Applied Logotherapy

Applied Logotherapy

Viktor Frankl’s Philosophical

Psychology

By

Stephen J. Costello
Applied Logotherapy: Viktor Frankl’s Philosophical Psychology

By Stephen J. Costello

This book first published 2019

Cambridge Scholars Publishing

Lady Stephenson Library, Newcastle upon Tyne, NE6 2PA, UK

British Library Cataloguing in Publication Data

A catalogue record for this book is available from the British Library

Copyright © 2019 by Stephen J. Costello

All rights for this book reserved. No part of this book may be reproduced,
stored in a retrieval system, or transmitted, in any form or by any means,
electronic, mechanical, photocopying, recording or otherwise, without
the prior permission of the copyright owner.

ISBN (10): 1-5275-3142-2

ISBN (13): 978-1-5275-3142-0
I dedicate this book to my parents, Val and Johnny, in gratitude and love.
‘If architects want to strengthen a decrepit arch, they increase the load that
is laid upon it, for thereby the parts are joined more firmly together. So, if
therapists wish to foster their patients’ mental health, they should not be
afraid to increase that load through a reorientation toward the meaning of
one’s life’.

‘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’.

Viktor E. Frankl
TABLE OF CONTENTS

Acknowledgements ................................................................................... ix

Prologue...................................................................................................... x

Foreword ................................................................................................... xi

Part One: Logotherapeutic Techniques

Chapter One ................................................................................................ 2

Dereflection

Chapter Two ............................................................................................. 13

Paradoxical Intention

Chapter Three ........................................................................................... 51

Socratic Dialogue

Part Two: Mass Neurotic Triad

Chapter Four ............................................................................................. 74

Aggression

Chapter Five ............................................................................................. 87

Addiction

Chapter Six ............................................................................................... 98

Depression

Part Three: Cultural Malaise

Chapter Seven......................................................................................... 106

Anger

Chapter Eight .......................................................................................... 133

Anxiety
viii Table of Contents

Chapter Nine........................................................................................... 137

Boredom

Part Four: Theory and Therapy of Mental Disorders

Chapter Ten ............................................................................................ 156

Neuroses and Psychoses

Chapter Eleven ....................................................................................... 182

Criminality

Chapter Twelve ...................................................................................... 194

Suicidality

Epilogue.................................................................................................. 217

About the Author .................................................................................... 218

Bibliography ........................................................................................... 219

ACKNOWLEDGEMENTS

I would like to extend my heartfelt gratitude to my friends and colleagues

in the global logotherapeutic community, especially Elly Frankl, Alex
Batthyany, Manfred Hillmann, Harald Mori, Franz Vesely, Robert Barnes,
Robert Hutzell, Marshall Lewis, Charles Mc Lafferty, Ann Graber, Walter
Kohl, Alex Pattakos, Michael Thir, Dmitry Leontiev, Marianna Falcon
Cooper, Marie Dezelic, Anne-Marie Neale, and Irina Abinya, as well as to
my students and patients. Many thanks to my family and friends also for
supporting and encouraging me, in particular, Darren Cleary, and my
parents Val and Johnny Costello, to whom I dedicate this book.
PROLOGUE

Dr Viktor Emil Frankl (1905-1997) was a world-famous Viennese

psychiatrist, philosopher, Holocaust survivor, founder of ‘logotherapy and
existential analysis’ and author of the internationally acclaimed bestseller,
Man’s Search for Meaning, which was voted one of the ten most influential
books ever written. His main emphasis is on our will-to-meaning as the
basis of mental health and flourishing.
I never had the pleasure of meeting Dr Frankl, which is one of my gentle
regrets in life. After my doctorate in philosophy and training in
psychoanalysis I was looking for a psychology that took philosophy and
spirituality seriously, one that would build on Freud without rejecting his
contribution to depth-psychology, and which would be practical and open
to new developments. I found such an integral model and open system’s
approach in the work of Viktor Frankl.
Having set up my own Institute in Ireland in 2009 and to further outreach
its scope to bring Frankl’s message of meaning to the English-speaking
world I decided, approaching the tenth anniversary of the Institute, to offer
a fully-formatted distance-learning programme in logotherapy and
existential analysis, accredited through Vienna, with whom we retain close
ties. Indeed, aside from presenting papers there at the International
Congresses, I attended the last clinical master-class of Dr Elisabeth Lukas,
Frankl’s foremost living disciple, from whom I have benefitted enormously.
I have also had the honour and great privilege of meeting Eleonore (‘Elly’)
Frankl on a number of memorable occasions, as well as other members of
Frankl’s family, including Alex (grandson) and Franz Vesely (son-in-law).
These contacts and connections have made this present work possible.
This book is a contribution to applied and clinical logotherapy and
covers areas as diverse as anger and aggression, anxiety and depression,
boredom and addiction, criminality and suicidality, as well as therapeutic
technique. It is intended for all those interested in applying the lessons of
logotherapy to their own lives in whatever capacity, be they students,
psychologists, philosophers, parents, teachers, or mental health professionals.
Eleonore Frankl was described by philosopher Jacob Needleman once
as the warmth that accompanied the light. I wish that you may experience
both the warmth and the light of the logos.
FOREWORD

“Stephen wrote yet another book?” my wife asked me, with a slight tone of
disbelief in her voice after I told her that I’ve been bestowed with the
undeserved honour to write its foreword. “Yes”, I replied, “and not just one
book, but the book we were all waiting for” – and, indeed, it is the book we
were all waiting for: a concise, precise and carefully argued outline of what
has become internationally known as the third Viennese School of
Psychotherapy, i.e., Viktor Frankl’s logotherapy and existential analysis.
Here, readers who so far are only remotely familiar with logotherapy’s
image of man, its methods and its approach to life (in sickness and in health)
will, in the following pages, find a treasure house of insights and ideas to
live by (and, if active in the helping professions, work by), whereas those
who are already familiar with logotherapy, yet looking for a deeper
understanding and new insights will find a lot on which to ponder. And to
those logotherapists who are looking for a book they can give to friends,
colleagues and family members who want to know “what you are doing in
logotherapy”, here’s the book you were looking for.
Whoever you are – someone completely new to logotherapy, or someone
already familiar with it – what you are about to encounter is existential
psychology at its best: realistic, insofar as it embraces life in its fullness (i.e.,
its brighter and its darker sides); profound, insofar as it offers no easy
recipes, but invites one to a life of lived and mature responsibility; and
clinically proven, insofar as logotherapy has been tested in clinical and
laboratory settings in a few hundred studies (often by non-logotherapists)
and found to be enormously efficient.
Against the background of these research studies which highlight and
corroborate particular aspects of Frankl’s logotherapy, it is perhaps
important to recall at this point that Frankl did not propose a series of
mutually independent psychological hypotheses and therapeutic methods,
but rather formulated a highly generative overall psychological model,
which forms the basis for the development of logotherapeutic methods.
These methods, consequently, represent both the applied and the applicable
(and empirically verifiable) side of the philosophical foundations of
logotherapy, viz., of existential analysis, as described in this book.
It is often said that a philosophy is only as good as it is applicable to
everyday life; and that a psychology of everyday life is only as good as the
xii Foreword

underlying realism in its philosophical outlook on self, others, life, and the
world. To cover this vast territory, one needs a good map (in this context:
logotherapy), and one needs a good guide – and here, you have found it.
Now let the journey begin.

Alexander Batthyány
Prof. Alexander Batthyány, PhD, holds the Viktor Frankl Chair for
Philosophy and Psychology at the International Academy of Philosophy in
the Principality of Liechtenstein. He lectures in cognitive science at Vienna
University, and logotherapy and existential analysis at the Department of
Psychiatry in the Vienna Medical School. Since 2012, he is Visiting
Professor at the Moscow Institute of Psychoanalysis. He is Director of the
Viktor Frankl Institute of Vienna and of the Viktor Frankl Archives as well
as editor of the 14-volume edition of the Collected Works of Viktor Frankl.
He has published several books and articles and lectures widely in the areas
of philosophical and existential psychology, philosophy of mind, and
cognitive science. He is consultant to the Viktor Frankl Institute of Ireland.
PART ONE:

LOGOTHERAPEUTIC TECHNIQUES
CHAPTER ONE

DEREFLECTION

Introduction
Viktor Frankl’s empirical and evidence-based therapeutic techniques are
revolutionary, practical, easy to implement, and have been hugely
successful clinically.
Dereflection is one of three logotherapeutic techniques devised by
Professor Frankl, which we will consider in this first part. It was described
by him as early as 1946. It engages the human capacity for self-
transcendence (the ability to go beyond ourselves). So, self-transcendence
is the basis of dereflection.

Dereflection as Radical Reorientation

The human person is not a closed system but one open to the world and to
meanings to fulfil. Dereflection is the attitudinal decision to turn (much
like the prisoners did in Plato’s Allegory of the Cave in the Republic) from
negative or obsessive or excessive self-preoccupations, psychological
conflicts, complexes and concerns, and neurotic symptoms toward positive
and meaningful feelings, thoughts and actions. Plato’s word is periagoge
(the turning). Christian theology talks of a metanoia (conversion).
Dereflection is not a denial or a distraction – it is a radical reorientation.
Clinically, dereflection is employed when a problem is caused for the
patient by too much reflection or thinking (‘hyperreflection’) or by paying
too much attention to solving a problem (‘hyperintention’). Dereflection
puts a stop – applies the brake – to pathological hyperintention. Sometimes
either paradoxical intention or dereflection can be used, for example, in a
sexual neurosis where there is a fight for or fear of sexual performance.
We shall draw on some concrete cases later. Suffice at this stage to give
one example: a person on a plane begins to get anxious and upset. One
could always engage in a ‘Socratic’ dialogue (more about this anon) with
this person in the attempt to put their mind on positive dimensions of their
holiday, for example, asking what they intend to do the minute they land
Dereflection 3

in Malaga airport, what their plans are for their holiday etc. This type of
simple dereflection can provide real relief and reassurance. In the best
cases of dereflection, for example, an absorbed activity of any kind (where
one is said to be in in a state of ‘flow’), one’s entire being is engaged and
taken up with something powerfully meaningful which draws the person
into the activity, and they begin to forget themselves.

Frankl’s Dereflection
In Man’s Search for Meaning, Frankl gives an example of what I think we
could describe as a dereflection:
‘A thought transfixed me: for the first time in my life I saw the truth as it
is set into song by so many poets, proclaimed as the final wisdom by so
many thinkers. The truth – that love is the ultimate and the highest goal to
which man can aspire. Then I grasped the meaning of the greatest secret
that human poetry and human thought and belief have to impart: The
salvation of man is though love and in love. I understood 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. In a position of utter
desolation, when man cannot express himself in positive action, when his
only achievement may consist in enduring his sufferings in the right way –
an honourable way – in such a position can, through loving contemplation
of the image he carries of his beloved, achieve fulfilment. For the first
time in my life I was able to understand the meaning of the words, “The
angels are lost in perpetual contemplation of an infinite glory”’ (Frankl,
Man’s Search for Meaning, pp. 30-1).

Notice in the passage above words like ‘transfixed’, ‘grasped’, ‘perpetual

contemplation’. This is the draw ‘upwards’ which engages our being on
‘higher things’; the energy associated with this noetic (spiritual – in a non-
religious sense) dimension of the self is altogether different from that
pertaining to the somatic-psychical (the bodily instincts for example).
Later Frankl says, ‘My mind still clung to the image of my wife’. His inner
life was being intensified and nothing could distract him. Frankl speaks of
‘the contemplation of her image’ and his ‘mental conversation’ with his
wife. So, a process of visualisation and inner spiritual dialogue is
occurring. A few pages later he writes this:
‘I was again conversing silently with my wife, or perhaps I was struggling
to find the reason for my sufferings, my slow dying. In a last violent
protest against the hopelessness of imminent death, I sense my spirit
piercing through the enveloping gloom. I felt it transcend that hopeless,
meaningless world, and from somewhere I heard a victorious “Yes” in
4 Chapter One

answer to my question of the existence of an ultimate purpose. At that

moment a light was lit in a distant farmhouse which stood on the horizon
as if painted there, in the midst of the miserable grey of a dawning
morning in Bavaria. “Et lux in tenebris lucet” – and the light shineth in the
darkness’ (Frankl, Man’s Search for Meaning p. 33).

Again, we find Frankl conversing inwardly, perhaps in prayer. The light

that draws him from the mud and misery, the barbed wire and brutality of
Auschwitz, is the light of the Logos (the meaning-dimension of life).

Iris Murdoch’s Example of Dereflection

Another powerful and practical example of dereflection comes from The
Sovereignty of Good by the Dublin-born British moral philosopher and
novelist, Iris Murdoch, who writes:
‘I am looking out of my window in an anxious and resentful state of mind,
oblivious of my surroundings, brooding perhaps on some damage done to
my prestige. Then suddenly I observe a hovering kestrel. In a moment
everything is altered. The brooding self with its hurt vanity has
disappeared. There is nothing now but kestrel. And when I return to
thinking of the other matter it seems less important. And, of course, this is
something which we may also do deliberately: give attention to nature in
order to clear our minds of selfish care’ (Murdoch, 1970, p. 84).

Let us cite another example which highlights a slightly different point: it is

the famous Zen story of the two monks, which is illustrative of our
attachments and detachments and the problems we have in letting go (‘dis-
identification’).

Two monks were making a pilgrimage to venerate the relics of a great

saint. During the course of their journey they came to a river where they
met a beautiful young woman – an apparently worldly creature, dressed in
expensive finery and with her hair done up in the latest fashion. She was
afraid of the current and afraid of ruining her lovely clothing, so she asked
the brothers if they would carry her across the river.
The younger and more exacting of the brothers was offended at the
very idea and turned away with an attitude of disgust. The older brother
didn’t hesitate and quickly put the woman upon his shoulders, carried her
across the river and set her down on the other side. She thanked him and
went on her way, and the brother waded back through the waters.
The monks resumed their walk, the older one in perfect equanimity
and enjoying the beautiful countryside while the younger one grew more
and more brooding and distracted, so much so that he could keep silence
no longer and suddenly burst out: ‘Brother, we are taught to avoid contact
Dereflection 5

with women and there you were not just touching a woman but carrying
her on your shoulders!’. The older monk looked at the younger one with a
loving, pitiful smile and said: ‘Brother, I set her down on the other side of
the river; you are still carrying her.

The younger monk was unable to dereflect; he was tormented and

preoccupied by his own ego-projections. Let us repeat: through dereflection
the spiritual resources of self-transcendence are deployed. Dereflection,
within the logotherapy clinic, is the therapeutic application of our will-to-
meaning and this capacity of self-transcendence. A patient is ‘dereflected’
from his disturbances; dereflection it is intended to counter his/her
compulsive inclination to self-observation (excessive self-scrutiny).

Examples from the Sexual Neuroses

If we take an example of sexual neurosis (impotence or frigidity): the
sexual neurotic (unlike the obsessive-compulsive) doesn’t fight against his
obsessions or compulsions, but for his/her sexual pleasure. This direct
intent on procuring pleasure prevents the person from finding it. Frankl is
always cautioning us not to pursue happiness directly: ‘The more people
run after happiness, the more happiness is running away from them’. If a
direct aim is strived for, to such an extent, then hyperintention can ensue.
Dereflection is less specific than paradoxical intention (another
logotherapeutic technique which we will meet with shortly). Dereflection
always involves the refocusing of attention; it helps us break out of the
cycle of unnecessary (avoidable) suffering. Three questions:

1. Ask (yourself or someone you’re trying to help): what is the person

hyperintending?
2. Then seek to direct the person’s awareness towards more
meaningful aspects and areas of their lives. (What interests them or
excites them? What are their passions?)
3. This may be done through Socratic questioning (which we will deal
with in a later section) and eliciting examples of meaningful
pursuits, goals, mission or vocation.
4. A list can be generated of such meaningful activities which enrich
and engage the person.

In this way the person is confronted by the logos of his existence; he

discovers what feeds him, fulfils him, and fills him with hope and
happiness, as new meanings begin to emerge or old ones from childhood,
once forgotten, begin to come to the surface. So, clinically, for example,
6 Chapter One

when a person is thinking endlessly of pain or age or death they begin to

focus more on their interests and aspirations instead.
In a section on sport in The Unheard Cry for Meaning, Frankl urges
the athlete to focus away from winning the race and toward swimming his
own race. ‘The athlete will swim best if he attempts to be his own best
rival’ (Frankl, The Unheard Cry for Meaning, p. 100). Logotherapy can be
a powerful coaching tool in sports psychology as much as in business
consulting or therapeutic counselling. The real athlete only competes
against himself.
According to Frankl, there are three pathogenic patterns:

1. The phobic pattern (flight from fear)

2. The obsessive-compulsive pattern (fight against obsessions and
compulsions)
3. The sexual neurotic pattern (the patient is not fighting against
something but for something such as sexual pleasure)

The more one aims at pleasure the more one misses it. When you make
potency and orgasm the target of intention, they are also made the target of
attention, so hyperintention and hyperreflection reinforce each other so
that a feedback mechanism is established. To secure potency, the person
pays attention only to himself – to his own performance and experience.
Consequently, potency and orgasm are in fact diminished. This in turn
enhances the patient’s hyperintention and the vicious circle is completed
and repeated. To break the circle, centrifugal forces must come into being.
Instead of striving for potency and orgasm the patient should be himself
and give himself. Instead of observing himself, he should forget himself.
In the case of a husband who strives desperately for sexual perfection, we
can say that his hyperintention causes his impotence. In such a case the
logotherapist can instruct him to give his wife himself. Then her pleasure
would be the consequence of his attitude and not the aim itself. In short,
the fight for pleasure is self-defeating. The patient can be instructed: ‘no
intercourse for a period’. This instruction relieves the patient’s anticipatory
anxiety. The problem with hyperintention is that it imposes an imperative:
you should – a ‘demand quality’. This can be accentuated by peer pressure
or by a society preoccupied with achievement. The prevailing culture of
pornography, sex education, and the mass media are all hidden persuaders
that foster a cultural climate of sexual expectation and demand.
Dereflection removes the demand.
Frankl sometimes instructs his male patients to tell their partners that
coitus is absolutely forbidden; they are therefore released and once freed it
Dereflection 7

is possible for their sexuality to be expressed again, unblocked form the

demand/pressure/expectation. This 1946 technique of Frankl’s has been
paralleled in the 1970’s by Masters’ and Johnson and their research into
human sexuality. Frankl gives several clinical examples concerning
impotence and frigidity throughout the corpus of his writings. In all cases
dereflection (a refocusing of attention) was applied with success.

‘Positive’ and ‘Negative’ Dereflection

Where paradoxical intention (PI) ridicules the problem humorously, in
dereflection the problem is ignored. PI counteracts anticipatory anxiety;
dereflection is intended to counteract the compulsive inclination to self-
observation. So-called ‘negative’ dereflection is from anticipatory anxiety,
‘positive’ dereflection is to something else. The focus shifts. It is now for
something. By so doing, the patient discovers the concrete meaning of his
personal existence. Dereflection ushers in ‘right activity’, where the focus
is away from the person themselves, from what Iris Murdoch calls ‘the fat,
lying, illusion-making, deceitful ego’. Dereflection enables one to become
aware of the full spectrum of his/her existence in the world.

Insomnia
Let’s give another concrete example: Insomniacs watch themselves with
highly strung attention; sleeplessness is anxiously anticipated; the act of
sleep is scrutinised and thereby rendered impossible. The vigorous desire
for sleep is precisely the very thing that drives sleep away. Fear of some
(pathological) event can, ironically, precipitate that event. In the aetiology
(cause) of a neurosis one finds excess of attention and intention. With
insomnia the forced intention to sleep is accompanied by the forced
attention to observe whether the intention is becoming effective or not.
The attention of insomniacs inhibits the sleeping process and perpetuates
the waking state. The hyperintention to sleep incapacitates the patient.
Sleep is like a dove which has landed in one’s hand. It stays there only as
long as one does not pay any attention to it. If one attempts to grab it, it
flies away. So, the logotherapeutic advice is: not to try to force sleep. To
draw on paradoxical intention: the patient might be instructed to punch a
time clock every quarter of an hour to stay awake. If one awakes with
noise in the neighbourhood and one becomes angry at one’s inability to get
back to sleep, Frankl advises that they imagine that they are urged to leave
their beds to do something disagreeable, for example, shovelling snow or
coal at five in the morning. If they yield to this fantasy, they feel so tired
8 Chapter One

that they fall back to sleep again. So, don’t say, ‘don’t think of sleep’ but
rather invite the person to face into his everyday problems. Forcing the
patient to direct his attention in negative terms is like saying ‘don’t think
of a chameleon’. Now you’re thinking of one! When the philosopher Kant
had to discharge a servant by the name of Lampe for thieving, which really
hurt Kant after having lived with him for so long, he put a large sign above
his desk saying: ‘Lampe must be forgotten’. Of course, this only ensured
he would be thinking of him constantly. In Dostoyevsky’s novel The
Double a man is not invited to a party, so he goes along to the restaurant
and walks up and down outside it ‘to show with all my might that I could
do without them’. Finally, there is the story of the centipede who ran very
well until one day it decided to observe just how it was that he ran with all
his legs. The more he became conscious of how he ran, the more difficult
it was for him to function until finally all he could do was lie down in a
ditch in despair. He died of hyperreflection.

Some More Clinical Examples

In The Doctor and the Soul, Frankl gives a number of clinical examples:
Miss B compulsively observed the act of swallowing: having become
uncertain she anxiously expected that the food would go down the wrong
way or that she would choke. Frankl writes: ‘Anticipatory anxiety and
compulsive self-observation disturbed her eating to the extent that she
became very thin’ (Frankl, The Doctor and the Soul, p. 234). She was
taught to trust her own organism and its automatically regulated
functioning. She was therapeutically dereflected by the following formula:
‘I don’t need to watch my swallowing because I don’t really need to
swallow. In fact, I don’t swallow. It does’. She was thus able to leave to
the it the unconscious and unintentional act of swallowing.
A Gerhardt B who was 19 years-old suffered from a speech
disturbance since he was six which began in a storm when a bolt of
lightning struck near him. For eight days he couldn’t speak at all. He was
given psychoanalytic treatment for five months followed by four months
of speech and breathing exercises. It was explained to him that he would
have to give up all attempts to be a good orator; indeed, only as he
resigned to being a poor speaker would he improve his speech, for then he
would pay less attention to the ‘how’ and more to the ‘what’ of his speech.
A 38-year-old man came to a Dr Kaczanowski because he had stopped
working eight years earlier. Each year he paid his dues to his professional
organisation and so remained in good standing but for the last two years
his name was not listed in the register of his profession. He lived alone and
Dereflection 9

had a modest income from his investments. For ten years he had been
troubled with unexpected bouts of diarrhoea. At times he soiled his pants;
this had happened twice at a dance. He now avoided company and stayed
home. He was treated by two psychiatrists and had even had part of his
intestine removed. He consulted with Dr Kaczanowski who told him it was
as if he didn’t exist anymore – not on the professional register, and worse,
he had submitted to his bowels. They were his master dictating his every
move. For a while the patient was suicidal, but he finally started to realise
that he had potentialities, that he had freedom and was responsible, that he
could rebel against the tyranny of his bowel movements. Within a year he
could make decisions and go against his bowels.
As Frankl observes: ‘…dereflection can only be attained to the degree
to which the patient’s awareness is directed towards positive aspects. The
patient must be dereflected from his disturbance to the task at hand or the
partner involved. He must be reoriented towards his specific vocation and
mission in life. In other words, he must be confronted with the logos of his
existence! It is not the neurotic’s self-concern, whether pity or contempt,
which breaks the vicious circle: the cue to cure is self-commitment’
(Frankl, The Doctor and the Soul, p. 236).

Sigmund Freud’s Example of Dereflection

Once when Bruno Walter, the German conductor and composer,
complained to Sigmund Freud of pains in his arms, Freud advised him to
go to Sicily and visit the art treasures there. What he needed was not
analysis but dereflection from his troubles (albeit with an artistic content).
Similarly, with a violinist Frankl mentions in Man’s Search for Ultimate
Meaning who tried to play as consciously as possible with full self-
reflection paying attention to every trifling detail which led to a complete
artistic breakdown. Therapy began by eliminating this tendency to
hyperreflection. Treatment was through dereflection and the patient was
urged to trust in his unconscious and he began to realise how much more
musical his unconscious was than his conscious. As Frankl informs us:
‘…this treatment oriented toward the patient’s reliance on his unconscious
brought about the release of the artistic “creative powers” of his
unconscious. Dereflection liberated the creative process from the
inhibiting effects of any unnecessary reflection’ (Frankl, The Doctor and
the Soul, p. 43).
10 Chapter One

Three Logotherapeutic Techniques

Frankl offers a sustained treatment of dereflection in his 1956 publication,
On the Theory and Therapy of Mental Disorders, especially chapter
twelve entitled ‘Paradoxical Intention and Dereflection’, translated into
English as late as 2004. Frankl begins by reminding us that there are three
distinctive logotherapeutic techniques:

1. Paradoxical Intention
2. Dereflection
3. Socratic Questioning (modification of attitudes)

Dereflection or Paradoxical Intention?

Dereflection mobilises and promotes self-transcendence by helping the
patient practise ‘self-forgetting’ to allow the natural processes to produce
the desired state. It should be noted that the same disorder – say insomnia
or impotence – can be treated with paradoxical intention in one case and
with deflection in another. The reason being is that the aetiology of one
and the same disorder can be understood in different ways. For example,
insomnia can be understood as resulting from a hyperintention of sleep (in
which case dereflection is indicated) or from an anxious fear of
sleeplessness (in which case paradoxical intention is indicated); or
impotence may arise from an undue focus on getting erect rather than on
the partner (calling for dereflection) or from an anxious anticipation of
impotence (calling for paradoxical intention). One must understand the
psychological dynamics (and not just the diagnosis) behind the disorder.
Dereflection is, in short, a redirecting (Umstellung). Frankl notes:
‘Self-transcendence marks the fundamental anthropological fact that
human existence is always directed toward something that is not itself –
toward something or someone, namely, either a meaning to be fulfilled or
an interpersonal existence that it encounters. Human beings become
genuinely human and are entirely themselves only when, rising in
devotion to a task in service to a cause or out of love for another person,
they go beyond themselves and forget themselves’ (Frankl, The Doctor
and the Soul, p. 4).

Both dereflection and paradoxical intention work very quickly without

needing to identify the underlying causes of the neurotic behaviour. Even
if they both constitute nonspecific therapy they attack neurosis at its root.
Paradoxical intention is good for anticipatory anxiety, but compulsive self-
Dereflection 11

observation calls for dereflection. Paradoxical intention enables patients to

mock their symptoms, dereflection enables them to ignore their symptoms.

Four Options
There is:

1. ‘Improper passivity’: running away from anxiety attacks

2. ‘Improper activity’: a) fighting against obsessions or compulsions;
or b) forced intending of sexual pleasure with a forced reflection on
the sexual act
3. ‘Proper passivity’: dereflection (ignoring the symptoms through a
reorientation and refocusing) or paradoxical intention (a mocking
or ridiculing of symptoms)
4. ‘Proper activity’: acting-past-the-symptoms or existing-toward-
something

Frankl: ‘For the symptomatology of many neuroses ultimately shows itself

to be a sort of mental debris that fills a spiritual vacuum’ (Frankl, The
Doctor and the Soul, p. 209), which Frankl calls the existential vacuum –
this void of inner emptiness (‘ev’).

Dereflection and Self-Transcendence

Analogously, the human eye sees the world only to the extent that it can’t
see itself. The eye sees itself only when it is ill (when it has a cataract or
glaucoma). In logotherapy we counter hyperreflection with a dereflection
so don’t think about success or happiness or the orgasm. The less you care,
the sooner it will come about by itself. Abstain, in order to obtain.
Dereflection is understood along the lines that human beings are meant
to know and love things beyond themselves. Neurosis is incarceration in
our ‘sweaty selves’ (as Gerard Manley Hopkins, SJ puts it). Dereflection
brings us outward to the Other and away from our fears, anxieties, and
symptoms. Dereflection works best when we discover a concrete meaning
or purpose and, in this way, ‘psychotherapy becomes logotherapy’ (Frankl,
The Doctor and the Soul, p. 189). Frankl observes: ‘In the final analysis,
dereflection means ignoring one’s self. In Bernanos’s Diary of a Country
Priest, we find the beautiful expression, “It is easier that one believes to
hate oneself; grace consists in forgetting the self”’ (Frankl, The Doctor
and the Soul, p. 207). Dereflection is possible only when we exist for
something else (a concrete meaning). Frankl expands: ‘Persons do not
12 Chapter One

exist for the sake of observing themselves and contemplating their own
egos; rather, they exist in order to give themselves up, to give themselves
away, to knowingly and lovingly devote themselves’ (Frankl, The Doctor
and the Soul, p. 208). All knowing and loving is directed to something
outward. The essence of the person is this ‘being-directed-toward’ – an
outward directedness. Only in so far as we are intentional (goal-directed)
are we existential. Frankl calls this the ‘fundamental law of human
existence’ (Frankl, The Doctor and the Soul, p. 208), one which is also
therapeutically fruitful. Thus, it is that people with anxiety neurosis are
drawn out of the vicious circle of their own self-encircling thoughts as we:

A. Focus on removing attention away from the symptoms

B. Focus instead on a concrete task that is personally important

It is not by allowing our thoughts to circle around our anxiety that we are
free of this anxiety, but rather through a self-donating – a giving-up-of-
oneself and a devoting of oneself to a worthy object. ‘That is the secret of
all self-formation’ (Frankl, The Doctor and the Soul, p. 209). We are what
we are through the things we give ourselves to. We may conclude this
section with three relevant quotes: Max Scheler: ‘…only those who want
to lose themselves in some … thing … will find their authentic self’.
Schelling: ‘the most noble activity of the human person is that activity
which is not aware of itself’. Nietzsche: ‘all perfect doing is precisely
unconscious, and is no longer willed’.
Elisabeth Lukas, a Viennese logotherapist and close associate of Dr
Frankl’s, best sums up dereflection in her Meaningful Lines:

‘A problem becomes large when you pay attention to it,

becomes heavy when you place weight on it,
becomes gigantic when your thoughts circle around it,
becomes enormous when you see it as a tragedy.
A problem becomes small when you smile about it,
becomes light when you minimize it,
becomes tiny when you ignore it,
and vanishes when you accept it’.
CHAPTER TWO

PARADOXICAL INTENTION

Introduction
‘The way of paradoxes is the way of truth’,
—Oscar Wilde.

‘Paradoxical Intention’ (PI) is another evidence-based, scientific technique

developed by Viktor Frankl, possessing has an efficacy rate of 77.8%
(indeed some clinicians have reported an 88.2% success rate) in empirical
studies and has proven particularly effective in the treatment of phobias,
insomnia, and Obsessive-Compulsive Disorder (OCD). It has also been
used in sports psychology to train athletes. Paradoxical intention is an
easy-to-understand method, can be applied by anyone without necessitating a
therapist or physician with practice, and consists of a few key elements.
Paradoxical intention is the oldest of Dr Viktor Frankl’s treatment
techniques. Dr Lukas – a world authority on Frankl’s logotherapy, likened
PI to a magician’s trick!, maintaining that it is, in almost every case,
successful. Lukas, after almost a life-time practising PI, notes: ‘With
paradoxical intention there are almost always no relapses’. It is not a
panacea – but then again nothing is in therapy.
Imagine this scenario: someone is taking a photograph of the family at
Christmas. He looks through the lens of his camera or I-phone and sees
non-smiling faces. He decides to say the following: ‘Now whatever you
do, don’t smile. No, no smiling. Did I see someone smiling?’ Immediately,
everyone relaxes and begin to smile naturally. This is the heart of PI.
What PI is not. PI is nothing to do with Magnum PI! Anyone over 45
years of age will remember the 1980’s show set in Hawaii starring Tom
Selleck as a private investigator who drove a red Ferrari. However, PI was
used to good effect in the Rocky movies, starring Sylvester Stallone, who
would regularly taunt his opponents in the boxing ring with: ‘is that all
you got? You hit like my mother’. By so doing, he threw his opponents off
and made himself more relaxed – it took the fear and sting out of the
14 Chapter Two

situation. PI is a superb technique for a wide variety of neurotic

conditions.
Frankl utilised paradox for the basis of his psychological technique to
help people suffering from a number of symptoms ranging from stuttering
and sexual dysfunctions to insomnia, phobias, anxiety and panic attacks.
He speaks of ‘neuroses’, in other words, all those things that are not
physiological/biological. They have their origin (genesis) in our minds
(psyches). So, the first port of call is to rule out any underlying medical
condition. Only when we rule out the organic (as a cause) can we rule in
the psychological. So, always get checked out medically first.

The Human Person According to Logotherapy

Before detailing the dynamics of paradoxical intention, we need to
understand how Frankl construes the human person. For Frankl, the person
is a unity in diversity. He or she is layered; there are three such levels to
our humanity: soma (body), psyche (soul: mind/feelings), and noös (spirit
– in the non-religious sense). The ‘body’ (and brain) is our biology
consisting of organic cell processes, physiological body functions and
chemical processes. The ‘mind’ is our psychological dimension consisting
of emotional (character disposition) and cognitive (intellectual abilities)
processes. The noetic dimension is where we can take a stance towards our
conditioned situation (free will, humour, creativity, religiosity, conscience,
values, will to meaning, love). The core of personhood is the noetic
dimension. Every human being strives to answer to his personal calling
and vocation in the singular situation. Recognising and realising meaning
enables the human being to free himself (sufficiently so) from his
psychophysical facticity (organism). Psyche and soma form a unity
(psychosomatic) but the integration of the noetic leads to wholeness.
Paracelsus, the philosopher-physician, once said that our illnesses come
from nature, but the cure comes only from the spirit. The key to mental
health is meaning and meeting our multidimensional needs as human
persons. We need to look after our bodies through sleep, exercise and
nutrition, our psyches in terms of keeping up some intellectual interests
and staying emotionally self-regulated, and our spirits in terms of
mindfulness practice or prayer, accessing nature, culture, and art, living a
life of meaning and purpose, and obeying the call of conscience, as well as
loving. Daily disciplines soon become habits of the heart.
Paradoxical Intention 15

Disidentification
At the outset you need to know that you need not be identified with the
feelings dominating you at the present moment. You are NOT your fears
or your anxieties, or your depressions. They are things that you have (or
have you) but they are not who you are. It’s the difference between having
and being. You can choose your ATTITUDE towards those feelings; you
can even defy them by what Frankl calls ‘the defiant power of the human
spirit’. You can’t choose your emotions (what you’re feeling) but you can
control and change them by your will. PI is applied in this area of freedom.
The first few times using PI patients can be sceptical or hesitant or unsure
or they can feel insecure and perhaps not even believe in the technique.
Trust must be established, and the technique explained and practised.
Before we do this let me run you through a short exercise taken from
Assagioli’s school of psychosynthesis to help with self-detachment so
crucial for the effective workings of PI. It is an exercise in what he calls
‘dis-identification’ whereby we distinguish the ‘I’ (you) from its contents
of consciousness, such as sensations, emotions, desires, thoughts (what
you’re feeling, thinking etc).

Exercise
Please find a comfortable chair. Close your eyes, relax and enter into
yourself. Sink into silence. Take a few deep breaths. Become still and
quiet. Affirm to yourself:
‘I have a body, but I am not my body’. I am not my body in the sense
that I am more than just my body. My body may find itself in different
conditions of health or sickness. It may be rested or tired, but it has
nothing to do with who I really am – with my real self, my ‘I’. My body is
my instrument of experience and of expression, but it is only an
instrument. I treat it well, keep it in good health but it is not myself. I have
a body, but I am not my body’.
‘I have emotions, but I am not my emotions. My emotions are
countless, changeable, contradictory, and yet I know that I always remain
I, my-self in times of hope or despair, joy or sorrow, irritation or calm.
Since I can observe my emotions and increasingly dominate and direct
them it is evident that they are not myself. If I ‘see’ them, so to speak, I
can’t be them. I have emotions, but I am not my emotions’.
‘I have desires, but I am not my desires, aroused by the drives
(physical or emotional), and by outer influences. Desires too are
16 Chapter Two

changeable and contradictory, with alternations of attraction and repulsion.

I have desires, but they are not myself’.
‘I have an intellect, but I am not my intellect. My intellect is developed
and active; it is undisciplined but teachable; it is an organ of knowledge in
regard to the inner and outer world, but it is not myself. I have an intellect,
but I am not my intellect’.
‘So, who am I? I recognise and affirm that I am a Centre of pure self-
consciousness, and of Will, capable of mastering, directing, and using all
my psychological processes and my physical body’.
W.B. Yeats penned a poem which runs thus: ‘Things fall apart; the
centre cannot hold. Mere anarchy is loosed upon the world’ (‘The Second
Coming’). But the Centre – your core – must hold. For we are One while
yet being Many.

Paradoxical Intention and Self-Detachment

Paradoxical Intention makes use of this ability to dis-identify, to self-
distance. It draws on the specifically human capacity for self-detachment.
Because in the noetic dimension we are free to take a stand towards our
condition, we can rise above the plane of somatic and psychic determinants
of behaviour – a new dimension opens up. This is where healing resides.
When we detach from ourselves, we leave the plane of the purely
biological and psychological and pass into the space of the noölogical (this
specifically human dimension of humour, conscience, love and the like,
not accessible to the non-human animal). So, self-distancing is used in
paradoxical intention where we can take a free stand, involving humour, to
mock our symptoms, and gain distance from them. Because, as we said,
we are not our symptoms. There are symptoms (which we have) and there
is the self (which we are). The ability to self-detach is an essential feature
of being human – it is an ability in every human being. Frankl writes:
‘With paradoxical intention one enters the noetic dimension as the
characteristic and constitutive dimension of human existence’ (Frankl,
Psychotherapy and Existentialism, p. 153).
Paradoxical Intention was practised by Frankl in 1929; it was described
by Frankl in 1939; it became a methodology in 1953; and incorporated
into logotherapy in 1956. Examples and case-histories given in the logo-
literature include: stuttering, sexual dysfunctions, sleeplessness, sweating,
tremors, twitches, blushing, claustrophobia, washing compulsions, etc. To
understand the effects of PI one must understand the phenomenon of
anticipatory anxiety, the mechanisms of which are:
Paradoxical Intention 17

1. Something disagreeable happens in a certain situation

2. It upsets you
3. You develop an anticipatory anxiety that it might happen to you
again
4. This anxiety causes you to think about it excessively and makes
you insecure, expecting things to repeat.

This, of course, makes recurrence likely. Fear brings about what is feared.
And one gets anxious about being anxious. In short, fear causes
anticipatory anxiety and anticipatory anxiety causes the fear. So, we need
to explore, briefly, the subject of anxiety, as well as fear, since these
affects are precisely what PI tries to help with.

Analysis of Anxiety
Anxiety can manifest itself as nervousness, dry throat, shaky hands,
unsteady voice, perspiring forehead, butterflies in the stomach, and a
whole host of physical concomitants and complaints. Some people get
anxious thinking of doing an exam, or having to make a speech, or going
to the doctor or dentist. Even mental or metaphysical anxiety about the
emptiness or absurdity of life, of the ‘unbearable lightness of being’,
possesses a physical as much as a psychical component. These two aspects
(body and mind) are intertwined.
Anxiety is more than a mere nervous reaction to an unexpected or
dangerous event which fills us with fear and dread, however. It’s a broad
term employed to describe anything from panic attacks to post-traumatic
stress disorder. Statistics available from the National Institutes of Health
suggest that almost 40 million American adults, that is about 18% of the
population in the United States, suffer from ‘anxiety disorder’. Such
sufferers are usually put on anti-anxiety medications or anti-depressants or
beta-blockers such as Xanax or Prozac. Still others engage in the ‘talking
cure’ of therapy.
Aristotle recognised that any given emotional state is the result of three
factors: the underlying psychological condition, the events that
precipitated or provoked the emotion, and the intentional object of the
emotion (what it’s directed at). If we take the example of anger, Aristotle
will say what state people are in when they are angry, with what people
they are accustomed to be angry at, and in what circumstances. So, try to
apply this philosophical schema to your own life. Try, in other words, to
figure out: 1. What’s the psychologically process that is happening to you;
18 Chapter Two

2. What were the events that triggered this condition; and 3. Who or what
are you directing your anger/fear at?
Anxiety wasn’t really written about until the nineteenth-century,
beginning with the work of the Danish father of modern existentialism. In
The Concept of Anxiety (1839) Soren Kierkegaard wrote: ‘All existence,
from the smallest fly to the mysteries of the Incarnation, makes me
anxious’. And, again: ‘Deep within every human being there still lives the
anxiety over the possibility of being alone in the world, forgotten by God,
overlooked by the million and millions in this enormous household’. This
kind of ontological anxiety is part of the makeup of human beings – we’re
stuck with it. As Samuel Beckett said: ‘you’re on earth, you’re on earth;
there’s no cure for that’. Anxiety is directed towards the future and is an
element in the constitution of every human being.
Paul Tillich, the Protestant theologian, shows some parallels with
Kierkegaard in his concept of anxiety, when he describes it as ‘finitude in
awareness’. We’re aware we have come into existence and we will pass
out of existence. Anxiety is ontological (it affects us in our very being)
rather than merely psychological. Anxiety relates to our fundamental
finitude (the fact of our mortality). Freedom and the possibilities that
freedom brings produces anxiety.
Anxiety comes into the world with the asphyxia of birth. Anxiety is
always present, though it may be latent. Kierkegaard describes his
anxiousness as ‘the eternal night brooding within me’. Anxiety is a mood
of our being-in-the-world. Anxiety is the dizziness of freedom; it reveals
‘the nothing’ to us, and dwells in the heart of all of us. If lack creates
desire, the lack of a lack (too much presence) causes anxiety.
Anxiety is free-floating – diffusive, less concrete than fear. Unlike fear,
it lacks an object. It’s indefinite. Fear, in contrast to anxiety, has an object,
latches on to something specific. Let’s bring out the differences by
examining fear next before seeing exactly how PI works with both fear
and anxiety.

Facing Fears
Usually with our emotions, we engage in fight-flight, or freeze. Thus,
these three main reactions of fight (anger), flight (avoidance) or freeze
(paralysis). Beyond this pattern is another ‘f’, and that is facing into our
fears and anxieties. Philip Larkin, the poet, sums up human existence thus:
‘Life is first boredom, then fear’. Over the centuries, fear hasn’t received
as much philosophical attention as anxiety. But the fear-factor, arguably, is
ubiquitous especially in an age of global terrorism. Fear underlies our