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Saturday, December 11, 2010

#24 Franklian Diagnostics and Clinical Indications for the Use of Logotherapy

Click here to download Franklian Diagnostics and Clinical Indications for the Use of Logotherapy

Happy Chanukah and Merry Christmas from LogoTalk.Net!

This month's podcast combines two related topics that are an outgrowth of the logotherapy clinical practicum that I am currently completing.

Franklian Diagnostics

Viktor Frankl's diagnostic system was based on presumed cause of a disorder and primary presentation of the disorder.  The most detailed explanation of Franklian diagnostics can be found in Frankl's On the Theory and Therapy of Mental Disorders.  I made the table below to help me follow along in the book.  Clicking on the picture below should enlarge it.


For an account of the DSM-IV-TR category of "Religious or Spiritual Problem" please see:

Lukoff, D., Lu, F., and Turner, R. From spiritual emergency to spiritual problem: The transpersonal roots of the new DSM-IV category. Journal of Humanistic Psychology, 38(2), 21-50, 1998.

To note its absence in the proposed DSM-5, please visit http://www.dsm5.org/.

Clinical Indications for the Use of Logotherapy

Viktor Frankl outlines five indications for the use of Logotherapy:

1.  Logotherapy is a specific treatment when the source of the psychological disturbance is a lack of meaning-orientation.  Logotherapy then aids in the discovery of personal meaning.  Frankl referred to this condition as the "noogenic neurosis."  Several modern tools are available to measure personal meaning.  I use the Meaning in Life Questionnaire, available here:

Steger, Michael F., Patricia Frazier, and Shigehiro Oishi, "The Meaning in Life Questionnaire: Assessing the Presence of and Search for Meaning in Life," Journal of Counseling Psychology 53 (2006):  80-93.  Online at:

http://www.itari.in/categories/higherpurpose/meaning_in_life.pdf

2.  Logotherapy is a non-specific treatment when the source of the disturbance is rooted in physiology or psychology.  Specific logotherapeutic methods such as paradoxical intention and dereflection may be helpful in such cases.  In these cases, Logotherapy is seen as an adjunct to other treatments and may be combined with other treatments.

3.  Medical Ministry:  This is Frankl's term for the use of Logotherapy in situations of terminal illness.  In such cases, Logotherapy is used to help patients retain an orientation toward the meaning of their lives up to the very end.

4.  On the level of society, Logotherapy is seen as a tool to counter the influence of nihilism.

5.  Within the medical and therapeutic community, Logotherapy is seen as a tool to counter reductionism,

Finally, the proposal that I made to my employer to allow me to engage in the clinical practicum is offered below.  I offer this for the use of others who may be in a similar situation.  My employer is a community mental health center:

http://homepage.mac.com/mhlewis/papers/practicum.pdf

Thank you for listening. Please email any questions or comments to logotalk@pld.com and may you have a meaningful day.

Saturday, November 13, 2010

#23 Logotherapy Techniques: Supplementary Techniques

Click here to download Logotherapy Techniques: Supplementary Techniques

Today's topic covers a number of supplementary techniques developed within the context of logotherapy.  The topics covered in this podcast, and their references, are listed below.

Writing Assignments:

King, L.A. (2001). The health benefits of writing about life goals,  Personality and Social Psychology Bulletin, 27, 798-807.

King, L.A. and Miner, K.N. (2000). Writing about the perceived benefits of traumatic events: Implications for physical health, Personality and Social Psychology Bulletin, 26, 220-230.

Values Clarification and Goal Setting:

Hutzell, Robert R. and Eggert, Mary D.  (1989, 1995, 2009).  A Workbook to Increase Your Meaningful and Purposeful Goals (2009 PDF Edition).  Online at:
http://www.viktorfrankl.org/source/hutzell_workbook_2009.pdf

Structured Experiences

Barnes, Robert C.  (1995, 2006).  Franklian Psychology and Attitudinal Change.  Edited by George E. Rice and developed by Paul Welter.  Abilene, Texas:  Viktor Frankl Institute of Logotherapy.

Existential Dream Analysis

Frankl, Viktor E.  (2000).  Man's Search for Ultimate Meaning.  New York:  Basic Books.

Logoanchor Technique

Graber, Ann V.  (2004).  Viktor Frankl's Logotherapy:  Method of Choice in Ecumenical Pastoral Psychology.  Lima, Ohio:  Wyndham Hall Press.

The Golden Imprint

Lukas, Elisabeth.  (2000).  Logotherapy Textbook:  Meaning-centered Psychotherapy consistent with the principles outlined by Viktor E. Frankl, MD.  Translated by Theodor Brugger.  Toronto:  Liberty Press.
http://www.liberty-press.com

And, as promised, my Mountain Range Experience sample:


Thank you for listening. Please email any questions or comments to logotalk@pld.com and may you have a meaningful day.

Monday, October 11, 2010

#22 Interview with David A. Hallowell, M. A.

Click here to download Interview with David A. Hallowell, M. A.

LogoTalk.Net is pleased to be joined today by David A. Hallowell, M. A.  David is a U.S. Fulbright Fellow alumnus of the Viktor Frankl Institute Vienna and holds the master of arts degree in philosophy from Boston College.  He is an aspiring author who is fascinated with the notion of finding meaning and conversion in the face of hedonistic technocracies.

David authors a blog entitled the Existential Cosmopolite.  The blog is focused on the pursuit of authentic subjectivity for the aspiring Cosmopolite: Pondering philosophy of science & religion, post-pop psychology, existentialism, critical realism, and illumination in the spirit of Søren Kierkegaard, CS Lewis, Viktor Frankl, Bernard Lonergan, JRR Tolkien, St. Augustine, St. Bonaventure, and any other thought that shines a light.

David is also the creator and administrator of the Official Viktor Frankl Facebook page, with the permission of the Frankl family.

The references for David's papers and the links to them are:

Hallowell, David A.  (2010).  Personhood in an Anti-Reductionist's Universe: Frankl's Dimensional Ontology and Lonergan's Notion of the Thing  The International Forum for Logotherapy, 32, 89-100. 

Frankl, Viktor E.  (2008).  The Pluralism of the Sciences and the Unity of the Person.  Translated by David A. Hallowell.  Unpublished translation.

The original paper was published as:

Frankl, Viktor E.  (2005).  Der Pluralismus der Wissenschaften und die Einheit des Menschen.  In Der Mensch vor der Frage nach dem Sinn, Munchen:  Piper.

The book David mentioned is:

The Feeling of Meaninglessness: A Challenge to Psychotherapy and Philosophy
by Viktor E. Frankl.
Edited and with an Introduction by Alexander Batthyány.


Published 2010 by
Marquette University Press






Summary of links:

David's Paper on Personhood in an Anti-Reductionist's Universe

Translation of Frankl's paper on the Pluralism of the Sciences and the Unity of the Person

The Existential Cosmopolite

Official Viktor Frankl Facebook page

Viktor and  I - A Film by Alexander Vesely

Thank you for listening. Please email any questions or comments to logotalk@pld.com and may you have a meaningful day.

Saturday, September 11, 2010

#21 Logotherapy Technique: Dereflection

#21 Logotherapy Technique: Dereflection
Replaced by Lesson 4: The Primary Techniques of Logotherapy
11 September 2010

#20 Logotherapy Technique: Paradoxical Intention
Replaced by Lesson 4: The Primary Techniques of Logotherapy
14 August 2010

#19 Logotherapy Technique: Socratic Dialogue
Replaced by Lesson 4: The Primary Techniques of Logotherapy
15 July 2010

Dereflection is to divert attention away from one's symptoms.  Dereflection ignores the self and leads to self-transcendence through focusing attention on someone or something else.  Lukas defines it a "disregarding of something that can be disregarded, which would become worse through reflection, not better.  At the same time, it is more than a disregarding and quite more than a diversionary tactic."

Frankl himself recognized two techniques:  Dereflection, based on the human capacity for self-transcendence and Paradoxical Intention, based on the human capacity for self-distancing.  Lukas and others have added the third technique, taught by the Viktor Frankl Institute of Logotherapy as Socratic Dialogue and referred to by Lukas as Attitude Modification.  

Case studies are presented from Dr. Frankl, Dr. Lukas, and my own practice.

Thank you for listening. Please email any questions or comments to logotalk@pld.com and may you have a meaningful day.

Saturday, August 14, 2010

#20 Logotherapy Technique: Paradoxical Intention

#21 Logotherapy Technique: Dereflection
Replaced by Lesson 4: The Primary Techniques of Logotherapy
11 September 2010

#20 Logotherapy Technique: Paradoxical Intention
Replaced by Lesson 4: The Primary Techniques of Logotherapy
14 August 2010

#19 Logotherapy Technique: Socratic Dialogue
Replaced by Lesson 4: The Primary Techniques of Logotherapy
15 July 2010

Paradoxical intention is to wish for that which is most feared.  By pushing one's fear to exaggeration, usually in a humorous way, the wind is taken out of the sails of the fear.

Humor is one of those characteristics of the human spirit that, according to Frankl, can be used as a source of health.  Of course, when using humor, one must be careful to understand that the humor is directed toward the symptom, not toward the person.  That is, when using paradoxical intention, humor is used as a tool to defeat the symptom, not used to poke fun at a human being.

Paradoxical intention appears to be associated with para-sympathetic arousal, particularly learning to decrease sympathetic arousal through humor (as opposed to the more common approach of relaxation).  As such, it teaches the client that she is not a slave to her anxiety, that she can take a stand against it, and even reduce it.

Case studies are presented from Dr. Frankl, Dr. Lukas, and my own practice.

Update:  Since this podcast was recorded, Dagmar Devorah Sigrid Fabry has published a comprehensive review of outcome studies on paradoxical intention and concludes that "...Paradoxical  Intention has a sound evidence base."

Reference:  Fabry, D. D. S.  (2010).  Evidence base for paradoxical intention:  Reviewing clinical outcome studies.  The International Forum for Logotherapy, 33, 21-29.

Thank you for listening. Please email any questions or comments to logotalk@pld.com and may you have a meaningful day.

Thursday, July 15, 2010

#19 Logotherapy Technique: Socratic Dialogue

#21 Logotherapy Technique: Dereflection
Replaced by Lesson 4: The Primary Techniques of Logotherapy
11 September 2010

#20 Logotherapy Technique: Paradoxical Intention
Replaced by Lesson 4: The Primary Techniques of Logotherapy
14 August 2010

#19 Logotherapy Technique: Socratic Dialogue
Replaced by Lesson 4: The Primary Techniques of Logotherapy
15 July 2010

The Socratic Dialogue is a way of engaging the client in a discussion that allows the client to discover what he or she already knows on some level.  The Socratic Dialogue is a technique shared with other forms of psychotherapy, though in other therapies it often involves "trapping" the client in a logical snare, revealing to them the errors of their reasoning.  In Logotherapy, Socratic Dialogue is closer to the vision attributed to Socrates.  That involves "midwifing" or allowing the client to give birth to new ideas.  For this reason, the technique is often called Maieutic Dialogue in Logotherapy.  Maieutic is a term derived from the Greek that means to act as a midwife. 

One may surmise that the client has already formed these ideas, either preconsciously, unconsciously, or through the spiritual unconscious.  The therapist does not presume to know the right solution for the client, accepts this ignorance, and appeals to the wisdom of the client's spirit.  Frankl wrote: "It is not necessary, however, to enter into sophisticated debate with the patients.  Logos is deeper than logic." 

One way in which Socratic or Maieutic Dialogue is begun in Logotherapy is by asking what Dr. Elisabeth Lukas calls a two-legged question.  A two legged question has one leg in the client's presenting problem and the other leg in the client's area of freedom.  A famous example from Dr. Lukas is, "Why stand among the flowers and water the weeds?"  This same principle is illustrated in another famous quote by Dr. Jerry Long, a Franklian psychologist who was paralyzed from the neck down, when he said, "I broke my neck, it did not break me,"

Case studies are presented from Dr. Frankl, Dr. Lukas, and my own practice.

Thank you for listening. Please email any questions or comments to logotalk@pld.com and may you have a meaningful day.

Sunday, June 13, 2010

#18 Logotherapy and American Health Care Reform


Click here to download Logotherapy and American Health Care Reform

Click here to download Logotherapy and Evidence Based Practices

Click here to read the blog post Logotherapy and Evidence Based Practices

Click here to read a related blog post on American Health Care Reform

The Affordable Health Care Act of 2010 passed the United States Congress on March 21, 2010.  The act provides for full parity between mental health services and general medical services.  This means that the provisions of the new law directly impact your local psychotherapeutic practice.  Most provisions of the new law do not go into effect until January 1, 2014.

Background:  The new law is designed to reform two main problems with American healthcare:  The overuse of high cost interventions and the underuse of prevention strategies.  To that end, national health reform has four goals, or "pillars," of which the new law primarily addresses the first two.

Four Pillars of Healthcare Reform
  1. Insurance Reform
  2. Coverage Expansion
  3. Delivery System Redesign
  4. Payment Reform
Coverage Expansion and Insurance Reform

According to the National Mental Health Association, 83.1% of Americans currently have some type of insurance coverage.  After the provisions of the new law go into effect, this number will rise to 93%.  These numbers represent 30 million Americans.  Sixty-six percent of the increase will come through an expansion of Medicaid, while the remainder will come from insurance reform and the creation of state insurance exchanges.  Medicaid expansion will be accomplished by making the only requirement for coverage set at a household income of 133% of the federal poverty level.

Delivery System Redesign

Previous studies have shown that 29% of those receiving Medicaid had a mental health problem.  A new study, based on data gathered about medications prescribed and not based on providers seen, suggests that 49% of those receiving Medicaid have a mental health issue.  This means that those extra 20% are receiving psychiatric medications, but are not being seen by a psychiatric specialist.

The new law calls for a closer integration of mental health and general medical services.  It remains unclear what this new integration will look like.  It may mean local mental health centers entering into contractual relationships with existing medical practitioners, or it could mean local medical clinics hiring mental health staff and local mental health centers hiring general medical staff.

Such a redesigned community mental health center may come to be known as a "federally-qualified behavioral healthcare center."  This represents the greatest redesign of public mental health services since the passage of the Community Mental Health Act of 1963 that originally established community mental health centers.

Payment Reform

The fee-for-service model is moving toward extinction with the new law.  It is being replaced by a "case rate" model.  That is, a federally-qualified behavioral healthcare center would receive funds from a payor, say Medicaid, based on the number of Medicaid consumers seen.  Moreover, centers with better outcomes would be paid more than centers with worse outcomes, adjusted for number of patients.

For example:  Assume the ABC Center for Logotherapy has 200 Medicaid clients in 2014, and the XYZ Center for Logotherapy has 200 Medicaid clients in 2014.  If the clients of the ABC Center show more improvement than those of the XYZ Center, then the ABC Center would receive more Medicaid dollars than the XYZ Center, though serving the same number of clients.

Opinion:  Opportunities and Challenges for Logotherapy

With an additional 30 million people receiving health care coverage, and with conservative estimates that more than 10 million of them will required mental health treatment, a demand for therapists of all kinds will increase.  If we use Frankl's numbers that about 20% of clinical cases are noogenic in origin and suitable for logotherapy, then we have an increase of at least 2 million people likely to respond to logotherapy.  How many more logotherapists do we need to treat those 2 millon people?

A closer integration of mental health and general medical care will provide more settings in which logotherapists could be employed.  Frankl's concept of a Medical Ministry may become more fully realized, if logotherapists start positioning themselves for it now.

Evidence Based Practices and outcome data will tie into reimbursement.  Logotherapy simply must develop more hard data.   I encourage you to download and listen to the podcast on Logotherapy and Evidence Based Practices for more information in this area,

There are currently about 4 or 5 outcome measures on the market that are positioning themselves to take advantage of payment redesign.  Logotherapy, with its special emphasis on the therapeutic relationship, could and should get on the forefront of that developing research.

Thank you for listening. Please email any questions or comments to logotalk@pld.com and may you have a meaningful day.

Wednesday, May 12, 2010

#17 A Franklian Reading of the Book of Job: A Dissertation Proposal

Click here to download A Franklian Reading of the Book of Job: A Dissertation Proposal

Purpose in Life May Reduce Alzheimer's Risk

Read more at:

Medscape Today

and at:

The Archives of General Psychiatry


Dissertation Proposal:  A Franklian Reading of the Book of Job

"This dissertation will develop a hermeneutic based on the existential approach to suffering of Dr. Viktor E. Frankl.  The Book of Job will be read in light of this hermeneutic.  Special emphasis will be placed on the existential question of whether Job will "curse God and die."  Job's final, ambiguous response to the speeches of God will be treated as an existential challenge to the reader.  The dissertation will conclude with a discussion of how a Franklian hermeneutic is of benefit in understanding and responding to this challenge."

Click here for the full PDF proposal.

Thank you for listening. Please email any questions or comments to logotalk@pld.com and may you have a meaningful day.

Wednesday, April 14, 2010

#16 Unconditional Faith in Unconditional Meaning

Click here to download Unconditional Faith in Unconditional Meaning

One of the very great privileges of hosting LogoTalk.Net is that I get to interact with our listeners. A listener emailed the following question:

What does Viktor Frankl mean by the word "meaning"?

Our listener has discovered a working answer to this question that is definitely worth sharing. He presently defines meaning as "whatever moves that motivating spirit inside you." Personally, I think that is one of the best definitions of meaning I have heard.

In addition to this question, the listener asked for some examples, large and small, of meaning.

This question is an important one. A misunderstanding of the answer is the basis of a criticism leveled against logotherapy by other existentialists and by cognitive psychologists. Specifically, that criticism is that logotherapy suggests to, or even tells, the client what a certain event means.

When Frankl was asked this same question, his response was that "meaning is what is meant."

To understand this rather cryptic response, it is necessary to know that Frankl believed that each unique situation carried both a variety of potential meanings and a demand characteristic. From all the potential meanings the human being may freely choose one and make it real. However, the situation also carries a demand characteristic. This means that there is only one right choice that the combination of unique person and unique situation demands. The person may make the right choice or the wrong choice, and the person may never know if he or she was right or wrong. We can make better choices, or be right more often, by learning to listen to the voice of conscience. It is an imperfect guide, but it is one we all share.

Now, one example of meaning is the way certain threads in life come together. As if on cue for this podcast, three threads came together. One thread is the email from our listener. Another thread is a question from the course Meaning-Centered Interventions that I am presently taking through the Viktor Frankl Institute of Logotherapy. The third thread is my recent stay at a hospital in a distant city, where I had plenty of time to consider this question.

Here are some verbatim notes I made for class:

As I write this, I am sitting in a hospital room in a distant city with nothing but the clothes on my back. I was sent here by air ambulance yesterday. I am writing with a borrowed pencil on a paper towel. I hope when I get home, the writing will have stood up well enough for me to transcribe.

At times like this, when the area of fate looms large, life comes down to the kindness of the nurse who lent me the pencil. A shower was a major event for the day. The goal is to wait until more tests can be run on Monday.

I remind myself of Frankl's words to face bravely what lies in the area of fate. Death certainly lies within that area. While I am not standing on death's doorstep at the moment, I have certainly taken a drive through the neighborhood and want to go home with no souvenirs of the trip!

So what are my thoughts on the meaning of life? A PA named Susan took time to sit and listen to my fears, to answer my questions, to later remind the doctor of one of my questions I had forgotten. She self-transcended. Life is about that and not about doing your work only, no matter how well.

A phone call from my son, telling me about his projects, and his determination that "of course you will pass your tests -- you're my daddy," the meaning of life is in that. And, of course, I will pass my tests, because of him.

During my little stay, I started making a list of meaningful things that I otherwise would not have considered, meaningful things that fall into the very, very small category:

• a pencil
• a shower
• a visitor
• communications
• a way home
• a doctor who listens
• clean clothes

I thought about how Frankl managed to get a hold of a pencil stub and to write notes that he had to hide. How that must have been!

So, for me, the meaning of life is closely tied to small, meaningful moments that lead to self-transcendence, expressed in the simplest way as the ability to communicate with family and friends, or the ability to at least take notes to later express oneself.

I took some comfort in thinking of death as one of those things in the "area of fate." As such, it is something toward which one has the ability to choose one's attitude. It also reminded me that each day is a gift. It is easier, now, for me, to discover the meaning of the moment when I consider how easily it could be the last moment. Which value, then, do I wish to actualize right now? This is done knowing that this moment may be the last, and this value the last to be actualized, or it may be yet another step on a journey of many years. Too often, we act on the assumption that there will always be tomorrow. The meaning of death is to remind us that this is not so. If life did not end, there would be no logical difference between actualizing values and postponing their actualization.

As to suffering, I am not sure that suffering has a meaning per se. Is there meaning in the suffering that Frankl endured? I know many theologians who would answer negatively. The meaning is found in the freedom to choose. Suffering provides the greatest contrast against which that meaning may be seen. I think that the meaning of choice would still be present if suffering did not exist, only, perhaps, more difficult for us to see.

It also occurred to me that suffering is a phenomena only of the body and mind. The invasive procedures can only invade the body, and thoughts thereof can invade the mind. The spiritual core cannot be invaded. As the seat of choice, it also has the ability to "push back" against these invasions through change in attitude.

Now that I am back from the hospital, I think the most meaningful experience was my son on the telling phone telling me, "of course I would pass my tests, you're my daddy." While passing the time in a CT scanner, I thought of this quote. The test was supposed to be repeated three hours later, but, as I was taking another test, the doctor came into the room and said that I had passed the test so well there would be no need to repeat it. I was to be discharged that day, a week ago Monday, if I also passed the other test that was presently being done, which, thank God, I did.

Some larger examples of meaning come from Frankl himself:

A client came to Frankl, a rabbi, who was grieving for the death of his children. The rabbi believed that his children were in heaven, but that he would never see them there. The children were young and innocent when they had died, but the client, as a grown man, had committed many sins. In working with Frankl, the meaning that the rabbi discovered was that the deaths of his children gave him the opportunity to thereafter live in such a way that he would eventually see his children in heaven. While the death of this man's children is certainly an objective evil, through the exercise of the human spirit, the rabbi was able to discover a meaning that changed his life for the better. This is an example of realizing an attitudinal value.

Frankl also tells a story that took place shortly after the Nazis invaded Austria. Frankl had the opportunity to get a visa to leave Austria and come to the United States. There were no visas for his parents, however. One day, he came home and found that his father had recovered a piece of the synagogue his father attended. It had been burned down by the Nazis. On this particular piece of ruble, there was a single Hebrew letter. The block had been part of the depiction of the 10 commandments, with a Hebrew letter abbreviating each one. Frankl asked his father which commandment this letter abbreviated. It was "honor your father and mother that your days may be long in the land."

Frankl believed that his father finding this block meant that he should stay in Austria, let the visa go, and try to protect his parents as best he could. He was able to do so for about a year before the family was placed into the camps. As you know, Frankl survived (though his parents and his young wife did not) and logotherapy took root because Frankl wrote his books in light of his experiences in the camps.

But conscience and the situation may demand not following a commandment:

Frankl writes of a young couple taken to the camps. The husband knew that the wife was very loyal and very faithful. She was also very beautiful. The young husband told her that she was free from her marriage vow, and that she could do whatever she needed to do in order to survive. In the midst of a death camp, the young husband tried to actualize the value of life above all else.

My former director, the woman whose position I now hold, left me a note which now hangs in my office. It is a quote from Frankl:

"Everyone has his own specific vocation or mission in life; everyone must carry out a concrete assignment that demands fulfillment. Therein he cannot be replaced, nor can his life be repeated, thus, everyone's task is unique as his specific opportunity to implement it."

So, in summary:

Frankl's philosophy is founded upon three pillars that Frankl describes as Freedom of the Will, the Will to Meaning, and Meaning in Life. Frankl accepts the first and third of these as philosophically axiomatic. The second pillar, the Will to Meaning, Frankl sees as demonstrable through psychological study. It is this pillar to which Logotherapy owes is practical applications. The Will to Meaning includes two components: an internal "pull" toward the discovery of meaning that is characteristic of the human person, and an external "demand quality" of a given situation or text. Each combination of human person and situation is unique. Thus, the meaning discovered will be unique to each person.

Frankl holds that all humans are subject to a particular demand quality he calls the tragic triad consisting of pain, guilt and death. These universal experiences lie within the "area of fate" outside of human free will. Unique meanings may be discovered by each person depending upon the attitude freely chosen toward these elements. Frankl refers to this free choice as the "attitudinal value." The attitudinal value lies within the "area of freedom" and is motivated by the will to meaning. Moreover, Frankl holds that the realization of the attitudinal value is superior to two other paths to the discovery of meaning - the actualization of creative values (such as through work) and the realization of experiential values (such as through love). It is through the actualization of the attitudinal value that the human person is capable of achieving self-transcendence - the ability to rise above circumstances, or to face the tragic triad as a fully human person. Of self-transcendence, Frankl writes, "What I have called the self-transcendence of existence denotes the fundamental fact that being human means relating to something, or someone, other than oneself, be it a meaning to fulfill, or human beings to encounter. And existence falters and collapses unless this self-transcendent quality is live out."

Thank you for listening. Please email any questions or comments to logotalk@pld.com and may you have a meaningful day.

Friday, March 19, 2010

#15 Interview with Sharise Parviz


LogoTalk.Net is delighted and honored to be joined today by Sharise Parviz, an actress and dancer, fitness and nutrition enthusiast, and home schooling mother of three.

Sharise graduated magna cum laude from Wright State University with a degree in the fine arts. She has won an Irene Ryan Award for her stage work in The Overcoat and has been nominated for her work in Good Night Desdimona and 1913: The Great Dayton Flood. Her extensive television and film credits include The Manson Family, Duplicate, Curse of the Smoke O’Lantern and The Crow: Purgatory II. She has performed in over a dozen leading roles. Named the "Conservative Bombshell," she also currently produces her own political satire show called RESTRAINED NO MORE, SILENT NO LONGER with her film company Fantasy Films, LLC.

Sharise has faced many struggles including bulimia, depression, and domestic violence. She has found the strength to overcome through being true to her spirit. In a statement immediately understandable to any logotherapist, Sharise says, “I have come to learn through experience that a lot of time and pain can be saved if we heed our spirit’s calling.” And heed it she has! With a fighting spirit, Sharise looks for ways to make a difference in the world by fighting for what is right and protecting the weak. She is motivated by passion and purpose. What is that purpose? Sharise states, “Not quite sure…I just know it is there and when the time comes my purpose will be revealed. Until then, I just pursue!”

Sharise's website is:



She also maintains a health and fitness blog called Balancing Act:



Sharise's fine sense of humor can be found at her political satire site, Restrained No More:






Click here to download Interview with Sharise Parviz

Thank you for listening. Please email any questions or comments to logotalk@pld.com and may you have a meaningful day.

Sunday, February 7, 2010

#14 Susan's Story, Part 2

For this month’s podcast, I am turning the microphone over to Susan. Susan first appeared on LogoTalk.Net in July of 2009 in Episode 7: Susan’s Story. She was being treated for depression with a combination of logotherapy and rational emotive behavior therapy. Now, with the depression clearly in remission, Susan returns for Episode 14.

Early therapy focused on Frankl’s attitudinal value, the human freedom to choose our attitude in any given set of circumstances. Now that symptoms are in remission, the creative and the experiential values leap to the foreground in Susan’s case. She has even opened her own restaurant!

Click here to download Susan's Story, Part 2.


Click here to download Susan's Story, Part 1 (Episode 7).

Thank you for listening. Please email any questions or comments to logotalk@pld.com and may you have a meaningful day.

Sunday, January 10, 2010

#13 Logotherapy and Evidence Based Practices

Today's topic is the thorny question of Logotherapy and Evidence Based Practices. When I started to practice, any professional therapist was expected to keep up to date with the latest scientific findings in the field. Of course, therapists ethically remain responsible for the techniques they use in their practices.

However, during the 1990’s, we saw the development of managed care. Third party payors became assertive in stating what forms of therapy they would and would not pay for. In the last decade, this has developed into the concept of evidence based practices, or EBPs. The idea is that a payor source, an insurance company, for example, will not pay for a form of therapy unless there is scientific evidence that it works. Different payors maintain their own lists of EBPs and the lists are not the same.

The US Federal government list is the National Registry of Evidence Based Programs and Practices maintained by the Substance Abuse and Mental Health Services Administration of the US Dept. of Health and Human Services. The list is at:

http://www.nrepp.samhsa.gov/

Another list is maintained by the Society of Clinical Psychology, which is Division 12 of the American Psychological Association. Their website is at:

http://www.PsychologicalTreatments.org

Logotherapy has yet to appear as an evidence based treatment in any of the lists, despite the fact that research is continually ongoing in logotherapy and among logotherapists. A list of scientific journals on logotherapy is maintained by the Scientific Society for Logotherapy and Existential Analysis at the Viktor Frankl Institute Vienna at:

http://www.viktorfrankl.org/e/periodicals.html

On the other side of the debate, another body of research stresses the therapeutic factors related to outcome. Consistent findings over many years demonstrate that differences among the various therapy models do not translate into differences in therapy outcomes. In fact, the preponderance of the evidence suggests that no meaningful differences exist among the various schools and forms of therapy.

Division 29, the Division of Psychotherapy, of the American Psychological Association has an interesting article presently posted on its website at:

http://www.divisionofpsychotherapy.org/wampold-2006/

The importance of the therapeutic relationship can be illustrated by this clinical example cited by Viktor Frankl at the First World Congress of Logotherapy:

"An American girl, a student of music, came to see me in Vienna for analysis. Since she spoke a terrible slang of which I could not understand a word, I tried to turn her over to an American physician in order to have him find out for me what had motivated her to seek my advice. She did not consult him, however, and when we happened to meet each other on the street, she explained: "See, Doctor, as soon as I had spoken to you of my problem, I felt such a relief that I didn't need help any longer." So I do not know even now for what reason she had come to me. This was an extreme example when human encounter, without any technique, was therapeutic."

In 1992, M.J. Lambert found 4 factors were responsible for psychotherapy outcome.

1. Extratherapeutic factors account for 40% of the positive change. These are factors not directly related to therapy at all. They include the strengths and resources of the client as well as random, chance happenings.

2. The therapeutic relationship accounts for 30% of the positive change. This refers to the quality of the relationship between the therapist and the client. Therapist factors include qualities such as empathy, respect and genuineness. Client factors include readiness for change, goals for therapy and the client's view of the quality of the relationship (not the therapist's view).

3. Specific therapeutic techniques account for 15% of the positive change.

4. Some combination of hope and the placebo effect account for the remaining 15% of change.

So what are we to make of this for logotherapy? Recently, I have started to speculate that the effectiveness we see with logotherapy is not because of the effect logotherapy has on the client, but on the effect logotherapy has on the therapist. Simply put, I believe that studying logotherapy makes us better therapists!

Bibliography

Lambert, M. J. (1992). Implications of outcome research for psychotherapy integration. In J. C. Norcross and M. R. Goldfriend (Eds.), Handbook of psychotherapy integration. New York: Basic

Wampold, B. E. (2006). Three ways to improve our effectiveness. In News you can use. Washington: APA Division 29. Online: http://www.divisionofpsychotherapy.org/wampold-2006/

See also:

Miller, S. D., Duncan, B. L., & Hubble, M. A. (1997). Escape from babel: Toward a unifying language for psychotherapy practice. New York: W. W. Norton & Company.

Norcross, J. C. (Ed.). (2002). Psychotherapy relationships that work: Therapist contributions and responsiveness to patients. New York: Oxford University Press.

Wampold, B. E. (2001). The great psychotherapy debate: Model, methods, and findings. Mahway, NJ: Lawrence Erlbaum Associates.

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