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An Interview with Marshall Lewis, M.A., on Logotherapy

David Van Nuys, Ph.D. Updated: Jun 14th 2011

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Marshall H. Lewis, MA ABD Logotherapy or the logos, comes from the Greek word logos, which means "meaning." In general, logos refers to not just "word," as is often translated - in fact, in Greek it's usually just translated the "word" - but it is words about something. It's words that convey a meaning or an argument for the meaning of something. In this system, the "will to meaning" is the primary human motivation. Freud's pleasure principle, which can be called the "will to pleasure," and Alfred Adler's superiority goal, which can be called the "will to power" both contrast with logotherapy's "will to meaning". Logotherapy sees both the will to pleasure and the will to power as inferior variations of the will to meaning; that basically what makes us human is a desire to find meaning and purpose in our lives.

David Van Nuys: Welcome to Wise Counsel, a podcast interview series sponsored by Mentalhelp.net, covering topics in mental health, wellness, and psychotherapy. My name is Dr. David Van Nuys. I'm a clinical psychologist and your host.

On today's show, we'll be talking with licensed clinical psychotherapist Marshall H. Lewis about logotherapy. Marshall received his terminal master's degree in clinical psychology from Marshall University in West Virginia in 1986 and has practiced psychotherapy with community mental health since. He is currently the director of a community mental health center serving three counties in southwest Kansas.

Marshall notes that he is entering the second half of life both personally and professionally. This transition, he says, has marked a change toward existential and meaning-centered practice, and a shift away from the cognitive-behavioral models in which he was trained. Marshall also says he feels as if he has been called to contribute to the ongoing work of Viktor Frankl's logotherapy and existential analysis for the remainder of his career. Now, here's the interview.

Marshall Lewis, welcome to Wise Counsel.

Marshall Lewis: Thank you.

David: You've been a listener to my podcast, I think, and we've had some emails back and forth letting me know about your involvement with logotherapy.

Marshall Lewis: Yes. I discovered your podcasts last summer, and I've been a fan ever since.

David: Well, that's great. And maybe I inspired your podcasting. I know that you're a podcaster now, too, right?

Marshall Lewis: Yes, I am a podcaster, too. And it was actually through my podcast that I discovered your podcasts. One of my listeners told me about you, and - yeah.

David: Oh, great. That's how it works.

Marshall Lewis: That's how it works. Word of mouth is better than anything sometimes.

David: Right, now you've been practicing as a master's level psychotherapist for more than 20 years. Do I have that right?

Marshall Lewis: That's right. It'll be 25 years this year.

David: And right now you're finishing up a doctoral program at the Chicago Theological Seminary?

Marshall Lewis: That's right, and that's not in psychology. That's in Jewish-Christian studies. But, yes, I'm possibly going to shift careers here in the second half of my life.

David: Oh, well, I'll want to be hearing a little bit more about that maybe towards the end.

Marshall Lewis: Sure.

David: I gather your doctoral work over the past four years has focused largely on Viktor Frankl and his logotherapy, and that you're also director of a regional mental health center in Kansas, where you live. Plus, as we've mentioned, you're a podcaster and also a blogger, and you're proficient in ancient languages, namely biblical Hebrew, Aramaic, classical Greek, common Greek, and Latin.

Marshall Lewis: That's right.

David: Wow. This opens up so many interesting paths we could go down.

Marshall Lewis: I suppose. The Classical languages are part of the doctoral program in theology, of course.

David: Oh, my goodness. But that's a lot of languages to master in one doctoral program.

Marshall Lewis: That is. That is. The emphasis of that program has been biblical literature, so it's necessary to be able to read and translate the texts from the original languages.

David: Okay, well, maybe this is a good place to talk about that second career, because -

Marshall Lewis: Well, okay.

David: Yeah, because just to satisfy my curiosity. I was wondering, well, when, and how, and why did you become proficient in these ancient languages. So what is all of this pointing you toward?

Marshall Lewis: Oh, that's a very large question, David. Well, I've been interested in religion really since the beginning of my academic career. In fact, my original major, back when I was very, very young, was religious studies. I had to take a psychology course as part of that and fell in love with psychology, started practicing psychotherapy after graduate school.

Then a few years later an opportunity came open to attend the Center for Jewish-Christian Studies in Chicago, which is the only center in North America that's based on - how shall I say it? - based on the dialog between Christianity and Judaism that grew out of the Holocaust. So when that opportunity became open, I jumped at it. I think the logotherapy with Viktor Frankl ties into that since, of course, he was a Holocaust survivor.

David: Yes.

Marshall Lewis: Just as part of the residency program for the Ph.D., the languages are required. If you're going to become expert in the Bible, then you have to be able to read it and not be dependent on someone else's translation for it. So that's where all of the languages come from.

David: Yeah. Boy, what a fascinating trajectory you've had. Now, is this leading towards your wanting to become a minister of some sort?

Marshall Lewis: No.

David: Or a theological academic?

Marshall Lewis: It would be a theological academic. My interests are more academic than pastoral although, now that I've discovered logotherapy, that does open up yet another avenue where perhaps, in addition to academic work, I can focus the psychotherapy not in general community mental health like I do now, but focus the psychotherapy more specifically on the meaning-centered types of therapy that Frankl was involved with.

David: Yeah, that certainly makes sense. Well, let's just back up a little bit. What were you doing before you decided to become a therapist?

Marshall Lewis: Oh, well, before I became a therapist there wasn't much back there. I was just a young college student. Yeah. I became a therapist very young. That was my first career, so...

David: Oh, okay. And I was going to ask you what drew you to becoming a therapist. I suppose I still should, although it's kind of - it's pretty much implied in what we said before. But what did draw you to it?

Marshall Lewis: It's difficult to put that into concrete terms. The fact is I just fell in love with psychology. I fell in love with the idea of figuring out problems, of solving the puzzles, and then with the payoff of being able to apply that in a way that helped people.

David: Fascinating. And how did you become interested in Viktor Frankl?

Marshall Lewis: Now, that was - I want to say accidental, but the older I get the less I believe in accidents.

David: Right.

Marshall Lewis: But for now I'll say accidental. It was about four years ago. I stumbled across a continuing education class that mentioned Viktor Frankl as a cognitive therapy, which is incorrect. It was an error in the continuing education class, but that drew my attention and so I took it. And I realized when I read it that Frankl had laid out in concrete, practical terms the way that people could discover meaning in their lives. Of course I'd read therapies that purport to do this. Many people talk about it. But I've never seen, in any other way, a very concrete program that leads directly to that.

So I became intrigued with that. I started to read his books and really felt that logotherapy was, in a sense, something that I was called to do because it combined these two great academic interests of mine: psychology on the one hand and theology, especially Jewish-Christian studies dealing with the Holocaust, on the other hand. Here they were combined in one system of thought that addressed human suffering in a way that no other system that I've ever run across did.

David: I think it's fascinating that you thought you were signing up for a course on cognitive-behavioral therapy.

Marshall Lewis: Yes, I did.

David: And then you ended up that it was something else -

Marshall Lewis: Completely different.

David: And a life-changing something else, a completely sort of career-reorienting and life-reorienting something else. I've had similar experiences close to that, so that's just kind of the part of the adventure of being on the path.

Marshall Lewis: If I may say so, David, that's one of the reasons why I enjoy listening to your podcasts - is that I know these so-called accidental things do happen, and you and many of your guests are able to talk about them, and that's one of the things that I really enjoy hearing on your podcasts.

David: I'm really glad to hear that, and you're definitely going to want to hear an upcoming one in this series with Stan Grof, who has written a book that starts off with just an amazing series of synchronicities. But that's a bit off-topic right now.

Marshall Lewis: Sure.

David: Everyone in our audience may not be familiar with Frankl, so why don't you take us through the high points of his life - you mentioned the Holocaust - so that we're all on the same page.

Marshall Lewis: Sure. Well, Viktor Frankl was a young medical student living in Vienna at the time when the Nazis annexed Austria. Prior to that he had kept up a correspondence with Sigmund Freud when he was a high school student, so his interest in therapy began very young.

David: Wow.

Marshall Lewis: He for two years was a member of Alfred Adler's Society for Individual Psychology, although he did get kicked out of that society for unorthodox beliefs at some point. After that, he started to develop his own system, which he called existenzanalyse or existential analysis. In English it came to be translated as logotherapy - or actually renamed logotherapy.

It was just during the formative time of the development of this system that the Nazis did annex Austria, and he was - well, since he was Jewish, he was prohibited from practicing medicine generally. I believe medical licenses were suspended for Jewish doctors. He was able to stay out of the concentration camps for perhaps longer than most because he was a doctor and he was allowed to treat Jewish patients. But eventually the events of those eras caught up with him and he was incarcerated in a concentration camp. Actually, he was transferred from camp to camp and spent time in four concentration camps.

David: Wow.

Marshall Lewis: Yeah. I think it was three years, three-and-a-half years he was in the camps, where he was able to certainly apply logotherapy, as best he could, to himself and to some of his fellow inmates. Of course he was liberated. He went through a period of depression after liberation. He did eventually come out of that, where he dealt with philosophy, he dealt with a sense of meaningless and nihilism.

Then after that he went on to become a professor of psychiatry and neurology at the University of Vienna. He was director of a clinic in Vienna, and that's where he worked for the remainder of his life, also travelling around the world giving lectures on logotherapy, and writing books. He's written some 32 books, 31 of which have been translated into English so far, and one of which was just recently discovered - actually two - two of which were recently discovered in his archives that had not been published.

David: Well, I had no idea that he had written so many books. And of course I read probably his most widely-read book, Man's Search for Meaning. It's been quite a few years ago since I read it, but in there he recounted his experiences in the Nazi concentration camps.

Marshall Lewis: That's right. Man's Search for Meaning is the book that most people read when they become familiar with Frankl, and that is his more popular presentation, I suppose. The others tend to be more technical regarding logotherapy and diagnosis and so forth.

David: Right.

Marshall Lewis: But it's also ironic, in a sense - and he talks about this - Man's Search for Meaning is the only book he intended to publish anonymously, until his friends talked him into including his name in it. He was originally just going to publish that under his prisoner number.

David: Wow. Now, I was under the impression that towards the end of his life he was teaching here in the U.S. at one of the standalone graduate schools - I think USIES or something - I can't remember the name of it - in the San Diego area.

Marshall Lewis: It may be. He was a guest lecturer and guest professor at many universities. I'm sure he was in that area, because the original Institute of Logotherapy began at Berkeley. A friend of his there began it. Joseph Fabry started the Institute of Logotherapy that's now the central training institute. But it began by collecting an archive of his works there.

David: Oh, okay.

Marshall Lewis: But, yes. He may have been at San Diego also.

David: Okay. Well, as you point out, Frankl calls his approach logotherapy. Being the master of ancient languages that you are, can you explain the significance of that term? What's it meant to communicate?

Marshall Lewis: For Frankl, logotherapy or the logos - it comes from the Greek word logos, which for Frankl means "meaning." Now, logos in theology and philosophy has a very rich, rich history, going back to Plato actually. Certainly it's used within the New Testament - by Paul extensively - to refer to Christ. In general, logos refers to not just "word," as is often translated - in fact, in Greek it's usually just translated the "word" - but it is words about something. It's words that convey a meaning or an argument for the meaning of something.

For example, in a court situation, a defense attorney will present closing remarks, a prosecuting attorney will present closing remarks, and each argument will have a different point of view about what the facts of a given case might mean. Each of those closing remarks could be referred to as a logos, a meaning for the facts. So what Frankl means by the term logotherapy is that his therapy is healing through the discovery of meaning in the facts of one's existence.

David: Okay. That's a great explanation. Clearly, meaning is essential. What are the other main theoretical pillars of logotherapy?

Marshall Lewis: Sure, sure. Again, Frankl was in correspondence with Freud, and then he was also associated with Alfred Adler. In his system, what he called the "will to meaning" is the primary human motivation. He contrasts this with Freud's pleasure principle, which he begins to call the "will to pleasure," and he contrasts it with Alfred Adler's superiority goal, which he comes to call the "will to power." He sees both the will to pleasure and the will to power as inferior variations of the will to meaning; that basically what makes us human is a desire to find meaning and purpose in our lives.

Now, what contrasts logotherapy with other approaches that may have a similar viewpoint is that he was able to draw a line between ultimate meaning and what he called the meaning of the moment. Ultimate meaning becomes a matter of faith. Often it's expressed religiously or spiritually - that is, what is the big picture as to the reason that we're all here? That might be more in terms of the logos as mentioned in the New Testament or in Plato.

But for Frankl, the meaning of the moment gets broken down into what is the one best or one correct value to actualize in any given circumstance; that every unique human life is different, every unique circumstance is different, so out of the many things that could be done, what is the one best thing to do. Being able to discover that meaning and then actualize that value then becomes the purpose of logotheraphy.

The meaning of the moment can be identified - this is where Frankl gets very concrete, and what I appreciate about logotherapy the most is that Frankl then gets very concrete in teaching that there are three basic values that can be actualized at any given point. These three values are the creative value, the experiential value, and the attitudinal value.

David: Okay, you're going to need to explain those to us.

Marshall Lewis: Sure. The creative value is what we give to the world that would not otherwise exist; that is, it's what we do, what we make. For many people this is actualized through meaningful work. If meaningful work is not available, it can be actualized through meaningful hobbies. It can be actualized through doing good deeds, through acts of charity, through acts of kindness.

The experiential value is what we take from the world. It's what we receive from either the world or from others. And that moves us into the area of loving human relationships, the discovery of truths, goodness, beauty, and art, and nature, and music, and literature - all of the experiences that we may choose to allow ourselves to have at any given moment.

The attitudinal value is considered by Frankl to be superior to the other two. Coming from his experience in the concentration camps, he recognizes that there are situations in life where one is cut off from the opportunity to actualize creative or experiential values. Obviously, being in a concentration camp is one such example, but also facing terminal illness, facing poverty, being in the midst of a war-torn region - all of these are times when one might be cut off from that opportunity. So the final value, the attitudinal value, becomes what Frankl called "the last of the human freedoms," which is the ability to choose one's attitude toward unjust or unavoidable suffering.

David: Yeah, I remember his story in Man's Search for Meaning, where - and you probably can recount it with more accuracy than I can since it has been such a long time since I've read it - it was something about having a bar of soap, as I recall, and also his observation that the people who survived the concentration camp experience were the ones who recognized that they still retained this ability to make even very small choices, even if it was like collecting soap shavings to create a bar of soap.

Marshall Lewis: That's right. In that case, creating a bar of soap might be the way in which the creative value is actualized, but even more importantly, sharing something like that, sharing a ship of soap or sharing a tattered blanket with someone else equally needy was a way of reaching what Frankl called "self-transcendence," which is the greatest actualization of the attitudinal value.

I might just give you a quote from Frankl. This is my favorite quote. This is not his most famous one; this is just one that's most potent to me when I read it.

David: Great.

Marshall Lewis: He's talking about - in the concentration camp, he writes: "There were always choices to make. Every day, every hour offered the opportunity to make a decision, a decision which determined whether you would or would not submit to those powers which threatened to rob you of your very self, your inner freedom; which determined whether or not you would become the plaything of circumstance, renouncing freedom and dignity to become molded into the form of a typical inmate."

David: That is a wonderful quote, and I'm also hearing a relationship to ideas in cognitive-behavioral therapy and also the Buddhist mindfulness literature.

Marshall Lewis: Yes.

David: Which places this emphasis on how we frame things. What we tell ourselves about things makes a difference.

Marshall Lewis: Yes, exactly. There are relationships to both of those. The theoretical underpinning of logotherapy of course is very different from cognitive-behavioral therapy, but you do see similarities in that framing things does make a difference. And logotherapy sees itself as being derived from what Frankl calls the "defiant power of the human spirit" - by which he means those things, those abilities, those values that are uniquely human and that cannot be explained in an empirical way, that cannot be explained in a behavioral way, where people sometimes do exactly the opposite of what their environment would suggest that they would do, such as sharing a bar of soap, for example, when soap is rare to nonexistent.

I think it does have - although I would certainly defer to your expertise on Buddhism and mindfulness - but I do think that from what I've heard about it and from what I've mainly heard from you in your podcasts about it, there are multiple similarities between Frankl's approach of living within the moment or actualizing the meaning of the moment relative to the practice of mindfulness.

David: You know as I hear you talking about these things, I'm also thinking about what's going on right now in some of the major news stories going on in other parts of the world - the peoples in the Middle East who are seeking to throw off tyranny, so there we see a kind of surfacing of the defiant power that you're talking about.

Marshall Lewis: Exactly.

David: So we have the people in the Middle East who are trying to shake off tyranny, and then the people in Japan who've just suffered these tragic tsunami and earthquake and now the threat of nuclear radiation. And a kind of grace, the sort of transcendence that you were talking about - as a culture, as a people they seem to be exemplifying some of that characteristic as well.

Marshall Lewis: Yes, I would certainly agree with that when I see these horrendous pictures of the tsunami on television and realize that's exactly the situation where creative and experiential values are literally washed away; yet you see the defiant power of the human spirit in the people as they choose attitudes of peace and of helpfulness and of survival in the face of the tragedy. That is exactly what Frankl was writing about.

David: Yes, and one of the stories that's been playing on the news is of at least one person - I think there were multiple examples of this - where somebody who had been injured is saying, "No, no. There are other people who are worse off than I am. Take care of them first."

Marshall Lewis: Exactly. Exactly.

David: And another thing that hearing you talk about Frankl's orientation raises for me - particularly in relation to the quest for meaning - is it seems to me that there's quite a bit of overlap in some ways with the Jungian perspective, and I wonder did Frankl have -? He must have had at least some passing contact with the Jungian world.

Marshall Lewis: You know this surprises me because I don't believe that he really had contact with the Jungian world. I've tried to look into that because I see so similarities between Frankl and Jung, and also some very real differences. The only point of connection that I can find is an early psychiatrist named Binswanger who developed an approach called daseinanalyse, which was also translated as existential analysis.

David: Yes. .

Marshall Lewis: Which is why existenzanalyse came to be called logotherapy. But, at any rate, I believe that Binswanger worked for or worked under Jung at one point. And Frankl considered daseinanalyse, based on Heidegger - obviously "design" - to be sort of preparational for logotherapy, that it didn't go far enough in that it was a system of analysis or explanation, but never developed into a therapy.

But, yes, getting back to the similarities, both Jung and Frankl talk about the human spirit. And, to my knowledge, they're the only two great psychotherapeutic figures that have made a real place for the human spirit within their systems of thought.

David: And it sounds like both maybe have a place for spirituality. I note that you've been studying Frankl and logotherapy through a theological seminary. Is there some sort of tie-in to religion or spirituality that's embedded in Frankl's approach? .

Marshall Lewis: Well, let me explain that a little bit. Actually I am very grateful to the Chicago Theological Seminary for allowing me to write a dissertation about Frankl. That was not my original dissertation proposal. They were willing to work with me as my interests changed and developed in the direction of logotherapy during the course of my studies there. So I do want to just mention how appreciative to them I am for letting me do that.

The logotherapy itself is not embedded specifically within the theological studies, although Frankl being a survivor of the Holocaust is of course relevant to the work of the Center for Jewish-Christian Studies there. Now, logotherapy for Frankl - he did want to make a clear division between religion and - I'll leave it at religion. I was going to say religion and spirituality, but I'll leave it at religion. He wanted to make a clear division between religion on the one hand and logotherapy on the other. Whereas religion deals with ultimate meaning and is interested in, well, the salvation of one's soul or one's ultimate relationship to God, whereas logotherapy is a specific technique to help and to heal people who are suffering. Its goal is to actualize the meaning of the moment.

He did think of it as a secular therapy that could be used with people of any religious persuasion or of no religious persuasion. Having said that, because Frankl is open to the concept of the human spirit, whereas many other approaches tend not to be, logotherapy has found more of a home among spiritually oriented types of therapists.

David: Okay. Now, both Freud and Jung emphasized the unconscious quite a bit...

Marshall Lewis: Yes.

David: I think Jung acknowledged the sort of negative unconscious of Freud, but went beyond that to see that the unconscious, in addition to having destructive elements, also had powerful creative elements as well. What about Frankl? Does the unconscious play much of a role in his theory and practical applications?

Marshall Lewis: Yes, very much so. In fact, it's similar to what Jung thought of, although Frankl does disagree with Jung mainly on the way in which it's conceptualized. And I can't help but wonder if we're really arguing semantics here more than anything else.

Frankl did acknowledge the dark side of the unconscious, I suppose you could say; that is, the unconscious as explained by Freud with the repressed desires and the elements of ourselves that we find unacceptable. But Frankl also saw the religious or spiritual elements of the unconscious. He called it the spiritual unconscious.

And in contrast to Jung - and this is where I wonder if we're just arguing semantics - Frankl saw the spiritual unconscious as being not below the personal unconscious in a collective area as Jung did, but more individual, more interior to the central identity of who a person actually is. And that this central core is the source of those things that make us uniquely human; that this spiritual unconscious is the source of love, the source of art. It's the source of the ability to transcend, as in that news story you reported where this Japanese person suffering in the tsunami wanted the medical team to go on to someone else who was more in need. These are the things that arise directly from the spiritual unconscious.

The spiritual unconscious is also, according to Frankl, the source of our conscience, that organ we have - as he called it - to be able to determine what is the correct value to actualize in this situation. As imperfect as human conscience is, it's what we have to use. And so whereas psychoanalysis In Freud's presentation of it has a goal making the unconscious conscious, for Frankl, logotherapy or existential analysis involves making the spiritual unconscious more conscious and more conscience, so that we become more responsible in our actions, actualize more of what our true inner values are, and become more aware of that spiritual part of ourselves.

David: Okay. Very beautifully stated.

Marshall Lewis: Thank you.

David: Now, some of our listeners might think that all of this is all very heady and philosophical, so let's talk about the practical application of these ideas because I know that you've been able to integrate them into your own therapeutic work. How have you been able to bring logotherapy into your clinical work? Maybe you have some relevant case examples that you could share.

Marshall Lewis: Sure, I do. And want to thank my employer also. Area Mental Health Center allowed me to set up a logotherapy practicum as part of my training at the center, and this is a practicum offered by the Viktor Frankl Institute of Logotherapy. It's an APA-approved practicum, where I work with clients using Frankl's techniques or integrate Frankl's techniques with other approaches. And then a clinical supervisor at the institute listens to the sessions and offers feedback and clinical supervision and so forth.

But, sure. I do have some clinical examples for you to show how all of this heady, philosophical, academic stuff translates into real-life therapy with real-life people.

David: Great.

Marshall Lewis: Well, and I'll just give you some examples of specific logotherapeutic techniques also. In one case - I'm making up names, I hope you know. These aren't actual names. I decided to pick the name Susie because that's a girl I knew in elementary school - I don't know why.

David: Okay.

Marshall Lewis: But anyway, the woman I'm calling Susie is a 20-year-old female who had her first panic attack here in the middle of one of our local department stores. And at the time she had this panic attack, of course as many people do, they feel like they're having a heart attack. It's the classic panic attack presentation, with shortness of breath, chest pain, numbness of the limbs, and so forth.

David: Yes.

Marshall Lewis: So a bystander at the store pulled out their cell phone and called 911. Within moments you have the ambulance arriving; you have the EMTs coming into the store with a stretcher; you have her being put on the stretcher and they start the cardiac procedures. Everybody in the store is standing around looking, trying to - as people will do - standing around looking at the trauma to see what's going on.

And it turns out she was not having a heart attack; she had a panic attack. So these started to happen more frequently before she came into the clinical. Her DSM diagnosis would be panic disorder with agoraphobia because now she's afraid of going out, going to the store. She's afraid this will happen again, and people will stand around and look at her.

So the logotherapeutic technique for this would be what Frankl called paradoxical intervention. Here, instead of dealing mere - I don't want to say merely - instead of dealing with incompatible responses such as relaxation and so forth that would be typical of a behavioral approach, Frankl wants to access a resource of the human spirit which, in this case, is humor. Now, you do have to be careful with humor in working with clients. You don't want the client at any point to feel like you're poking fun at them.

David: Right.

Marshall Lewis: But you develop a relationship with the client where you get the client to look at the symptoms as something different than who they are. Symptoms are something that they have. It's not something that they are. And then, using the spiritual technique of humor, poke fun at the symptoms. In paradoxical intention, the client learns to desire, in a humorous way, that which is most feared.

So Susie, in this case, learned to poke fun at her symptoms of fearing to have a heart attack and everybody looking at her, so she wanted to try to exaggerate it to the point of trying to figure out how many heart attacks she could have in one day. So today she would try to have two heart attacks, and tomorrow she might try to have three heart attacks, and the day after that she might try to have four heart attacks and a stroke to boot.

David: That's interesting because there are other approaches that also do that paradoxical sort of thing. I just recently interviewed a family therapist who does what she calls strategic family therapy, drawing upon people like Jay Haley and Milton Erickson. I don't know if you're familiar with them.

Marshall Lewis: Yes.

David: But they very much would give people paradoxical assignments much like the one that you've just cited, so that's an interesting parallel.

Marshall Lewis: It is. And paradoxical intention I know has found its way into other schools of therapy, and actually Frankl was gratified that it did. He saw that as something of a validation of his approach, I think. But, yes, that's exactly right. You address the symptom in a humorous way. In fact, there's going to be a documentary film on Frankl that's coming out later this year, and it has scenes of him lecturing where he is illustrating paradoxical intention in much the same way here that I did with Susie.

And what happened in her case was she decided that since she wanted to try to set a goal for herself to see as many people as possible could be looking at her, she decided to start going to the store not when she would ordinarily, but on the busiest days of the week, the weekends, when there were the most cars in the parking lot, so she could get as many witnesses as possible. And so what happens when you start to make fun of the symptoms like that is they simply lose their power, and she was able to go out and go to the store and go about her business, perhaps with a little bit of apprehension, but certainly nothing that resembled a panic attack or even significant anxiety.

David: So there was a behavioral element as well...

Marshall Lewis: There was, yes.

David: That she was instructed to go out to the very place that she feared?

Marshall Lewis: There was a behavioral element, yes, but it was less of an instruction on my part than more of a choice on her part.

David: Ah hah.

Marshall Lewis: After she had developed that attitude - "I'm going to push this to exaggeration. I'm going to have as much fun with it as I can" - then she came - actually this was her own idea to go at the busiest times. Being the cognitively-trained person that I am, if I had been doing therapy in the way that I had for the past 25 years, I probably would have prescribed graduated steps, where she becomes desensitized over time. It was her decision to jump into the deep end, so to speak, and go at the busiest times of the day because that's where she would be able to poke fun at the symptoms the most. So she did that herself and I endorsed it completely, and it worked.

David: Yeah. Well, there was a behavioral therapy technique from some years back. I don't know that it's around any more. I think it was called implosive therapy at the time. And it used the principle that I think has been described as flooding, which is pretty much what you've just described. So it is interesting the way these different approaches end up in similar places. So that's a panic attack. Maybe you can give an another example of a different diagnostic category.

Marshall Lewis: Sure. And let me just comment on flooding, if I can just for a second, just to illustrate the differences between logotherapy and other schools of therapy. Because you will see - and I think there's some research in psychotherapeutic outcomes that support this - that effective therapy often looks the same to an outside observer, and that the therapists are thinking that they're doing something that only they are thinking that - nobody else seems to be thinking that.

But for Frankl, when you take something like Susie's case, the difference between logotherapy and, say, a behavioral approach to panic attack would be logotherapy would want to be careful not to reduce what happened in Susie's experience to something that could be replicated in the laboratory, or something that could be replicated with animals.

Now, we do share learning curves, behavioral aspects with animals, as we share physiological aspects with animals. But for logotherapy, the key is to identify that which is uniquely human, and in that case, what I found is that that increases clients' motivations. Cognitive-behavioral therapy - easy to learn. Anybody can learn it. But until people change their attitude toward what they're trying to struggle against - in my experience at least - that's where the therapeutic change takes place. I get the philosophical underpinning, but I wanted to mention that by way of contrast.

David: Well, I'm glad you did, and we've got time maybe for one more example...

Marshall Lewis: Oh, okay. One more example. Okay. Let me take an example then of attitude modification is what it's called, as opposed to behavior modification. This also is a young woman. This is a young woman from Mexico who immigrated to the United States, 27 years old, and had just had her first child. She was hospitalized for suicidal ideation. She met DSM criteria for a major depressive disorder. All of that happened before I met her. I first met with her after she was released from the hospital on follow-up.

Her existential concern, or her logotherapeutic concern, was that she was afraid that she would not be able to be a good mother. She had been raised in extreme poverty in a poor Mexican village. She never knew her father, who left the family shortly after she was born. Her mother had died when she was very young, and she was raised by grandparents who showed her no affection, but basically just used her for the purpose of labor on the farm that they lived on.

So we did some values clarification, and we discovered that she had interests in education, charitable work, in teaching her newborn child values, and also in poetry. So as we continued to have this Socratic dialog, or this existential kind of discussion, her shift in attitude came when she saw her past not as a source of weakness, not as a lack of all of these things that she felt cheated out of and now was afraid she would not be able to provide for her family, but she started to see it as a source of strength because she had learned from her past, even if it was by negative example, what not to do in raising her child.

And so she felt like she could actually become a better parent because she knew what not having parents would be like. And she also came to see her background as the source of her poetry, which was actually very good, and which she's now working toward getting published. So that would be an example of how logotherapy might be used to address the meaning-related types of questions that might occur in a major depression.

David: Okay. Well, thank you for those two excellent case presentations, and I wish we had time for more because I know that you could give us more. And this has really been a fascinating conversation. I've really enjoyed our conversation. So Marshall H. Lewis, thanks so much for being my guest on Wise Counsel.

Marshall Lewis: Well, David, thank you very much for having me.

David: I hope you enjoyed this conversation with Marshall Lewis and learned as much as I did. As you heard, I had read Viktor Frankl's book, Man's Search for Meaning, quite a few years ago, and it made a lasting impression on me, as it did on everyone that I've ever met who has read it. But, sadly, my information about Frankl and logotherapy did not go much beyond that.

After speaking with Marshall, I see that Frankl clearly bridges the psychoanalytic tradition with the existential tradition which gave birth to humanistic psychology and related therapies. Like Jung, I think Frankl may have been ahead of his time, and his work may yet enjoy wider dissemination inasmuch as it seems very contemporary to me. I wouldn't be surprised if Marshall plays a key role in that dissemination.

As we mentioned earlier, Marshall hosts a podcast devoted to logotherapy and Viktor Frankl, and you can find that at www.logotalk.net. His logotherapy consulting business is named Defiant Power Consulting, and you can find something about that on the Web at www.defiantpower.com. Also you'll find a very fine review of logotherapy on that site, which I believe is part of Marshall's doctoral dissertation, and you can download that as a pdf file.

You've been listening to Wise Counsel, a podcast interview series sponsored by Mentalhelp.net. If you found today's show interesting, we encourage you to visit Mentalhelp.net, where you can add a comment or question to this show's web page, view other shows in the series, or simply page through the site, which is full of interesting mental health and wellness content. Access the show's page and show archive information via the podcast box on the Mentalhelp.net home page. If you like Wise Counsel, you might also like ShrinkRapRadio, my other interview podcast series, which is available online at www.shrinkrapradio.com. Until next time, this is Dr. David Van Nuys, and you've been listening to Wise Counsel.

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About Marshall H. Lewis, MA ABD

Marshall H. Lewis, MA ABD

Marshall H. Lewis, MA ABD received his terminal master's degree in clinical psychology from Marshall University in West Virginia in 1986 and has practiced psychotherapy within community mental health since. He is currently the director of a community mental health center serving three counties in southwest Kansas.

Marshall is currently pursuing a post-graduate diploma in logotherapy from the Viktor Frankl Institute and will complete that work in June. He is also writing a dissertation for his Ph.D. in Jewish-Christian Studies from the Chicago Theological Seminary.

Marshall notes that he is entering the second half of life both personally and professionally. This transition, he says, has marked a change toward existential and meaning-centered practice and a shift away from the cognitive-behavioral models in which he was trained. Marshall says he feels as if he has been called to contribute to the ongoing work of Viktor Frankl's logotherapy and existential analysis for the remainder of this career.

Marshall hosts a podcast devoted to logotherapy and Viktor Frankl found at: http://logotalkshownotes.blogspot.com/

His logotherapy consulting business is Defiant Power Consulting, on the web at http://defiantpower.blogspot.com/p/about.html

 

    Reader Comments
    Discuss this issue below or in our forums.

    Frankl and Jung? - Lisa Shalfoun - Jul 6th 2011

    A very interesting talk. I tried to look into the question whether Viktor Frankl ever met C.G. Jung. I did not come upon anything with only the help of the internet but I want to add my thoughts here. Oftentimes it is very helpful to look at the dates.

    Obviously, both Freud and Jung were much older than Viktor Frankl. If we compare a few significant dates, it might become clearer why Frankl and Jung possibly never met.

    Carl Jung met Freud for the first time in 1907. Their cooperation ended in 1912. We are still in the time before WWI. Carl Jung was Swiss where he also spent most of his life.

    Viktor Frankl was born in 1905 and graduated from highschool in 1923. Carl Jung went on many long trips to Asia and Africa in the 1920ies.

    Alfred Adler, on the other side, was also Austrian. He was born in 1870. In 1934 he moved to the US due to the political situation, only a few years before Hitler annected Austria.

    Switzerland has always been a neutral country, so to be a Swiss citizen was very different from being an Austrian one in the early decades of the 20th century.

    This might explain that Frankl and Jung maybe could not even have met, but again, this is only on the basis of a quick research and my background having studied Freud's writings and life. And me being from Austria..

    Interestingly, Frankl corresponded with Freud, while still in high school, and later, in 1925, two years into his university studies of medicine, met with Freud.

    Thanks again for another most interesting interview!

    Lisa

     

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