home-Suits-Logotherapy by V. Frankl - the will to meaning (practice). Logotherapy - what it is, basic principles, methods, techniques and exercises Author of Logotherapy

Logotherapy by V. Frankl - the will to meaning (practice). Logotherapy - what it is, basic principles, methods, techniques and exercises Author of Logotherapy

Logotherapy – at least once in a lifetime, every person needs this kind of psychological method. Age-related crises in life often lead to the loss of existing meanings on which a person could rely, and this is similar to a state when the ground is cut out from under one’s feet.

Logotherapy in psychology

Logotherapy and existential analysis are methods of existential psychology that grew out of psychoanalysis. Logotherapy comes from the Greek. logos – word, therapeia – care, care. Psychologists-logotherapists see their task as helping a person find lost meanings or create new ones. Logotherapy has proven itself very well in the treatment of neuroses.

Founder of Logotherapy

Frankl’s logotherapy briefly: “A person constantly needs semantic accompaniment of his actions, tasks, situations, and actions.” Logotherapy was founded by Viktor Frankl, an Austrian psychiatrist and psychologist who survived a German concentration camp. All his methods were passed through himself and the prisoners proved their effectiveness, that in any situation you can survive and say to life: “Yes!”

Logotherapy - Research

The foundations of Frankl's logotherapy are based on his research and presentation of man as a three-dimensional model, in the horizontal dimension it is the mental and physical core of the personality, and in the vertical dimension it is the spiritual (noetic) one. All together it is an indivisible whole. The spiritual distinguishes the individual from the animal. All three spheres are in a certain tension between the internal content and the external world; the desire to comprehend new things, to find new meanings to replace the outdated ones - this is the goal of man.

Types of logotherapy

The types and methods of logotherapy are supplemented by the followers of V. Frankl, but the immutability of what was suffered and tested on thousands of people suggests that the methods are working and relevant today. types of logotherapy techniques:

  • paradoxical intention;
  • dereflexia;
  • logoanalysis.

Objectives of logotherapy

The principles of logotherapy carry out its main task: finding personal meaning that helps you move on, create, love and be loved. Meaning can be found in one of three areas: creativity, emotional experience, conscious acceptance of situations that a person cannot change. V. Frankl gives priority in values ​​to creativity, defining a person as a creator. And in emotional experiences - love.


Indications for the use of logotherapy

Logotherapy is designed for people both in health and in illness, the goal of logotherapy is not to impose on a person the meaning that the therapist sees, but to help find it, here all responsibility lies with the patient. V. Frankl identified 5 areas of application of logotherapy:

  • psychogenic neuroses;
  • somatic diseases that cannot be cured;
  • sociogenic phenomena (feeling of emptiness, existential vacuum);
  • sociogenic doubt (iatrogenic neuroses, frustrations);
  • despair.

Frankl's Logotherapy – Basic Principles

Frankl's logotherapy has also shown its effectiveness in seemingly advanced cases when a person's insanity was a statement of the fact of mental illness. V. Frankl believed that even the altered core of the personality has a part that is fully healthy, and reaching this part of the personality helps to weaken the disease, and even bring it to remission, and in the best case, leads to recovery.

Principles of logotherapy:

  1. free will. A person is free to make any decisions, make a conscious choice towards illness or health, understanding this, any diagnosis is not a sentence, but a search for the meaning of why the disease arose, why, what it wants to show.
  2. The will to meaning. Freedom is a substance that has no meaning in itself until a person acquires the desire for meaning and builds a goal. All problems that arise are given for a purpose.
  3. Meaning of life. It is determined by the first two principles and is individual for everyone, although everyone has a general concept of values. The most important meaning of life is to make yourself better, and for those around you this will be an incentive to find their own meanings and strive for an improved version of themselves.

Frankl's logotherapy methods

Methods of logotherapy have proven themselves in the treatment of various kinds of phobias, neuroses, and anxiety of unknown origin. Logotherapy reaches its maximum effectiveness when a person trusts the therapist and goes with him in a creative tandem. There are three methods of logotherapy:

  1. Paradoxical intention. A person is afraid of something that complicates his life. This method helps you face your fear, meet it halfway, do what’s scary, increase your sense of fear to a critical point, and answer the question: “What’s the worst thing that will happen if I decide/do/don’t do it?”
  2. Dereflexion– a method developed for the treatment of hyperreflexia and control, has been successfully used to treat female anorgasmia: switching from oneself, anxiety and concentration on one’s partner, the problem of meeting other people’s expectations disappears and hypercontrol is released.
  3. Logoanalysis– a detailed inventory of a person’s life, allowing the logotherapist to find individual meaning. Neuroses, anxieties and fears go away.

Logotherapy - exercises

Logotherapy is a helping method, highlighting the bright sides of a person’s life, those resources that he can use in order to get out of the abyss of loss of meaning in life. Logotherapy – techniques and exercises for imagination (fantasizing, imagining, speculating), working with images:

  1. Fire. The symbol of fire is both life and death. What kind of fire does a person see in his imagination, maybe it’s the light of a candle or a torch in a dark dungeon, cozy crackling wood in the fireplace or a fire? Are there those present nearby who are also looking at the fire? All these associations can tell a lot about a person’s perception of the world.
  2. Water. Imagine what a body of water it is: a lake, a river, maybe an ocean. What is the color of the water and whether the current is stormy or the surface of the water is calm - even people with difficulty imagining the image of water can easily imagine. In relation to the water, where is the person located: on the shore, or standing in the water, swimming? ? Exercise helps you relax and get positive emotions and real tactile sensations.
  3. Tree. A person is like a tree, so what tree symbol he sees is important. Is it a thin sapling trembling in the wind, or a mighty gigantic tree, with powerful roots going deep into the depths and a spreading crown directed upward? Is it just one, or are there others around? All details: leaves, trunk, crown matter. The image can be refined and supplemented, helping a person strengthen.

Group logotherapy techniques:

  1. “I’m happy when...” continue in a positive way, the more statements, the better, a person gets used to the good and stops noticing it, the exercise helps to find this good in his life again.
  2. Positive perception of yourself and others. Each member of the group should praise himself for something in front of everyone, then give a compliment to the person sitting next to him, it should sound sincere.

Logotherapy - books

Viktor Frankl, Logotherapy and Existential Meaning. Articles and lectures" - this book is about the origin and development of logotherapy as a psychotherapeutic method. Other books by the author:

  1. « Say “Yes!” to life Psychologist in a concentration camp" The work is considered great and influences the destinies of people. Even in the inhuman conditions of a Nazi camp, you can survive through fortitude and finding your own meaning.
  2. « Man in search of meaning" What is the meaning of a single life and death of a person or phenomena: suffering, responsibility, freedom, religion - V. Frankl discusses this in his work.
  3. « Suffering from the meaninglessness of life. Topical psychotherapy" The book will be useful to people who have lost interest in life. V. Frankl analyzes the causes of the loss of meaning and gives recipes for getting rid of the painful perception of reality.

Books by followers of V. Frankl:

  1. « Logotherapy for professional help. Social work filled with meaning» D. Guttman. The professor of existential psychology leads a meaningful life every day, continuing the work of V. Frankl, helping many people to believe that their life is a gift, and all the events in it are filled with the deepest meaning.
  2. « Logotherapy: theoretical foundations and practical examples» A. Battiani, S. Shtukareva. The therapeutic process of logotherapy in action, how it happens, what methods are used - this book tells about all this.

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V. Frankl and the basics of logotherapy

1. Brief biography of V. Frankl

logotherapy frankl psychological clinical

Personality of Viktor Frankl

To understand the essence of any psychological concept, it is necessary to consider it in connection with the personality of the creator, with the history of his life, ideals, value orientations, scientific interests, etc. According to M.G. Yaroshevsky, the creative thought of a scientist “...is an independent quantity, without whose activity the development of science would be a miracle...” (Yaroshevsky M.G., 1996). YES. Leontiev wrote about it this way: “Viktor Frankl made the basis of his revolutionary psychology, first of all, the “case” of his own life” (Leontiev, D. A., 2005). He emphasizes that this is one of the most striking examples of how a person’s life path is connected by his ideas, how a person proves the correctness of his theory with his own life. "(Leontyev, D. A., 2005).

Viktor Emil Frankl was born on March 26, 1905 in Vienna, into a Jewish family. Vienna in those years was an important cultural center of Europe; innovative ideas in psychology were born and developed here; it could be called “the cradle of personality psychology” (Leontiev, D. A., 1990). His childhood was very prosperous, he felt care, support, protection and at the same time freedom. Frankl's character reflected the traits of his parents: stubbornness, integrity, deep religiosity, stoicism and perfectionism of his father and a positive attitude of sympathy for people, characteristic of his mother. Starting from an early age, from about three years old, V. Frankl wanted to become a doctor. The realization of his mortality came to him at the age of four. In his youth, he was worried about the question of whether the finitude of human existence destroys any meaning in life. He addressed the problem of the finitude of life, reflecting on the impact it has on life itself. Thus, his interest in existential issues began to take shape in his early years. V. Frankl described the next important episode of his life, which became one of the first manifestations of his interest in meaning. In junior high school, the words of a natural history teacher who said that life is ultimately nothing more than a process of oxidation evoked a strong emotional response in him. Frankl jumped up from his seat and asked: “Then what kind of life has meaning?” (Leontyev, D. A., 2005).

V. Frankl, while still a schoolboy, corresponded with Freud, on whose initiative his first scientific article was published in the International Journal of Psychoanalysis in 1924 (Letunovsky, V.V., 2001). As D. A. Leontiev notes, psychoanalysis was one of the most powerful temptations, and V. Frankl could not pass by it (Leontiev, D. A., 2005). According to Tikhonravov, Freud created the first Viennese school of psychotherapy, Adler's individual psychology became the second Vienna school; V. Frankl's logotherapy is often called the third Vienna school of psychotherapy, but to get to this point, he had to go through the first two schools (Tikhonravov, Yu. V., 1998). Frankl's fascination with psychoanalysis in its orthodox form did not last long. He was repulsed by the double reductionism of this direction: the truncation of the human dimension in a person - the absence in therapy of an explanation, introductory words, understanding, greeting, even a handshake, and also pathology, the attitude that every person is sick. This forced Frankl to abandon his intention to engage in psychoanalysis and join the psychoanalytic society. After some time, he tried himself at the second Viennese school of psychotherapy, founded by A. Adler (Leontyev, D. A., 2005). For several years he was an active member of the Society of Individual Psychology, but left it in 1927 after his critical speeches against some of the main provisions of this direction (Tikhonravov, Yu. V., 1998). Thus, having gone through the school of psychoanalysis, V. Frankl was able to critically rethink its main provisions, views on human nature and psychotherapy, in order to come to the creation of his own concept. In all his works, starting from the 30s, his teachers, Freud and Adler, are present as explicit or implicit opponents (Tikhonravov, Yu. V., 1998).

Viktor Frankl received his doctorate in medicine in 1930, and by the end of the 30s. in his various articles, formulations of all those basic ideas appear, on the basis of which he would subsequently create his own teaching - logotherapy. At the same time, Frankl wrote his first book, “Healing the Soul,” which was destined to see the light only after the war. It is about her that he mentions in his memoirs about the concentration camp; he managed to save the manuscript and publish it after the war (Leontyev, D. A., 1990). From 1933 to 1937 he worked in a psychiatric hospital, in a crisis hospital. At this time, F. Frankl himself was experiencing a state of loss of meaning and existential vacuum. YES. Leontyev describes this period of his life as follows: “he was young, quite popular, active, outwardly everything was fine: work, projects, many interesting ideas, tasks; the only thing missing was something worth living for” (Leontyev D.A., 2005). V. Frankl himself, looking back, wrote about this experience, which turned out to be so important for the development of his psychological ideas: “As a young man, I went through the hell of despair, overcoming the obvious meaninglessness of life, through extreme nihilism (over time I managed to develop I am immune to nihilism). Thus I created logotherapy" (Frankl, V., 1990).

V. Frankl continues to develop the issues that occupied him; he first uses the word “logotherapy” in his report in 1926, in 1929 he first tries to use a method that will later turn into the technique of paradoxical intention (Leontyev D. A., 2005).

In 1938, Austria was annexed by Nazi Germany. For V. Frankl, this was the end of an entire period of life and the beginning of its most difficult and tragic segment, in which there were the most challenges (Leontyev, D. A., 2005). Due to his Jewish origin, Frankl was threatened with a concentration camp, but he received a several-year reprieve thanks to a Gestapo officer who had recently been treated by him. V. Frankl had an invitation from the American embassy to go to the USA, but refused in order to save his parents from a concentration camp. He ended up in a concentration camp in 1942. Frankl went through Auschwitz, Dachau and Theresienstadt, preserving the manuscript of his first book and providing psychotherapeutic assistance to prisoners.

V. Frankl noticed that the greatest chances of surviving in a concentration camp were not those who were distinguished by the strongest health, but those who were distinguished by the strongest spirit, who had a meaning for which to live (Frankl, V.). The desire for meaning can help a person survive, it can lead to the decision to take his own life, it helps to endure the inhuman conditions of a concentration camp and withstand the ordeal of fame, wealth and honor (Leontyev, D. A., 1990). The manuscript of the book that he tried to save was written on scraps of paper that he obtained from the camp, it was the reason for his survival and gave meaning to his life. From that time on, he considered the meaning of his life to be the desire to “help others find their meaning” (Frankl, V., cited by Yalom, I., 1980). V. Frankl in his book “Say Yes to Life!” Psychologist in a concentration camp" wrote that the motto of all psychotherapeutic and psychohygienic efforts can be the following thought of Nietzsche: "Whoever has a “Why” can withstand almost any “How”” (Frankl, V.). He needed to help the prisoners realize their “Why”, their life purpose, which would give him the strength to endure their “How” - all the horrors and trials of camp life. A person who had lost the meaning of life no longer had the strength to resist. V. Frankl also says that a person always confronts his fate and this confrontation gives him the opportunity to turn internal suffering into internal achievement. There are many opportunities to find meaning in life in how a person accepts inevitable suffering, how he behaves in difficult life situations or in the last minutes of life. V. Frankl writes the following words: a person “... must realize the uniqueness of his suffering - after all, there is nothing like it in the entire Universe; no one can deprive him of this suffering, no one can experience it instead of him” (Frankl, V.). For him, suffering contains the possibility of a unique feat (Frankl, V.).

V. Frankl was released in 1945 (Letunovsky, V.V., 2001). Apart from Victor, only his younger sister survived the Second World War; even before the war she went to Mexico, then to Australia, and lived to a ripe old age. V. Frankl's elder brother, like their parents, died in a concentration camp (Leontyev, D. A., 2005). The extreme existential experience of being in a concentration camp had a huge influence on V. Frankl, changed his views on the meaning of human life and the meaning of the work of a psychotherapist, then the main ideas of his concept of the will to meaning crystallized and finally took shape. Frankl described his experience in the concentration camp in the book “Psychologist in a Concentration Camp” (1946) (Letunovsky, V.V., 2001).

The world changed after the war. It became more dynamic, more developed, richer, people had more prospects and choices, but they paradoxically began to feel a lack of meaningfulness in their own existence. V. Frankl wrote about it this way: “...to man, unlike animals, instincts do not dictate what he needs, and traditions do not dictate to modern man what he should. Without knowing either one or the other, a person loses the idea of ​​what he needs” (Frankl, V. 1990). Logotherapy created by V. Frankl responded to the needs of the time and was able to help millions of sick and healthy people. He said that one must not just look for meaning, one must fight for it, and this struggle is difficult. He called his worldview tragic optimism: based on faith in the capabilities of man, in the best in his nature, it, however, did not exclude the understanding that very often the evil in a person turns out to be stronger (Leontyev, D. A., 1990).

2. Fundamentals of logotherapy and the main provisions of the teachings of V. Frankl

Viktor Frankl had a huge influence on the development of the existential paradigm in psychology and psychotherapy. Logotherapy, created by him, is also called the “Third Vienna School” and is a unique, deep and elaborate teaching about the search for meaning. Logotherapy is a complex system of philosophical, psychological and medical views on the nature and essence of man, the mechanisms and driving forces of personality development in normal and pathological conditions, on the ways and means of correcting anomalies in personality development (Tikhonravov, Yu. V., 1998).

Three fundamental principles of logotherapy can be distinguished: “the will to meaning”, “the meaning of life” and “free will” (Tikhonravov, Yu. V., 1998). Let's take a closer look at them.

The will to meaning

V. Frankl owns the following words: “Psychoanalysis speaks of the principle of pleasure, individual psychology speaks of the desire for status. But where is that which is most deeply spiritual in man, where is man's innate desire to give his life as much meaning as possible, to actualize as many values ​​as possible - where is what I would call the will to meaning? (Frankl, V., 1997) The central concept with which logotherapy works is “life meaning”. According to V. Frankl, the desire to find meaning in human life is the main motivational force of a person (Frankl, V., 1990). The desire for meaning is a self-sufficient motivation that is neither an expression nor a generation of other needs (Frankl, V., 1993). V. Frankl writes about the so-called noodynamics, defining it as a driving spiritual force, “...which is generated in the field of tension that arises between two poles - between a person and his meaning” (Frankl, V., 1997). He emphasizes that the search for the meaning of life is more likely to lead a person to internal tension than to finding balance. But, disagreeing with “homeostatic” theories, he believes that this tension is a necessary condition for a person’s mental well-being (Frankl, V., 1997).

V.V. Letunovsky emphasizes an important aspect of Frankl’s understanding of life’s meaning: meaning for him is not something that a person invents or invents, as in the concept of the initial choice of a world project by J.-P. Sartre. Behind its semantic aspect lies something more, the core of meaning, which goes into the spiritual sphere transcendental in relation to man. Therefore, Frankl calls his approach not “meaning therapy”, but “logotherapy”, i.e. “therapy from a spiritual perspective.” He also introduces the important concept of “super-sense” (Letunovsky, V.V., 2001). Supermeaning cannot be known exclusively by rational means, it goes beyond the boundaries of man and his world, it is to some extent accessible to what is transmitted from the center of the human personality, from what is rooted in human being, through the existential act, which Frankl calls “ basic faith in Genesis" (Frankl, V., cited by Letunovsky, V.V., 2001). Existence goes beyond its own limits to transcendental entities. Only if there is a will to meaning can a person find himself face to face with super-meaning, then he becomes free and responsible for his actions (Tikhonravov, Yu. V., 1998).

The main thesis of the concept of the will to meaning sounds like this: a person strives to find meaning and feels frustration or a vacuum if this desire remains unrealized (Frankl, V., 1990).

Meaning of life

V. Frankl believed that there is meaning for everyone, and for everyone it is special. The meaning in question must vary from situation to situation, from person to person. According to Frankl, there is always a meaning that a given person can and should realize. That is, it is not a person who asks a question about the meaning of life, but life itself poses this question to him; the meaning appears to a person as an imperative that requires its implementation, not in words, but in action (Tikhonravov, Yu, V., 1998).

The role of meaning is played by value-semantic universals, crystallized as a result of generalization of typical situations in the course of the historical development of mankind. (Letunovsky, V.V., 2001). V. Frankl identifies three types of such values, three semantic systems:

What we realize or give to the world as our creations are the values ​​of creativity.

What we take from the world in the form of encounters and experiences are the values ​​of experience.

Our position in relation to suffering, in relation to fate, which we cannot change - the value of the attitude.

According to V. Frankl, a person realizes his need for meaning through such a specific human manifestation as conscience. He calls conscience the organ of meaning and defines it as the intuitive ability to find the only meaning hidden in a given situation. Frankl emphasizes that conscience allows a person to discover the meaning that contradicts existing value orientations if they do not correspond to rapidly changing situations. Conscience tells a person how much his choices and actions contribute to the realization of the values ​​and meanings to which he strives (Tikhonravov, Yu. V., 1998). Conscience is one of the specifically human manifestations, it is an integral part of the conditions of human existence, and its work is subordinated to the main distinctive characteristic of human existence - its finitude

Let's summarize the above. Logotherapy by V. Frankl is an existential psychotherapeutic school that has a powerful philosophical basis. At the same time, the concept of the will to meaning is a theory that has passed the test of unprecedented life. From the very beginning of his professional career, Frankl focused his interest on the role of meaning in psychopathology and therapy, and from his experience in a concentration camp he learned the most important idea: it is a stable sense of meaning in life that is a necessary condition for survival in unbearable conditions. His concept is based on three essential principles: the will to meaning, free will and meaning in life. The desire to find meaning in human life is the main motivational force of man. Logos, the spiritual dimension of existence as meaning is revealed for a specific person in a specific situation.

Therapeutic process.

Patients often complain of problems concerning the meaning of life, that is, philosophical or spiritual problems. These problems may be a sign of illness or neurosis. Neuroses and psychoses, including organic psychotic processes, have an existential aspect, as well as constitutional and psychogenic aspects. They affect both the freedom of spiritual attitude to constitutional and psychological factors, and the way of existence. Therefore, treatment must be more than just medical or psychological; it must also consider existential aspects.

Logotherapy is aimed precisely at these problems. The word logos has the dual meaning of “meaning” and “spirituality.” Logotherapy thus deals with the existential and spiritual nature of man.
Establishing diagnosis

Correct diagnosis is the first step in psychotherapy, and a very important one. Any emotional disorder or mental illness includes physical, psychological and spiritual factors: “there are no pure somatogenic, psychogenic or noogenic neuroses. All neuroses are mixed, in each of them the somatogenic, psychogenic or noogenic component comes to the forefront of theoretical consideration and, accordingly, therapeutic tasks” (Frankl, 1956, see preface). The purpose of diagnosis is to determine the nature of each factor and identify the primary one among them. If the primary factor is physical, it is psychosis; with the primacy of the psychological factor, we are dealing with neurosis; The primacy of the spiritual factor determines noogenic neurosis.

Therapy addresses the whole person and may include physical (or medical) interventions, psychotherapy and speech therapy, in parallel or sequentially. “Logotherapy aims not to take the place of existing psychotherapy, but only to complement it, thus forming a holistic picture of a person, including the spiritual dimension (Frankl, 1986, p. XVII). It focuses on meanings and values. Psychotherapy that “does not pay explicit attention to values,” on the grounds “that all psychotherapy is somehow concerned with values” (Frankl, 1986, p. XVII), is not suitable for addressing these problems.

Therapy and noogenic neuroses
Logotherapy is a specific therapy for existential frustration, existential vacuum or frustration of the will to meaning. These conditions, when they lead to neurotic symptoms, are called noogenic neuroses.

Logotherapy is about making people aware of their responsibility, because being responsible is the most important basis of human existence. Responsibility presupposes obligations, and obligations can only be understood in terms of meaning, the meaning of human life. The question of meaning is a truly human question, it arises when working with patients suffering from existential frustration or conflicts (Frankl, 1986, see p. 26). Logotherapy, therefore, deals with problems involving meaning in its various aspects and manifestations.

The meaning of work

Responsibility to life is accepted in the process of responding to the situations that life offers. “Reaction must be expressed not in words, but in deeds” (Frankl, 1986, p. 117). Understanding responsibility arises from awareness of a unique, specific personal task, a “mission.” The realization of creative values ​​usually coincides with a person's work, which mainly corresponds to the area in which the uniqueness of a given person can manifest itself in relation to society. This work, as a contribution to society, serves as a source of meaning and value for the uniqueness that a given person possesses. Realization does not depend at all on the specific type of occupation. “The work one does does not matter much; what matters is the way one does the work” (Frankl, 1986, p. 118). It is necessary to explain this to neurotic individuals who complain that another occupation would allow them to better realize themselves. It is not the occupation itself, but the expression of the uniqueness and singularity of a person in work or outside the scope of work duties that gives the activity meaning.

For some people, work is only a means of earning money, and life begins only on vacation. There are also those who are so exhausted by work that there is no time left for rest (besides sleep). Some devote all their time to the pursuit of wealth, then work can lead to neurosis. A neurotic person may sometimes try to escape from life by immersing himself in work. When such a person does not work, he feels confused, and the lack of meaning in his life becomes obvious.

“He who has no purpose in life runs through life as fast as possible so as not to notice the meaninglessness of his existence. At the same time, he tries to run away from himself, but all in vain. On Sundays, when this whirlwind stops for twenty-four hours, all the aimlessness, meaninglessness and emptiness of his existence appears before him.”

Logotherapy as a nonspecific therapy for neuroses

In the treatment of psychogenic neurotic reactions, logotherapy is not aimed at symptoms or their psychogenesis, but at the patient’s attitude towards the symptoms. In logotherapy there are two specific techniques for working with neuroses; These techniques are described below. In addition, general logotherapy, applicable to noogenic neuroses, is also suitable for the treatment of psychoses, since it is aimed at existing existential or spiritual problems.

When working with neurotic individuals, logotherapy is not a symptomatic intervention. Instead, it focuses on the patient's relationship to his symptoms. “Because logotherapy is not aimed directly at the symptom, but rather is an attempt to change the patient’s position, the personal attitude towards his symptom, it is truly personal psychotherapy”

Duration and scope.

Duration. There is not even a rough framework for logotherapeutic intervention. Thus, in the cases below, treatment usually lasted for several months. However, as stated by Gerz (1962), “the number of therapeutic sessions depends primarily on the duration of the patient's illness. In the case of acute illness... most patients respond to this (paradoxical intention) therapy within 4-12 sessions. Those who suffer for several years... require 6 to 12 months of twice-weekly treatment to achieve success” (p. 375).

If this is a case of paradoxical intention, then how long might it take when the goal of therapy is to help the patient find meaning? And for mastering logophilosophy? It is even difficult to imagine what the number of sessions should be for such treatment.

Application area. “Who is logotherapy intended for?.. Everyone can benefit from it for themselves. People at all stages of life, with and without problems, are mentally healthy and cannot benefit greatly from the benefits that logotherapy offers” (Sahakian, 1980, p. 3). However, logotherapy has a number of contraindications. “Paradoxical intention is strictly contraindicated in psychotic depression... As far as those suffering from schizophrenia are concerned, logotherapy is not an etiological treatment” (Frankl, 1986, p. 264). In schizophrenia, dereflection can be used as a “psychotherapeutic adjunct” to “support other forms of therapy” (Frankl, 1986, p. 264). Logotherapy is therefore optimally suited for neurotic states - collective, noogenic, phobic and obsessive.

3. Application of logotherapy in practice
The following case was described by Frankl (1967) in his collected works (pp. 153-154).
“Paradoxical intention is also applicable in cases more complex than monosymptomatic neurosis. The following case demonstrates that even severe obsessive-compulsive character disorders (in German clinical terminology, this is an ancaste psychopathic character structure) can be successfully cured with the help of paradoxical intention.

The patient, a 65-year-old woman, had suffered for sixty years from a severe compulsive hand-washing disorder for which she was admitted to our clinic. It was assumed that as a result of observation, she would be prescribed a leucotomy (which, in my opinion, was the only one that could bring relief in such a serious condition). Symptoms of the disorder began at age four. If something interfered with the ritual, the patient could even begin to lick her hands. Later, she began to experience a constant fear of contracting skin diseases. She didn't touch doorknobs at all. In addition, she insisted that her husband follow an elaborate preventive ritual. For a long time the patient was unable to perform any housework; eventually she stopped getting out of bed. Nevertheless, even in this state, she demanded that all things be wiped most thoroughly, and the rag had to be washed every minute. “Life has become hell for me,” the patient admitted.

In the hope of avoiding brain surgery, my assistant Dr. Eva Niebauer began a logotherapeutic intervention using paradoxical intention. As a result, nine days after hospitalization, the patient began to help her roommates by darning their socks, helping nurses wipe tables and wash syringes, and even emptied cuvettes with blood and pus-stained material in the dressing room! Thirteen days after admission, she spent several hours at home, and after returning to the clinic, she solemnly announced that she ate a bun with her hands stained with soil. After two months, the patient regained the ability to lead a normal life.

It would be inaccurate to say that she was completely free of symptoms, but the obsessive thoughts continued to haunt her. At the same time, relief was achieved due to the fact that the patient stopped struggling with her symptoms (this struggle only reinforced them); on the contrary, she treated herself ironically; in other words, she used a paradoxical intention. She was even able to make fun of her pathological thoughts. This patient is still in contact with the outpatient department because she requires supportive speech therapy. The improvement in this case turned out to be permanent, so there was no need for leucotomy, which was previously considered inevitable.”

The following case is taken from a report by an American psychiatrist (Frankl, 1961b) of the successful use of paradoxical intention in twenty-four of his patients.

“Patient A.V., 45 years old, married, mother of a 16-year-old son, had a 24-year history of phobic neurosis, consisting of severe claustrophobia associated with the fear of riding in cars. She was also afraid of heights, afraid to use the elevator, walk on bridges, afraid to faint, to leave the house (when she was forced to do this, she tried to hold on to trees and bushes). In addition, the patient was afraid of open spaces, being alone, and paralysis. Throughout her twenty-four years, she was treated unsuccessfully by various psychiatrists, including repeated lengthy psychoanalytically oriented psychotherapy. In addition, the patient was hospitalized several times, underwent several courses of electroconvulsive therapy (ECT), and was eventually offered a lobotomy. Four years before we met her, she spent a long time in the ward for restless patients of a state hospital. There she underwent ECT and intensive drug therapy with barbiturates, phenothiazides, monoamine oxidase inhibitors and amphetamine, which did not give a lasting result. The patient was so paralyzed by all her numerous phobias that she did not leave the corner of the room where her bed stood. She suffered greatly, despite high doses of tranquilizers. Her tension was so great that her muscles constantly ached. She was always concerned about “not fainting,” “not being nervous,” “not panicking.” The diagnoses of her illness, according to various psychiatrists, ranged from psychoneurosis to a schizophrenic reaction of the schizoaffective type with phobic anxiety and depressive manifestations. While in the hospital, the patient underwent “intensive analytically oriented psychotherapy” with an experienced clinical psychologist for a year and a half.

On March 1, 1959, all medications were stopped, and I began treatment using paradoxical intention. The intervention technique was explained in detail to the patient, and we worked together, symptom by symptom, fear by fear. We started by eliminating minor fears, particularly those related to the inability to fall asleep. The patient was moved from the anxiety ward and was given instructions to “try to faint and panic as much as possible.” At first she said angrily: “I have no reason to try! I'm already afraid! This is ridiculous. You're making it worse for me! After weeks of resistance, the patient was able to remain in her third-floor room, “unsuccessfully” attempting to faint and become paralyzed. The patient and I rode the elevator to the fifth floor together. The patient was advised to enter the elevator and go up with the firm intention of fainting and showing me “how wonderfully she can be afraid and paralyzed.” While in the elevator, I commanded her to faint, but she laughed and replied: “I try, but I can’t. I don't know what happened to me, I'm not afraid. I think I’m trying my best to be scared!” Having reached the fifth floor, the patient looked very proud. This was the turning point of the treatment. Since then, she has used paradoxical intention whenever the need arose. For the first time in many years, the patient left the hospital on her own to take a walk, although she “constantly tried to induce fear in herself.” After five months of this therapy, she was completely symptom free. The patient went home for the weekend and was pleased to note the absence of any phobias for the first time in 24 years. Returning to the hospital, she stated that her only fear now was walking on bridges. That same day we drove across the bridge in my car. As we drove across the bridge, I told her to get scared and faint, but she just laughed and replied, “I can’t!” She was discharged shortly thereafter. Since then, she comes to me every two to three months for an appointment “out of gratitude.” It should be especially emphasized that I deliberately did not get acquainted with her anamnesis and did not study psychodynamics.

Two months ago, the patient asked for a special appointment. When we met, she looked tense and expressed anxiety about the possibility of getting sick again. Her husband had been unemployed for several months and also suffered from a neurological disorder for which diagnosis had not yet been completed. The patient began menstruation, tension arose, and fear of returning to the vicious circle of the past illness. In one session, she managed to understand what had happened and avoid restoring the destructive pattern of her phobias. This patient never went to the hospital again and has been living a full and happy life with her family for two and a half years. Recovery became possible without any attempt on my part to “understand” the patient’s symptoms from the perspective of psychoanalytic theory and “depth psychology.”

In a paradoxical intention, patients are not told that “they will get better and better”; they are advised to deliberately try to worsen their condition. The logotherapist invites the patient to wish for a frightening event to happen to him. Frankl specifically says that “paradoxical intention is logotherapy in its purest form. The patient objectifies his neurosis, distancing himself from the existing symptoms. The spiritual in man must be disconnected from the psychic, and the patient must call upon the Trotzmacht des Geistes, the spiritual capacity of man to resist, to voluntarily choose a certain attitude in any given situation."

The following comments are given by an American logotherapist (Gerz, 1962; see also Frankl, 1967).

“When I feel that the patient has a good understanding of the technique, we put it into practice together in my office. For example, a patient who fears losing consciousness should try to “faint.” To make the patient laugh, I always resort to exaggeration and say things like, “Come on; Well, faint right here. Show me how great you can do it." When the patient tries to do this and fails, he begins to laugh. Then I tell him: “If you cannot faint here when you want to, then you will not be able to faint anywhere else if you try to do it.” Thus, together we apply the paradoxical intention here in the office again and again; but also, if necessary, we do it in the patient's home or any other place where he has neurotic symptoms. When a patient successfully gets rid of one of his phobias using paradoxical intention, he enthusiastically begins to use this technique for other symptoms. The number of therapeutic sessions depends mainly on the duration of the patient’s illness. For acute illness lasting several weeks or months, most patients respond to such therapy within 4-12 sessions. Those who have been ill for several years, even twenty years or more (I personally had six such cases, there are many more described in the literature), require six to twelve months of treatment with sessions twice a week to achieve a cure. Throughout the course, the patient must be retrained and encouraged to use the technique according to his specific symptoms. Since the nervous system itself is prone to repetition and since our feelings are mediated by the autonomic nervous system, the established stereotype of feeling will be reproduced, turning into a kind of reflex, even when the causes of neurotic symptoms have already been eliminated. Due to the tendency of the nervous system to repeat itself, a necessary condition for successful therapy is the repeated application of paradoxical intention...

Initially, patients respond well to paradoxical intention, but during therapy, especially in chronic cases, minor relapses occur again. This is explained by the fact that patients, trying to improve their condition, again enter into a vicious circle of struggle for health, and the neurosis receives new reinforcement. In other words, patients “forget” about the paradoxical intention, and the deterioration of their condition occurs due to self-hypnosis. The failure is based on the above-mentioned repeating stereotypes of neurotic behavior (“I have been trying to fight neurosis for so long with unsuitable means. It is difficult to relearn”). But there is also another element: the psychotherapist requires considerable courage from the patient, particularly in overcoming fear. For example, a patient who is afraid of blushing in public is encouraged to do just that. Here we appeal to the patient’s personal pride and his inner freedom in the spiritual dimension; this is the practice of logotherapy in the true sense. For all the reasons listed above, the psychotherapist must tirelessly remind the patient of the need to use paradoxical intention, precisely because the symptoms of neurosis arise again and again. Eventually the neurotic symptoms will become unsupported and go away. Unfortunately, they too often “try to return,” but in these cases they are held back by a paradoxical intention. “When they see that they can’t get through to me, they will completely disappear.”

Conclusion
Logotherapy is an existential approach aimed at helping an individual solve problems of a philosophical or spiritual nature. These are problems of the meaning of life - the meaning of death, suffering, work and love. Problems in these areas lead to existential frustration or a feeling of meaninglessness in life.

The meaning of life cannot be found by asking the question about the purpose of existence. It arises in the process of a person’s response to life, to situations and tasks that are set before him. Although biological, psychological and social factors influence a person's reactions, there is always an element of freedom of choice. An individual cannot always control the conditions in which he finds himself, but he can control his reactions to them. Therefore, a person is responsible for his reactions, choices and actions.

Existential frustration can manifest itself without neurosis or psychosis, but it can lead to neurosis, and neuroses and psychoses always have existential aspects. Logotherapy addresses existential frustration and these existential aspects of neurosis and psychosis. Consequently, it does not so much replace, but rather complement, psychotherapy. Logotherapy does not pay attention to psychodynamics or psychogenesis, but is aimed at the philosophical and spiritual problems of the patient. Its goal is to provide the patient with new opportunities, to realize his hidden values, and not to discover deep secrets. Self-actualization is not considered the ultimate goal. Self-realization is possible only to the extent that a person realizes the specific meaning of his personal existence. Self-actualization is thus a by-product.

Logotherapy uses two specific techniques: paradoxical intention and dereflection.

The first is reminiscent of negative practice according to Knight Dunlap (1933). Several other aspects of Frankl's method are similar to reconditioning. However, Frankl associates these techniques with existentialism and emphasizes the effects they cause beyond the elimination of symptoms. Nevertheless, there are some similarities and parallels between the cases described by Frankl and the reports of Salter and Wolpe. Paradoxical intention deals with symptoms. This method encourages the patient to expose himself to a feared situation, but without the fear-inducing consequences, thereby breaking the vicious circle and leading to the extinction of fear or anticipatory anxiety. Frankl, however, emphasizes the attitude aspects of the situation. It is the patient's attitude, rather than the therapist's command, insistence, or encouragement, that causes the patient to expose himself to a situation in which extinction may occur. It is possible that a necessary condition here is a change in the patient's attitudes, as in other methods leading to reconditioning and extinction, for example, in the approaches of Salter and Wolpe.

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Logotherapy- a method of psychotherapy and existential analysis, which is a complex system of philosophical, psychological and medical views on the nature and essence of man, mechanisms of personality development in normal and pathological conditions, ways of correcting anomalies in personality development.

Created by Viktor Frankl, logotherapy, as one of the influential areas of modern psychotherapy, helps a person find the meaning of life. Logotherapy is opposed, on the one hand, to orthodox psychoanalysis, and on the other, to behavioral psychotherapy.

Frankl called the worldview based on the philosophy of human responsibility tragic optimism:

"Despite our belief in the potential of man, we must not close our eyes to the fact that human people are, and perhaps can always remain, a minority. But that is why each of us feels called to join this minority. Things are bad. But they will become it's even worse if we don't do everything in our power to improve them."

In his theoretical structure, V. Frankl distinguishes three main parts: the doctrine of the desire for meaning, the doctrine of the meaning of life and the doctrine of free will.

Frankl considers the desire for a person to search and realize the meaning of his life as an innate motivational tendency inherent in all people and is the main driver of behavior and personal development. In order to live and act actively, Frankl concludes, a person must believe in the meaning that his actions have. The absence of meaning gives rise to a state in a person that Frankl calls an existential vacuum.

The necessary level of mental health is a certain level of tension that arises between a person, on the one hand, and the objective meaning localized in the external world, which he has to realize, on the other hand. Thus, the main thesis of the doctrine of the desire for meaning can be formulated as follows: a person strives to find meaning and feels frustration or a vacuum if this desire remains unrealized.

The main thesis of the doctrine of the meaning of life in Frankl’s theory: a person’s life cannot lose meaning under any circumstances; the meaning of life can always be found. No one, including the logotherapist, presents the only meaning that a person can find in his life. However, logotherapy aims to expand the patient's ability to see the full range of potential meanings that any situation may contain. It is not a person who poses the question about the meaning of his life - life poses a question to him.

The main thesis of Frankl's teaching on free will can be formulated as follows: a person is free to find and realize the meaning of life, even if his freedom is noticeably limited by objective circumstances.

There are specific and non-specific areas of application of logotherapy. Psychotherapy of various types of diseases is a non-specific field. A specific area is noogenic neuroses generated by the loss of the meaning of life. In these cases, the Socratic dialogue technique is used to push the patient to discover the adequate meaning of life. The personality of the psychotherapist himself plays an important role in this, although imposing your own meanings on them is unacceptable.

Modern clinical psychotherapy is a fairly powerful means of influencing the human psyche and behavior. Therefore, like any potent drug, it must be used consciously, carefully, taking into account all available indications and contraindications. Such an approach to clinical psychotherapy is impossible without an in-depth study of its origins and fundamental knowledge of its theoretical foundations.

The founder of logotherapy (from the Greek “Logos” - word and “terapia” - care, care, treatment) is W. Frankl.

In this direction, the meaning of human existence is considered and the search for this meaning is carried out. According to Frankl's views, a person's desire to find and realize the meaning of life is an innate motivational tendency inherent in all people, and the main driver of behavior and personal development. Frankl considered the “striving for meaning” to be the opposite of the “striving for pleasure”: “What a person requires is not a state of balance, peace, but a struggle for some goal worthy of him.”

However, the human desire to realize the meaning of life can be frustrated, and this existential frustration can lead to neurosis.

V. Frankl considers man a creator who spends his entire life creating his spirituality. He divides human actions into three types:

1 Contributing to the creation of a spiritual personality.

2 Destroying spirituality.

3 Indifferent to spirituality. A person is responsible for his actions. Avoiding responsibility is also an act for which a person pays. A person is always free to choose his actions, to make decisions, but only if he chooses a creative action is the meaning of life realized.

Creative actions are aimed at searching for the values ​​of creativity, experience and relationship. For each person, these values ​​are unique, specific and inimitable, so a person, in search of the meaning of life, seeks and finds his own area in which he realizes himself and builds his personality.

If a person experiences a loss of meaning in life, V. Franki recommends understanding and feeling the uniqueness and originality of one’s own personality. Having acquired self-worth, the value of the people around him and the world in which he lives, a person gains confidence in himself, his usefulness, his necessity, i.e. the meaning of existence. A person’s life cannot lose meaning under any circumstances - the meaning of life can always be found.

V. Frankl’s approach to personality is based on three main concepts: “free will”, “will to meaning” and “meaning of life”. According to V. Frankl, the question of the meaning of life is natural for a modern normal person. And it is precisely the fact that a person does not strive to achieve it, does not see the paths leading to this, that is the main cause of psychological difficulties and negative experiences such as a feeling of meaninglessness, worthlessness of life. The main obstacle is a person’s centering on himself, the inability to go beyond himself, to another person or to meaning.

Meaning, according to V. Frankl, exists objectively in every moment of life, including the most tragic. A psychologist cannot give a person this meaning; everyone has their own. But a psychologist can help the client realize it. As a rule, loss of meaning in life occurs during strong psychotraumatic events: the death of loved ones, participation in hostilities, etc.

Consequently, the task of logotherapy is to help a person find the meaning of life. The unique meaning of life (or generalized values ​​that perform the same function) can be found by a person in one of three areas:

  • creativity;
  • emotional experiences;
  • conscious acceptance of those circumstances that a person is unable to change.

Values ​​are semantic universals that are the result of a generalization of typical situations in the life of society.

Of the three groups of values ​​- creativity, experiences and relationships - priority belongs to the values ​​of creativity. In the values ​​of experience, Frankl especially highlights love as an experience that has the greatest semantic potential.

Central to V. Frankl's concept is the problem of responsibility. Man is free to choose meaning, but having found it, he is responsible for realizing his unique meaning. Freedom prevails over necessity.

V. Frankl refers to going beyond one’s limits with the concept of self-transcendence and considers self-actualization to be only one of the moments of self-transcendence.

Self-transcendence and the capacity for self-detachment are central concepts in logotherapy.

Frankl describes the mechanism of formation of a pathological fear reaction as follows: a person develops fear of some phenomenon (heart attack, heart attack, cancer, etc.), an expectation reaction - fear that this phenomenon or condition will occur. Individual symptoms of the expected state may appear, which increases fear, and the circle of tension closes: the fear of expecting an event becomes stronger than the fears directly related to the event. A person begins to react to his fear by running away from reality (from life).

In this situation, Frankl suggests using self-detachment. The ability for self-detachment is most clearly manifested in humor. Humor allows you to distance yourself from anything (including yourself) and thereby gain control over yourself and the situation.

Fear is a biological reaction that allows you to avoid situations that seem dangerous. If a person himself actively looks for these situations, then he will learn to act “past” fear, and fear will gradually disappear, as if “atrophying from idleness.”

This leads to the main principles of logotherapy:

A person cannot live normally if his life becomes meaningless, he loses peace until he regains the purpose and meaning of his life. The meaning of life cannot be given to a person from the outside, suggested or imposed. He must find it entirely on his own.

Technicians

In order to help a person solve his problems, Frankl offers two main methods:

  1. dereflection method;
  2. method of paradoxical intention (FOOTNOTE: Intention - intention).
  1. The dereflection method means removing excessive self-control, thinking about one’s own difficulties - what is commonly called self-examination. Thus, a number of studies have shown that modern youth suffer more from the idea that they have complexes than from the complexes themselves.
  2. The method of paradoxical intention assumes that the psychologist inspires the client to do exactly what he is trying to avoid. At the same time, various manifestations of humor are actively used.

V. Frankl considers humor a form of freedom, just as in an extreme situation heroic behavior is a form of freedom. V. Frankl's own experience as a concentration camp prisoner confirms the legitimacy of his positions. It was there that V. Frankl became convinced that even in inhuman conditions it is possible to remain human and rise above circumstances. To do this, you need to maintain the meaning of life. He described his experience in the book “Psychologist in a Concentration Camp” (1946). In the concentration camp, those people who had a task that was waiting to be solved and implemented were more capable of surviving. When Frankl was taken to Auschwitz, his manuscript, almost ready for publication, was confiscated, and “only the deep desire to write this manuscript anew helped to withstand the atrocities of camp life.”

The method of paradoxical intention is used in corrective work with fears. For example, if a person experiences a fear of closed spaces, he is asked to force himself to be in such a room. And as a result of a long stay, as a rule, fear disappears, and a person gains self-confidence and ceases to be afraid of what he previously avoided.

Logotherapy also uses the following techniques: personal understanding of life; "Socratic dialogue".

  1. Personal understanding of life.

The technique is to tell and show a person who has lost the meaning of life that another person needs him, that life without him loses its meaning for this person. For a mother who has lost an adult child, raising her grandchildren may become the meaning of life. A woman who lost a child as a result of cancer establishes a charity foundation and finds the meaning of life in helping other mothers who find themselves in a similar situation. Thus, a person acquires the meaning of his life through the realization that he is needed and useful to other people close to him. This is one of the ways to transform a life devoid of meaning into a meaningful one, realizing one’s uniqueness, irreplaceability, at least for at least one more person. A person can find the meaning of his life in creativity, in doing good for others, in searching for truth, in communicating with another person. The most important thing is that he can receive satisfaction from all these matters and activities. According to Frankl, the problem is not what situation a person finds himself in, but how he feels about his situation.



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