Book Review: Man’s Search for Meaning

This month I read the book, Man’s Search for Meaning by Viktor Frankl. The book is actually one of the top selling “self-help” books of all time. I put self-help in quotations because I’m not sure if that was the original intention behind Frankl writing it, but it seems that he might have recognized what it became between the years it was first published in 1946 and his death in the late 1990s. The first half of the book chronicles his experiences as a prisoner in concentration camps during the second World War, including Auschwitz. While this could be just read as an intense, heart-breaking story (and it is), the way that Frankl writes about his life experiences doesn’t come off that way. Instead, you can see his reflection and growth in his writing. It’s kind of hard to explain how that works, unless you read it for yourself. The story is also not chronological but instead jumps back and forth across his timeline in the camps to highlight pieces of the story that are connected to each other in some way.

While I don’t want to give away too much from the story, because I highly recommend that everyone read it, there were two main takeaways that I had from the first half of the book. First, is that if we believe our lives have no meaning, then we are more likely to give up when faced with difficult circumstances – and that meaning doesn’t have to be grand or anything, as the beauty of a sunset or holding the hand of a sick friend can bring some meaning for that day. Of course, as Frankl admits, in the concentration camps there was a huge element of dumb luck that you ended up in this line instead of that line (whereas that line led you to the gas chambers and this one didn’t), but for those with that luck, meaning became important. The other takeaway I had is that meaning is created by each other us, and is different for each person. It is solely up to us what that meaning is.

The second half of the book is about Logotherapy, which is a psychotherapy modality that Frankl (who was a psychiatrist) invented. It was kind of based on psychoanalysis, but with a heavy emphasis on existential philosophy, particularly meaning-making. During the second half of the book, Frankl does tell more stories from his time in the camps, integrating it with his theories about human existence and how helping people find meaning can aid with the treatment of many mental health problems. Frankl is considered one of the leaders of existential psychotherapy. Though logotherapy isn’t really used anymore, as there isn’t a huge amount of empirical evidence supporting it, it has influenced many other existentially-based therapies, including Acceptance and Commitment Therapy, which I practice. My personal beliefs are that life meaning is incredibly important, as are other existential concepts, which all humans ultimately deal with, and our ability to deal with contributes, at least partially, to our overall well-being.

Even if you aren’t interested in psychotherapy or existentialism, I highly recommend giving this book a read. There’s a reason that this is a best-selling self-help book. Many people struggle with finding meaning in their lives, especially at transitional periods, and this book can really open your eyes on how to find meaning, even in incredibly difficult circumstances. There are so many amazing quotes from this book, but I’m going to leave you with this one: “The helpless victim of a hopeless situation, facing a fate he cannot change, may rise above himself, may grow beyond himself, and by doing so change himself – he may turn personal tragedy into a triumph.”

For a podcast episode on meaning making with chronic illness, check out this one. Everyone, thank you as always for reading my posts. If you end up reading this book, let me know what your takeaways were. For now, keep making the most of it!

Pain Scales – The Enemy of Chronic Pain Warriors

Literally my least favourite question when I go into any doctor or specialist appointment is, “what is your pain like today?” or “on a scale of 1 to 10, 10 being the worst ever, how’s your pain right now?” To someone with chronic pain, these are the most useless, arbitrary questions. Here’s the thing, I understand why doctors and other healthcare professionals ask the question. They want to get a gauge on if your pain is better or worse than it has been in the past. It totally makes sense. However, there are a few things about chronic pain (and pain in general) that aren’t taken into account with this questions.

  1. My perception of what a “10” is may be higher or lower than your perception of what that is.
  2. I’m not always entirely sure what number I should give. Like really, what is the difference between a “6” and a “7”?
  3. Often pain changes throughout the day, so just because I give it a “4” right now, doesn’t mean that it won’t be an “8” in half an hour.
Hm… I’m smiling and happy in both pictures and yet my pain is a “0” on the left, and a “7-8” on the right.

And yet, this is always the first question asked at any appointment. Sometimes I literally just want to say “I don’t know.!” How many of you feel this way to? Plus, sometimes there is this need to want to give a higher number so that the pain is taken more seriously and not just dismissed. Here’s the thing that healthcare professionals often miss – there are better ways to describe pain than using a 1-10 scale. For example, “what type of pain are you experiencing/do you experience?” “What times of day are worst for pain?” “What activities or circumstances do you notice more pain or less pain?” “Are there any points in the day when you feel little to no pain?” And so on. These questions are easier to answer, and honestly, give a more realistic perspective of my pain than me guessing at a number to give my doctor.

Just gonna throw in the random deer visiting a retirement home across the street from me.

The main model used in medicine (and psychology) right now is the biopsychosocial model (except sometimes doctors forget to use it when talking about chronic pain it seems). For those of you not familiar with this, it is the interplay between biological and psychosocial causes (or maintenance) of a medical (or psychological condition). When applying this model to chronic pain, we look at the biological causes of an illness or injury, and how psychosocial factors maintain or increase the physical sensations of pain. It’s that mind-body connection. Here’s an example: the hypothalamic-pituitary-adrenocortical (HPA) system in your brain has been associated with several chronic pain syndromes including fibromyalgia, chronic fatigue syndrome, rheumatoid arthritis, and MS. It is one of the biological causes of pain (though not necessarily the only). Psychological factors that can maintain or increase this pain include feelings of helplessness and hopelessness. Social factors and behaviours that maintain and increase pain include door diet and nutrition, lack of exercise, and substance use (including smoking). Stress is another major psychosocial factor associated with chronic pain. So, rather than asking what are pain is on a scale from 1-10, looking at these factors is likely more productive in both understanding and managing pain!

Image from: https://www.practicalpainmanagement.com/treatments/psychological/biopsychosocial-approach
The paragraph on the biopsychosocial model is cited from this article.

Let’s talk about pain management. Whether you do this on your own, or with the help of your healthcare team, here are some ways to improve your pain management (because let’s face it, chronic pain is unlikely to magically go away):

  • medication compliance – taking all medication as prescribed!
  • addressing psychological factors – such as anxiety – this could be through relaxation and meditative techniques or even exercise, or going to see a psychotherapist
  • utilizing interdisciplinary healthcare teams – do you have a family doctor? A specialist for your illness or injury? A psychotherapist? A physical and/or occupational therapist? Anyone else who can help you with your pain? (I also have a naturopath and chiropractor for example).
Make a therapist part of your healthcare team! We’re here to help!
(just noting that I’m a therapist-in-training right now)

For anyone reading this who is not a chronic pain warrior, please remember that pain isn’t in our heads, and telling us to just deal with it isn’t helpful. In fact it can be stigmatizing, and people with chronic pain always face stigma because of a lack of understanding. We may laugh, smile and have fun, and yet be in pain at the same time. The things are not mutually exclusive. I’m going to link a few episodes of my podcast that complement this post below. For now, keep making the most of it everyone!

Mental Health and Chronic Illness

The “I Suck” Feeling

Locating Our Inner Strength

How Stress and Anxiety Manifest in the Body

Holistic Approaches to Chronic Pain