Frankl believed that at the spiritual level, the depressed man faces tension between who he actually is in relation to what he should be. Frankl refers to this as the gaping abyss. Source

We admitted we were powerless over food,
that our lives had become unmanageable.
The gaping abyss stretched out before us,
nudging us, urging us, pulling us into recovery.
It’s not that we had not tried. God, how we had tried.
Those courses of action that once seemed to work
now laughed at us, ridiculed us, from beyond the abyss,
driving us to food as something we could control,
as something that dulled the pain, diverted our gaze.
Then that ceased to work as more than anything else
it careened out of control, mocking us, shaming us,
driving us to grief, to depression, to despair, to surrender.
And that didn’t help except to face us toward the promise,
recovery. And when that finally pointed out just how
and to whom we were to surrender, a solid bridge appeared
solidly spanning the gaping abyss.