Logotherapy of a mother with an unconscious son

Tomoe Makino Introduction

V. E. Frankl believed that humans, even those experiencing misfortune, can make their suffering meaningful by changing their attitude toward the circumstances. In this thesis, I will introduce the case of a mother in anguish about her unconscious son and examine the case from a logotherapeutic perspective.

1. Case: Mother with an unconscious son
After having fertility treatment for more than 10 years, Ai Inoue (anonym) finally had a baby at the age of 40. When I met Ai for the first time, her son, Kazunari (anonym, then 5 years old) had been unconscious and was somehow maintaining his life on a respirator for approximately a year in a hospital as a result of a complicated infectious disease. Although the hospital’s medical staff had been diligently treating Kazunari in a private room in the ICU, Ai was filled with anger and hatred toward them, believing that a medical mistake by the hospital staff had caused the unconsciousness of her son. In addition, Ai was recently tested pseudo-positive for uterine cancer. For these reasons and on the advice of her husband and the nurses at the hospital, Ai came to me for counseling.

Initially, Ai expressed anger toward the hospital medical staff. But her anger gradually subsided during counseling. She stated, “Since my son became unconscious, some friends of mine have left me, which helped me identify true friends of mine. This is why my husband and I planned a Christmas Eve event to be dressed as Santa Claus, visit houses of my friends, and give presents to their children. We were very happy to see the children get delighted by our presents.” She looked so happy that I told her that the event may be a present from her son. She replied, “That’s right. If I had no son, I would not have met those friends or planned such an event. This must be a present from my son. I’ve never thought like that. I have to express my thanks to my son.” She said so clearly, in a low, even tone. After a few hours of counseling, she returned to her son with a lightened and peaceful demeanor.

A week later, Kazunari breathed his last after one year of hospitalization. Before leaving the hospital, Ai expressed her gratitude to the medical staff persons for whom she had felt anger and hatred before counseling. When she became pregnant one year later, she chose the same hospital to give birth of her second baby. Three years later, she expressed her gratitude to the hospital for its faithful service to her late son, saying “Unconsciousness of my son may have been avoidable. If he had been in other hospital, the hospital would have given up my son insisting they had neither mistake nor responsibility. I don’t know such a full-hearted hospital like this one.” She said the past event was unavoidable and the attitude of the hospital staff was dedicated.

This mother seems to have begun to move toward meaning and values despite the recent tragedy.

2. Ai’s meaningful life
1) Ai’s freedom of will
In any given circumstance, even when constrained by fateful events, humans have the freedom of will to choose their attitude toward the circumstances, and thus, change the suffering into a meaningful experience. Ai, for example, could have chosen to ignore the medical staff when leaving the hospital, or could have chosen another hospital when giving birth to her second baby, but she did not do so. As shown in Ai’s case, people have the freedom to choose their attitudes toward circumstances even while being subjected to various psychological restrictions. Frankl called this human faculty “the defiant power of the human spirit,” saying “Man can become human in the true sense of the term by overcoming circumstances with his defiant power of spirit.”

Ai chose a meaningful attitude by awakening her free will and using the defiant power of her spirit. In addition, she responsibly reacted toward the situation.

2) Ai’s will to meaning
Ai chose the attitude of not being driven by her feelings but resisting the feelings using her freedom of will. Where did her self-determination come from and toward what did it direct her?

When I met her, Ai was feeling anger or hatred at the hospital medical staff. Did she truly desire to retain such feelings? I think this behavior possibly resulted from the emptiness she felt in such anger or hatred, but she still had the will to meaning in the innermost recesses of her mind. She just needed someone to show her how to bring the will to meaning back to the forefront of her mind. I believe that’s why she came to me for counseling.

Frankl said that people have the will to meaning, which helps them bear the worst situations and make lasting efforts.

I believe that Ai’s will to meaning induced her to seek counseling and reminded her of the hope for her son. Logotherapists need to be convinced that any person has the will to meaning, and that the will to meaning never become sick under any circumstance.

Frankl asserted that the human dignity shall be granted to all people under any situation.
He wrote that man has spiritual freedom to decide what his existence will be, what he will become in the next moment.

3) Meaning of life
Logotherapy aims to show clients that their lives have meaning under any circumstances. No one can give meaning to the life of another. Counselors are requested to help clients in with discovering the meaning in their own lives through dialogue with them.

How could Ai make her life meaningful? Even after Kazunari became unconscious, Ai had been eagerly taking care of her son, believing in the possibility of his recovery. When her son remained unresponsive to her for nearly a year, Ai began to feel that he was far away. However, in the course of talking about her son with me, she realized that the event on Christmas Eve was a gift from her son, and that her son wanted her to be a good mother living for others. I believe this realization triggered her intention to respond to her son’s hope.

Frankl discussed that human being is shaped by physical, mental and social conditions. But final decision is made not by such conditions but by spiritual person. Fuculty of spiritual person made it possibel to change attitude in an existential way. Logotherapy aims existential change in clients’ attitude in the basic sense.

In Ai’s case, the spiritual aspect of her son’s affection for her and hers for him led to an existential change in her attitude. This mutual approach in a spiritual dimension can be called love. In her words of gratitude to the medical staff when leaving the hospital, we can see that her attitude has changed, and that she has overcome sadness and anger in response to recognizing the love from her son.

The above study was the examination of a case from a logotherapeutic perspective. Meaning in life is not always the same; rather, it changes with time and by person. Her attitude was meaningful not only for herself but also for the medical staff including myself.

We cannot pretend as if sad events have not occurred, nor can we change past events by returning to that time. However, we can change our attitude toward the past, which will change our suffering into our achievement. This case supports this conclusion.