Viktor Frankl's concept regarding survival and fully living was developed through his observations and experiences in the concentration camps. He used his psychiatric training to discern the meanings of observations and to help himself become a better person. He uses analysis to develop his own concepts and describes them in steps throughout the book. When the prisoners first arrived at the camp most of them thought they would be spared at the last moment. The prisoners believed they had a chance of surviving, but this belief was eventually eliminated and it was at this time when the prisoners began to learn how to survive by using their internal strength. A sense of humor had emerged among the prisoners. This humor helped to get through some difficult situations they faced. .
Viktor also observed how much a person could really endure and still live. Even though the prisoners could not clean their teeth and were deprived of warmth and vitamins, they still were able to survive. The sores and abrasions on their hands did not suppurate despite the dirt that gathered on them from the hard labor. The challenge of staying alive under these wretched conditions was to have and maintain strong internal strength. .
During the time he spent in the camps, Viktor learned what was needed to survive and how to keep his internal strength despite his weakening external strength. During the second stage of Viktor's psychological reaction, prisoners lost their sense of feeling and emotion toward events that would be emotional to people outside the camps. This was a result of the violent environment, which consisted of beatings of prisoners and the death of many others. The prisoners could no longer feel any disgust or horror since these emotions where very common. From Viktor's professional point of view, this observation surprised him and also gave him a different point of view of the whole situation. .
The pain that hurt Viktor the most was the pain he felt when he received punishment for no reason.