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Adam Moscoe

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Critique

The Doctor and the Soul by Viktor E. Frankl

(Translated by Richard & Clara Winston)

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Written for:

Dr. Peggy Kleinplatz

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University of Ottawa

March 2011

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 Viktor E. Frankl, a leading luminary of Twentieth Century psychology, published no less

than 32 books during his lifetime. The Doctor and the Soul is his most comprehensive defense of

logotherapy — far more empirical than his undisputed bestseller Man’s Search for Meaning —

and is a classic for students of psychotherapy. It was originally published in 1946 in German,

only one year following the end of the Second World War and Hitler’s Holocaust, of which

Frankl was a survivor. In fact, Frankl entered the Auschwitz concentration camp carrying under

his arm his manuscript for this book, soon to be confiscated. Against a backdrop of systematic

death, a worrisomely ill Frankl spent many late nights before liberation reconstructing the

manuscript on scraps stolen for him by a fellow prisoner. Around him, he saw core tenets of

logotherapy manifesting themselves in the prisoners of the concentration camps, as they oriented

towards a “will to meaning” which Frankl believes enabled their — and his — survival. I have

thoroughly enjoyed immersing myself in The Doctor and the Soul, having grown up under the

spiritual leadership of Rabbi Dr. Reuven P. Bulka, a student of logotherapy whose research on

the technique of “dereflection,” which will be explored with regards to sexual anxiety and “self-

observation,” is cited in this book (Frankl 298). I will present an evaluation of Frankl’s success in

meeting his objectives, and will locate his theoretical framework in the context of competing

schools of thought during Frankl’s time. I will also offer a detailed analysis of Frankl’s theory as

it relates to love and sexuality.

Frankl views psychotherapy as the art and science of orienting a client towards awareness of his

responsibility to complete concrete life tasks, through which he can actualize creative,

experiential and/or attitudinal values (Frankl 51). In its simplest terms, it is a theory of

empowerment and recognition of the power and potentialities of humans. Fittingly, this respect
and confidence with which Frankl treats each patient translates into ethically sound

methodologies. Frankl maintains that every life is worth living and can be purposeful, and as

such he firmly opposes the practices of suicide and euthanasia (Frankl 52). For Frankl, a

psychotherapist must serve as an “agent of the sick man’s will to live” (Frankl 59), guiding him

to experience the full extent of conscious human freedom — that is, freedom to accept

responsibility. In finding aim and purpose in life — such as Frankl’s own case of walking out of

a concentration camp and publishing a revolutionary text in psychotherapy — he embraces his

irreplaceability and uniqueness. This should give him the confidence to meet the task-based

“demands of each day” (Frankl 65) and ultimately, carve an existential mission for his life.

Rather than ask ‘what is the meaning of life?,’ he should understand it is he who is due to

respond to the questions posed by life.

Frankl writes in the vein of humanistic psychotherapy, examining existential issues such as the

meaning of life and death. The book contains a blend of spiritual and individualistic values,

“mirroring the prevalent Western values of the post-war period” (Papadima 542). The Doctor

and the Soul derives reliability through its consideration of the biological, psychological, and

sociological aspects of humanity and his destiny. This “biopsychosocial” interactionist

perspective is indeed aligned with current holistic methods in psychology. In his discussion of

destiny and “neurotic fatalism,” Frankl speaks to the dangers of humans blaming their

weaknesses on them having a certain psychological, racial, or class-based label. (Frankl 98). He

also accuses the Adlerian school of Individual Psychology for endorsing this line of thinking.

Here, Frankl too swiftly dismisses the constraints posed by one’s environment. Situational and

characterological factors such as race, culture, class and family do have an important influence
on development that is often less escapable than Frankl contends. His view that only neurotic

fatalists blame childhood educational and environmental influences for their current state and

weakness of character (Frankl 94) neglects to give attention to much of what has shaped a

person’s life. This betrayal of the aforementioned holistic “biopsychosocial” perspective is the

most severe instance of theoretical inconsistency in The Doctor and the Soul. However, I agree

strongly that an unpleasant upbringing should motivate an individual to put forth extra effort to

surmount these obstacles from his past or present, and take an affirmative attitude toward life.

The opposite effect, that of using such externalities as scapegoats, is deeply problematic and

intolerably lazy. We are not slaves to our biological disposition or sociological situation, and thus

we are acting as neurotic fatalists when we hold this position accountable for how we evolve or

behave. “The man who believes his fate is sealed is incapable of repealing it” (Frankl 87), and I

would add, reclaiming consciousness of responsibility. For this leads to a state of apathy, of

“resting on our laurels” (Frankl 130).

Throughout the book, Frankl articulates his diametric opposition to Sigmund Freud’s school of

psychoanalytical thought and its notion of man’s “id”-driven “instinctivity” culminating in

“neurotic fatalism” (Frankl 87). In Frankl’s logotherapy, the ego represents freedom of will, and

can make decisions independent of the id, which stands for weakness of will. He objects to a

“nihilistic” presentation of humanity as “an automaton of reflexes, as a mind-machine, as a

bundle of instincts, as a pawn of drives and reactions, as a mere product of instinct, heredity, and

environment” (Frankl 19). This foreshadows Frank’s vocal opposition to the “pleasure principle”

in his chapter on love, which will be discussed. Additionally, I support Frankl’s criticism of

‘psychologism,’ the tendency to reduce all human behaviours to psychic causes. Frankl was long
plagued by these concerns, especially as psychology programs had begun to copy medical

schools with regards to their subscription to reductionism. In response, he began a crusade to re-

humanize psychotherapy. I empathize with Frankl, and am reminded of my own dissatisfaction

with early Twentieth Century social psychological thinking, obsessed with the fragmentation of

human action into scientifically-managed components. Frankl boldly accuses these nihilists

(including Freud) as championing the line of thinking responsible for the systematic, scientific

Holocaust. This unwarranted claim may be explained, but not excused, by the author’s

experiences in the Nazi concentration camps.

The most sweeping criticism of The Doctor and the Soul lies in what some readers consider to be

Frankl’s presumption of the necessity of believing in a supreme, all-knowing God, in order to

achieve the author’s definition of ultimate purpose in existence. He appears to impose even

further limitations by restricting this state of being to monotheist faiths, saying that

monotheism’s greatest achievement is the conveying to humans the permanent consciousness of

a divine authority, the absence of which cannot be supplemented. Throughout the book, belief in

God offers significant relief to Frankl, his fellow concentration camp inmates (many of those

who survived, at least), and his own clinical patients. However, Frankl does clarify that there are

alternative routes to accessing the spiritual aspects of existence. There are other sources of

“authority” to guide humanity, though they are likely incomparable to God. Moreover, the book

contains a great deal of discussion surrounding the role of the therapist in bringing man into the

“spiritual realm” or, for instance, the possibility of treating obsessional neurosis in “spiritual

terms” (Frankl 194). The reader is at times left to ponder what constitutes this seemingly

untouchable world. Yet I believe this process of bewilderment and contemplation is intimately
connected with Frankl’s grand intention. When one considers all that which is essential to his

fulfillment — be it his child, his occupation, or his monthly practice of delivering blankets to the

homeless — he comes closer to grasping the concrete tasks which for him constitute a

meaningful life. During this exercise, he may begin to experience God as the

“taskmaster” (Frankl 71) who has assigned to him this mission. Frankl’s logotherapy facilitates

this patient-centric process.

Frankl maintains that “man cannot really exist without a fixed point in the future” and illustrates

this using the case of the concentration camp and the “futurelessness” (Frankl 99) embodied by

the majority of inmates. The source of this surrender to the “physico-psychic influences” of their

unforgiving environs is a breakdown of their system of “spiritual support” (Frankl 98). Indeed,

many prisoners famously shook their fists at the God which allowed this suffering to be brought

upon them, as so poignantly documented by Elie Wiesel. This self-imposed disconnection from

God meant that their former “fixed point in the future” — the obligation to serve God at every

moment while simultaneously anticipating the afterlife (olam haba) — went abruptly out of

focus. Meanwhile, the liberated prisoner “enjoys the precious feeling that...there is nothing left in

the world that he need fear — except, perhaps, his God” (Frankl 104). In this way, Frankl and

other inmates differentiated themselves from the mass through their ability to set personal and

community goals and adopt a “spiritual attitude” (Frankl 98) about their present and future.

I return briefly to the notion of humanity’s finite existence being directed outwards to someone

or something. Frankl offers a beautiful metaphor for this capacity for “self-

transcendence” (Frankl 294) that demonstrates the breadth of his thinking and the strength of his
fascinating with the human condition. The ability of the human eye to process the outside world

is ironically reliant on its inability to perceive itself in whole or in part. Furthermore, those rare

times when the eye can see a part of itself are cases of malfunction — a cataract or glaucoma.

This suggests the essence of Frankl’s thesis - that man actualizes his humanity “to the extent that

he overlooks and forgets himself by giving himself to a cause to serve or another person to

love” (Frankl 294). I believe the author is apt to protest against the fields of psychoanalysis and

behavioural psychology for largely ignoring this quality of “self-transcendence.”

The line between religion and medicine is surprisingly fine, considering the conventional

wisdom of Frank's time — and often today’s — which polarizes faith and science as two

opposing realms. These intersections are most intensively explored in a late chapter entitled,

“From Secular Confession to Medical Ministry.” Frank emphasizes the ethical dillemma of a

decidedly non-religious person turning to his physician yearning for answers to existential

questions usually delegated to the spiritual realm. Here again, the author responds to his critics

and denies any attempt to be a “surrogate for religion” (Frankl 271). Rather, he pledges to open

this conversation in order to extend medicine and psychotherapy into the spiritual sphere — a

familiar concept, by this point. I fully support this bold, integrated perspective. Admittedly, it

was ahead of its time.

***

We now turn to an exploration of Viktor Frankl’s contributions to the field of sexology, as

outlined in The Doctor and the Soul. With reference to key elements of logotherapy, I will

evaluate the authors’ reasoning on the nature of love, sexuality, and psychosexual development.
For Frankl, love is the actualization of experiential values — that is, experiencing another person

in all her uniqueness and singularity (Frankl 132). A lover develops an awareness of his concrete

life task as he becomes indispensable and irreplaceable to another person. Frankl once again

radically departs from Freudian notions of the “pleasure principle” and of sex as no more than

instinctual gratification — a will to pleasure that is an end in itself. The experience of love is

firmly within the spiritual realm of arousal, in contrast to the lesser physical arousal and psychic

arousal or eroticism. Frankl repeatedly emphasizes that true love means loving not just what a

partner has, but what she is. Thus, physical attraction is not the sole ingredient in love, and this

appears to be good news for self-conscious individuals, this writer included. Meanwhile, our

marketing and media-fueled society does not accept, let alone project, this concept of loving the

whole of a person, including his potentialities that lie far beyond the current moment or

impression. Our society’s unceasing emphasis on physical attraction overshadows the ingredients

of meaningful arousal, ultimately devaluing the human capacity for love. Abundant criticism of

our hyper-sexualized society is concerning when combined with the prevailing notion of sex as

an instinctual gratification of physical arousal, when it should be the expression of the singularity

and irreplaceability of love between two specific individuals. This is the most concrete

illustration of Frankl’s opposition to Sigmund Freud. In light of Frankl’s theory, I am reminded

that jealousy truly has no place in a strong relationship. The root of this self-fulfilling prophecy

called jealously is a perverted notion of wanting to “have her all to myself,” when the reader has

learned that love is not a commodity to be possessed, or for that matter, replaced. Furthering the

notion of love as the experience of all that a person is (and all that he has the potential to

become), Frankl outlines his two objectives of marriage, which, interestingly, run counter to each
other. In today’s prevalent society of serial monogamy, one is instructed to be faithful to his

current partner, while also keeping one eye open, seeking the right partner. I would draw a clear

parallel to the phenomenon of career networking, in which one must balance the necessary

commitment to his current position and loyalty to his present superiors, while always being on

the lookout for a possible advancement. Issues surrounding marriage will be further explored.

Frankl’s depiction of psychosexual development can be criticized as out of pace with current

knowledge regarding child development. His assertion that sexual development begins in puberty

reflects the thinking of his time, whereas today there is enhanced research observing “sexual”

behaviour in early childhood. Frankl notes a progression from sexual urge to sexual instinct to

sexual striving, seeing increased intentionality from one sexual phase to the next (Frankl 162).

Like the model proposed by Zilbergeld and Ellison, Frankl emphasizes desire as a factor in

sexual response, yet he shows how this desire is, upon maturity, directed toward a definite

person. This outward focus is consistent with the aforementioned tenet of logotherapy known as

self-transcendence. Meanwhile, Frankl has been accused of preaching abstinence, when really he

is pleading with youth to engage in sexual relations when they are psychosexually mature, and

truly in love. Frankl completely refutes the oft-heard suggestion that ‘it’s just a bit of

unimportant sex’ and demonstrates the implications of sex on living a meaningful existence

consistent with one’s attitudinal values. Similarly, Frankl promotes monogamy not merely on

account of God’s commandment, but because this sexual attitude emerges from true love, and

offers a source of fulfillment for which promiscuity does not, by definition, allow. Monogamy is

“the culmination of sexual development, the goal of sexual education, and the ideal of sexual

ethics” (Frankl 165). Sexologists may take issue with this implicit intolerance for open sexual
relationships, as well as his affirmation of gender role stereotypes. However one must understand

Frankl in the context of his post-Second World War, Westernized, temporally and religiously-

informed position. On an immediate level, it is easy for this writer to appreciate Frankl’s views

on sexual development, since I share his allegiance to Western conservative Judaism and its

inherent values and traditions. Yet a broader perspective of sexology in cultures around the world

creates numerous questions for readers of The Doctor and the Soul.

There exists a large body of research in sexology which investigates the phenomenon

‘spectatoring’ — neurotic anxiety surrounding one’s interminable evaluation of his own sexual

performance. This compulsive inclination to self-observation — an inability to experience one’s

partner ‘in the moment’ — has been attributed to poor satisfaction in sexual relationships

(Trapnell 97). Viktor Frankl has much to contribute to this discussion, particularly his work

countering the vicious cycle of “anticipatory anxiety” and “hyper-reflexion” through a

logotherapeutic technique named “dereflection” (Frankl 255). I refer to this condition as a

vicious cycle since the fear of an event occurring ironically brings it about, leading to increased

anxiety. Patients may fear their own obsessions and compulsions, as well as their own perceived

capacity to develop a critical psychotic condition, or submit to suicidal tendencies.

“Dereflection,” an offspring of the primary technique, Paradoxical Intention, is remarkably

effective in reducing anticipatory anxiety related to sexual neuroses. Moreover, it has been

suggested that dereflection is an early model of the approach to sex therapy led by Masters and

Johnson (Bulka 106). These tools of psychotherapy appear to be more impactful here than in

addressing life-threatening neurotic conditions, wherein anti-psychotic drugs are necessary and,

as Frankl admits, are likely more influential than logotherapy. The reader is reminded that
motivating oneself to change — say, to control self-observation during sex — is a significant

milestone of the treatment regimen. Therefore, we see logotherapy as grounded in nothing more

lavish or lofty than basic human potentialities.

Viktor Frankl emphasized how consummation of love can give both partners access to the

spiritual realm, as each partner “wishes to be worthy of the other, to become like the other’s

vision of him” (Frankl 150). I would add that each lover therefore becomes conscious of the

belief that all humankind was created in the image of God, in accordance with the Torah and the

Old Testament. This would seem the appropriate moment to re-introduce the work of Rabbi Dr.

Reuven Bulka in identifying bridges between Frankl’s theories as applied to marriage, and

ancient Jewish teachings. Bulka views love as “the selfless orientation towards the other in an

authentic expression of self-transcendence” which allows for the “actualization of one's

destiny” (Bulka 111). One is reminded the requirement to go beyond the self “toward an ethic of

[mutual] self-transcendence” (Bulka 107) catalyzed by love, in order to improve prospects for a

successful marriage. Schulenberg et al applied this understanding of love to develop a

logotherapeutic approach to marriage counseling, “meaning-centered couples therapy

therapy” (Schulenberg 95). These techniques borrow directly from Frankl’s theories related to

self-transcendence, and awareness and actualization of values. (Refer to their “Value Awareness

Technique” and the “Value Auction” program.) They aim to reinforce “an unselfish love where

the partner is experienced and appreciated as unique” (Schulenberg 96). This work, conducted in

2009, also contributes substantial evidence pointing to the continued relevance of Viktor Frankl

in the field of psychotherapy in the Twenty-First Century.

Moving forward, Rabbi Bulka expands on the congruence between logotherapy and Judaism,

focussing on marriage as a “shared destiny” which actualizes the will of God as conveyed to the

Jewish people. The members of a happily-married Jewish couple view one another as “the

duality who make possible the expression of value in the shared destiny framework” (Bulka

108). Meanwhile, Bulka is concerned with increased narcissism in marriages, a shift from “we”

to “me” — the antonym of the lifestyle loudly promoted by “Free The Children” founders Craig

and Marc Kielburger (authors of the manifesto, “Me to We.”) Bulka and Frankl are, I feel,

correct in jointly condemning the attitude put forth by many feminists or sexists that one should

aim for orgasm not to sanctify and strengthen a union, but to derive singular pleasure. Rather, as

has been discussed, marriage is an outward phenomena with a fixed point in the future. It

demands a great deal of responsibility from both partners, yet the embrace of this hefty load

brings fulfillment in the spiritual realm of life. For believers, this is one avenue of meeting the

expectations of God.

***

While The Doctor and the Soul is primary an overview of Viktor Frankl’s logotherapy — in

theory and in practice — there are a number of vignettes chronicling the patient’s pursuit of

meaning in life. I will not soon forget the following poignant tale. A nurse described to Frankl

how a twenty-two year-old female, who had been critically injured in an accident with a gunshot,

would scan the daily news for reports of troubled individuals. Using a mouthstick, she would

type them letters of comfort. For me, this brief story validated my reading of The Doctor and the

Soul, convincing me that meaning is infinitely attainable when humankind wards off the easy

seductiveness of apathy. I would highly recommend this book to not only students and
practitioners of clinic psychology and sexology, but also to individuals who have felt a lack of

fulfillment from life or from relationships, or a disconnection from their core experiential,

creative or attitudinal values. To those who resist Frankl’s texts, alleging their inadmissibility due

to their presumption of the existence of a single God, I challenge them to read The Doctor and

the Soul, and see what degrees of meaning and focus they can derive — in spite of their distance

from Frankl’s own monotheism.

Reference List

Bulka, R. P. (1981). Some Implications of Jewish Marriage Philosophy for Marital Breakdown.
Pastoral Psychology. 30(2). pp. 103-112.

Frankl, V. E. (1986). The doctor and the soul: From psychotherapy to logotherapy (Rev. ed.).
New York, NY: Vintage.

Papadima, M. (2004). Book reviews: The doctor and the soul. Psychology and Psychotherapy:
Theory, Research and Practice. 77(1). pp. 541–547

Schulenberg, S.E., Schnetzer, L.W., Winters, M.R., Hutzell, R.R. (2009). Meaning-Centered
Couples Therapy: Logotherapy and Intimate Relationships. Journal of Contemporary
Psychotherapy. 40(2). pp. 95-102.

Trapnell, P.D., Meston, C.M., Gorzalka, B. B. (1997). Spectatoring and the relationship between
body image and sexual experience. Journal of Sex Research. 20(2). pp. 93-110.