The International Journal



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The International Journal

Published by the Viktor Frankl Institute Vienna
Formerly (up to Volume 5, Number 2):
Journal des Viktor-Frankl-Instituts
The biannual journal appeared between 1993 (Volume 1, No. 1/ Spring 1993) and 1998 (Volume 6, No. 2 / Fall 1998). The following texts are taken from the corrected manuscripts, not the printed copy. Honoring the authors’ copyright, they are rendered in PDF format, thus inhibiting changes in the text.

Volume 1, Number 2 (Fall 1993)
Editorial

Ignazio Punzi | AIDS - A Challenge to Logotherapy [AIDS - Eine Herausforderung an die Logotherapie]

Robert C. Barnes | Finding Meaning in Unavoidable Suffering [Sinnfindung bei unabwendbarem Leiden]


Elisabeth Lukas | Beispiel einer logotherapeutischen Krisenintervention [An Example of Logotherapeutic Crisis Intervention]


Claudio Garcia Pintos | What is Behind Depression among the Elderly? Logotherapy and the Treatment of Geriatric Depression [Was verbirgt sich hinter Depressionen bei alten Menschen? Logotherapie und die Behandlung der Altersdepression]

David Guttmann and Ben Zion Cohen | Excessive Behaviors and Meaning-in-Life Among the Active Elderly in Israel [Über den Zusammenhang zwischen Sinnerleben und exzessivem Verhalten bei alten Menschen in Israel]

James M. DuBois | Eclecticism, Evidence, and Logotherapy: A Study on the Foundations of Human Psychology, with Special Reference to the Contributions of Viktor Frankl [Eklektizismus, Beweisbarkeit und Logotherapie: Eine Untersuchung über die Grundlagen der Humanpsychologie, mit besonderer Berücksichtigung der Beiträge von Viktor Frankl]

Paul Bresser | Werterkennen oder Sinnfindung? [Perception of Values, or Detection of Meaning?]

Aureliano Pacciolla | The Unconscious in Religiosity, Spirituality, and Morality [Das Unbewußte in Religiosität, Spiritualität und Moralität]

Franz Grundtner | Zwiespalt und Widerspruch überbrücken - Paradoxe Intention [Overcoming Conflict and Contradiction - Paradoxical Intention]

EDITORIAL

Quote from our Guidelines for Authors:


"Official languages are English and German. In some cases papers in French, Spanish or Italian will be accepted. Every article must be preceded by an extensive English and German abstract."
A journal that aims to be a podium for all scholars and users of logotherapy must needs be bilingual - at least. It is our hope that by providing extensive abstracts in both German and English we render the contents of this magazine accessible and useful to all our readers, whatever their native language may be.
Altogether, there are nineteen articles in the first two issues, presenting views and results on various aspects of theory and application. If this journal is to be a lively marketplace of opinions, we need your critique, both with respect to the published papers and to the format and direction of the journal itself. Your response permitting, we will include a "Letters to the Editor" section in the issues following this.
Our original Board of Editors consisted of "volunteers" who were commissioned, in an ad hoc manner, by the chief editor. I am proud to present now a regular list of editors, with many a resounding name in it. In addition to the members of the International Advisory Board of the Viktor Frankl Institute, there are: Prof. Dr. Michael Ascher (University of Pennsylvania), Dr. James DuBois (Franciscan University, Gaming Campus), Dr. Reuven P. Bulka (Center for the Study of Psychology and Judaism, Ottawa), Prof. DDr. Viktor E. Frankl (Vienna).
With deep regret we have to report that Dr. Hiroshi Takashima, member of our International Scientific Committee, has died. Prof. DDr. Katsutaro Nagata, president of the newly-founded Japanese Society for the Study of Logotherapy, has kindly consented to take over the position of Far East representative in the Institute's Advisory board.

Franz J. Vesely



VORWORT
Zitat aus unseren Richtlinien für Autoren:
"Die offiziellen Sprachen des Journals sind Englisch und Deutsch. In einzelnen Fällen können auch Manuskripte in Französisch, Spanisch oder Italienisch angenommen werden. Jedem Artikel ist je eine ausführliche Zusammenfassung in Deutsch und in Englisch voranzustellen."
Eine Zeitschrift, die ein Podium für alle Forscher und Praktiker auf dem Gebiet der Logotherapie sein soll, muß notwendigerweise zweisprachig sein - wenn nicht sogar mehrsprachig. Wir hoffen, daß wir durch die ausführlichen Zusammenfassungen in Deutsch und Englisch den Inhalt unseres Journals für alle Leser, unabhängig von ihrer Muttersprache, zugänglich und nutzbar machen.
In den ersten beiden Heften sind insgesamt neunzehn Arbeiten abgedruckt, in denen Ansichten und Ergebnisse zu verschiedenen Aspekten von Theorie und Anwendung präsentiert werden. Wenn diese Zeitschrift ein Ort des lebhaften Meinungsaustausches sein soll, dann brauchen wir dazu Ihre Kritik - sowohl in Hinblick auf die veröffentlichten Arbeiten als auch hinsichtlich der Aufmachung und der Richtung des Journals selbst. Wir werden daher, beginnend mit dem nächsten Heft, eine Rubrik "Briefe an den Herausgeber" einführen - immer vorausgesetzt, daß wir in ausreichendem Maße Rückmeldungen von unseren Lesern erhalten.
Unser Redaktionsbeirat bestand ursprünglich nur aus "Freiwilligen", die von Fall zu Fall vom Chefredakteur eingesetzt wurden. Mit Stolz präsentiere ich nun eine ordentliche Liste von Koredakteuren, die eine Reihe von klingenden Namen enthält. Neben den Mitgliedern des Internationalen Wissenschaftlichen Beirats des Viktor-Frankl-Instituts sind dies: Prof. Dr. Michael Ascher (University of Pennsylvania), Dr. James DuBois (Franciscan University, Gaming Campus), Dr. Reuven P. Bulka (Center for the Study of Psychology and Judaism, Ottawa), Prof. DDr. Viktor E. Frankl.
Mit tiefem Bedauern haben wir zu berichten, daß Prof. Dr. Hiroshi Takashima, Mitglied unseres Internationalen Wissenschaftlichen Beirats, verstorben ist. Prof. DDr. Katsutaro Nagata, Präsident der neugegründeten Japanischen Gesellschaft für Logotherapie, hat sich freundlicherweise bereiterklärt, die Position eines fernöstlichen Vertreters im Wissenschaftlichen Beirat zu übernehmen.
Franz J. Vesely
OBITUARY

Dr. Hiroshi Takashima was born in 1912 and died in April 1993. He has done pioneering work by spreading knowledge of logotherapeutic ideas in Japan, both as an author and as president of the Japanese Society of Humanistic Anthropology. A graduate of Nihon University, School of Medicine, he studied pharmacology in Keio University, School of Medicine. He worked as a director of Maruzen Clinic. In addition, he was visiting professor of Tokyo Rissho Women's Junior College and Paris University. He is the author of a number of important books on logotherapy and philosophy. He was a director of the American Logotherapeutic Society.


Dr. Takashima was very eager to invite Prof. and Mrs. Frankl to Japan for the spring of 1993. It is very regretful that he died just one month before Prof. Frankl's arrival. He was to make a speech on the newly founded Japanese Society for the Study of Logotherapy.
We pray for the repose of his soul.

Katsutaro Nagata


Aids - A Challenge to Logotherapy

Ignazio Punzi

Abstract:
The author reports various cases he has encountered in his work in a home for Aids patients. The general framework applied in the makeup of the "Casa Famiglia Padre Monti" is fundamentally logotherapeutic. It is also integrative in the widest sense, in that it takes into account the basic meaning orientation both of the patients and of the team that hosts these patients.

Zusammenfassung:


Der Autor präsentiert verschiedene Fälle, denen er in seiner Arbeit in einem Heim für Aids-Patienten begegnet ist. Die Prinzipien, die dem Aufbau der "Casa Famiglia Padre Monti" zugrundeliegen, sind zutiefst logotherapeutisch. Darüberhinaus sind sie im weitesten Sinn integrativ, insoferne sie die Sinnorientierung nicht nur der Patienten, sondern auch des Teams, das die Patienten betreut, in Betracht ziehen.
The house "Padre Monti" is a family home   "Casa Famiglia" -, founded in Rome in 1989. It is a place where we receive those declared affected by the Aquired Immune Deficiency Syndrome - the ones called "in final stage".
We can host 10 persons, men as well as women. During these past years we had guests from 2 to 70 years of age: Michelino was 2: his mother, Luisa, died a few months before him and you can well imagine that it was one of the heaviest and most sorrowful moments we have experienced. The persons who died are more than 40.
In Italy, contrary to other countries, two thirds of the people affected by Aids are drug addicts, and in some way our family home reflects this proportion.
Our patient has robbed, stolen, peddled drugs, he was sentenced to prison a number of times, has known the lunatic asylum, sometimes he has prostituted himself or herself. He is homeless, without any family support and when he has, the family usually cannot take care of him in this terrible moment, i.e. when the disease reaches its peak.
These persons are reached through a centre of coordination set up by the Regional Health Department. When we reflect on the sense of our experience, we cannot avoid asking ourselves what must be the basic attitude in receiving and assisting these persons. People at large often think in terms of: receiving these persons, taking care of them, having trained people to take care of them, having some volunteers more or less able to assist them until they die, but please, keep them away from the others, from ordinary healthy people, so that they may not disturb them, as they used to.
The crucial question for us to understand is the framework within which our challenge lies: to propose a family home, a place of life instead of death. A home where, for sure, death is constantly present, in the empty beds   then taken again   in the memory of things, in the lives of those who remain, in the persons who "exist" here, but a home too, as a place for growth and meaningful relations, as an environment for the development of a culture of solidarity.
We ask ourselves how these persons can return to life, to society. At present, we are trying to adjust a project based on a logotherapeutic community procedure which includes the following objective: to live one's own life even if in bitter agony, evidencing life and hope, progressing through creation inside the family home in a "significant context". What does that mean?
1. The group of health and social workers has to form, or better direct one's efforts towards, the creation of a welcoming community. Its existential significance must be recognized before its professional ability.
2. The group has to learn to recognize and give a sense to the community circle in which the sick person arrives.
3. The family home has to be constructed together with those affected by Aids, offering them opportunity for action, relations, plans and responsibility.
4. The community should perceive the development site as a place in which to experience new actions, meaningful relations, free growth and shared responsibility.
If hopefully all of this takes place, while remaining anyway a never ending struggle, I do believe that a significant framework can be established, making it easier for our patients to realize what V. Frankl calls creative, experiential, and attitudinal values.
Frankl's anthropology refers to "relation" as basic in the constitution of the human being. I believe that it is exactly what we try to achieve day after day. Only to the extent in which we are able to perceive the person who is behind sickness, drug addiction, sarcoma of Kaposi, pneumonia, behind the central nervous system's infection, we can realize an encounter between an "I" and a "You" and, as a result, it will be possible to share all the resources inherent in each one.
It is fundamental to build an environment where it is possible for everyone to live this encounter. As Frankl says: "Community confers existential meaning upon personal uniqueness and singularity. But community can also be a rich field of human experience. This is especially so with "twoness", the intimate community of one self with another". (1986, p. 132)
I will talk about Carlo, an ex-drug addict, psychotic, coming from a rich family, completely self distroyed due to the psychiatric problems of its members. Carlo had a brother who died from an overdose; his wife died a few years ago after having been stabbed, leaving behind two children. For two years he stayed in another family home which he left; he eventually came to us. Carlo is very creative, he writes poems, which are now getting printed. Some time ago, one day after lunch, in a cheerful moment, Carlo exclaimed: "If in this moment they were to discover how to cure Aids, I would kill myself!". Of course, that was a joke and everybody laughed. What Carlo really wanted to communicate was: in this very moment, among all of you I feel so well that if I was not affected by Aids, I would not feel what I am feeling, since I would not be here. The paradox is only apparent: it is in fact possible that people realize and discover values even through an extreme distress. He was that kind of unsuccessful person, coming from a heritage utterly destroyed by drugs. At the time, however, he was trying through the art of writing to communicate his own values, and I can assure he has a lot to communicate to others. The title of his book may sound brutal: "A step away from the grave   Pieces of writing by a person affected by Aids who intends to live".
"Our aim must be to help our patient   writes Frankl   to achieve the highest possible activation of his life, to lead him, so to speak, from the state of a patiens to that of an agens. With this in view we must not only lead him to experience their existence as a constant effort to actualize values. We must also show him that the task he is responsible for is always a specific task", (1986, p. 54).
A meaning to discover or a task to realize is the nucleus around which the person re organizes his own life and then his own staying in the community.
The following is the story of Stefano: 38 years old, homosexual, he arrived within the first month of the opening of the "Casa Famiglia". When found infected by Aids, his family rejected him. He was in therapy for 9 years, even in a psychiatric hospital were several times he tried to commit suicide. With us, he was alternating periods of almost autistic closing with periods in which his gifted artistic sense was exploding. Stefano left us wonderful paintings. But he was considered and he too considered himself finished. After one year in "Casa Famiglia" Stefano expressed the wish to travel to Denmark where his friend was living. It might seem something trivial, but I can assure you that in "Casa Famiglia", people who can plan a long journey are an exception. His proposal was welcomed and he left. Here is a page of one of his letters from Denmark; "Hello, I am writing you after a sleepless night, I have a terrible stomach ache which has been oppressing me since my arrival. It is probably psychological because I am feeling anxious even if externally I know how to appear equilibrated and relaxed. My second week in Copenhagen is over and besides taking pictures at every occasion I'm not a good tourist. I'm spending almost all my time in Wolfgang's home. I do the shopping, the cooking, the washing, and prepare tea or coffee. During the first day I even studied English but after my second letter to you I was not able to do it anymore. I don't care very much even if I would enjoy knowing it, and it would help in many things, but it is better to have some difficulties than to face the fact of not being able to relate with the environment. The more characteristic trait of the Danes is that while somehow reserved they are very kind and in fact they like everything that is expressed with courtesy and cordiality. Don't you find all that beautiful? In a note I wrote I am saying they are people who live quietly. Before starting writing to you, I was thinking of the future. What shall I do when I come back? So I told myself: I should write to Ignazio so that among all the things I want to do when I come back there is at least one thing I could do. And you can help me understand what I really want to do. These days I feel a strong desire to have my own little house. I would like it outside Rome in a small village near the sea. Wouldn't it be wonderful! You should stop me as it is impossible for me because life is expensive and I would face economical difficulties."

Well, Stefano is still alive. Back from Denmark, he bought a car, went to live in a village close to Viterbo where from time to time he finds work in the fields, he does ceramics and during his holidays he comes to us in "Casa Famiglia".


When we tell the story to the doctors who sent him to us they would not believe it. They say Stefano was finished, a person without a future, a person with whom it wasn't worth speaking about things of life. Stefano had instead been able to do what he did because be replaced death with life even though he got messages of the type: "You are done for". Stefano could reconstruct enough social tissue to be able to get out of our home alive. His story gives us hope to go ahead.
A person's dignity resides in his spiritual being; somebody may be degraded in his body, in his psyche; but a real encounter between an "I" and a "You" resides in the spiritual dimension. From this point of view there exists a real reciprocity between the operator and the "user". For the handicapped, those affected by Aids, the prisoners, all barriers disappear: freedom and responsibility of the human being are found in the spiritual being. As a matter of fact, nobody is "free from"... Everyone of us has a name and a culture we never chose. However everyone is "free to" take a stand with regard to what is unavoidable, such as illness.
Two months ago Luigi arrived at the "Casa Famiglia", 32 years old, married but separated. He had not seen his wife and his 8 year old son for a long time. He arrived in a high state of catatony: he was not moving or walking and the doctors told us to keep him because there was no room in the hospital. I remember one day he remained steady, straight on his feet with an open dripping peach in his hand, for three quarters of an hour. One month later we discovered that he had been compelled   against his will   to come to us. We then told him that violence had been done to him as well as to us and that there was no need to escape; if and when he wanted to leave we would bring him where he wanted to go. We tried to send him messages of this type even though we were not sure he could hear us, until one morning, when as he got up, he asked for a piece of cloth and started dusting the furniture. From that day he took this as his task. After about one month he called his wife telling her his state of health and asking news of his son. He now walks normally and exercises in the small gymnasium we have in the attic. Luigi, too, was done for. Official medicine was cherishing no hope: Luigi was also in the "final stage"   imprecise, ambiguos and maybe with a perverse concept that means: you have no future, if not death.

We have ascertained that the opportunity to interpret life as a duty, as a capacity to discover values, is to build up a daily and authentic possibility to give again a meaning to life, and possibly to prolong it. If life has a meaning it is certainly not linked to its length. In one instant a troubled and wretched existence can be redeemed. Particularly for those persons who have lived badly and are expecting to die even worse.


A project we are very much interested in is creating the possibility for our patients to renew again relations with their original families with the ultimate aim of their reintegration at home. It is one of the most difficult and burdersome tasks, but one which gives us the concrete possibility to discover and realize the most profound and significant meanings.
Katia is a 29 year old woman. She arrived here last January from the psychiatric section of a Roman hospital. For her the diagnosis was a notification of Aids. Her only "guilt", as people said, was to have been in love and married to a drug addict and to have given birth to a son. Two years ago, at the age of 18 months, the baby died, six month after the father, both from Aids. The family, who had always obstructed the marriage, supported Katia during her son's illness: but when the major crisis appeared and even more the illness was reported, the family announced that they were not able to cope anymore with the situation (in particular a 24 years old brother was terrorized by the fear of infection). The environment of "Casa Famiglia" revealed itself favorable to Katia: after one month psychiatric delirium ceased completely and we were able to reduce the psychopharmacologic therapy. Little by little Katia started to express the wish to return home. But the family   we were in weekly consultation with them   advanced a number of difficulties. One of the parents fell into depression because of retirement and from time to time because of alcohol. The repeated discussions have however brought a gradual improvement in the brother's attitude towards Katia. Despite the progress of the illness and the above mentioned difficulties, favorable conditions were acknowledged for a meaningful reunification of the family nucleus. At the end of May Katia went home where she now lives with a domiciliary assistance.
The message we want to send is as follows; despite Aids ­- indeed many times thanks to it   it is possible to realize what once was only a dream.
Giuseppe was a 29 year old man who died last October after almost two years in "Casa Famiglia". Fatherless, his family entrusted him very early into an institution. At the age of 9 he smoked his first joint and when 14 he was already in jail. At the age of 23 years he had a daughter with a drug addict who was his girlfriend. She was seropositive too. One day, while he was sitting under a tree overlooking the valley, he told me: "I never realized how beautiful it is to see a flower grow!". Giuseppe was spending whole days going all over the fields with our dog observing the goats deliver their kids. He discovered that he really enjoyed fishing. We went to the lake to fish trout, he was almost blind by then, but continued to enjoy this until the day before he died.

In the book entitled "Homo Patiens" Frankl wrote: "I act according to what I am and I become according to how I act" (1979, p. 98). Giuseppe has peddled drugs, stolen cars, robbed, but he is one of the dearest and most tender memories I cherish.


There are people who even in extreme situations, during times of a great distress, have realized exceptional encounters.
I would like to tell you, as an example, about the love which is growing in our home between a boy and a girl. The girl, having been in an institution since the age of 2 (she is now 33), left at 17. She had her first contact with drugs when she was 21. She spread panic in a neighborhood of Rome where, with a boy, she went around stealing in all the big stores. She told me she would walk into a store with a levelled gun, because "the boys don't have the attributes to be men". With a motorbike, alone, she was robbing and her big dream was to become a mercenary. In France, too, she was put in jail for attempting homicide. A horrible life. A person to keep away from. She arrived here six months ago and 9 days later she ran away because of her need of a shot. Two days later she went back to hospital to get out of drugs and she let us know that she was there. We went to see her and she told us she wanted to come back to us. We had a meeting, at the end of her stay in hospital, in the home of her parents, with all the family present. We then took her with us. We now assist to the blossoming of feelings of friendship and love between her and another of our guests which is giving them the push to grow in the future.
The possibility to create a chance for faithfulness is and remains the assumption through which these persons face their own illness in a different way. They rediscover their own values as persons: there is an encounter between an "I" and a "You".
When this happens, we become happy witnesses since every other thing is secondary. Now, even if everything ended in a week, we will be proud of this achievement. We cannot but rejoice with them for the sentiments of love they discovered and for their encounter. We are filled with joy, knowing that we have no right to change anybody, but on the contrary we have the duty to change ourselves fighting our own many prejudices. There are probably many people in contact with persons whose lives were torn apart who discovered the genuineness of an encounter. Where the essentials of life have been laid bare, there is a person to discover and an encounter to realize. The human resources disclose themselves where a real encounter is realized.
Bibliography:

Frankl, Viktor E. (1979), Homo Patiens. Interpretazione umanistica della sofferenza, Brezzo di Bedero, Salcom.


Frankl, Viktor E. (1986), The Doctor and the Soul; From Psychotherapy to Logotherapy, New York, Vintage Books.
Punzi, Ignazio (l992), Logoterapia e Aids, in: Fizzotti Eugenio (Ed.), "Chi ha un perche nella vita ..." Teoria e pratica della logoterapia, Roma, LAS, pp. 202 210.
Punzi, Ignazio, Logoterapia e Aids. L'esperienza della Casa famiglia "Padre Monti","Orientamenti Pedagogici", 39(1992), pp. 1191 1198 .
Sebastiani, Rolando e Ignazio Punzi, Casa Famiglia per malati terminali di AIDS, "Notiziario CISM", 1993, n. 277, pp. 347­352; 401 403.
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