Research and Empirical Results
Logotherapy has significant application to every dimension of an individual (the tri-dimensional ontology). Psychologically, logotherapy uses the specific techniques of paradoxical intention and dereflection to deal with problems of anxiety, compulsive disorders, obsessions, and phobias. These will be discussed in further detail in the next section.
Physiologically, logotherapy is an effective way to cope with suffering and physical pain or loss. Spiritually, logotherapy demonstrates that life has meaning or purpose when people suffer from the “existential vacuum” that we experience as boredom, apathy, emptiness, and depression (Frankl, 2006).
1. PTSD and acute stress
One of the most effective things about logotherapy is its ability to empower individuals, allowing them to be freed from their symptoms and increase their capacity to be proactive.
Since logotherapy was founded on a preface of suffering, it is a natural therapy for treating traumatic experiences. Logotherapy is a useful treatment for individuals with acute stress disorder or post-traumatic stress disorder (PTSD).
In numerous case studies of clients with combat-related PTSD, logotherapy exercises that highlight the construct of meaning led to a significant decrease in symptoms of stress, anxiety, and depression (Schiraldi, 2000). Research on logotherapy’s effectiveness for treating PTSD has mostly been established through qualitative research and case studies.
2. Alcohol and drug treatment
There are obvious parallels between the spiritual elements of Alcoholics Anonymous and the concepts of discovering personal meaning found in logotherapy.
Frankl (2006) discussed a “mass neurotic triad” of aggression, depression, and addiction that occurs when individuals experience an existential vacuum. This vacuum leads to violations of social norms, symptoms of stress, and addiction.
The treatment for this existential vacuum is, of course, to guide the client into discovering the freedom to choose, the will to find meaning, and the responsibility of living a purposeful life (Hutzell, 1990).
Logotherapy has been effective in reducing cravings and participation in drinking among alcoholics. Additionally, logotherapy groups successfully improved the meaning of life and mental health among wives of alcoholics (Cho, 2008).
Frankl would argue that when individuals can tap into their freedom, responsibility, and life purpose, there is no longer a need or desire for mind-altering substances like alcohol or drugs.
3. Anxiety and depression
Logotherapy has successfully been used to treat depression and anxiety. One study looked specifically at depression and stress among cervical cancer patients (Soetrisno & Moewardi, 2017).
Researchers measured cortisol levels (stress hormone) and scores from the Beck Depression Inventory (BDI) among two groups of 15 patients. One group received logotherapy treatment for a total of six weeks (45-minute sessions once per week), and the control group received standard cancer treatment.
After six weeks, there was a significant decrease in BDI scores and levels of cortisol for the treatment group, while the control group had no change (Soetrisno & Moewardi, 2017). It makes sense that improving the meaning of life for cancer patients decreased their levels of stress and depression.
Logotherapy also successfully decreased measurable levels of suffering and increased the meaning of life in a group of adolescent cancer patients when compared with a matched control group (Kang et al., 2009).
Similarly, two-hour sessions of logotherapy among a group of 22 breast cancer patients significantly decreased BDI scores (Hagighi, Khodaei, and Sharifzadeh, 2012). This research demonstrated that logotherapy can be a beneficial treatment for individuals struggling through cancer or other major illnesses.
4. Group logotherapy
There is also significant research to support the use of logotherapy in group settings. Instructing both individuals and groups on the dimensions of responsibility, freedom, and values can help decrease suffering and increase various measures of psychological wellbeing.
When comparing the effectiveness of gestalt and logotherapy in a group setting of divorced women, logotherapy provided a more substantial decrease in depression, anxiety, and aggression (Yousefi, 2006).
Group logotherapy also led to increased psychological wellbeing, positive relationships, autonomy, personal growth, and mastery among mothers of children with intellectual disabilities (Faramarzi & Bavali, 2017).
3 Techniques of Logotherapy
Frankl’s efforts to humanize psychotherapy included practical techniques to use with clients with depression, suffering, chronic pain/health conditions, anxiety, phobias, obsessions, and significant life change.
There are similarities between the therapeutic techniques of logotherapy and both Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT).
1. Dereflection
The first technique is dereflection, which is aimed at helping clients focus attention away from problems and complaints and toward something positive. It is based on the concept of self-distancing and self-transcendence.
Practically speaking, it involves asking questions like “What would your life be like without X problem?”; “If everything went perfectly in your life, what would that look like?”; and “Is there anything in your life you would die for?”
2. Paradoxical intention
Paradoxical intention is an effective technique to use with phobias, fear, and anxiety.
The basis of this technique is that humor and ridicule can be useful when fear is paralyzing. Fear is removed when action/intention focuses on what is feared the most. For example, if a person struggles with a fear of rejection, they would purposely put themselves in positions where they would be rejected or told “no.”
An apt illustration is in Harry Potter and the Prisoner of Azkaban (Rowling, 1999), where young students had to face their worst fears. To conquer their fear, they had to turn the terrifying thought into something laughable, such as a big spider on roller skates, thereby ridiculing and overcoming the paralyzing fear.
3. Socratic dialogue
Socratic dialogue is a tool in logotherapy that walks a client through a process of self-discovery in their own words.
It is different from Socratic questioning, which is often used in CBT. Socratic questioning breaks down anxious or negative thoughts, while Socratic dialogue is used to find meaning within a conversation. It allows the client to realize they already have the answers to their purpose, meaning, and freedom.
As the sun cascades behind the distant mountains, it creates a beautiful array of orange, peach, and pink.
Viktor E. Frankl was a professor of neurology and psychiatry at the University of Vienna Medical School.
What our readers think
I found the topic very interesting. I wish to understand it fully.
I am a trauma survivor, I didn’t even realize, what I was dealing with for such a long time was PTSD, Disassociation, Depression, Grief and Anxiety. I found a lot of relief when I discovered that I have the power, in how I perceive my past. I listen more than I speak, unless someone wants to hear what I have to say. During COVID-19 I was deemed an essential worker, I am an Auto Technician, before and during COVID-19 I was Shop Manager, I had never felt such extreme pressure knowing that the safety of the people I work with was in my hands. I drove to work everyday with no other car in sight, until I got to work. The atmosphere was so tense, I felt where I cut into it, as I walked from my car to the building I work in, I could not understand other managers attitudes and why I questioned mine. Like a wise Philosopher once said in a moment of chaos, normal behavior seems abnormal. I encouraged everyone everyday, letting them know, this wasn’t the first time in history this has happened, just like the Philosopher King Marcus Aurelius. Everyday I had something humors to say. I am used to pressure, being I grew up around violence and witnessed a kid get shot and killed by drive a by. This wasn’t my first Rodeo. What was going on in the moment, did not phase me. I would find justification in my own way, why things happen. I continued until my back eventually gave out from so much stress. I felt guilt that I had never felt before, I kept giving happiness and hope until I lost my own, and gave into the excruciating pain that bulging disc in my lower back produce. This was the life changing moment in my life. COVID-19 in full bloom and running rampant, I did not turn to traditional medicine. Instead I found a Phycologist and Therapist that helped me get past my own internal struggles, as I have come together with myself and countless hours of reading, exercising, meditation, yoga, and Philosophy. I have come to this website. After reading your article, and understanding my own struggles, I am a firm believer Logotherapy can help so many people.
Dr. Melissa Madeson,
Thank you for your well defined points about V Frankle and logotherapy. I once led a group of seniors at a convalescent center. We discussed the meaningful moments they recalled in their lives. I encouraged the participants to write their short and focused memoirs. These writings were subsequently published in a small volume. The writers and participants took part in a public reading, with family, friends, facility staff , and public in attendance. Overall, the lectures, writing, and readings were meaningful to all involved.
Finding meaning in trauma patients’ stories help them heal. Their traumas don’t define them, they’re just facts when their stories make sense.
I am a trauma therapist and I love Viktor Frankl. This article actually helped me realize that how I work with trauma patients is actually how logotherapy help patients. Thank you.