Frankl and Courage

Out of Alfred Adler's theories came a greater appreciation for the positive aspects of the individual: his or her abilities to confront difficulties in the personality, the importance of altruism, sacrifice and service. These ideas of human nobility were largely ignored by Freud, or at least attached to darker ulterior motives and drives. But in contradiction with Freud (and often scorned by him), Adler set a trend for many psychiatrists and psychoanalysts who would follow him in their interest of the magnanimity of man. Victor Frankl was the next in line to receive notoriety for his interest in forwarding Positive Psychology. Courage played a key role both in Frankl's life, and in his development of his Logotherapy, though perhaps in a more implicit way than Adler's explicit use and understanding of the concept.

Frankl's notoriety and insight are not simply due to to his place in psychiatry, but also to his experiences. Frankl spent the years between 1942 and 1945 in Nazi concentration camps, living alone as his wife, mother and father were murder or died in separate camps. After his release from Auschwitz, Frankl would wrote the book "Man's Search for Meaning" in which he described his experiences and observations as a therapist, and then developed his theory of "Logotherapy". His theory centered on the idea that "meaning", in an existential or spiritual sense, is the reason the man lives--and in the case of the concentration camps, the reason a man could stay alive. Frankl's difficult and unique experiences gave him a window into the dignity and bravery of individuals, but also the depth of their despair. In such a situation, Frankl felt that man needed to be able to look beyond himself to overcome difficult circumstances, for he experienced that those who survived the concentration camps were often the ones who had something to live for outside of the camp. Being under perpetual physical abuse and taunts from the guards, but most of all the "mental agony caused by the injustice, the unreasonableness of it all" (Frankl 1986 p. 42) caused many to give up hope. This ultimate despair he in concrete terms of saving cigarette vouchers that could be traded for soup, and "when we saw a comrade smoking his own cigarettes, we knew he had given up faith in strength to carry on, and, once lost, the will to live seldom returned" (Frankl 1986 p. 26).

However, if a man could find a way to focus on an object, belief or experience that gave him purpose, Frankl believed he could survive and even flourish no matter how difficult the circumstances. Frankl recounted such an experience with the memory of his wife, though not being sure if she was dead or alive:

Occasionally I looked at the sky, where the stars were fading and the pink light of morning was beginning to spread behind a dark bank of clouds. But my mind clung to my wife's image, imagining it with an uncanny acuteness. I heard her answer me, saw her smile, her frank and encouraging look. Real or not, her look was then more luminous than the sun which was beginning to rise (Frankl 1986 p. 57).

It was this image of his wife which Frankl said, helped him understand how "a man who has nothing left in this world still may know bliss, be it only for a brief moment, in the contemplation of his beloved" (Frankl 1986 p. 57). By cultivating these moments that kept his inner life vital, Frankl felt he was able to regain his courage, and fight off despair despite a constant attack to the stability of his psyche.

Frankl's ideas bear witness and similarity to Adler's, but ultimately, Frankl felt what a man derives meaning from must come from a more spiritual place than Adler. Adler saw his ideas of social interest and contribution as containing a sort of mystical or spiritual element to them, while Frankl saw concepts as incomplete in of themselves. Walter E O'Connell, an Adlerian, commented that "Frankl's spirituality seems to be Adler's social interest in diguise..." (O'Connell 1970 Journal of Religion and Health p. 136), while Frankl would have seen Adler's theory "within a reductionist view, reduced by psychodynamic and biological forces" (Hillmann 2004 Handbook of Motivational Counseling p. 358) Frankl understood this choice more existentially, as a man or woman's need for hope. This was explored in what he called the "will to meaning", rather than Freud's "will to pleasure", or the Adlerian "will to power" (the overcoming of inferiority" (Frankl 1986 p. 120). Adlerian's would disagree with Frankl, claiming he misunderstood Adler's conception of willing to power--simply in Adler's mind, "the ideal of expanded self-esteem and social interest" (O'Connell 1970 p. 135). This is understandable in Frankl's case, as a first hand experience of Nazism would have given him skepticism about the health of a theory based around social participation. Frankl had witnessed social participation and the drive for superiority become a driving force behind the conformity in Germany that led atrocity. But he saw that "man, is able to live and die for the sake of his beliefs and values" (Frankl 1986 p. 115), thereby making him an agent for courageous individual choices.

However, Frankl and Alder shared a common concept in that of treating Neuroses. But Frankl departs from Adler in the excavation of the inner life as a tool for health. Rather than a focus that is retrospective or introspective like Adler, asking the patient to face their therapeutic relationship or larger social relationships, Frankl saw Logotherapy as a forward pointing therapy. However, they shared a common view that the neurotic was someone who wanted to avoid the responsibilities of life. For Frankl, neurotic behavior would not be seen as a loss of courage, but rather the loss of meaning that would propel an individual to courage. The goal for Frankl was to see that the "self-centeredness of the neurotic is broken up instead of being continually fostered and reinforced" (Frankl 1986 p. 120). These neuroses, Frankl called Noogenic because they were not problems rooted in physiology, but in the mind (noos meaning "mind" in Greek), and originated not from "conflicts between drives and instincts, but rather from existential problems" (Frankl 1986 p. 123). A person who is suffering from a noogenic neurosis, might find that their lost meaning would result in somatic affectation. But this ultimately leads to feelings of emptiness, apathy, permanent boredom and weariness, or incessant chasing after pleasure (Hillmann 2004 p. 363). Thus, apathy undermines a person's courage for life choices and acts. Logotherapy, focuses on recovering meaning by placing courageous choice back in the hands of the patient. For as Frankl claimed, "each man is questioned by life; and he can only answer to life by answering for his own life; to live he can only respond by being responsible. Thus logotherapy sees in responsibleness the very essence of human existence" (Frankl 1986 p. 131).

While Frankl thought of Adler's theory mainly for the purpose of dealing youthful or adolescent formation (O'Connell 1970), he was interested in helping people recover the meaning in their life at all states. The two main categories that his theory falls into are that of "self-distancing" and "self-transcendence" (Millmann 2004). The person who is able to act courageously is able to excercise both of the concepts. While self-transcendence looks toward the "logos" or purpose a person needs, self-distancing is done through small courageous acts towards the self. This applies most readily to those with anxiety disorders, phobias or panic disorders--any situation where all mental energy is focused on the fear itself. When neuroses reaches the level of affecting a person somatically, a cycle is developed where the physical symptom becomes mental anxiety of experiencing the symptom, which in turn perpetuates the physical symptom. The concept of self-distancing is expressed in the technique of "paradoxical intention", where the neurotic individual courageously chooses to wish for exactly what one fears (Millmann 2004). This choice may look something like the insomniac who chooses to wish not to go to sleep, and this works because, "the fear of falling asleep cannot coexist with the actual wish not to go to sleep" (H illmann 2004 p. 368). Here the obsessive pattern is broken, and the individual "experiences the self as strong, he evidences courage, seizes the "bull by the horns", and faces anxiety-filled situations intentionally and deliberately" (Lukas 2000 p. 105--quoted in Hillmann p. 367).

Humor has long been seen as a virtue that the brave individual carries into the face of fear. So too, the courageous act of self-distancing opens up the possibility of humor as a new paradigm through which to see the old anxiety. The person who attempts to wish themselves awake, "miserably fails in this project by immediately falling asleep" (Hillmann 2004 p. 368), and finds what once an object of fear, has now become laughable. However, it is not just the person suffering from crippling phobia that finds humor an appropriate expression of courage.

In his book, Find Meaning In Life, David Guttmann wrote about the use of humor for the elderly as they reach the end of their lives. He said, "humor, as the psychologist Reuven P. Bulka(1989) has said, is one of the most useful ways for the individual to gain distance from a given situation" (Guttmann 2008 p. 114). This ability to self-distance becomes important for the elderly as death seems imminent, and most of life has been live--existing for them to be analyzed and remembered. Humor allows for the expression of and shielding of one's mental courage. In speaking of concentration camp prisoners, Guttmann said of their humor: "it became an integral part of life in the camps. It protected the courage of the prisoners and raised their morale" (Guttmann 2008 p. ???)(Citing Cronstrom-Beskow 1991). Instead of attention being kept on the obsession, fear or threat, the patient learns to "ridicule them by irony and by applying paradoxical intention..." wherein the "the vicious circle is cut, the symptom diminishes, and the obsession finally atrophies" (Guttmann 2008 p. ???). So humor becomes the mark of the healthy neurotic, who gathers the courage to laugh at the ridiculousness of the obsession and the inhibition it causes.

But loss or requirement of courage may come from within (such as overcoming a phobia) or from without (facing death). Frankl said, "when we spoke about attempts to give a man in camp mental courage, we said that he had to be shown something to look forward to in the future. He had to be reminded that life still waited for him, that a human being was waiting for his return" (Frankl 1986 p. 114) Circumstances or environments can often be the hammer that drives a crack between an individual and his or her meaning. If the circumstances are exceptionally punishing, this may drive an individual to "hyper-reflection"(Hillman 2004 p. 368), an introspective trap that creates a maze of neurotic self-obsession (Guttmann 2008 pg. ???). Here is the moment where self-transcendence is needed. Comparisons can easily be made to the elderly, who are often thrust into foreign and isolating existences in nursing homes, They watch their bodies break down, and life-long relationships pass, without seemingly much to look forward to. Existence can become a chore, without meaning, causing them to turn inward. This hearkens back to Frankl's reminiscing about his wife while working in the concentration camp. Relationships and goals were what Frankl believed would lead someone to look beyond their "self-concern"(Hillmann 2004 p. 369). He stressed that we find meaning in three 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" (Frankl 1986 p. 133). The ability to turn outward to experience beauty, relationships, and see the rewards of your own work are all abilities that are inhibited by a painful environment or situation. But Frankl argued that there was meaning to be found even in suffering, if one new how to look at it. Once, when treating an elderly man who had lost his wife several years before, Frankl revealed to his patient, that if he (the patient) had died before his wife, she would have had to suffer his absence. This new perspective, that his suffering in turn meant that his wife did not have to, was a courageous paradigm to require. But in the end, the man found a meaning for his suffering (Frankl 1986 p. 135).

There is a real sense in which Frankl's opinion could be seen as simply avoiding the senselessness of evil and pain. But Frankl was not a niave optimist. He had seen the worst mankind could offer. He recognized in the above example that he could not change the patient's life or bring back his wife, but he was able instill courage when his lost meaning had the potential to drag him into existential despair. Frankl said that the "role played by the therapist is that of a 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" (Frankl 1986 p. 132). Frankl's final stage in logotherapy consisted of this new way of seeing, a rebuilt courage for a new paradigm. This is also referred to as "self-formation" (Hillmann 2004 p. 369). This is the personal growth established by the ability to self-distance, and self-transcend. Riedel, Deckart and Noyon commented that this new attitude toward struggle, suffering and adversity "is especially necessary if the problems that give rise to these attitudes cannot themselves be changed" (2002 p. 34). There is a recognition that the threat to mental health will not simply disappear, so techniques are built, courage established, and greater depth is gained by looking beyond the self, rather than within it. Frankl would be instrumental in directing the course of therapy away from Freudian psychoanalysis, and toward a more holistic approach to the psyche. Thus establishing room for the various existenial therapies that follow, and furthering the place of courage and man's nobility in that tradition.

In turning to Victor Frankl and courage, I think I should turn to focusing on the choices that are made in life that require courage despite meaningless circumstances. One of these aspects would be with the elderly, as they are on the tail end of life, and looking for ways in which they can finding meaning. Death is imminent, life seems behind, it has mostly been written now to be remembered and analyzed--what does the elderly then do to find purpose in the NOW? Adler focused much more on the present--being happy in the present by overcoming neurotic tendencies, and living contentedly through social interest and social contribution.

Does one need anything beyond this? How often must the elderly become discouraged in the sight of their decaying minds and bodies, do they still find help in their relationships with one another, or are they left simply to decay alongside those who are in the same state they are. What gives them meaning? Do we have to turn at this point to our beliefs? When we reach the end of life, are we kept alive by our relationships with our family or friends? Does that work anymore?