Man's Search for Meaning

by Viktor E. Frankl

As for the actual causation of neuroses, apart from constitutional elements, whether somatic or psychic in nature, such feedback mechanisms as anticipatory anxiety seem to be a major pathogenic factor. A given symptom is responded to by a phobia, the phobia triggers the symptom, and the symptom, in turn, reinforces the phobia. A similar chain of events, however, can be observed in obsessive-compulsive cases in which the patient fights the ideas which haunt him.15 Thereby, however, he increases their power to disturb him, since pressure precipitates counterpressure. Again the symptom is reinforced! On the other hand, as soon as the patient stops fighting his obsessions and instead tries to ridicule them by dealing with them in an ironical way—by applying paradoxical intention—the vicious circle is cut, the symptom diminishes and finally atrophies. In the fortunate case where there is no existential vacuum which invites and elicits the symptom, the patient will not only succeed in ridiculing his neurotic fear but finally will succeed in completely ignoring it.