that a person can be ill at the somatic and psychological levels, but never in the noetic dimension. “Mental illnesses”, as psychotic disorders are called in popular science, are normally not even psychic illnesses, but disturbances in the nerve cells, in other words they are somatogenic. And, of course, people with psychosis, confusion, dementia, Alzheimer’s patients, etc., have an intact spiritual dimension, even if it is sometimes inaccessible, blocked by the processes of a psychophysical illness.
“Anyone who knows about the dignity, the unconditional dignity of every single person, also has unconditional reverence for a human person, even for a sick person, even for the incurably ill, and even for the incurably mentally ill. There are no “spiritual” illnesses. For the “spirit,” the spiritual person, cannot get sick, and remains present even behind psychosis, even when “invisible” to the psychiatrist.”11
The human spiritual dimension cannot be lost. It is latent in the child – not yet unfolded – just as language is latent in the newborn child and has simply not yet been developed. It resides in people ravaged by age and people with cerebral damage, although hidden by disruptive biological factors, and in schizophrenics, although restricted by neurochemical impairments. It flourishes in the drug addict, although crippled by artificial influences. The fact that human spirituality is always potentially present is what guarantees the inviolable dignity of the human being.
From the outside, the progressive blocking of the spiritual dimension largely hides what is uniquely human. Thus, a small child, a drunk or an imbecile can hardly be distinguished from an intelligent animal, because in them spiritual freedom and power of judgement – and thus human decision-making capability and responsibility – are drastically reduced. Nevertheless, there remains a difference in potentiality that cannot be lost – a dimension that is beyond health and illness (or intelligence and lack of intelligence), even though – temporarily or permanently – it can no longer come to expression in the other dimensions of being.
This has implications for establishing indications and contraindications for logotherapeutic treatment. Where a person’s noetic dimension is “asleep”, meaning that the patient is completely benighted by unconsciousness, immaturity or illness on the other levels of being, no logotherapeutic help is possible. Logotherapy can be used in all other contexts, even with older children and adolescents, and even with senile, mentally disabled or psychotic people to a limited extent, depending on the extent of their spiritual freedom – which is, according to experience, often greater than one initially thinks.
The overview makes it clear that there are qualitative gradations within the psychic dimension (and analogously within the somatic one). There are many gradations between “sick” and “healthy”, “abnormal” and “normal”, or – as one prefers to say today – between having or not having a “disorder”. Each of us at any time is somewhere on this continuum between the two poles, as regards both spiritual and physical condition.
On the spiritual level, it is more a question of quantitative accessibility between the extremes of “completely open” and “completely blocked”. While a severe illness, abnormality or disorder is not a contraindication for logotherapy in the psychic (or even somatic) areas, a loss of accessibility of the noetic dimension represents the only important contraindication for applied logotherapy. With small children, and in cases of significant impairment of consciousness, serious physiological brain defects, complete loss of sense of reality, chronic personality breakdown, and so on, we no longer reach the spiritual person to whom all logotherapeutic arguments and appeals are addressed.
Let us now specify the areas in which the logotherapeutic seed can grow and bear fruit. They include physical and mental disorders which have an effect on the spiritual level, and spiritual frustrations which have an effect on the psychic and the psychosomatic level. Wherever logotherapy is applied, it always deals with the interaction between the psychophysical and the spiritual. However, this is characterised by the rhythms of human life as a whole: the alternation and interplay between the material and the ideal, the vulnerable and the intact, the transitory and the permanent.
And when it is denied that there is something “intact”, unbroken and unbreakable in the human being? That something can be intact even though it falls outside the norm, yes, that there exists truth in spite of illness and suffering in spite of health? Well, then we arrive at a view of a human as a machine in need of repair. In this view, deviations from the norm only reveal functional weaknesses, and anyone who does not function in the expected way is sick. If, for example, a patient is not immediately enthusiastic about a therapist, this is “resistance”; if a searcher asks about the meaning of life, this is “autoaggression”; if an artist struggles to produce a creative design, this is an “inferiority complex”. We quickly end up with a general discrimination against spiritual concerns and achievements, with a “hyper-diagnosis” of all human statements that no longer recognises that there is something in human beings that is beyond health and illness. Something which is capable of engaging with content, something which cannot be interpreted merely as a product of psychological and psychopathological development, as psychologism and the related approach of pathologism try to do.
“[Psychologism] sees nothing but masks everywhere; behind them, it wants to admit the existence of nothing but neurotic motives. It sees everything as artificial, improper. It wants us to believe that art is ultimately nothing more than a flight from life or love; religion is nothing but the primitive human’s fear of cosmic forces. The great intellectual creators are dismissed as neurotics or psychopaths. With this kind of “unmasking” through psychologism one can finally claim with a breath of relief that, for example, Goethe was “actually only” a neurotic. This way of thinking does not see anything real, which means that it does not really see anything.”12
Psychologism commits the error of persistently projecting phenomena from the spiritual space onto the psycho-sociological plane. It rejects human individuality, in the light of which deviations from the norm need not be a sign of illness, but can be individual ways of life, an expression of human intactness. Only in the psychophysical plane is any deviation from the norm a symptom of illness; in the spiritual dimension, in contrast, the “special” nature of each human being, which cannot be calibrated, finds its form.
Thus, as pan-determinism denies human freedom and responsibility, psychologism closes its eyes to the genuinely human, to genuine human creativity and spirituality.
The Dialectic of Pleasure Orientation and Meaning Orientation
Logotherapy differs from other psychotherapies mostly in its concept of motivation. It calls into question the prevalent philosophy of happiness in psychology. According to this philosophy, happiness is the fulfilment of needs. If we take the noetic dimension of human beings into account, however, happiness means the inner fulfilment of meaning. It has been demonstrated in logotherapeutic studies that people are ready to give things up for the sake of a meaningful task and, if necessary, to let needs go unsatisfied. Physical and psychic well-being plays a secondary role in the search for meaning. On the other hand, as can be easily observed in psychological practice, failure in the search for meaning cannot be compensated for by any kind of psychophysical well-being.
How can this discrepancy be explained by the concept of what happiness means? Undoubtedly it emerges from the origins of European psychology and psychotherapy as a science. After all, the first half of the twentieth century, which is when psychology was developed, was a time of extreme hardship. World wars, economic crises, and mass unemployment followed one after another. It is easy to understand why the people of that time wanted only one thing: liberation from their daily distress. They thought they would be happy if only the constant pressure of the struggle to survive were removed, with the associated need to swallow humiliation, bitterness and deprivation.
Also, psychology could not help
