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Mason, H. D. (2016). Logotherapeutic self-care. International Forum for : Journal of Search for Meaning, 39(2), 97–102.

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LOGOTHERAPEUTIC SELF-CARE

Henry D. Mason

Offering light to the world carries with it the inevitable danger of burning (Gentry, 2002). Those in the helping professions (hereafter referred to as “therapists”) unavoidably witness human disease, disorder, and distress in the course of their daily work. The concepts of disease, disorder, and distress have, at the exclusion of human goodness, strengths, and talents, become prominent foci of contemporary psychological discourse (Seligman & Csikszentmihalyi, 2000). This dominant dialogue gave rise to a proliferation of research focused almost exclusively on pathology (Peterson, 2006). In an attempt to address this imbalance, Seligman (1998) introduced , which proposes that human goodness, strengths, and talents are as authentic as disease, disorder, and distress. Hence, a height psychology, to complement the pervasive pathology-based depth psychology, was proposed (Peterson, 2006; Seligman, 1998). Frankl introduced the notion of a height psychology, which was conceptualized as logotherapy, during the pre-WW2 period (Frankl, 2000, p. 138). The Nazi concentration camps served as the “experimental laboratories” where Frankl’s theoretical suppositions were tested. The concept of a height psychology asserts that humans can, amongst other things, transcend beyond the stressful confines of the biopsychosocial plane toward the uniquely human dimension of the Noetic (Frankl, 1992). The Noetic dimension rises above the dichotomous constraints of pathology versus health by calling attention to Meaning (Frankl, 2000). The discovery of Meaning is not dependent on negative, benign, or positive conditions (Mason, 2012). Rather, it is an unconditional potentiality that overarches all of life (Frankl, 1992). Humans, such as therapists, can subsequently reach out to, amongst others, clients with compassion in an attempt to discover Meaning regardless of the circumstances. However, a plethora of empirical data indicates that compassionate interaction with clients can negatively impinge on therapists’ wellbeing and bring about deleterious effects (Figley, 2002; Gentry, 2002). These deleterious effects, which echo the prominent pathology-based psychological

97 discourse, have been defined as, amongst other things, compassion fatigue and burnout (Stamm, 2010). Compassion fatigue mirrors post-traumatic stress disorder symptomology while burnout refers to a syndrome of emotional exhaustion (Stamm, 2010). Only recently has the positive psychological consequence of compassionate caring, namely compassion satisfaction, been defined and studied. The concept of compassion satisfaction refers to the pleasure that helping professionals derive from their work. Helpers are encouraged, as an ethical imperative, to engage in self-care activities in attempts to curb the incidence of compassion fatigue and burnout and enhance the potentiality for compassion satisfaction (Stamm, 2010). The above-mentioned perspective disregards the Noetic. The Noetic refers to a dimension where the discovery of Meaning exists as a potentiality to be actualized in spite of conditions such as compassion fatigue, burnout, and compassion satisfaction. Logotheory offers, through its emphasis on Meaning, a novel perspective on therapist self-care. It views self-care from a height and value-directed perspective, which pulls therapists forward toward the realization of meaning-centered values even when they are confronted with clients’ and their own personal suffering. The present conceptual article describes the concept of self-care from a logotherapy perspective. It is argued that logotherapeutic self-care does not constitute a particular set of techniques, but encompasses a “way of being.” In other words, therapists ought to regard both their compassionate interactions with clients and self-care duties as Meaning-centered tasks that they are called to fulfill (Shantall, 2002).

Compassion in the Helping Context The concept of compassion refers to the feelings of empathy and understanding that helpers express toward clients (Figley, 2002). Research suggests that compassion may open therapists up to the traumatic content and experiences of clients. As such, therapists may experience secondary forms of traumatization (Figley, 2002). Stamm (2010) suggests that helpers who express greater levels of compassion are often most vulnerable to the risks of compassion fatigue and burnout. Additionally, aspects such as stressful working conditions, high workload, and unrealistic expectations may exacerbate the conditions of compassion fatigue and burnout (Mason, 2013). Research indicates that compassion fatigue and compassion satisfaction can co-occur while burnout and compassion satisfaction are regarded as mutually exclusive concepts (Stamm, 2010). It has also been hypothesized that compassion satisfaction could serve as a buffer against burnout (Mason, 2013).

98 From a logotherapy perspective, the dichotomy of positive versus negative is replaced by a focus on Meaning. The challenge, therefore, is to discover Meaning in spite of, or even because of, both positive (e.g., compassion satisfaction) and negative (e.g., compassion fatigue and burnout) situations and experiences (Frankl, 2000; Mason, 2013).

Self-Care Therapists are often subjected to various attitudes regarding professional discourses, for example, that they should disregard their personal needs and emotions, are responsible for fixing problems, should always be objectively neutral, and are the experts (Feminist Institute, 2000). Consequently, therapists could ignore their own, at the expense of clients’, needs. The capacity to act in self-enhancing and constructive ways is referred to as self- care. Lack of self-care can be regarded as unethical, as it can lead to harming clients. Consequently, self-care can be seen to imply respect for the dignity of the self and clients (Feminist Therapy Institute, 2000).

A Logotherapeutic Perspective of Self-Care In Frankl’s (1992) seminal work, Man’s Search for Meaning, he provides examples of compassionately reaching out to fellow prisoners amidst inhuman concentration camp conditions. Amongst other things, Frankl entered into Socratic Dialogue and challenged two men who were contemplating suicide to search for a “why” that could outweigh their suffering. Instead of being overcome by the clinical conditions of compassion fatigue and burnout, or being motivated by the pursuit of compassion satisfaction, Frankl forgot about his pain and focused on the task that Life had put in front of him (Shantall, 2002). While Frankl may have experienced a sense of psychological satisfaction from having impacted the two men’s lives, he also discovered Meaning by addressing the task that Life had placed in front of him, namely to, notwithstanding his pain, compassionately reach out to two fellow human beings. Frankl (1992, p. 89) also makes reference to moments when he was caught in the apparent depths of despair: “I was not in the mood to give psychological explanations or to preach any sermons—to offer my comrades a kind of medical care of their souls. I was cold and hungry, irritable and tired, but I had to make the effort and use this unique opportunity. Encouragement was now more necessary than ever.” In demanding moments like this, when Frankl could have hidden behind pathology-based labels such as compassion fatigue and burnout, he remained sensitive to the message, communicated via the Conscience, that challenged him to search for and discover Meaning. Frankl (1992, p. 59) explains: “And

99 I quoted from Nietzsche: ‘Was mich nicht umbringt, macht mich starker.’ (That which does not kill me, makes me stronger.)” Frankl’s actions illustrate a moment of Tragic Optimism and heroism (Wong, 2007). In a situation where pathological consequences, such as compassion fatigue and burnout, may have been regarded as natural consequences, suffering served to awaken his spiritual aspirations (Mason, 2012). He engaged in logotherapeutic self-care by discovering a “why” that pulled him, and his fellow inmates, forward out of existential apathy: “I saw that my efforts had been successful. When the electric bulb flared up again, I saw the miserable figures of my friends limping toward me to thank me with tears in their eyes” (Frankl, 1992, p. 91). Nonetheless, Frankl (1992, p. 91) confessed to being finite: “…I have to confess here that only too rarely had I the inner strength to make contact with my companions in suffering and that I must have missed many opportunities for doing so.” Consequently, therapists’ tasks to search for Meaning within trying conditions could create a dynamic tension between “who they are” and “who they ought to be.” Even when therapists fail to heed the call of Life, subsequent feelings of guilt ought to inform the continuous search for Meaning (Shantall, 2002). Logotherapeutic self-care should therefore not necessarily be focussed on reducing tension, or more accurately, on transforming compassion fatigue and burnout into compassion satisfaction. Rather, logotherapeutic self-care should be centered on establishing a dynamic Noetic-based tension with Life.

Discussion: Logotherapeutic Self-Care The concept of logotherapeutic self-care can be described as a destined and once given opportunity where Life questions the therapist to act in a Meaning-centered, self-enhancing, and, in some instances, a self-sacrificial way. Because of the Freedom of Will, the therapist can choose to answer the call of Life by searching for and discovering Meaning of the Moment (Shantall, 2002). The discovery of Meaning, as a function of logotherapeutic self-care, could infuse therapists’ lives with existential value, which may serve as a potential protective factor against the pathological threats of compassion fatigue and burnout (Bulka, 1984). Even if therapists find themselves battling compassion fatigue and burnout, Meaning remains an overarching potential. An ongoing endeavor to discover Meaning can be a valuable self-care strategy. However, logotherapeutic self-care ought not to be thought of as a “strategy.” Rather, it encompasses courage to answer the calls from Life in all situations (Shantall, 2002).

100 Logotherapeutic self-care can subsequently be defined as a pervasive Meaning-centered attitude as well as a “way of being” to embrace the unavoidable suffering of clients and the Self as opportunities to act in self- enhancing ways by transcending to the Noetic plane and offering insights, actions, and reflections to the world as gifts. It challenges therapists to superimpose the contents of the Meaning Triad over situations defined by the Tragic and Mass Neurotic Triads to realize Meaning in the face of the bleakest of circumstances; it inspires an attitude of Tragic Optimism within the context of self-care (Bulka, 1984; Wong, 2007).

Conclusion The main argument presented in this article is that logotherapeutic self- care ought to serve as the impetus to awaken the Noetic aspirations and destined life-tasks of therapists – it could aid in the discovery of Meaning and may be realized by forgetting the Self. To expand on an analogy used by Frankl, just as a healthy eye that does not see the Self, similarly, the therapist engaged in logotherapeutic self-care, does not see the Self. However, a cataract in the eye, or in the context of this article, the experience of compassion fatigue and burnout, could be interpreted as a call that pulls therapists forward toward the search for, discovery, and realization of Meaning. Similar to Homo Patiens who emphasize the discovery of Meaning during times of disease, disorder, and distress, logotherapeutic self-care calls on therapists to transcend beyond the pervasive pathology-based paradigm and embrace the infinite potentialities to discover Meaning as afforded by the Noetic dimension (Frankl, 2000). From a logotherapeutic perspective, therapists have been called as lights to shine in the darkness; they are challenged to light a thousand other candles, without the radiance of their candles being stifled: "Et lux in tenebris lucet" (Frankl, 1992, p. 52).

Henry D. Mason [[email protected]] holds a Doctoral degree from the School of Psychology at the University of South Africa and obtained his Diplomate accreditation in logotherapy in 2012. Henry serves as the President of the Southern African for Counseling and Development in Higher Education and is employed by the Tshwane University of Technology, South Africa, as a social science researcher. His research interests include logotherapy, post-traumatic growth, care-for-the- caregiver, and existential and radical positive psychology.

101 References Bulka, R. P. (1984). Logotherapy as an answer to burnout. The International Forum for Logotherapy, 7, 8-17. Feminist Therapy Institute. (2000). Feminist therapy code of ethics. Revised by Marcia Chappell. San Francisco: Author. Figley, C. R. (Ed.). (2002). Treating compassion fatigue. New York: Brunner-Routledge. Frankl, V. E. (1992). Man’s search for meaning: An introduction to logotherapy (4th ed.). Boston: Beacon Press. Frankl, V. E. (2000). Man’s search for ultimate meaning. Cambridge: Perseus Publishing. Gentry, J. E. (2002). Compassion fatigue: A crucible of transformation. Journal of Trauma Practice, 1(3-4), 37-61. Mason, H. D. (2012). In honor of logotherapeutic paradox: Reflections from a diplomate logotherapy student. The International Forum for Logotherapy, 35, 23-28. Mason, H. D. (2013). Relationship between meaning and professional quality of life among nursing students. The International Forum for Logotherapy, 36, 25-31. Peterson, C. (2006). Positive psychology: A primer. New York: Oxford University Press. Seligman, M. E. P., & Csikszentmihalyi, M. (2000). Positive psychology: An introduction. American , 55, 5-14. Seligman, M. E. P. (1998). President’s address from the American Psychological Association’s annual report. Retrieved from: https://ppc.sas.upenn.edu/sites/ppc.sas.../APA%20President%20Address %201998.doc Shantall, T. (2002). Life’s meaning in the face of suffering: Testimonies of Holocaust survivors. Jerusalem: Hebrew University Magnes Press. Stamm, B. H. (2010). The concise ProQOL manual (2nd ed.). Pocatello, ID: ProQOL.org. Wong, P. T. P. (2007, August 11-14). Radical positive psychology for radical times. Keynote address: International Council of in San Diego. Retrieved from: http://www.meaning.ca/archives/ archive/art_radicalPP_P_Wong.htm

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