The term ‘logotherapy’ was first used by Frankl in 1926, when this form of therapy began to propose the importance of reflecting on such dimensions as freedom vs responsibility and seeking meaning in life, which Frankl saw as essential components in therapeutic endeavours. The Basic tenet of Logotherapy lies in its proposed need to consider human beings in their irreducible wholeness, as subjects endowed with values and presenting existential thematics which cannot be dealt with by purely psychological means.

Logotherapy defines itself as a psychotherapy which starts with the soul and has as its objective true psychic consciousness (Seele), and a constant ‘intentionality’ towards human values. Thus, in treatment, themes relating to the meaning of life are placed at the heart of therapeutic intervention, with the method thereby being positioned on the border between philosophy and psychology. In the vision of this form of therapy, human behaviour should be guided towards the search for meaning and existential truth in all of its diverse manifestations. Psychic distress, expressed through the neuroses, is seen as a ‘falling’ or ‘stumbling’ along the path that leads towards true meaning, and human suffering is considered not as a symptom but rather as an ‘action’ or working condition (Leistung), which forms part of the dynamic of the spiritual decisions to be made during the course of one’s life. In this regard, Frankl proposed a new diagnostic category, the 'noogenic neurosis', which indicates a form of neurosis linked to the experience of an existential void.

The function of the therapist then is to provide help to contrast the various human forms of 'metaphysical irresponsibility', gradually leading the patient towards a consciousness of the various possibilities and freedom implicit in his/her choices. The treatment provides for specific forms of intervention, represented by ‘dereflection’ and ‘paradoxical intention’, supported by two typically human capacities which become instruments of reference: those of self-trascendence and self-detachment.

Everyone experiences moments in life when one is subject to a temporary malaise or distress, which, for the most part, would be considered normal and not really worth paying any particular attention to. However, it may occur that people cope with these moments and events as if they were real problems, and so much so that they begin to wage a battle to overcome them, thereby forcing the situation - but only to become more and more entangled in a mesh. For example, this happens when a person suffering from insomnia makes a great effort to fall asleep but ends up by feeling increasingly awake. To overcome the situation, Frankl proposed the dereflection method, based on the concept of ‘intentionality’. In practice, it is a question of helping a person eliminate excessive attention focused on the self, while emphasizing other aspects and objects of interest in life. For it to be effective however, it is not sufficient to be merely ‘distracted’: one must focus attention on something positive. Moreover, as the ultimate aim of the technique is to shift the person’s attention from the ‘presumed’ problem, it is important for the intervening therapist not to dwell too long on providing preliminary explanations.

With the term 'paradoxical intention', Frankl means stimulation towards the ‘opposite desire’. The individual is guided towards desiring that which he or she fears, employing his or her capacity of self-distancing. Frank’s explanation of the concept starts with the 'mechanism of ‘anticipatory anxiety’, whereby, "A given symptom evokes, on the part of the patient, the fearful expectation that a certain thing may occur. The fear itself, however, always tends to cause a ‘fulfilment of the prophesy’, generating precisely that which the individual is afraid of and, likewise, anticipatory anxiety is likely to bring about the occurrence of the thing the patient expects will happen. In this way, a vicious circle is formed which tends to self-perpetuate."

Continuing his discussion of anticipatory anxiety - also referred to as 'expectation anxiety', Frankl goes on to state, "... the  patient reacts in relation to a certain symptom with the fear that it may be repeated, and thus presents expectation anxiety. The presence of this expectation anxiety results in the actual reappearance of the symptom, and such occurrence will only reinforce the patient’s original fear". Moreover, "… the symptom produces a corresponding phobia; the phobia reinforces the symptom, and the reinforced symptom further consolidates the patient’s phobic condition."

The areas of application of this form of therapy include the neuroses and sexual disorders, but in recent years it has been adopted with adolescents, deviants, patients presenting a high risk of self-harm and suicide, drug addicts and HIV patients (E. Fizzotti, R. Carelli, 1990; E. Fizzotti, 1993).

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Bibliographical references:

Fizzotti E., Carelli R. (1990), Logoterapia applicata, Salcom, Varese;

Fizzotti E. (1993), Chi ha un perchè nella vita, LAS, Roma.