LOGOTHERAPY IN A NUTSHELL
(ABRIDGED)
Readers of my short autobiographical story usually ask for a fuller and more direct explanation of my therapeutic doctrine. Accordingly I added a brief section on logotherapy to the original edition of From Death-Camp to Existentialism. But that was not enough, and I have been besieged by requests for a more extended treatment.
Therefore in the present edition I have completely rewritten and considerably expanded my account.
The assignment was not easy. To convey to the reader within a short space all the material which required twenty volumes in German is an almost hopeless task. I am reminded of the American doctor who once turned up in my office in Vienna and asked me, “Now, Doctor, are you a psychoanalyst?” Whereupon I replied, “Not exactly a psychoanalyst; let’s say a psychotherapist.” Then he continued questioning me: “What school do you stand for?” I answered, “It is my own theory; it is called logotherapy.” “Can you tell me in one sentence what is meant by logotherapy?” he asked. “At least, what is the difference between psychoanalysis and logotherapy?” “Yes,” I said, “but in the first place, can you tell me in one sentence what you think the essence of psychoanalysis is?”
This was his answer: “During psychoanalysis, the patient must lie down on a couch and tell you things which sometimes are very
disagreeable to tell.” Whereupon I immediately retorted with the following improvisation: “Now, in logotherapy the patient may remain sitting erect but he must hear things which sometimes are very disagreeable to hear.”
Of course, this was meant facetiously and not as a capsule version of logotherapy. However, there is something in it, inasmuch as logotherapy, in comparison with psychoanalysis, is a method less retrospective and less introspective. Logotherapy focuses rather on the future, that is to say, on the meanings to be fulfilled by the patient in his future. (Logotherapy, indeed, is a meaning-centered psychotherapy.) In logotherapy the patient is actually confronted with and reoriented toward the meaning of his life. And to make him aware of this meaning can contribute much to his ability to overcome his neurosis.
Let me explain why I have employed the term “logotherapy” as the name for my theory. Logos is a Greek word which denotes “meaning.” Logotherapy focuses on the meaning of human existence as well as on man’s search for such a meaning. According to logotherapy, this striving to find a meaning in one’s life is the primary motivational force in man.
THE WILL TO MEANING
Man’s search for meaning is the primary motivation in his life and not a “secondary rationalization” of instinctual drives. This meaning is unique and specific in that it must and can be fulfilled by him alone; only then does it achieve a significance which will satisfy his own will to meaning. A public-opinion poll was conducted a few years ago in France. The results showed that 89 percent of the people polled admitted that man needs “something” for the sake of which to live.
Moreover, 61 percent conceded that there was something, or someone, in their own lives for whose sake they were even ready to die. I repeated this poll at my hospital department in Vienna among both the patients and the personnel, and the outcome was practically the same as among the thousands of people screened in France; the difference was only 2 percent.
Another statistical survey, of 7,948 students at forty-eight colleges, was conducted by social scientists from Johns Hopkins University.
Their preliminary report is part of a two-year study sponsored by the National Institute of Mental Health. Asked what they considered “very important” to them now, 16 percent of the students checked “making a lot of money”; 78 percent said their first goal was “finding a purpose and meaning to my life.”
THE IMPORTANCE OF TENSION
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 the philosopher 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 1 confiscated.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 based on a healthy tension between a meaning that is to be fulfilled and the person who has to fulfill it.
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 the philosopher Schopenhauer when he said that 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.
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
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 different 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.
2In logotherapy, love is not interpreted as a mere epiphenomenon 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, Doctor, 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 office. 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.
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.
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.”
A LOGODRAMA
I should like to cite the following instance of a patient who confronted me with the question, “What is the meaning of my life?” 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 disabled, 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 anti-polio 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
3 that there was no son of his own who would ever say Kaddishfor 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 4explained that his children, since they died as innocent martyrs, 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 5 Psalms that God preserves all your tears?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.”
FREEDOM AND RESPONSIBILITY
What I find dangerous is a view of man which disregards his capacity to take a stand toward any conditions whatsoever. Man is not fully conditioned and determined but rather determines himself whether he gives in to conditions or stands up to them. In other words, man is ultimately self-determining. Man does not simply exist but always
decides what his existence will be, what he will become in the next moment.
By the same token, every human being has the freedom to change at any instant. The individual personality remains essentially unpredictable. The basis for any predictions would be represented by biological, psychological or sociological conditions. Yet one of the main features of human existence is the capacity to rise above such conditions, to grow beyond them. Man is capable of changing the world for the better if possible, and of changing himself for the better if necessary.
Let me cite the case of Dr. J. He was the only man I ever encountered in my whole life whom I would dare to call a satanic figure. At that time he was generally called “the mass murderer of Steinhof” (the large mental hospital in Vienna). When the Nazis started their euthanasia program, he held all the strings in his hands and was so fanatic in the job assigned to him that he tried not to let one single psychotic individual escape the gas chamber. After the war, when I came back to Vienna, I asked what had happened to Dr.
J. “He had been imprisoned by the Russians in one of the isolation cells of Steinhof,” they told me. “The next day, however, the door of his cell stood open and Dr. J. was never seen again.” Later I was convinced that, like others, he had with the help of his comrades made his way to South America. More recently, however, I was consulted by a former Austrian diplomat who had been imprisoned behind the Iron Curtain for many years, first in Siberia and then in the famous Lubianka prison in Moscow. While I was examining him neurologically, he suddenly asked me whether I happened to know Dr. J. After my affirmative reply he continued: “I made his acquaintance in Lubianka. There he died, at about the age of forty, from cancer of the urinary bladder. Before he died, however, he showed himself to be the best comrade you can imagine! He gave consolation to everybody. He lived up to the highest conceivable moral standard. He was the best friend I ever met during my long years in prison!” This is the story of Dr. J., “the mass murderer of Steinhof.” How can we dare to predict the behavior of man? We may predict the movements of a machine, of an automaton; more than
this, we may even try to predict the mechanisms or “dynamisms” of the human psyche as well. But man is more than psyche.
Freedom, however, is not the last word. Freedom is only part of the story and half of the truth. Freedom is but the negative aspect of the whole phenomenon whose positive aspect is responsibleness. In fact, freedom is in danger of degenerating into mere arbitrariness unless it is lived in terms of responsibleness. That is why I recommend that the Statue of Liberty on the East Coast be supplemented by a Statue of Responsibility on the West Coast.
THE PSYCHIATRIC CREDO
There is nothing conceivable which would so condition a man as to leave him without the slightest freedom. Therefore, a residue of freedom, however limited it may be, is left to man in neurotic and even psychotic cases. Indeed, the innermost core of the patient’s personality is not even touched by a psychosis. An incurably psychotic individual may lose his usefulness but yet retain the dignity of a human being. This is my psychiatric credo. Without it I should not think it worthwhile to be a psychiatrist. For whose sake? Just for the sake of a damaged brain machine which cannot be repaired? If the patient were not definitely more, euthanasia would be justified.
PSYCHIATRY REHUMANIZED
For too long a time—for half a century, in fact—psychiatry tried to interpret the human mind merely as a mechanism, and consequently the therapy of mental disease merely in terms of a technique. I believe this dream has been dreamt out. What now begins to loom on the horizon are not the sketches of a psychologized medicine but rather those of a humanized psychiatry.
A doctor, however, who would still interpret his own role mainly as that of a technician would confess that he sees in his patient nothing
more than a machine, instead of seeing the human being behind the disease!
A human being is not one thing among others; things determine each other, but man is ultimately self-determining. What he becomes —within the limits of endowment and environment—he has made out of himself. In the concentration camps, for example, in this living laboratory and on this testing ground, we watched and witnessed some of our comrades behave like swine while others behaved like saints. Man has both potentialities within himself; which one is actualized depends on decisions but not on conditions.
Our generation is realistic, for we have come to know man as he really is. After all, man is that being who invented the gas chambers of Auschwitz; however, he is also that being who entered those gas chambers upright, with the Lord’s Prayer or the Shema Yisrael on his lips.
This section first appeared as “Basic Concepts of Logotherapy” in the 1962 edition of Man’s Search for Meaning. It is presented here in an abridged form. The full text can be found in Beacon Press’s paperback and gift editions of Man’s Search for Meaning.
1. It was the first version of my first book, the English translation of which was published by Alfred A. Knopf, New York, in 1955, under the title The Doctor and the Soul: An Introduction to Logotherapy.
2. A phenomenon that occurs as the result of a primary phenomenon.
3. A prayer for the dead.
4. L’kiddush hashem, i.e., for the sanctification of God’s name.
5. “Thou hast kept count of my tossings; put thou my tears in thy bottle! Are they not in thy book?” (Psalm 56, 8.)
