as it remains without doubt the story of a holocaust survivor, it contains meaning and truth. Pytell (2000) suggests that Frankl’s work likely dramatizes his survival, representing his own rather than ‘Man’s’ cry (Frankl, 1992) for meaning, an unheard cry at that (Frankl, 1978). None the less, Frankl’s (2000, 1978, 1969) writings gained wide acceptance over time, especially his observation that the contemporary society was sick due to the loss of meaning in people’s lives. He referred to this condition of meaninglessness as noogenic neurosis. He described it as an existential vacuum resulting from a loss of touch with the natural environment; loss of grounding in traditions, religious practices, and philosophy; and the lack of a self-transcendent connection to something larger than ourselves. Symptoms of the malady were boredom and meaninglessness which were expressed through aggression, addiction, depression and suicide (Frankl 1992, 1969).
In this book, we use Frankl’s notion that human beings are primarily motivated by a search for meaning in life. We agree that a lack of meaning in life can plunge one into a sense of emptiness (Frankl’s ‘existential vacuum’) and subsequently into a lack of a sense of well-being. This lack can in turn lead to self-destructive behaviors such as addictions and even suicide. However, rather than subscribe to Frankl’s pathologization of meaninglessness as a disease, we prefer to follow Maslow’s (1970) suggestion that the search for meaning is actually a search for personal growth. We then propose that occupational therapists and scientists can help people realize this search for growth and ultimately for meaning in life by enabling them to carefully select occupations in which they participate every day of their lives.
Frankl’s ideas as a guide to meaning-making
Our discussion of Frankl’s theory is consistent with McNamee’s (2007) suggestion that: ‘Human beings are meaning junkies. It is not enough for people to just experience the world as it is; we are desperate to make sense of it’ (p.1 of 15). However, McNamee’s perspective of ‘meaningfulness’ is not existential, but seems to belong to a Western middle class understanding of life meaning found in the puritan values of hard work and healthy leisure which evolved over the 19th century (Flanders 2006; James, 2006). The dominance of this perspective of meaning originated from the growth of the middle classes during the 19th and 20th centuries, when there was a demand for a variety of professional occupations consistent with a rapid economic development. Such professional disciplines included engineering, teaching, medicine, and banking among others. The professionals defined themselves by their work, and were eager to distinguish themselves from the laboring classes in the neighbouring streets. These distinctions were based on a range of values: cultural, spiritual, educational, and familial. They were visible in the evident disparities in health between the wealthy and the poor.
The poor were very often held to blame for their own condition. Eugenic ideas of natural fitness and unfitness for genetic survival were used to spread fear that the healthy and wealthy might be contaminated by the rising numbers of diseased and impoverished people (James, 2006, Werskey, 1994). During that time in Britain, a third of the population was barely able to feed itself properly (Marr, 2009; Werskey, 1994). Even today, while there have been overall improvements in health, significant differences in life expectancy – between 71 for men and 78 for women in Glasgow compared to 85 for men and 87 for women in Chelsea and Kensington - remain the same as they were in the 1930s (National Records of Scotland 2011; Thomas, Dorling, & Smith, 2010). These disparities are still held to be natural [and perhaps pre-ordained] (Dorling, 2011). Under these circumstances of gross disparities, many working class people related ‘meaning’ to the value of their experiences and their place as witnesses to history. Their perceptions of quality of life were recorded in written autobiographies (Ragon 1986; Vincent 1981) as well as in folk songs (Buchan, 1997; Copper, 1975; Lloyd, 1969).
Thus, even within a particular culture the search for meaning can represent different things for different people. For those in the upper socio-economic status, meaning is perceived differently in comparison to the understanding by those in the lower socio-economic ranks. Even Frankl (2000, 1992, 1969) acknowledged that there is no one universal definition of the construct of meaningfulness. Rather, meaning is embedded in the concrete engagement in tasks that help individuals achieve specific goals, particularly transcendental missions in life, or to create desired legacies which are intended to continue once their lives are over (Frankl, 1969).
One complication when considering how people maintain a meaningful existence in the modern world is that technological gains appear to have eliminated many of the evolutionary challenges which gave meaning and purpose to life. For example, people no longer need to walk because they can get around by driving; they don’t need to climb stairs because they can use a lift; and they do not even need to retain and recall information because they can access the internet through their phones. Many tasks that in the past made people feel competent (one of the ways in which people experience meaning in life) have disappeared. Instead of dealing with the challenges of survival, the problem facing the modern human being has become the question of what to survive for. The paradox is that people have an unprecedented ability to survive and to stay alive even in cases of severe injury or illness, but have ‘nothing to live for’ (Frankl, 1978, p. 21).
Creating meaning and happiness by not actually pursuing either
Throughout history, the nature of human action was often determined by social and cultural factors that ensured that achievements were recognized by an individual’s peers and often more significantly, met the demands of the gods. Frankl (2000) argued that these motivations for action were always present even if they were not always recognized. The way to address the urge to achieve was to desist from merely striving to win for the sake of winning, for happiness, or for other gains. Striving to achieve happiness often led to loss of happiness. Such efforts resulted in aggression and were often unsuccessful. A better attitude in life, he suggested, was to adopt a philosophy of doing one’s best while paradoxically maintaining self-detachment. Success and happiness would naturally follow (Frankl, 1978). He described a ‘will to meaning’ (p. 15) as a determination to achieve an end despite everything that may stand in the way of one’s objective. He frequently referred to the idea of heroism which he argued pertained to finding meaning even in suffering (Frankl, 1978, 1969), making it possible to rise above pessimism and fatalism in the face of the inevitability of failure or death. If individuals could recognize that their past achievements could not be taken away from them, they could gain a sense of value, purpose, and meaning, and realize the potential for change, despite death or loss.
In occupational therapy, do Rozario (1994, p. 46) agreed with Frankl’s position by asserting that the profound ‘human longing for ritual and meaning’ was expressed through spiritual pursuits. It is important to point out though that forms of spirituality may have actually originated from practical concerns about the necessity to organize society and to structure communal tasks in order to ensure human survival in particular environments (Mair, 1962; Pryor, 2004). Spirituality thus became important in imbuing humanity with a sense of meaning, yet also served to both uphold and sometimes challenge the status quo throughout the development of human societies. However, though people subscribed to religious beliefs, they tended not to be involved with the deeper discussion of the significance of such beliefs. Such discussion occurred amongst intellectuals concerned with sacred discourses (Berger, 1973).
Frankl’s writings link the quest for human meaning with spirituality and imply that the spiritual crisis of meaning is rather a modern phenomenon. These views appear consistent with a wider recognition of the effects of loss of spirituality and the ritual that comes with it. For example Marr (2009, p. xi) and Dorling (2011, p. 24) suggest that a feature of modern society is that people have abandoned a purposeful [spiritual] ideology and are ‘shopping’ for new guides to a deeper significance to their lives, be it popular astrology, feng shui, angels, crystal therapy or Mayan prophecy (Redfield, 1994). Many of the traditional religions have also at times been rejuvenated to become part of the spiritual bazaar of our times (Berger, 1973).
The development of meaning
In