Frankl defines the existential vacuum as a twentieth-century phenomenon in which many people feel that life is meaningless. He says that once, man was able to over come great loss by relying on tradition, but in the twentieth century, these traditions are falling away. An existential vacuum manifests itself primarily through boredom, which then leads to distress. Frankl notes, for example, that many people become distressed on Sundays when they are not so busy and have time to contemplate the meaning of their lives. Those living in such a vacuum often try to fill this void with sex or money.
Frankl relates his philosophy to a twentieth-century phenomenon more broadly. After WWII many people came to believe that life was meaningless, because they could not reconcile a just or meaningful universe with the atrocities committed during the war. Having lived through these atrocities himself, however, Frankl remains certain that every life has purpose.
Frankl says that many patients have other types of neuroses that need to be addressed by more traditional psychoanalysis, but argues that the patient will never be successful if treated through psychoanalysis alone. Once the truly mentally ill patient has been cured of his other neuroses, his noögenic neuroses must then be addressed in order for him to remain cured.
Frankl doesn’t think that psychoanalysis is useless, but he does believe that the practice leaves some problems untreated. He asserts that no one who is mentally ill can become healthy (and remain healthy) without using logotherapy.