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PSYCHOLOGY, Vol: 21 (No. 202), 1970
ANONYMOUS AS GROUP LOGOTHERAPY
Robert M. Holmes*
alcoholics abiding need is for an 'acceptance
experience' of such genuineness and certainty that it can
beyond the stultifying restrictions of social rejection
self-rejection that encumber him."
was born to ask why he was born. It is his quest for
meaning that makes him human. Many animals seek power, and
animal seeks pleasure, but only man seeks meaning. His
preoccupation with this search is neither idle nor pathological,
but urgently important if life for man is to rise appreciably
above the animal level. The frustration entailed in this
is not a hazard to be avoided or outgrown, but a constant
that can give life its vitality. The absence of meaning
either to the slow death of neurosis or to the instant death
suicide. Therefore it is to the discovery of meaning (by
cultivation of responsibility in the present moment) that
contemporary psychotherapy would do well to direct greater
in broad outline, is the underlying philosophy of the
Viennese psychiatrist, Viktor Frankl, and the fundamental
orientation of his unique therapeutic approach which he
"logotherapy." While Frankl is not the first to
as the principal clue to psychoneurosis and the key to its
he remains the one who has framed the problem concisely
emphatically within the psychotherapeutic context and has
developed an entire therapeutic technique around it.
Chaplain and Associate Professor of Christian Thought, Rocky
Mountain College, Billings, Montana.
the directness with which Frankl wrestles with his
patients may seem crudely unpermissive to some counselers
more Rogerian persuasion (some of his writing hints of a
"positive thinking with a Ph.D."), he reflects
insights of such divergent existentialists as Heidegger,
Kierkegaard, and Max Scheler, who have emphasized the
individuality of each person's unique opportunity and necessity
live life and face death for himself. Frankl, as did Luther,
asserts that each man's faith, like each man's death, is
His theory, in fact, is not unrelated to Paul Tillich's
upon the need to recover "the lost dimension of religion"
represented by ultimate Questions of meaning.
and quite coincidentally, there is, in our
society, no group that provides a better laboratory for
logotherapy goals than Alcoholics Anonymous. In. A.A., the
for the meaning of life does not appear in these words as
explicit aim, but an examination of what actually happens
reveals that a fundamental concern for meaning is basic
alcoholic's need and central to A.A.'s therapeutic program.
intent of this article is to show how A.A. functioning quite
independently of Frankl or any other psychiatric tradition,
fact virtually without psychiatrically-oriented or even
professionally skilled leadership, operates with the very
presuppositions which happen also to be basic to logotherapy.
Moreover, if it can be shown that the experience of A.A.
essentially a "group logotherapy experience,"
implications can and should be drawn for groups within the
which are designed to meet a broad spectrum of human problems.
is to Frankl's philosophy rather than to his clinical
procedures that A.A. is to be compared. The four basic concepts
Frankl's doctrine of man seem also (though unwittingly,
to be fundamental to A.A.'s therapeutic program: 1) dimensional
ontology; 2) existential frustration; 3) freedom; and 4)
must be seem in terms of dimensions rather than layers or
compartments, and to be understood fully must be viewed
these dimensions simultaneously - namely, the psychic, the
somatic, and the noetic. Yet it is in the noetic dimension
man's distinctly human nature and his divine potentialities
be found. This is his "spiritual" nature. The
word Frankl uses is
geistig rather than geistlich. The latter means "spiritual"
specifically religious connotation, while the former is
"noetic" or spiritual without a necessary religious
Frankl's choice of word is made out of respect for the limits
psychotherapy's concern: that is to say, the psychiatrist
is not a
theologian nor is the doctor's office a church. But ample
left for the development of specific content with respect
nature of God and the bearing of theological convictions
life of the patient. In any event, an acknowledgment of
individual's dimensional ontology and of the primacy of
dimension as the avenue to his ultimate attainment of wholeness
fundamental in Frankl's anthropology.
the most intellectually sophisticated of A.A. members
would probably be hard-pressed to articulate the concept
that underlies A.A. philosophy. Many would, however, be
testify from experience to the inadequacy of trying to meet
problem of alcoholism from some essentialist point of view
simply seeks to provide a psychiatric analysis of the past
medical "cure" for the present. The alcoholic
has a psychological
structure and history to be sure, just as he has a set of
biological needs and problems. But he also possesses that
dimension too often overlooked if not specifically rejected
- namely, the noetic.
the alcoholic is really to be understood as a person he
must be viewed in all of his dimensions. Many an alcoholic
long history of futile attempts to deal with his drinking
independently. In this sense, A.A. is profoundly existential
its approach in that its focus is upon a person with a drinking
problem, the alcoholic as he "exists." There is
interest in the etiology of alcoholism generally or in an
of its customary symptoms, but only in the experience of
alcoholic. The extent to which the A.A. program encourages
alcoholic to become aware of his total existence is daring
depth and often painful in its intensity. The original fellowship
of A.A. was founded on the insight that one's drinking problem
could not be separated from the total combination of his
relationship to others, his attitude toward self, and his
to life. Herein lies the importance of steps four and ten
Twelve Steps of A.A:
made a searching and fearless moral inventory of
continued to take personal inventory and when we were
wrong promptly admitted it.
the genius born of experience rather than religious
training, A.A. has discovered that the alcoholic must not
with as a bundle of symptoms or a pawn of drives, but as
existing person who must be met as a total self and must
see himself in this way. With the help of Frankl, we might
that A.A. majors in the "existential act," which
is that of
"emerging oneself spiritually above one's own psychophysical
success of A.A. like that of logotherapy, is dependent
upon the noetic dimension. Though both programs refuse to
out God's nature in any specific terms, the reality of God
the spiritual nature of man are basic assumptions of both.
concern themselves with the healing of the soul, leaving
saving of the soul to religion. But A.A. is unapologetic
theocentrism of its program. Six of its twelve steps make
reference to God. Repeatedly, in the handbook of A.A. the
"God" is followed by the modifying phrase, "as
we understood him;"
yet while 'A.A. does not press for an "objective"
of God, it speaks of its program as a "spiritual awakening."
vast clinical experience and the frequency with
which the psychotherapeutic needs of his patients seem to
been preceded by metaphysical needs, have led him to formulate
concepts of "existential frustration" and "existential
The former refers to the frustration of one's will to meaning,
"existential vacuum" refers to that condition
of emptiness that
exists when all meaning seems lost or undiscovered. In contrast
psychoanalysis' hasty translation of this concern for meaning
mere "instinct determinism," and the individual
diagnosis of "inferiority complex," Frankl maintains
existentil frustration. far from being pathological, is
human of phenomena.
the etiology of alcoholism could hardly be reduced
simply to existential frustration, the crucial role that
should not be too hard to see. For example, many psychologists
sociologists today speak of boredom as one of the factors
nation's growing alcohol problem. They see a nation of people
are unequipped to use their increasing leisure time healthfully.
Frankl speaks of existential vacuums becoming manifest in
condition of boredom, which, he says, demonstrates that
all apparent needs are satisfied there is still a fundamental
that is not met which is not described on the psychic or
speaks of "victims of 'Sunday neuroses"' who "get
order to flee from their spiritual horror of emptiness."
in the deepest sense, means not just lack of something to
lack of any real sense of purpose or meaning. The use of
is one of the most prevalent escapes from this intolerable
This would seem to explain why alcoholics are often rich,
highly skilled, and sometimes extremely gifted people. What
possessions or abilities one has are always secondary to
meaning he finds in these endowments. If meaning is lost,
amount of evidence of well-being will provide a satisfying
The slow death of alcoholism is selected as the only apparent
alternative to suicide (though obviously, suicide is often
as the easier course). If the alcoholic is to be helped,
will not be by making him see the dangers of his drinking
increasing his already intolerable sense of guilt for his
misuse of life, but by meeting him at the point of his sense
meaninglessness - his existential vacuum.
not using any of the technical terminology, this is
precisely what A.A. does. It achieves it in two ways: first
providing an acceptance experience in which the alcoholic's
as a person is reaffirmed, irrespective of his alcoholism,
second, by providing him with a sense of purpose that arises
in spite of his alcoholism but out of the very fact of it!
affirmation of personal worth. To Frankl this is crucial
to all good therapy. In his encounters with patients he
frequent reference to the value of the contributions the
has made in his past life and of his potential for the future.
stress upon the supreme importance of "attitudinal
aimed at helping the patient achieve, or retrieve, a sense
personal integrity and importance by seeing the unique
opportunities that are his and his alone. If one can create
little, thus possessing few "creative values,"
and even if one's
sphere of experience is limited, thus providing little in
of "experiential values," each patient has a unique
limitless field of "attitudinal values" which
arise out of the
manner in which he faces and deals with his particular existential
alcoholic's abiding need is for an "acceptance
experience" of such genuineness and certainty that
it can move him
beyond the stultifying restrictions of social rejection
self-rejection that encumbers him. Accordingly, the most
fundamental characteristic of the atmosphere of A.A. is
maximum acceptance. It provides a context where the individual
a person again in his own right. Frankl would maintain that
provision for a sense of personal worth is essential in
discovery of purpose. Frankl is of the personal
persuasion that no life is meant to be purposeless and that
life can find purpose, no matter what its history. The older
citizen or the terminal patient can choose to look upon
death as a
fitting climax to a meaningful life, or his response to
of death can itself become an event of ultimate meaning
the highest meaning a mortal life can achieve.
is like death in that it is an inescapable fact.
He cannot look hopefully to the day when he will not be
alcoholic. He can only confront this fact, accept it, and
how he is going to deal with it. A.A. suggests that the
significant meaning his life may ever achieve can arise
out of the fact of his alcoholism. When an alcoholic testifies
his own experience he discovers that it is of value to others.
Thus the culminating step of the program asks him to be
on call at
virtually any hour and to be willing to travel any distance
at the side of an alcoholic who has taken the initiative
for help. The realization that as an alcoholic there are
he can perform better than anyone else (even a psychiatrist
pastor) provides the ultimate satisfaction of his existential
frustration. There is a famous declaration of Nietzsche
Frankl is fond of paraphrasing: "He who has a 'why'
endures almost every 'how'."
is unequivocal in his rejection of any anthropology
which sees man as the victim of some kind of determinism.
free to make choices, free to respond, free to take a position,
free to say "yes" or "no" to life. He
is free even if he does not
yet understand the ultimate meaning of things. He is free
he pretends not to be free.
alcoholic, whose history has been marked by alternate
encounters with sympathy and rejection, comes into Alcoholics
Anonymous, where he finds neither. The judgement under which
has lived - that he is a "hopeless drunk" - is
A.A.'s affirmation that although he is indeed a drunk he
the least hopeless.
entire program of A.A. is predicated on the assumption
that the individual, no matter how depressing his past,
is free to
choose - to accept or reject a positive future - step by
day, one hour at a time. To make the admission called for
"first step" (one's powerlessness over alcohol)
is to make a
decision of the greatest importance. It launches the alcoholic
a program that enables him to accept his situation and to
freedom creatively within the limits of that situation.
He is free
to acknowledge that he is not free to drink, and he is free
abide by the self-imposed restriction of abstinence. Step
states: "We made a decision to turn our will and our
lives over to
the care of God as we understood Him." Indeed, in a
each of the Twelve Steps is accepted only by personal decision.
Frankl would applaud this insistence upon the recognition
and responsibility imply each other. According to
Frankl, in the same way that authentic therapy frees the
from much that has encumbered him, it must educate him to
of responsibility. Though a man may not be responsible for
everything that happens to him, he is inevitably responsible
what he does about what happens to him. He may not be responsible.
for his symptoms, but he is responsible for his attitude
his symptoms. Though there may be a limit to the extent
he can alter his existential situation, nevertheless he
obligation to realize values and discover meaning in his
matter what the circumstances.
phrase "education to responsibility" would appear
to be a
particularily apt description of the A.A. program. The education
begins at the point where the alcoholic first dials A.A.'s
or attends his first closed meeting. To be sure, alcoholism
always the result of a complex of factors which spread the
responsibility for the condition far beyond the alcoholic
But it is of no help to the alcoholic to dwell on this fact.
Recovery comes rather by way of the difficult but releasing
process of self-acceptance, the vital core of which is acceptance
of personal responsibility.
of the Twelve Steps presupposes the alcoholic's capacity
to respond. This responseability includes the acceptance
condition, the confession of one's willful wrongdoing and
tendencies to evade responsibility, and a sense of obligation
apply one's own experience to the needs of others. The focus,
therefore, is upon responding creatively in the present
such a way that meaning is discovered not apart from or
of the circumstances of life, but out of their very warp
SOME IMPLICATIONS FOR THE CHURCH
Frankl's anthropology is correct, then. the patient who
enters his clinic, the alcoholic, who comes through A.A.,
parishioner in the average church are not essentially (or
existentially!) different. The fact bears profound implications
for lay groups in the local church.
is to Frankl's philosophy rather than to his clinical
procedures that A.A. is to be compared and to which the
church might profitably direct its attention. Clinically,
employs techniques which the church is neither called upon
equipped to use. But "group logotherapy" in the
in the manner of A.A.'s rejuvenated Oxford Movement, could
large spiritual dividends. A.A. dramatizes the possibilities
implementing the logotherapy philosophy in concrete "growth
situations under relatively unskilled but devoted leadership.
could predict the results of such a group in the church,
called to discuss their own failures, their own "existential
vacuum?" What personal discoveries might be made in
of "telling one's own story" from the standpoint
of one's search
for meaning in the unavoidable facts of his life? What theological
insights or what receptivity to new revelation might result
reexamination of the Fourth Gospel in the light of Frankl's
on Logos as "meaning?" With a logotherapeutic
executed in the pattern of the informal quasi-class meeting
structure of A.A., and informed by the New Testament, the
could become a laboratory in which the average parishioner
forge ahead with new freedom and vitality in his essential
for life, liberty, and the pursuit of meaning.