes conscious and visible to him.
By declaring that man is responsible and must actualize the potential meaning of his life, I wish to stress that the true meaning of life is to be discovered in the world rather than within man or his own psyche, as though it were a closed system. I have termed this constitutive characteristic “the self-transcendence of human existence.” It denotes the fact that being human always points, and is directed, to something, or someone, other than oneself—be it a meaning to fulfill or another human being to encounter. The more one forgets himself—by giving himself to a cause to serve or another person to love—the more human he is and the more he actualizes himself. What is called self-actualization is not an attainable aim at all, for the simple reason that the more one would strive for it, the more he would miss it. In other words, self-actualization is possible only as a side-effect of self- transcendence.
Thus far we have shown that the meaning of life always changes, but that it never ceases to be. According to logotherapy, we can discover this meaning in life in three dif- ferent ways: (1) by creating a work or doing a deed; (2) by experiencing something or encountering someone; and (3) by the attitude we take toward unavoidable suffering. The first, the way of achievement or accomplishment, is quite obvious. The second and third need further elaboration.
The second way of finding a meaning in life is by experiencing something—such as goodness, truth and beauty—by experiencing nature and culture or, last but not least, by experiencing another human being in his very uniqueness—by loving him.
The Meaning of Love
Love is the only way to grasp another human being in the innermost core of his personality. No one can become fully aware of the very essence of another human being unless he loves him. By his love he is enabled to see the essential traits and features in the beloved person; and even more, he sees that which is potential in him, which is not yet actualized but yet ought to be actualized. Furthermore, by his love, the loving person enables the beloved person to actualize these potentialities. By making him aware of what he can be and of what he should become, he makes these potentialities come true.
In logotherapy, love is not interpreted as a mere epiphenomenon3 of sexual drives and instincts in the sense of a so-called sublimation. Love is as primary a phenomenon as sex. Normally, sex is a mode of expression for love. Sex is justified, even sanctified, as soon as, but only as long as, it is a vehicle of love. Thus love is not understood as a mere side-effect of sex; rather, sex
is a way of expressing the experience of that ultimate togetherness which is called love.
The third way of finding a meaning in life is by suffering.
The Meaning of Suffering
We must never forget that we may also find meaning in life even when confronted with a hopeless situation, when facing a fate that cannot be changed. For what then matters is to bear witness to the uniquely human potential at its best, which is to transform a personal tragedy into a triumph, to turn one’s predicament into a human achievement. When we are no longer able to change a situation—just think of an incurable disease such as inoperable cancer—we are challenged to change ourselves.
Let me cite a clear-cut example: Once, an elderly general practitioner consulted me because of his severe depression. He could not overcome the loss of his wife who had died two years before and whom he had loved above all else. Now, how could I help him? What should I tell him? Well, I refrained from telling him anything but instead confronted him with the question, “What would have happened, Doctor, if you had died first, and your wife would have had to survive you?” “Oh,” he said, “for her this would have been terrible; how she would have suffered!” Whereupon I replied, “You see, Doc- tor, such a suffering has been spared her, and it was you who have spared her this suffering—to be sure, at the price that now you have to survive and mourn her.” He said no word but shook my hand and calmly left my offce. In some way, suffering ceases to be suffering at the moment it finds a meaning, such as the meaning of a sacrifice.
Of course, this was no therapy in the proper sense since, first, his despair was no disease; and second, I could not change his fate; I could not revive his wife. But in that moment I did succeed in changing his attitude toward his unalterable fate inasmuch as from that time on he could at least see a meaning in his suffering. It is one of the basic tenets of logotherapy that man’s main concern is not to gain pleasure or to avoid pain but rather to see a meaning in his life. That is why man is even ready to suffer, on the condition, to be sure, that his suffering has a meaning.