6.5. The Logotherapeutic Theory of Neuroses: V. Frankl's Three Pathogenic Patterns of Response

Logotherapy, developed by the Austrian neuropsychiatrist and philosopher Viktor Frankl, is a psychotherapeutic approach that pays particular attention to the search for meaning in life as a key factor in the treatment and prevention of neuroses and other psychological problems. Here are the main aspects of the logotherapeutic theory of neuroses:

1. Meaning in life: The central concept of logotherapy is the idea that a person strives to find meaning and values in life. Neurotic states, including neuroses, can arise when a person feels an absence of meaning and direction.

2. The existential vacuum: Frankl described a state he called the “existential vacuum” as one of the main causes of neuroses. This state is characterized by a feeling of meaninglessness and a loss of goals, which can produce psychological distress.

3. The will to meaning: Logotherapy holds that a person possesses a “will to meaning” — the capacity to actively seek meaning and values in life. Patients in logotherapy are invited to explore their beliefs, goals, and interests in order to find the meaning that suits them specifically.

4. Meaning in suffering: Frankl maintained that the capacity to find meaning even in suffering and hardship can help a person overcome neuroses and other psychological problems. Accepting suffering with dignity and meaning can strengthen psychological resilience.

5. Meaning and responsibility: Logotherapy emphasizes that a person bears responsibility for seeking and creating meaning in life. Each individual can determine his or her own values and goals and live in accordance with them.

6. Treatment through the search for meaning: Logotherapy uses methods such as conversation, reflection, and active exercises to help patients find meaning in their lives and resolve inner conflicts.

First of all, let us give a definition of the three pathogenic patterns of response.

V. Frankl called the first pathogenic pattern of response phobia, or anticipatory anxiety. What is its essence? A given symptom arouses in a person the apprehension that it may recur, and together with this arises anticipatory anxiety (phobia), which leads to the symptom actually reappearing, which only reinforces the original apprehension. Under certain conditions, the fear itself may turn out to be the very thing whose recurrence the person fears. How does a person react to the fear of fear? By flight. In the case of agoraphobia, the person simply tries not to leave the house. This is an example of the first neurotic pattern of response, the phobic type.

The second pathogenic pattern of response is observed in cases of obsessive-compulsive neuroses. A person is under the oppression of obsessive ideas and tries to suppress them. He tries to counteract them. This counteraction, however, only strengthens the original pressure. The circle closes, and the patient finds himself trapped within this vicious circle. Unlike phobia, obsessive-compulsive neurosis is characterized not by flight but by struggle — a struggle against obsessive ideas. The person is afraid of himself, since, for example, he is afraid that obsessive ideas of a criminal content will actually drive him to harm someone — another person or himself. A person suffering from obsessive-compulsive neurosis experiences not a fear of fear itself, but a fear of himself.

The third pathogenic pattern of response is found in sexual neuroses, in cases of impaired potency and orgasm. In these cases, as in obsessive-compulsive neuroses, the person is engaged in a struggle, but this is not a struggle against something (as in obsessive-compulsive neuroses — against obsessive ideas), but a struggle for — in this case, for sexual pleasure in the form of potency and orgasm. Yet the more intently we strive for pleasure, the more decisively it eludes us. The path to attaining pleasure and to self-realization leads only through self-giving and self-forgetfulness.

Logotherapy represents a unique approach to the treatment of neuroses and other psychological problems, focusing on the search for meaning in life and the active striving toward it. An important aspect of this therapy is its emphasis on the individuality of each person and his or her capacity to create meaning in his or her own life.