But let me make it perfectly clear that in no way is suffering necessary to find meaning. I only insist that meaning is possible even in spite of suffering—provided, certainly, that the suffering is unavoidable. If it were avoidable, however, the meaningful thing to do would be to remove its cause, be it psychological, biological or political. To suffer unnecessarily is masochistic rather than heroic.
Edith Weisskopf-Joelson, before her death professor of psychology at the University of Georgia, contended, in her article on logotherapy, that “our current mental-hygiene philosophy stresses the idea that people ought to be happy, that unhappiness is a symptom of maladjustment. Such a value system might be responsible for the fact that the burden of unavoidable unhappiness is increased by unhappiness about being unhappy.”4 And in another paper she expressed the hope that logotherapy “may help counteract certain unhealthy trends in the present-day culture of the United States, where the incurable sufferer is given very little opportunity to be proud of his suffering and to consider it ennobling rather than degrading” so that “he is not only unhappy, but also ashamed of being unhappy.”5
There are situations in which one is cut off from the opportunity to do one’s work or to enjoy one’s life; but what never can be ruled out is the unavoidability of suffering. In accepting this challenge to suffer bravely, life has a meaning up to the last moment, and it retains this meaning literally to the end. In other words, life’s meaning is an unconditional one, for it even includes the potential meaning of unavoidable suffering.
Let me recall that which was perhaps the deepest experience I had in the concentration camp. The odds of surviving the camp were no more than one in twenty-eight, as can easily be verified by exact statistics. It did not even seem possible, let alone probable, that the manuscript of my first book, which I had hidden in my coat when I arrived at Auschwitz, would ever be rescued. Thus, I had to undergo and to overcome the loss of my mental child. And now it seemed as if nothing and no one would survive me; neither a physical nor a mental child of my own! So I found myself confronted with the question whether under such circumstances my life was ultimately void of any meaning.
Not yet did I notice that an answer to this question with which I was wrestling so passionately was already in store for me, and that soon thereafter this answer would be given to me. This was the case when I had to surrender my clothes and in turn inherited the worn-out rags of an inmate who had already been sent to the gas chamber immediately after his arrival at the Auschwitz railway station. Instead of the many pages of my manuscript, I found in a pocket of the newly acquired coat one single page torn out of a Hebrew prayer book, containing the most important Jewish prayer, Shema Yisrael. How should I have interpreted such a “coincidence” other than as a challenge to live my thoughts instead of merely putting them on paper?
A bit later, I remember, it seemed to me that I would die in the near future. In this critical situation, however, my concern was different from that of most of my comrades. Their question was, “Will we survive the camp? For, if not, all this suffering has no meaning.” The question which beset me was, “Has all this suffering, this dying around us, a meaning? For, if not, then ultimately there is no meaning to survival; for a life whose meaning depends upon such a happenstance—as whether one escapes or not—ultimately would not be worth living at all.”
Meta-Clinical Problems
More and more, a psychiatrist is approached today by patients who confront him with human problems rather than neurotic symptoms. Some of the people who nowadays call on a psychiatrist would have seen a pastor, priest or rabbi in former days. Now they often refuse to be handed over to a clergyman and instead confront the doctor with questions such as, “What is the meaning of my life?”
A Logodrama
I should like to cite the following instance: Once, the mother of a boy who had died at the age of eleven years was admitted to my hospital department after a suicide attempt. Dr. Kurt Kocourek invited her to join a therapeutic group, and it happened that I stepped into the room where he was conducting a psychodrama. She was telling her story. At the death of her boy she was left alone with another, older son, who was crippled, suffering from the effects of infantile paralysis. The poor boy had to be moved around in a wheelchair. His mother, however, rebelled against her fate. But when she tried to commit suicide together with him, it was the crippled son who prevented her from doing so; he liked living! For him, life had remained meaningful. Why was it not so for his mother? How could her life still have a meaning? And how could we help her to become aware of it?
Improvising, I participated in the discussion, and questioned another woman in the group. I asked her how old she was and she answered, “Thirty.” I replied, “No, you are not thirty but instead eighty and lying on your deathbed. And now you are looking back on your life, a life which was childless but full of financial success and social prestige.” And then I invited her to imagine what she would feel in this situation. “What will you think of it? What will you say to yourself?” Let me quote what she actually said from a tape which was recorded during that session. “Oh, I married a millionaire, I had an easy life full of wealth, and I lived it up! I flirted with men; I teased them! But now I am eighty; I have no children of my own. Looking back as an old woman, I cannot see what all that was for; actually, I must say, my life was a failure!”
I then invited the mother of the handicapped son to imagine herself similarly looking back over her life. Let us listen to what she had to say as recorded on the tape: “I wished to have children and this wish has been granted to me; one boy died; the other, however, the crippled one, would have been sent to an institution if I had not taken over his care. Though he is crippled and helpless, he is after all my boy. And so I have made a fuller life possible for him; I have made a better human being out of my son.” At this moment, there was an outburst of tears and, crying, she continued: “As for myself, I can look back peacefully on my life; for I can say my life was full of meaning, and I have tried hard to fulfill it; I have done my best—I have done the best for my son. My life was no failure!” Viewing her life as if from her deathbed, she had suddenly been able to see a meaning in it, a meaning which even included all of her sufferings. By the same token, however, it had become clear as well that a life of short duration, like that, for example, of her dead boy, could be so rich in joy and love that it could contain more meaning than a life lasting eighty years.
After a while I proceeded to another question, this time addressing myself to the whole group. The question was whether an ape which was being used to develop poliomyelitis serum, and for this reason punctured again and again, would ever be able to grasp the meaning of its suffering. Unanimously, the group replied that of course it would not; with its limited intelligence, it could not enter into the world of man, i.e., the only world in which the meaning of its suffering would be understandable. Then I pushed forward with the following question: “And what about man? Are you sure that the human world is a terminal point in the evolution of the cosmos? Is it not conceivable that there is still another dimension, a world beyond man’s world; a world in which the question of an ultimate meaning of human suffering would find an answer?”
The Super-Meaning
This ultimate meaning necessarily exceeds and surpasses the finite intellectual capacities of man; in logotherapy, we speak in this context of a super-meaning. What is demanded of man is not, as some existential philosophers teach, to endure the meaninglessness of life, but rather to bear his incapacity to grasp its unconditional meaningfulness in rational terms. Logos is deeper than logic.
A psychiatrist who goes beyond the concept of the super-meaning will sooner or later be embarrassed by his patients, just as I was when my daughter at about six years of age asked me the question, “Why do we speak of the good Lord?” Whereupon I said, “Some weeks ago, you were suffering from measles, and then the good Lord sent you full recovery.” However, the little girl was not content; she retorted, �
��Well, but please, Daddy, do not forget: in the first place, he had sent me the measles.”
However, when a patient stands on the firm ground of religious belief, there can be no objection to making use of the therapeutic effect of his religious convictions and thereby drawing upon his spiritual resources. In order to do so, the psychiatrist may put himself in the place of the patient. That is exactly what I did once, for instance, when a rabbi from Eastern Europe turned to me and told me his story. He had lost his first wife and their six children in the concentration camp of Auschwitz where they were gassed, and now it turned out that his second wife was sterile. I observed that procreation is not the only meaning of life, for then life in itself would become meaningless, and something which in itself is meaningless cannot be rendered meaningful merely by its perpetuation. However, the rabbi evaluated his plight as an orthodox Jew in terms of despair that there was no son of his own who would ever say Kaddish6 for him after his death.
But I would not give up. I made a last attempt to help him by inquiring whether he did not hope to see his children again in Heaven. However, my question was followed by an outburst of tears, and now the true reason for his despair came to the fore: he explained that his children, since they died as innocent martyrs,7 were thus found worthy of the highest place in Heaven, but as for himself he could not expect, as an old, sinful man, to be assigned the same place. I did not give up but retorted, “Is it not conceivable, Rabbi, that precisely this was the meaning of your surviving your children: that you may be purified through these years of suffering, so that finally you, too, though not innocent like your children, may become worthy of joining them in Heaven? Is it not written in the Psalms that God preserves all your tears?8 So perhaps none of your sufferings were in vain.” For the first time in many years he found relief from his suffering through the new point of view which I was able to open up to him.
Life’s Transitoriness
Those things which seem to take meaning away from human life include not only suffering but dying as well. I never tire of saying that the only really transitory aspects of life are the potentialities; but as soon as they are actualized, they are rendered realities at that very moment; they are saved and delivered into the past, wherein they are rescued and preserved from transitoriness. For, in the past, nothing is irretrievably lost but everything irrevocably stored.
Thus, the transitoriness of our existence in no way makes it meaningless. But it does constitute our responsibleness; for everything hinges upon our realizing the essentially transitory possibilities. Man constantly makes his choice concerning the mass of present potentialities; which of these will be condemned to nonbeing and which will be actualized? Which choice will be made an actuality once and forever, an immortal “footprint in the sands of time”? At any moment, man must decide, for better or for worse, what will be the monument of his existence.
Usually, to be sure, man considers only the stubble field of transitoriness and overlooks the full granaries of the past, wherein he had salvaged once and for all his deeds, his joys and also his sufferings. Nothing can be undone, and nothing can be done away with. I should say having been is the surest kind of being.
Logotherapy, keeping in mind the essential transitoriness of human existence, is not pessimistic but rather activistic. To express this point figuratively we might say: The pessimist resembles a man who observes with fear and sadness that his wall calendar, from which he daily tears a sheet, grows thinner with each passing day. On the other hand, the person who attacks the problems of life actively is like a man who removes each successive leaf from his calendar and files it neatly and carefully away with its predecessors, after first having jotted down a few diary notes on the back. He can reflect with pride and joy on all the richness set down in these notes, on all the life he has already lived to the fullest. What will it matter to him if he notices that he is growing old? Has he any reason to envy the young people whom he sees, or wax nostalgic over his own lost youth? What reasons has he to envy a young person? For the possibilities that a young person has, the future which is in store for him? “No, thank you,” he will think. “Instead of possibilities, I have realities in my past, not only the reality of work done and of love loved, but of sufferings bravely suffered. These sufferings are even the things of which I am most proud, though these are things which cannot inspire envy.”
Logotherapy as a Technique
A realistic fear, like the fear of death, cannot be tranquilized away by its 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 cases, too. To understand what is going on whenever this technique is used, we take as a starting point 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 or by-product, and is destroyed and 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 centered 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.9
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 1939.10 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 of 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’m going to pour at least ten 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 use of the specifically human capacity for self-detachment inherent in a sense of humor. 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 neuro- sis. A statement consistent with this is found in Gordon W. Allport’s book, The Individual and His Religion: “The neu- rotic who learns to laugh at himself may be on the way to self-management, perhaps to cure.”11 Paradoxical intention is the empirical validation and clinical application of Allport’s statement.
A few more case reports may serve to clarify 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 legibly as possible, to write with the worst possible scrawl. He was advised to say to himself, “Now I will show 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.
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