Finding a Living Relationship to the Therapeutic Process

Issue83cover1By Adam Blanning, MD

Spring 2016, Campaign Finance and the Social Order in the 2016 Election - Issue #83, Vol. 21

There is a curious experience that comes about in the process of learning anthroposophic medicine and its remedies; that is, when you learn about the therapeutic use of a substance, you often then see a whole string of patients who need that exact treatment! You learn a migraine treatment and then see ten migraine patients in a week, or learn how a particular substance can be used for sore throat and have a wave of pharyngitis go through the local school. Of course, this has much to do with awareness, just as when you get a new car you are amazed by how many of that same kind of car you see driving on the road. Admittedly, we see better what we are primed to observe. But the use of a remedy extends beyond that kind of concrete repetition, because the string of patients who come in needing a particular remedy may actually complain of categorically different problems. How is it possible for different problems to be treated with one remedy? Isn’t that a sign that it is all just a placebo effect? The answer is no. It is more than placebo, because when this happens, all of the problems will have some common thread. And the thread is that they share a certain “process” imbalance.

Illnesses are not just names or categories; they are related to physiologic processes. Let’s look at how this might relate to a particular remedy: Mercurius vivus. Mercurius is a well-known anthroposophic and homeopathic preparation of the metal mercury (quicksilver). Mercurius helps to stimulate movement where things have become stuck, and to bring physiologic processes back to a healthy whole, to integrate what has become isolated. In its natural form of Cinnabar (a mineral combination with sulfur), Mercurius is a very nice remedy to address the swelling that occurs with large tonsils and a very sore throat. But Mercurius (now combined with Aurum, gold) can also be used for a thought that has become stuck, like an obsessive or compulsive thought pattern. Or, Mercurialis perennis, a mercury-type plant, is included in many anthroposophic wound creams, as it helps to bring the parts of the skin that have been traumatically separated back into a whole. So a sore throat, an obsessive thought, and a cut in the skin can all be seen as situations that will benefit from a mercury remedy. This learning to see different shades of a common process allows for a whole new kind of therapeutic insight, and it often occurs that patients with all of these situations will walk into the medical office in a short period of time. These windows of therapeutic insight offer a special opportunity to practice what one has just learned. They are often accompanied by the experience of a kind of cosmic humor, as if one is supposed to say to the universe: “Okay, I now understand that I am supposed to pay attention to this and start using it!”

Day-to-day practice of anthroposophic medicine is of course not always that elegant or elevated. There are regularly situations where one is not quite sure what to do and turns to the suggested treatments gleaned from the collective observation of multiple generations of anthroposophic doctors. This is also not a bad way to use the remedies, although a different kind of pattern comes into view. For even when the use of a remedy begins out of an intellectual orientation (“give X, for Y”), over time consistencies as well as nuances of activity begin to present themselves. Give the remedy often enough and you will learn to see what it does. Then one discovers that Cinnabar tends to work better if the person with the sore throat is experiencing a lot of pain and tends overall to be thin and more sculpted; and that Cinnabar works less well for someone who is red-faced with rounded features. One can start with the whole (the process, Mercurius) and then discover its parts (the specific situations where it is used: a sore throat, obsessive thought, a wound). Or one can study many repeated situations and from that experience come to an appreciation of the larger process (a person who is thinner or more sculpted tends to benefit more from a loosening process, and so Cinnabar works better for these people). Work with a remedy becomes not just about knowing its indications, effects, and dosing, but evolves into a living relationship.

That relationship deepens even further when one seeks the opportunity to really live with a substance and to know it phenomenologically. Book knowledge cannot give you this aspect. It requires special effort, but the time devoted to developing this deeper understanding brings unique gifts. Last spring, at the annual doctor’s training course (the International Postgraduate Medical Training) this was proven to be especially true, when, within a group of fairly experienced physicians, we worked with the plant Chamomile. Now Chamomile is probably one of the best known medical plants; many people know about having a cup of Chamomile tea to calm before bed, or sipping it to soothe a cramped or upset stomach. And the group of people assembled for this plant observation could easily have narrated a whole list of medical and therapeutic indications for the plant—book knowledge! But we put that all away (at least we worked hard to do it); and then spent six days, an hour and fifteen minutes a day, observing this plant. It began with the details: what do the flowers look like, what is their size, what colors, what smell, how many? What about the stems: how do they branch; are they hard, soft, spiraling, or straight? What color, and how do they connect to the ground? The roots? Oh, yes, we forgot about the roots… going round and around the group, bringing one objective description after another. At certain points, people got bored, but then something new would be brought and the whole group looked anew with even deeper interest. The next day we considered the plant’s cycle of growth through the year, then over several years. Next day—the mood, the artistry. If Chamomile were a piece of music, what would it be? If Chamomile were a person? Then, finally, what is the being of Chamomile? And amazingly, through that journey, the group came to a new, richer, living understanding of this beautiful flowering plant. And the indications and uses that were shared resonated with the intellectual indications everyone could have identified at the beginning, but they were no longer just “head” medicine.

This experience is perhaps related to the difference experienced when you read a printed poem found in an anthology and when you hear it read aloud by the poet who wrote it. The space between the words is somehow much more powerful. If that same kind of enlivened space can be built for therapeutic activity, the remedies one comes to know work better. The body of experience relating to what remedies to use, in what dose, and for how long, is of course important, because if we waited to have such a profound relationship with every mineral, plant, and animal incorporated into anthroposophic remedies, we well might never dare to practice medicine. Much of the knowledge can only come out of the doing.

Understanding this, we can see why the use of anthroposophic remedies is different from the usual prescribing patterns that guide allopathic medicine. With standard pharmaceutical drugs, the great emphasis is placed on standardization. One learns what medication to give for a particular situation, in what dose, and for how long. The qualities of the individual practitioner do not matter, except for the practitioner’s familiarity with the latest treatment guidelines. For anthroposophic medical practice, the experience and interest of the individual practitioner does matter. It’s important for the physician to learn to love certain remedies.

This truth came to me in a roundabout way. At a certain point in my own training, as a very new doctor, I was working to find my way more and more into the use of anthroposophic remedies. I presented a case to a circle of much more experienced physicians at a medical conference. The medical situation I described was very vivid for me, as I had spent a lot of time trying to understand the different elements of the case and to weave them into a therapeutic plan. And with my remedies the patient had improved! So I shared my case, and what do you know—many in the circle did not agree with what I had done. They would have used completely different remedies. Many different opinions were voiced, and then some of the most experienced physicians started to disagree with one another! But when the discussion turned to the process and less to the specifics, much broader consensus was reached. It required moving beyond rigid algorithms and instead placing trust and confidence in the truth of a living experience. I am convinced that if that same patient had been seen by each doctor in the room she would have received very different sets or combinations of remedies. Not only that—I believe that she probably would have gotten better with each of those treatment regimens, too. This is not to say that just anything could be given; that is not true. But it is rather to acknowledge that anthroposophic physicians, nurses, and therapists necessarily use and prescribe the treatments which are most alive for them. This is not a heresy (as it might be in a strictly allopathic medical model), but a celebration of the living learning and devoted observation that is possible within this vital medicine.

To say it differently, we best know what we love, and our best offerings to the world arise out of that love. The use of anthroposophic remedies (or therapeutic eurythmy exercises, rhythmical massage strokes, colors for painting, or tones for music therapy) can be described as a practice of learning to love the bounty of the natural world and finding its relationship to the human being; and then using that living knowledge to effect a healing change.
Adam Blanning, MD, practices anthroposophic family medicine in Denver, Colorado. He teaches widely on supporting healthy growth and development for children, and currently serves as president of the Association for Anthroposophic Medicine and Therapies in America.

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