archive

Making the Impossible Possible:
Viktor Frankl’s Resilience

A Presentation for The American Institute for Medical Education, October 2014 – Vienna, Austria

Viktor Frankl was a doctor of philosophy, a doctor of medicine, a neurologist, a psychiatrist, a surgeon, an author, an elite mountain climber, a composer, a cartoonist, a playwright, a pilot, and the creator and energetic force behind the worldwide movement of Humanistic psychology he called, Logotherapy, and later, Existential Analysis.

Frankl, was born in Vienna in 1905 and at the tender age of three declared he would become a physician. The desire to save people may have had something to do with the fact that age two his father had snatched him off the railroad tracks just before the train was leaving the station. At four, he was startled by the thought that one day he would die. Did that mean, he questioned, that life had no meaning?

A profound experience at age five may have influenced his answer to the question of meaning: He recalled once on a family vacation lying in bed one sunny morning and with his eyes still closed was “flooded by the utterly rapturous sense of being guarded, sheltered.” When he opened his eyes, his father was standing there, bending over him, smiling- a beautiful example of having been provided, what we now call, “secure attachment.” Frankl later decided that it was death itself that gave life meaning. That death gives meaning to everything one experiences and everything one accomplishes in life.

On starting H.S, he began taking adult night classes in philosophy and began writing papers on topics that interested him. He gave his first public lecture at 16 at the adult education school on, “The Meaning of Life.” How many of us would have been able to give a public lecture at age 16 on any topic? His final examination paper for graduation from the gymnasium or high school was titled, The Psychology of Philosophical Thinking. And around this time, he began a long correspondence with Freud. A paper he’d sent to Freud was later published in the Int. Journal of Psychoanalysis. Freud wrote to him apologizing for sending it on without his permission. This was 1924 and Frankl was 19 years old. The following year, Alfred Adler published one of his papers in the International Journal.

By this time Frankl’s knowledge of philosophy was extensive. By the time of his death in 1997 at age 92, Viktor Frankl had written 39 books. He held 29 honorary doctoral degrees and had spoken in over 200 venues outside of Europe. Viktor Frankl has been described as one of the greatest intellects of the twentieth century.

This extraordinary man entered medical school at the University of Vienna, and between 1928 and 1930, while still a medical student, he created free youth counseling centers, paying special attention to the times when students received their report cards, as suicide was a serious problem. Of note here is that Frankl’s father had served as director of the Ministry of Social Services and had created a Department of Child Welfare. It appears Frankl had internalized his father’s caring attitude and sense of ‘justice’.

Volunteer staff in his counseling centers included such luminaries as Charlotte Buhler, August Eichorn and Rudolph Drikurs. That next year, 1931, marked the first year that there were no suicides after report cards were issued. The counseling centers expanded to other cities and their success resulted in invitations for Frankl to lecture on his program in Budapest, Prague and Berlin.

Dr. Frankl completed his residency in neurology and psychiatry at the Steinhof Psychiatric Hospital in Vienna and there became responsible from 1933-1937 for the so-called, Suicide Pavilion, where he treated approximately 7,000 depressed and suicidal women over those four years. In 1937 he opened a private practice in neurology and psychiatry in Vienna.

The evening of the day in March, 1938 when the Nazis were welcomed into Austria, Frankl was giving a public lecture on “Nervousness as a Phenomenon of our Time” when the door was thrown open by an SS man in Nazi uniform. He knew his intent was to create chaos and close-down the lecture. He told himself: “I should make the impossible possible and lecture in such a way that he’ll forget why he came here. Divert his attention!” Frankl faced the man openly and continued to speak- the Nazi didn’t move until the end of the lecture and then turned and left.

With the Nazis in control, Dr. Frankl was prohibited from treating “Aryan” patients from that point on, and at the Rothschild Hospital- the only hospital admitting Jews- he treated ten suicide attempts each day. He was able to save a number of patients from the Nazi euthanasia program by giving them medical diagnoses instead of psychiatric ones. In 1941 his quota number came up which made it possible to get a visa for the U.S. He deliberated on this, wondering if he could leave his parents knowing what would likely happen to them. He asked God for a sign. When he went home, he found a piece of tile on the table. What is that, Frankl asked his father. His father answered that it was a tile he’d found in the rubble of the largest synagogue in Vienna, burned down by the Nazis. It was from the Torah and had a Hebrew word on it. What is it? He asked. His father said it represents the commandment, “Honor thy father and thy mother that thy days may be long on the land thy Lord God giveth thee.” That was the sign. He would stay in Austria with his parents.

In that same year, 1941 Viktor married Tilly Grosser, a nurse he’d met working in the hospital. The next year, they along with Frankl’s parents were deported to the Nazi Theresienstadt Ghetto where Frankl worked as a general practitioner in a clinic. While there, he set-up a suicide watch, and he also organized a series of open lectures on topics such as: Sleep & Sleep Disturbances; Medical Care of the Soul; The Psychology of Mountaineering. Tilly became pregnant and was forced to have an abortion as Jewish women were not allowed to be pregnant. When his father was dying of pulmonary edema and starvation, Frankl smuggled in a vial of morphine and felt content that he could help his father die without agonizing pain.

In October, 1944, he asked his mother’s blessing before he and his wife, Tilly, were sent to Auschwitz. One week later, his mother was sent there too, directly to the gas chambers. He didn’t know until the end of the war that his wife had died in the gas chambers of Bergen-Belsen. His brother and his wife were killed in another camp. Frankl had been processed and sent to Kaufering, a camp affiliated with Dachau. He spent 5 months there working as a slave laborer and then another camp until he was liberated after 3 years of starvation, near-death from typhus, and always ministering to as many inmates as possible.

The “truth” he discovered in surviving the concentration camps was this: “The salvation of man is through love and in love.” This became the basis for his best-known and best-selling book, Man’s Search for Meaning, first published in German in 1946 and titled, From Death Camp to Existentialism. Man’s Search for Meaning has sold millions of copies in 28 different languages, with each edition adding more testimonies to its life-saving message.

In addition to discovering his truth about the power of love, Frankl also felt he owed his survival to his resolve to reconstruct his lost manuscript for The Doctor and The Soul. On his 40th birthday in the camp, 1945, he was given a pencil stub and a few scraps of small SS forms that a friend had pilphered. He scribbled notes to reconstruct his book during his sickness with typhus, keeping himself awake at night in order to not go into delirium and die. (Six men were dying every day in his part of the camp.)

What most people don’t know is that his true “Opus magnum”- his great work- was this first book, a draft of which he’d tried to smuggle unsuccessfully into the camps, The Doctor and the Soul. He recreated this book, 300 pp after the liberation and published it in 1946.

Shortly after, he was inspired to write Man’s Search for Meaning, which he dictated in 9 days! What is his message? What was and is the universal appeal?

His message is:

1.That life itself is meaningful no matter what kind of life it is. 2 that suffering in life can only be endured and made meaningful in three ways: (1)Through love: “Love is the ultimate and the highest goal to which man can aspire.” (2) through a passion for one’s work, and through( 3) the courage to be responsible for handling challenges over which we have no control. He believed deeply in personal responsibility. He even spoke of being “worthy of one’s suffering.”

This is one of his famous quotes:

Everything can be taken from a man but one thing: the last of the human freedoms- to choose one’s attitude in any given set of circumstances.”

I pondered that personal responsibility concept…. And it led me back to developmental psychologist, Erik Erikson’s book, Insight and Responsibility, a book Erikson wrote exactly 50 years ago, two decades after Frankl’s writing. It further establishes the relationship between maturity, love and personal responsibility:

Erikson echoes Frankl when he writes, “ Love is the greatest of human virtues, in fact, the dominant virtue of the universe…”

“In the mature stage of generativity, “man must now learn to accept the responsibility which evolution and history have given him.”

“…the responsibility of each individual for the potentialities of all generations…”

It was the responsible, intimate love that Viktor Frankl had for his wife, Tilly, that helped him through the worst times in the camp. He thought of her constantly, talked to her, and once when he fell into the snow and ice from exhaustion she appeared in a vision and encouraged him. At the same time, a bird landed right in front of his face and he knew he was being loved through the experience.

Another time he recounted how in the midst of unbearable suffering, he suddenly imagined himself in a lovely bright, warm lecture hall giving an uplifting talk to a room filled with people. (That image did of course, come to pass many times.)

After his liberation from Turkheim, the last camp he was in- and discovering how each of his family members died, he wrote a poem in 1946. Some of it goes like this:

“So it is for me now to erase the debt of your extermination…

You’ve given me the silent charge to live for you…

Until I hear that every bird’s song is your voice

Sounding out to bless me and perhaps to say

That you forgive me that I live.”

During this deep grief, a physician friend, fearing he might commit suicide had him sign a blank piece of paper: His friend used that signature to apply for Frankl to head the neurology department at the Vienna Policlinic Hospital- a post that he received and held for the next 25 years. He’d poured his grief into dictating The Doctor and the Soul- day and night, often collapsing and weeping from the painful memories.

I believe it’s appropriate here to recount Dr. Frankl’s split from Freudian psychoanalysis before he was deported to Theresienfelt. While Frankl had great respect for Freud and his ground-breaking work, he felt that Freud objectified patients, seeing them as “mechanisms,” and thus “degraded the self. “ And when the therapist “sets out to repair the ‘mechanism,’ the wholeness of the human person is destroyed.” He felt that “depth psychology followed man into the depths of his instincts, but too little into the depth of his spirit.”

He liked to joke that he believed in “height psychology”- especially after he learned to fly in San Diego, during the time he held a chair at the United States International University in La Jolla.

In his book, The Unconscious God: Psychotherapy and Theology , (’48; Eng. ’75) he posits an instinctual unconscious and a spiritual unconscious. We know about the instincts, but Dr. Frankl suggests that the spiritual unconscious consists of moral conscience, love and art.

“The existential core of the human is the center of spiritual activity,” he wrote, his essence. So, Values, Love and Art, Frankl asserted, are a part of the spiritual unconscious.

Frankl was constantly making a plea, a passionate plea, that pathologizing patients be stopped; that focusing on the past must move to a focus on the future- “the meanings to be fulfilled by the patient in the future. “ He worked tirelessly because of the “compassion I feel toward the victims of today’s cynicism, which has infested psychotherapy.” In Logotherapy he practiced a meaning-centered psychotherapy. When he opened his youth counseling centers, “I tried to forget what I had learned in psychoanalysis and individual psychology so that I could LEARN FROM LISTENING TO MY PATIENTS and find out how THEY managed to improve their conditions. “

And later, he knew how important a focus on a future vision could be because he knew those visions are what kept him going in the camps, knew they kept him alive. He imagined seeing his wife again, finding his mother alive and kneeling to kiss the hem of her dress.

While most of us could easily declare that we would die for those we love, Dr Frankl asks us to consider how much suffering we would endure in order to live for those we love or those who love us, or for a cause. He quoted Nietzsche, “He who has a Why to live for can bear almost any How.”

Freudian psychoanalysis posits a “will to pleasure,” which is the focus of children.

Adlerians assert a “will to power,” which is the focus of adolescents.

Existentialists believe that it is “the will to meaning” that mature adults wish to discover. Frankl wrote: “The goal of psychotherapy is to make the patient aware of what he really longs for in the depths of his self.”

Components of Frankl’s Philosophy

There are three main components at the heart of the Frankl’s philosophy:

  1. Each person has a healthy core self.

  2. The primary focus of therapy is to enlighten a person to their own internal resources and provide them with the tools to use this inner core self.

  3. Life offers us purpose and meaning; it does not owe us a sense of fulfillment or happiness. Each individual is responsible to discover their life’s meaning. Happiness is the result.

This sounds like Positive Psychology and indeed, Dr. Frankl’s grandson, Alexander, who I had the pleasure of interviewing earlier this year in Los Angeles, suggested the same- that his grandfather spoke the foundations of positive psychology, consistently emphasizing a person’s strengths to help them deal with trauma. He exemplified the most outstanding characteristic of Human Resilience--- Optimism. He always made the Conscious Choice to try to influence a positive outcome. He always looked for what was Right about life. A subtitle to one of his early book editions was, “Say Yes to Life in Spite of Everything!”

Frankl acknowledged that he had “intrusions” or flashbacks and nightmares for the rest of his life, but he’d wake up and think, “Yes, I’m alive. It’s the bad times that make the good ones so meaningful.”

What can we learn for our own work from his determination to find meaning in every experience? He saw thousands of suicidal people, sometimes for only one session. What do you say to a woman whose only child, a 17 yr old son, was murdered and she has no desire to keep living?

I provide services to the Resource Center for Victims of Violent Death in Albuquerque. The clients there are mainly parents of murdered children. I was asked to meet with Maria, I’ll call her, at one of our open houses. We sat down at a small table in a tiny room and I began to ask her questions. She mumbled her answers, looking down at the table, never at me.

She told me that she was living in Los Angeles and that her son, Angelo, was shot and killed by a gang member right outside of their house. The killer had never been arrested. She finally decided to move back to Albuquerque and care for her elderly father. The trouble is, she said, that most mornings she can’t get out of bed. And even when she can, she’s terrified to leave the house. So she hasn’t been buying groceries.

I asked Maria if she is a religious person- does she believe in God? “Yes,” she answered, “I’m Catholic.”

“And do you believe then that Angelo is in heaven?”

“Yes,” she said emphatically.

Then, I want you to do something, I told her. “I want you to write a letter to Angelo telling him about all the things about him you loved and what a gift he was in your life. Will you do that?”

She nodded, yes.

“The next day,” I said, “I want you to write a letter back to yourself

from Angelo telling you all the things he loves about you, and what a gift you are in his life. He’ll tell you what he wants for you in your life now. And then you must do what he asks and honor him in that way. Will you do that?”

Maria looked up at me with wide eyes. “I can do that?” she asked.

“Yes, you must.”

She nearly leaped across the table to give me a huge hug. “Thank you,” she said, and left.

There are three main Logotherapy techniques, and it was the first one

I used with Maria, de-reflection. I shifted her attention away from her own internal grief to what her son would want for her to be doing in her life now.

  1. De-reflection – is redirecting attention away from the self.

  2. Paradoxical intention – is actually asking for the thing we fear the most. For those with anxiety or phobias, using humor, they can wish for the thing they fear the most, and thus remove the fear and the anxious symptoms.

  3. Socratic dialogue – is using the person's own words along with questions as a method of self-discovery.

Dr. Frankl used all of these methods masterfully, and there are entire books that illustrate case examples. But I’ll share one example of his use of Socratic dialogue that I love: An elderly woman was in hospital, dying of a terminal illness. The staff was concerned as she had become depressed and withdrawn. Dr. Frankl was asked to see her. He sat down and began asking her about her life. She said she really hadn’t accomplished anything. She’d never married and had no children. When he pressed further, he discovered that she had been a nanny for many years to a family of four children. He extolled her virtues and then declared that her life had been a monument to the importance of love and nurturing.

It was reported back to Dr. Fankl that her depression dissolved following that meeting. The last note in her chart was that just before her death, she said, “My life is a monument.”

One definition of resilience used in psychology is, “the capacity to cope with adversity or even catastrophe and return to homeostasis afterward.” I was surprised to learn that Dr. Frankl did not believe that homeostasis was a desired state! He believed that a certain amount of stress and tension was important for growth, for actualizing one’s values. He believed that responsibly handling challenges and suffering raises man “from being a victim of life to achieving victory.”

I believe that Viktor Frankl was victorious in every area of his life. One of the last photographs of him shows him climbing a mountain at age 70! He seemed to consistently make the impossible possible! How can you use his philosophy of responsible optimism and belief in the power of love to effect changes in your life? How might you even make something you previously thought impossible possible?