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Takashima (1990) said that in diagnosis we must also consider the so-called "func­
tionaldimension." This is the fourth dimension (the body, psyche and spirit are the
firstthree). An ulcer, for example, can be an organicillness. The symptoms ofthe
illnesscan be the result ofprolonged anxietyor fear in the psychologicaldimension,
it influences the functional, and causes harm in the somatic dimension.
Logotherapeutic theory claimsthatthe human spirit cannot get sick and thatit plays
an important role in the treatment ofsickness. The originofsickness can be caused
by a conflictbetween values, or a lack ofmeaningand purpose in life. According to
Takashima the attitude people take toward their illness is ofcrucial importancefor
health, survival and death. He is ofthe opinionthatthere are six possibilities with
respect to the results ofan illness:
1. Sick persons can be cured by themselves, or by nature.
2. They can be cured by a physician.
3. They can die without medical treatment.
4. They can die, despite, or even because ofmedical treatment.
5. They can remain chronically ill, even after medical treatment.
6. They can get healthyfrom a humanistic and existentialperspective, albeit not
biological viewpoint, by logotherapy,which helps to change their attitude toward
the illness, or to adopt an attitude of"living with the disease" in line with the
concepts of'humanistic psychosomaticmedicine (Guttmann 1996:124 &
Takashima 1990:25)
For a chronically ill client livingwith the disease means acceptance ofthe fact that
the disease cannot be cured. What can be done, therefore, is to concentrate the
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