Eurythmy therapy for five patients with advanced AIDS syndrome
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Steinke, U., Schnurer, C., & Broz, F. (1994). Eurythmy therapy for five patients with advanced AIDS syndrome (H. Hermann, Trans.). Journal of Anthroposophic Medicine, 11(3), 44–60
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By: U. Steinke, C. Schnurer, M.D., F. Broz
Case 1a: AIDS-Related Hodgkin's Disease and Insomnia
Patient: Male, 29 years old
Appearance: Medium height, slim but robust. Well-proportioned figure, dark hair, dark eyes with a warm expression, beautifully shaped hands.
1) Physician's treatment plan
CLINICAL DIAGNOSIS: Progressive HIV syndrome (T4 = 80/mµL, T8 = 100/mµL quotient = 0.2). Hodgkin's disease originating from the left inguinal region, with a tumor the size of a child's head with hyperemia and thrombosis.
SPIRITUAL-SCIENTIFIC DIAGNOSIS:
Only at age 27 did the patient feel the need to introduce order and structure into his relatively chaotic life. He started vocational training. The effect of this on the patient's imbalance between I and astral body on one hand, and etheric and physical bodies on the other, resulted in an excessive response of the etheric organization; this excessive vitality manifested locally in the form of Hodgkin's disease. HIV develops from a predominance of astral force; with insufficient activity of the I.
OTHER TREATMENTS:
Stibium infusion as basic treatment for the restoration of rhythm in the astral and etheric bodies, Marcumar (phenprocoumon) to inhibit blood coagulation, Tramal (tramadol) in decreasing doses, Conchae 6x against night sweats, Wobenzym (pancreatin, bromelains, papain, etc. as anti-inflammatory preparation) (at patient's request). Ferrum uslum for regulating the impaired iron process. Hel1eborus strength 5 (Weleda) and Abnoba Viscum fraxini 20x, locally s.c. Painting and music therapy.
2) Eurythmy therapist's movement analysis
MOVEMENT DIAGNOSIS:
The patient showed a fine sense of self-restraint in his general bearing; his gait was slow and toe-centered. During the initial exercises such as I A O he displayed a pronounced tendency to bend over backwards into a hollow back. Forward and backward movements were hesitant and slow. Initial arm movements showed up tensioning in the shoulder blade region as well as pronounced tremor of the leg muscles in connection with any downward movements.
TREATMENT PLAN:
The patient's legs had to be strengthened and the chest and shoulder regions relieved of tension. Furthermore the swelling of the lymphatic tumor in the left groin had to be reduced and further swelling prevented. Thirdly his inability to sleep, which had persisted for three months now, needed to be addressed by eurythmy movement therapy.
TREATMENT OUTLINE AND OBJECTIVE:
We started with concentrated I A O balance exercises in standing posture; the I was strongly built up from the feet in order to strengthen the spine and work on the hollow back. During three-fold walking particular attention was paid to the phase of touching down, in order to make the patient feel his feet more strongly. After that the M was worked on, in standing posture and with large movements, with the aim of establishing a balance between the tension in the upper parts and the weakness in the lower. Due to the instant improvement in the depth of breathing and increased blood flow in the feet the patient was able to report that he slept very well at night after the second treatment. The L sound was worked on, using a rocking step - with arms waist level - with the purpose of introducing movement into the inguinal tumor. The patient reported a sensation of warmth in the groin.
REVIEW:
The patient entered into eurythmy therapy with great intensity and exuberance and very soon showed a tendency of getting carried away hysterically with the consonants. G with the legs in X-position, and the N with heels pulled up and knees bent, were added; this led first of all to a tangible strengthening of the calves and also the thigh muscles; however, it also affected the patient's inclination to sleep, which had become somewhat excessive by now. Then the pentagram was done with the 5 vowels as follows: Spatial movements and arm movements were gradually reduced in size, in other words, the pentagram started out big, was then reduced to a medium size and finally worked with very small movements, almost entirely in a static position. Initially the patient was tentative in forming the so and stiffened up again in the shoulder region. For a while the pentagram was done with the A only. This encouraged full exhalation, and overall movement became more fluid, going beyond the patient's fingertips. However, the entire exercise had to be redesigned, and then brought to a close, with a small I in front of the chest, as the patient immediately loosened up again and hysterically flowed out into the space.
COMPARISON OF OBJECTIVES SET AND MOVEMENT ACHIEVED:
All 7 ET treatments represented a struggle between flowing out on the one hand and holding back too much on the other, in other words between “I am so tired and so weak" and "this resonates so strongly with me."
Strengthening was achieved in the legs, at first mainly in the lumbar region. Further swelling of the tumor was successfully prevented from increasing in size; the patient was inclined to sleep too much and too deeply.
Duration and number of treatments: 7 treatments of 30 minutes each.
3) Physician's final report
Marked subjective (and objective) improvement in general health in course of treatment. Increased strength, greater sense of purpose and clearer formulation of life objectives. Measurable recession of groin tumor. Reduced need for analgesics. T-cell production increased to 140/mµL.
Physician: Christoph Schnurer, M.D.
Eurythmy therapist: Ursula Steinke
Case 1b: AIDS-Related Hodgkin's disease
Patient: Male, 30 years old (same patient as in previous report)
Report on four inpatient treatments 1991-1992
Appearance: Medium height, slim, muscular. Dark hair, dark eyes with warm and open expression, beautifully shaped hands and feet.
1) Physician's treatment plan
CLINICAL DIAGNOSIS:
Progressive HIV syndrome. Hodgkin's disease starting from the left groin, initially showing marked regression, from July 1992 stage IV with short-term chemotherapy (low dosage).
SPIRITUAL-SCIENTIFIC DIAGNOSIS:
As described in the first set of reports, the patient attempted for the first time at age 27 to bring order into his relatively chaotic life and decided to train for a career. This struggle for a greater sense of order in his everyday life continues to the present day. However, the patient faces up to his problems. Hence the higher principles (I and astral body) are constantly under stress in order to contain the disorder of the other parts. The patient's underlying hysteria renders this struggle very difficult, especially since he started to consciously experience a feeling of being torn between exuberance and rejection, brought on by his own intellectual as well as soul responses to outer events.
OTHER TREATMENTS PRESCRIBED:
During each hospital stay further infusions of Stibium 6x, additionally mistletoe in potency and Helleborus niger. In July 1992 during escalation of disease low-dose chemotherapy (VCR 1 mg, ADR 10 mg, Prednisolone 50 mg). Continuous art therapy, frequent music therapy and modeling. Intermittent massage of the spleen with lead ointment (rhythmical massage).
2) Eurythmy therapist's movement analysis
MOVEMENT DIAGNOSIS:
1) During the first two admissions in Spring the patient continued to exhibit shyness and hesitation in connection with all movements prescribed. When discussing the program of exercises with him, he would always say: "Oh dear, I can't manage that." But since he likes doing eurythmy, he could be motivated quickly but had to be slowed down and corrected immediately when the actual work was going on.
2) There was a constant tendency for the flow of movement to dissolve upwards beyond his head.
3) The patient's legs continued to be weak in the sense of insufficient stepping out for a male, and a certain helplessness with regard to the creation of rhythms.
4) All movements lacked attainment of and adherence to a given beat. During his first hospital stay in 1991 the patient had indeed managed to establish the great rhythm of sleeping and waking, but it was not possible to integrate him into smaller time structures.
5) During his hospitalization in summer 1992 he was confined to bed and developed high temperatures. His movements became more gentle, but at the same time more exact and effective.
6) During his last stay the patient presented as a strong young man with an excellent ability to carry out movement exercises quickly and purposefully, yet with a lot of self-doubt still in his soul.
TREATMENT PLAN AND OBJECTIVES:
1) The overriding concern must always be to ensure that the movements the patient sets out to perform involve his whole body. There had to be complete agreement between what was intended and what was achieved in the execution.
2) The tendency for the flow of movement to dissolve upwards must be counteracted by directing the flow downwards along the body towards feet.
3) The patient's legs needed further strengthening; above all they needed anchoring in time structures by walking rhythms.
4) The patient needed to establish differentiated and structured rhythms of time himself and adhere to these.
5) Specific antipyretic measures were to be used during periods of pyrexia.
6) The patient needed to set himself certain tasks and fulfill them.
TREATMENT PROGRESS AND OBJECTIVES:
Work already initiated with the sounds M, N, L, G and T as well as the vowels and the hexameter was stepped up and continued in various forms. Extreme care was always taken in connection with the L to prevent further growth of the Hodgkin's tumor in the groin. Work with the M, on the other hand, was very intense to direct the flow of movement downwards along the body. The patient urgently needed to gain better orientation in space; hence stepped up the pentagram exercises. Work with poems by Fontaine and Morgenstern proved very helpful for orientation in space as well as interacting the patient's extreme disposition to exuberance. The content of this poetry brought a mood of calmness into the disease process.
We also developed an exercise involving the S, variously executed to the spatial form of a triangle, where the three points were formed by a U which strongly involved the toes. The patient also carried out this exercise during his interim stay at home. He reported that this made it possible for him to control any temperature rises in the mornings. It is our experience that the execution of the S gesture requires concentration and a strong will impulse. Forming the S from above to below via the right and left requires acute awareness of spatial dimensions.
REVIEW:
During the summer, when the patient had been highly febrile, losing a lot of weight and lying in bed in a very weakened state, we did vowel exercises involving hands and feet every day, especially the A and E, and also the S. We reconstructed from memory the eurythmic performance of a poem we had used the previous year: "Im Nebel ruhet noch die Welt ... " by E. Miricke. When we formed the sound gestures pertaining to the words of the poem on the third day, with the patient lying in bed, he said: "This is unique. This way of recalling a form worked out some time ago has given me a definite sense of who I am for the first time in my life."
During the last hospitalization period we continued working with the S and the U and added the "thrust E" to strengthen the legs. In addition the patient worked out a poem by Morgenstern independently.
COMPARISON OF OBJECTIVES SET AND MOVEMENT ACHIEVED:
The struggle which the patient has taken on was fought through all imaginable depths and heights. This has been partly successful. In spite of losing a lot of weight and strength the patient became stronger in his whole stature. He succeeded in creating certain rhythmic patterns in his everyday life as well as his art therapy work. He attained excellent orientation in space. This was borne out by the independently worked-out form relating to the last poem.
Duration and number of treatments during 4 in-patient periods: 35 treatments of 30 minutes each.
3) Physician's final report
CLINICAL DIAGNOSIS:
Unusually favorable progress with intermittently almost entire regression of Hodgkin's tumor and advanced immune deficiency syndrome. Approx. 1.7 years after onset of tumor renewed flare-up of tumor process, now generalized. Practically total reversion of c1inical and laboratory pathology values following extremely low-dose chemotherapy.
SPIRITUAL-SCIENTIFIC DIAGNOSIS:
In the clinical context we were able to establish a new balance between the higher principles and the etheric realm. They were thus able to intervene in the etheric and push the tumor back. Intermittent periods at home resulted in the patient falling back into old habits; this led to interruptions in the continually ascending process of change. Therapeutic measures must therefore be aimed at further stabi1izing this process of change and giving it greater continuity.
4) Patient's report
"Without my eurythmy work I feel totally adrift. The exercises we have practiced here give me the firm hold I need."
Physician: Christoph Schnurer, M.D.
Eurythmy therapist: Ursula Steinke
Case 2: AIDS-Related Cryptococcal Meningitis
Patient: Female, 28 years old
Appearance: The patient is of small, slight build, harmoniously proportioned, but with a hollow back. Her head is oval-shaped and quite large in relation to her body size, with gray astigmatic eyes, with a hint of blue, and short dark blonde hair. Very slender limbs. Hands and feet are small, but well-formed and strong. Especially in the first phase of eurythmy therapy patient's eyes showed interest but at the same time critical distance.
1) Physician's treatment plan
CLINICAL DIAGNOSIS:
HIV syndrome. Acute cryptococcal meningitis. Patient was admitted in a highly febrile state, with rapidly worsening symptoms like stiff neck, visual and aural disturbances, growing stupor.
SPIRITUAL-SCIENTIFIC DIAGNOSIS:
The patient was seriously ill and confined to bed; with regards to appearance and behavior the impression was of a much younger person. Her movement; were soft, yet with a firm handshake. Comprehension and speech were extremely slow. Her gaze, too, showed that she was not fully present in her mind. Memory and orientation in time were very limited. When demands were made, she exerted herself greatly to address a particular question or task, and tired very fast. All the above points to an insufficient connection between the soul-sentient as well as the will realms and the etheric and physical bodies.
Other treatments prescribed:
After completion of diagnosis, treatment with antifungal agents, accompanied by specific anthroposophical measures: Stibium 6x infusion, Arnica Cerebrum, Helleborus niger, Diflucan (fluconazole) (high dose). Schlaffhorst-Andersen therapy and art therapy.
2) Eurythmy therapist's movement analysis
MOVEMENT DIAGNOSIS:
Beginning of eurythmy therapy one week after admission during phase of first improvement.
1) Whilst the patient's movements were extremely slow, her determination, to do them properly was very strong.
2) She moved her arms and legs (when she first got up and walked) as if they were moved from outside as if in a dream; patient observed this.
TREATMENT PLAN:
1) The most immediate need was to awaken the patient's senses, with special emphasis on the sense of touch in order to help the patient relate to her own body and her life in the present.
2) Following that she needed to gain an understanding of time sequences with the help of rhythmic elements.
3) When greater control of the body and overall strength had been achieved the diagnosed condition could be addressed therapeutically.
TREATMENT PROGRESS AND OBJECTIVES:
1) Copper balls were chosen to activate the patient's sense of touch. These have a hammered surface and conduct heat extremely well; this allows a highly effective exchange of body heat. After touching these spheres all over, she exchanged them with those of the therapist at a rhythm of long/short/short (dactyl). During the 'long' the sphere is passed to one partner with one hand while the other sphere is received by the other hand. During the 'shorts' that follow the hands are brought dose to the body and the sphere is passed from one hand to the other, and so on. This rhythm was chosen to lead from the relaxation of the 'long' into the concentration of the 'short.' It was intended to aid the patient's awakening and to bring her to herself.
2) As soon as the patient was able to stand up, the same rhythm was practiced with a copper roller; she was asked to roll it along the floor with her feet. For the long measure the roll was moved towards the therapist by means of the feet, and she was asked to glide her feet along the roller from toes to heels, feeling the roller, for the two short measures. Soon many other rhythms were added.
3) The patient was also asked to carry out certain movements involving arms and hands unaided. Thus she was asked to spread out her arms and bring them together before her chest whilst listening to a poem. This breathing movement was first to be done on a small scale, then more expansively, for the patient to experience the space in concentration and develop a differentiated sense of inner space and surrounding space.
4) When the patient's condition improved, the dactyl was performed with a wide, relaxed step for the 'long' and small invigorating steps for the two 'shorts'. After that the patient, stepping out in this manner, exchanged the copper spheres with the therapist as described under 1); the aim was to develop simultaneous, differentiated movement of both arms and legs for greater harmony of respiration and pulse through the rhythms employed.
5) The following exercise involved the formation of the pentagram. First of all the patient was to experience this form with her own body; to this end she was asked to imagine the lines from head to right foot, to the left hand, to the right hand, from there to the left foot and back again to the head. Then she was asked to imagine this form lying in front of her, imagine herself in space walking it with four dactyls per line. She was encouraged to structure her own figure and achieve an ordered relationship to space by walking the form, with the aim of strengthening her imaginative powers as well as her memory. To enable her to relate properly to her feet and general gait, walking was practiced with special emphasis on the three phases:
1) Lifting the foot off the ground
2) Taking it forward and
3) Placing it on the ground again. This was performed with a copper rod balanced on the patient's head with the aim of developing a proper erect posture, correcting the hollow back that caused pain.
6) Finally the walking sequence M N L G T was practiced; this was specifically developed for AIDS patients.
REVIEW:
As the patient's sense of balance was severely affected and she tended to nearly fall over during walking exercises, the U exercise was added. The concentrating, incarnating character of this exercise has the effect of patients gaining better hold of their limbs, it warms these up; it was used here to help the patient stand and walk more confidently. She was asked to speak the sound U three times, then form it with her arms several times, before practicing it with her legs, concluding with a repetition of the arm movements. It was considered important that the patient inwardly consolidated the exercise by reconstructing it in its entirety in stillness of thought. Immediately after that she was able to walk and move in a purposeful and balanced manner.
COMPARISON OF OBJECTIVES SET AND MOVEMENT ACHIEVED:
1) After a relatively short time the patient was much more awake and displayed better coordination of hand and foot movements.
2) The patient recovered quickly and was soon able to practice for 20 minutes or longer in a concentrated way, achieving good circulation in her hands and feet, which were normally quite cool.
3) Her relationship to her own body and the space around her improved very markedly, as borne out by enhanced control of her movements and steadily improving orientation when walking spatial forms. She also recovered her sense of balance which gave her a sense of security.
4) The walking exercises resulted in the beginnings of subjective and objective correction of the hollow back.
Duration and number of treatments: 22 treatments of 30 minutes each.
3) Physician's final report
CLINICAL DIAGNOSIS:
Unusually rapid recovery from meningitis and extensive overall recovery without noticeable set-backs. The patient would like to take up employment again (nursing). Final CSF examination: almost normal, no cryptococci.
SPIRITUAL-SCIENTIFIC DIAGNOSIS:
The gradual awakening of the patient's senses resulted in increasingly effective soul-spirit-body cohesion; the patient achieved better control of her body, and the peripheral circulation improved. Her movements became more controlled and purposeful.
4) Patient's report:
Comments during first sickbed visit: "Eurythmy therapy - not for me." Halfway through treatment - after the U-exercise: "It is quite unbelievable that such an exercise should help me find my balance so quickly." And at the end of the treatment: "I would like to practice this every day and have outpatient eurythmy therapy once a week, though at first I did not like it at all."
Physician: Christoph Schnurer, M.D.
Eurythmy therapist: F. Broz
Case 3: AIDS-Related Pneumocystis carinii Pneumonia
Patient: Male, 34 years old
Appearance: Slender figure, very boyish, blond hair, watery blue eyes which are always a little hazy in expression. Toe-centered walk, rough, clumsy hands and feet.
1) Physician's treatment plan
CLINICAL DIAGNOSIS:
Progressive HIV syndrome, [T4 = 20; T8 = 1,760, quotient = 0.01]. Pneumocystis carinii pneumonia. Kaposi's sarcoma, enteric candidiasis. Eurythmy therapy started after conclusion of acute phase.
SPIRITUAL-SCIENTIFIC DIAGNOSIS:
Impressions are not 'digested' and therefore affect metabolism and limbs directly, going straight into the body. The 34-year-old patient constantly swings to and fro between the extremes of excessive exuberance and deepest melancholia. His longing for platonic love reveals a dual personality who is at odds with the person of distinct and uncontrolled drives.
OTHER TREATMENTS PRESCRIBED:
Stibium 6x infusion, Helleborus strengths 3 and 4 for the Kaposi's sarcoma, Viscum Abnoba fraxini 20x, Bactrim (co-trimoxazole) for a few days (high dose), followed by pentamidine inhalation with Stibium lOx, in decreasing doses, Ampho-Moronal (amphotericin) lozenges, Hepatodoron, art therapy.
2) Eurythmy therapist's movement analysis
MOVEMENT DIAGNOSIS:
During the first exercises for balance it became clear that the patient's torso bends backwards, with the stomach and thighs vehemently thrust forward, as if the ligaments around the lumbar vertebrae were worn out; the patient keels forward and back and is unable to establish a calm center. Walking exercises reveal a superficial, hurried, toe-centered walk. Arm movements cannot be executed close to the body and display a tendency to overstretching.
TREATMENT PLAN, OUTLINE AND OBJECTIVES:
The movements described above pointed to the following objectives: the patient must learn to position his feet in a more definite manner to attain greater stability and control of his legs; this in turn would stabilize his breathing by freeing the lungs. L was chosen, as the large movements encourage deep inhalation, followed by M, whose small movements facilitate exhalation, with the overall process supported by the increased circulation of arm and leg muscles. In other words, the very first aim was to help the patient breathe in and out. The G was chosen for the pneumonia, as the entire region of the chest is aerated and formed as a result of the tensing of the thigh muscles with the legs in X-position and the quiet gesture of the plosive sound. As the patient displays a predominantly euphoric and hysterical tendency in his movements, vowels, representing formative forces, were initially just practiced cautiously with the patient seated. Mainly the A as a sound developed from the rear space was worked at, and then the U for concentration whilst standing.
REVIEW:
It became clear that the extreme looseness of the lumbar vertebrae needed further attention; so we introduced the "coordination I," which we walked backwards and forwards in the room to the rhythm of short-short-long, with appropriate arm movements. In the course of this work the consonants N M L G were alternated with the vowels A, I and U in the order N M A, L A, G I U, followed by the T, walked as large forms in space and then done seated, in the same order. This made possible a very strong internalization of the gestures concerned, the patient became very collected and achieved excellent body concentration. The spatial form of the pentagram was carried out to a poem by Lina Kroner "Wer Du auch bist, was Du auch tust, nach einem such' allein, in unsres Daseins dumpfen Wust, ein Mensch, und nur ein Mensch zu sein" (whoever you are, whatever you do, seek one thing only in the dull chaos of existence - to be human, and human only).
COMPARISON OF OBJECTIVES SET AND MOVEMENT ACHIEVED:
Due to rapid strengthening of his thigh muscles the patient's gait became calmer and steadier. The G, with the rhythmical coordination I added later, contributed to greater firmness in the lumbar region. This enhanced the effect of other treatment for the pneumonia. The patient carried out the exercise to the poem in an attitude of inner peace and with good expressiveness; this had positive repercussions on his outer comportment and helped him to develop much greater seriousness.
Duration and number of treatments: 11 treatments of 30 minutes each.
3) Final medical report
CLINICAL DIAGNOSIS:
Improvement of all symptoms, in particular total remission of pneumonia, partial regression, partial stabilization of Kaposi's sarcoma. Extensive rehabilitation.
SPIRITUAL-SCIENITIFIC DIAGNOSIS:
The I-guided astral interacted more effectively with the physical and etheric bodies and could thus resume its formative work on the disintegrated body. The patient had become more amenable and was able to keep appointments; he viewed his illness with a greater sense of responsibility. Through the I the astral body is able to structure the body.
Physician: Christoph Schnurer, M.D.
Eurythmy therapist: Ursula Steinke
Case 4: AIDS-Related Cytomegalovirus (CMV) Colitis
Documentation: Eurythmy therapy sessions
Patient: Male, 49 years old
Appearance: Tall, neurasthenic gaunt figure, finely formed hands and feet, blonde curly hair, flat face with strongly formed, hanging mandible; rigid, withdrawn blue eyes.
1) Physician's treatment plan
CLINICAL DIAGNOSIS: Progressive HIV syndrome; [T4 = 40/mµL, T8 = 170/mµL, quotient = 0.04], status following miliary tuberculosis, Kaposi's sarcoma, polyneuropathy, HIV encephalopathy, herpes zoster, development of abscesses. Clinically preeminent: Diarrhea with clinically confirmed CMV colitis, Karnofsky index =5.
SPIRITUAL-SCIENTIFIC DIAGNOSIS:
The first impression is one of quiet reticence. The etheric appears drained, used up by the astral, the I appears as if repressed, pushed away by the astral (expression of the eyes). The neurosensory human being is totally rigid, i.e. fixated on habitual activities. The rhythmic human being lights up a little at each encounter, but seems completely devoid of strength. The limb human being seems to lead a life of his own, and is presently reduced to being mere creature.
OTHER TREATMENTS PRESCRIBED:
Medicines: Stibium 6 infusion, Helleborus up to strength 3, Chamomilla radix 2%, Birch charcoal comp. Bactisubtil (spores of bacillus), Ampho-Moronal