Therapeutic Colloquium: Tinnitus

By: Walter Holtzapfel, M.D.

In the first circular letter (Rundbrief) of the Medical Section at the Goetheanum 1, sent out by Rudolf Steiner and Dr. Ita Wegman on March 11, 1924, a question regarding treatment of tinnitus (Ohrensausen) is answered. "For tinnitus we generally recommend juice of the poppy (papaver somniferum) D6. Psychologically the treatment would consist in encouraging the patient to activate sufficient inner strength in order to transform the passive attention to the sound and transform it into active representation, as if one were to generate it oneself. After some time improvement may be noticed. Tinnitus is based on a weakening of the astral body in relation to the etheric body in the region of the bladder."

What is here described as psychological healing, the transformation of passively attending to the state of illness into active production of this state, is a method which Viktor Frankl described in 1952 (2) and which he desig­nated as "paradoxical intention." The attempt is made with all the strength at one's disposal to bring about the disturbing symptom and just by this means brings about its disappearance. Arthur Jores who reported about the successful application of this method in several cases (fear of blushing, fear of examinations), is of the view that the intensive activation of the will to actively bring about the disturbing state so fills out the inner space of the person that there is no more room for the passive development and thereby healing comes about.

How can the insights of spiritual science explain the modus operandi of this therapeutic measure, in which both the pathological manifestation and the treatment are events in consciousness? To begin with, it is surprising that Rudolf Steiner does not begin in his explanation with the ear, in which the pathological manifestation is perceived, but rather with the bladder: "Tin­nitus is based upon a weakening of the astral body in relation to the etheric body in the region of the bladder."

Ear and bladder, two far removed regions in the organism are brought into relation. In seeking for such correspondences one follows astral laws. Rudolf Steiner indicates that it is a characteristic of the astral region that two spatially separate formations constitute a unified whole 4. In the two loca­tions compared the astral body behaves in an opposing manner. If it is too weak in one place then it is active too strongly in the other. The relation to the etheric body is then of significance. Thus, if "a weakening of the astral body in relation to the etheric body in the bladder region" is detected, a con­sequence is that in the region of the ear the astral body activity is excessive in relation to the etheric body. This enhancement of astral activity manifests then in tinnitus.

The shift between above and below in the relation of the members of being can be perceived when they express themselves in physical symptoms. For the upper region we have tinnitus as a perceivable symptom; for the lower region no symptom is indicated in the circular let­ter. — I once had a patient in whom tinnitus began at the same point in time when pappilomas were discovered in his bladder. In this case there were clear symptoms above and below. The weakening of the astral body in rela­tion to the etheric body in the bladder region — or in other words: the predominance of the etheric body — clearly showed itself in the prolifera­tive tendency of the papillomas.

We are concerned here with two reciprocally related processes of illness: What is too much in one is deficient in the other. Many symptoms of illness appear in this double form.5 A simultaneity of two different illness manifes­tations can be observed for example in the paraneoplastic syndrome, in focal infections, in systemic lupus erythematosus, and in others. Mostly however, only one side of such reciprocal illness states is detected, the other side remains latent or unnoticed.

Also in the aged, tinnitus occasionally occurs simultaneously with blad­der symptoms (sphincter incompetence). There, too, a withdrawal of the astral body from the lower region and a corresponding strengthening above. — Rudolf Steiner also utilized the relation of bladder to the ear-nose-­throat region for therapeutic purposes when he suggested, for example, to make compresses of Berberis fructus 10% to the bladder region for adenoidal hypertrophy.6

Let us return again to the question of how the therapeutic effect of the self-generated mental representation of tinnitus can be understood. It is a case of "taking over" the illness process through therapy. What was ex­perienced passively (through the astral body) is now generated actively (through the ego). The astral body is thereby relieved of its pathological ac­tivity in causing tinnitus and can return to its proper activity in the bladder region from which it was withdrawn.

This "taking over" of the illness process through therapy is a principle also applied by Rudolf Steiner in medicinal therapy. Illness and therapy thereby become similar. This is a kind of modified similia similibus principle which also applies to the recommended remedy Papaver somn. D6.7 In chapter XV, "The Method of Healing" in the book Fundamentals of Therapy Rudolf Steiner gives several examples for similar relations between illness and remedy and concludes: "The organism has the tendency to balance out its deficiencies. For that reason it reconstitutes itself if, for a period of time, an irregularity is artificially so regulated that the inwardly occasioned process, which must cease, is countered by a similar process which is ac­tivated from the outside."


1. Rudolf Steiner, Course for Young Doctors, GA 316

2. Viktor Frankl, Grundriss der Existenzanalyse und der Logotherapie. In: Hand­buch der Neurosenlehre, Munchen-Berlin, 1959.

3. Arthur Jores, Der Kranke mit psychovegetativen Storungen, Gottingen, 1973.

4. Rudolf Steiner, Geisteswissenschaftliche Menschenkunde, GA 107.

5. Walter Holtzapfel, Krankheit und Heilung als zweiphasiges Geschehen, BEH, Jan. 1971.

6. Rudolf Steiner, Curative Education, GA 317.