The Doctor and the Soul

Just notes from book The Doctor and the Soul: From Psychotherapy to Logotherapy written by Viktor E. Frankl:

• p8 If we take people as they are, we make them worse. If we treat them as if they were what they ought to be, we help them to become what they are capable of becoming. --Johann Wolfgang von Goethe
• p9 What, ultimately, does psychoanalysis hope to accomplish in its treatment of neurotics? Its alleged goal is to help bring about a compromise between the demands of the unconscious on the one hand and the requirements of reality on the other.
• p9 In contrast, the goal of individual psychology goes deeper. Beyond mere adjustment, it demands of the patient a courageous reshaping of reality; to the id's "must" it opposes the ego's "will." But we must now ask ourselves whether these goals are all there are; whether a break-through into another dimension may not be permissible, or even requisite in order to yield a true picture of the total psycho-physico-spiritual entity which is man. Only then shall we be in a position to help the suffering human person entrusted to us, and trusting us, to achieve his own wholeness - and health.
• p13 Every psychotherapist knows how often in the course of his psychiatric work the question of the meaning of life come up.
• p15 We repeat: the psychic health or illness of the holder of a world-view has no bearing on the correctness of incorrectness of that view. Two times two equals four even if a paranoiac makes the statement. Our evaluation of idea does not depend on the psychic origins of those ideas.
• p17 We would certainly not be entitled to brand something as "true" because it was "healthy" or, vice versa, something as "false" because it was "sick."
• p21 For when man opposes the limitations of nature, when as a human being he "takes a stand" on them, when he ceases to be subjugated and blindly obedient to the constraints imposed by the biological factor (race), the sociological factor (class), or the psychological factor (characterological type) - only then can he be judged morally.
• p22 In striking and conscious contrast to pagan thought, it is held that a man can be ethically judged only where he is free to decide and to act responsibly; he is not to be judged where he is no longer free.
• p25 Psychotherapy endeavors to bring instinctual facts to consciousness. Logotherapy, on the other hand. seeks to bring to awareness the spiritual realities. As existential analysis it is particularly concerned with making men conscious of their responsibility - since being responsible is one of the essential grounds of human existence. If ti be human is, as we have said, to be conscious and responsible, then existential analysis is psychotherapy whose starting-point is consciousness of responsibility.
• p26 Whether expressed or implicit, this is an intrinsically human question. Challenging the meaing of life can therefore never be taken as a manifestation of morbidity or abnormality; it is rather the truest expression of the state being human, the mark of the most human nature in man.
• p39 "The most certain science is conscience."
• p40 Only when the emotions work in terms of values can the individual feel pure "joy." This is the explanation of why joy can never be an end in itself; it itself, as joy, cannot bu purposed as a goal. How well Kierkegaard expressed this in his maxim that the door to happiness opens outward. Anyone who tries to push this door open thereby causes it to close still more.
• p43 For even though only a single moment is in question - the greatness of a life can be measured by the greatness of a moment: the height of a mountain range is not given by the height of some valley, but by that of the tallest peak. In life, too, the peaks decide the meaningfulness of the life, and a single moment can retroactively flood an entire life with meaning.
• p52 ... human freedom is not a "freedom from" but a "freedom to"
• p69 Instinctual gratification and biological reproduction are, after all, only two aspects of marriage - and not even the most important ones. The spiritual factor of love is more essential.
• p69 If all man were perfect, then every individual would be replaceable by anyone else. From the very imperfection of men follows the indispensability and inexchangeability of each individual; for each is imperfect in his own fashion. No man is universally gifted; but the bias of the individual makes for his uniqueness.
• p69 A bilogical example will make this clear. As is well known, when one-celled life forms evolve into many-celled organisms they pay the price of losing their immortality. They also sacrifice their omnipotence. They exchange all-aroundness for specificity.
• p70 But an individual existence not only must have the community in order to become meaningful; vice versa, the community needs the individual existence in order for it itself to have meaning. Therein lies an essential distinction between community and the mere mass.
• p72 By escape into the mass, man loses his most intrinsic quality: responsibility. On the other hand, when he shoulders the tasks set him by society, man gains something - in that he adds to his responsibility. To escape into the mass is to disburden oneself of individual responsibility.
• p73 When it comes to evaluating people, collectivism leads us astray.
• p76 During no moment of his life does man escape the mandate to choose among possibilities. Yet he can pretend to act "as if" he had no choice and no freedom of decision. The "acting as if" constitutes a part of the human tragicomedy.
• p79 To have been is the "safest" form of being. By being past, possibilities are saved from passing away; only unrealized possibilities pass away.
• p82 The eternal combat between man's spiritual freedom and his inward and outward destiny is what intrinsically makes up his life.
• p97 Freedom is not something we "have" and therefore can lose; freedom is what we "are."
• p105 While the values of the first category are actualized by doing, experiential values of the first category are actualized by doing, experiential values are realized by the passive receiving of the world (nature, art) into the ego. Attitudinal values, however, are actualized wherever the individual is face with something imposed by destiny. From the manner in which a person takes these things upon himself, assimilates these difficulties into his own psyche, there flows ans incalculable multitude of value-potentialities. This means that human life can be fulfilled not only in creating and enjoying, but also in suffering!
• p108 Suffering therefore establishes a fruitful, one might say a revolutionary, tension in that it makes for emotional awareness of what ought not to be. To the degree that a person identifies himself with things as they are, he eliminates his distance from them and forfeits the fruitful tension between what is and what ought to be.
• p109 But activity does not exist for the purpose of our escaping boredom; rather, boredom exists so that we will escape inactivity and do justice to the meaning of our life.
• p110 But the act of looking at something does not create that thing; neither does the act of looking away annihilate it.
• p111 There is a type of melancholia in which sadness is conspicuous bu its absence. Instead, the patients complain that they cannot feel sad enough, that they cannot cry out their melancholy, that they are emotionally cold and inwardly dead. Such patients are suffering from what we call melancholia anæsthetica. Anyone acquainted with such cases knows that greater despair can scarcely exist than the despair of such person because they are unable to be sad.
• p113 "Life is not anything; it is only the opportunity for something." --Hebbel
• p118 The work in itself does not make person indispensable and irreplaceable; it only gives him the chance to be so.
• p118 ... the job at which one works is not what counts, but rather the manner in which one does the work.
• p127 "Where love is lacking, work becomes a substitute; where work is lacking, love becomes an opiate." --Alice Lyttkens
• p127 The person who is wholly wrapped up in his work, who has nothing else, needs that week-end bustle. In any city, Sunday is the saddest day of the week. It is on Sunday, when tempo of the working week is suspended, that the poverty of meaning in everyday urban life is exposed.
• p129 To the person hungry for excitement the greatest possible sensation is death - in art as well as in reality. The dullard newspaper-reader sitting at his breakfast table is avid for stories of misfortune and death. But mass misfortunes and deaths en masse cannot satisfy him; apparently the anonymous mass seems to abstract. And so your newspaper-reader may feel the need to go to a movie and see a gangster film. His pattern is like that of every addict: his hunger for sensation requires a nervous jolt to satisfy it; the jolt to the nerves engenders a more intense hunger, and so the dose must be constantly stepped up. What such a person really gets out of these vicarious deaths if the contrast effect: it seems as though other people are always the ones who must die. For this type of person is fleeing what most horrifies him: the certainty of his own death - which his existential emptiness makes unbearable to him. The certainty of death terrifies only the person who has a guilty conscience toward his life.
• p132 Love is living the experience of another person in all his uniqueness and singularity.
• p141 In fact love is only one of the possible ways to fill life with meaning, and is not even the best way.
• p144 For where the quality of happiness in love is lacking, the lack must be compensated by quantity of sexual pleasure.
• p149 "Love sees a person the way God meant him." --Von Hattingberg
• p150 Awareness of values can only enrich a person. In fact, this inner enrichment partly constitutes the meaning of his life, as we have seen in our discussion of experiential values. Therefore, love must necessarily enrich the lover. This being so, there can be no such thing as "unrequited, unhappy love"; the term is self-contradictory. Either you really love - in which case you must feel enriched, whether ot not the love is returned; or you do not really love, do not actually intend the inner being of another person, but rather miss it completely and look only for something physical "about" him or some (psychological) character trait which he "has."
• p185 The logotherapist is not concerned with treating the individual symptom or the disease as such; rather, he sets out to transform the neurotic's attitude toward hi neurosis.
• p185 Pressure generates counterpressure.
• p197 "The intellect, like an opera glass, should only be turned up to a certain point; if you screw it any farther, you see more hazily" --Leo Tolstoy
• p213 ... the act of knowing makes the subject into an object.
• p221 "The only thing we have to fear is fear itself." --Franklin D. Roosevelt
• p225 I would venture to say that humor also deserves to be mentioned among the basic human capacities. After all, no animal is able to laugh.
• p241 A.V., aged forty-five, married and the mother of a sixteen-year-old son, had a twenty-four-year history of phobic neurosis consisting of severe claustrophobia, such as fear of riding in cars or elevators, of heights, and of crossing bridges. She also had a fear of collapsing, of leaving the house, of open spaces, of being alone, and of becoming paralyzed. ... She spent the last four years in a state hospital, where she remained continuously in a disturbed ward. Again she received electro-shock therapy and intensive drug therapy, with barbiturates, phenothiazines, MAO inhibitors, and amphetamine compounds; all to no avail.
• p254 However, there are patients whose sleep is disturbed so that they are awakened early in the morning by a noisy neighborhood, for instance, and cannot sleep further because of anger at their neighbors and their hyper-intention to fall asleep again. I advise such patients simply to imagine that they are urged to leave their bed to do something disagreeable - for example, shoveling snow or coal at five o'clock in the morning. It they yield to this fantasy, they suddenly feel so tired that they fall asleep again.
• p276 The physician should never be allowed to take over the patient's responsibility; he must never permit that responsibility to be shifted to himself; he must never anticipate decisions or impose them upon the patient. His job is to make it possible for the patient to reach decision; he must endow the patient with the capacity for deciding.
• p291 In 1960 I had arrived at the conviction that "phobias are partially due to the endeavour to avoid the situation in which anxiety arise."
• p294 The normally functioning eye does not see itself, it is rather overlooking itself; likewise man is human to the extent that he overlooks and forgets himself bu giving himself to a cause to serve or another person to love. By being immersed in work or in love, we are transcending ourselves and, thereby, actualizing ourselves.
• p296 If man can find and fulfill a meaning in his life he becomes happy but also able and capable of coping with suffering. If he can see a meaning he is even prepared to give his life. On the other hand, if he cannot see a meaning he is equally inclined to take his life even in the midst, and in spite, of all the welfare and affluence surrounding him.
• p300 And I won't forget an interview I once heard on Austrian's TV given by a Polish cardiologist who, during World War II, had organized Warsaw ghetto upheaval. "What a heroic deed," exclaimed the reporter. "Listen," calmly replied the doctor, "to take a gun and shoot is no great thing; but if the SS leads you to a gas chamber or to a mass grave to execute you on the spot, and you can't do anything about it, except for keeping your head high and going your way with dignity, you see, this is what I would call heroism." He should know.