By Michaela Gloeckler M.D.
Issue: Summer 2007, Climate Change; Issue #48
Broadening the Scope of Preventative Medicine Through Anthroposophy
Prevention of illness— a science of health
Preventative medicine in our time falls into three categories:
Primary prevention: avoiding or excluding the factors that are responsible for an outbreak of illness. For example, in the case of lung cancer, smoking or inhaling toxins which have proven to be carcinogenic. In stomach cancer, factors such as malnutrition, in particular protein deficiency, chronic infections and other preconditions play a strong role. Food preservatives used in smoked or salted foods have also been found to be carcinogenic. And a strong causative factor in colon cancer has been found with the consumption of high levels of animal fats, proteins and refined carbohydrates which affect the intestinal flora and alter the stomach acid in the intestines. This can lead to a splitting off of carcinogenic biliary acid derivatives. If there is insufficient fiber in the diet it slows down the passage of waste through the colon, and this is considered to be a contributing factor in that cancer-causing agents have more time to take effect. Cholesterol is also considered as a strong factor in the cause of cancer. Cancers such as breast cancer, uterine cancer and prostate cancer do not allow for primary prevention since the causative risk factors are not known. Only vague indications are offered for support in the illness. In the case of leukemia, however, ionic rays as well as chemicals such as benzene and chloramphenicol are contributing factors.
Secondary prevention: Early detection of the various kinds of cancer through regular check-ups or good self-examination. Health education is important here, for example, taking a stomach problem seriously or taking note of a change in the stool such as an increase in diarrhea or constipation as a possible sign of a developing colon cancer.
Tertiary prevention: Treating an illness that has already begun, the goal of which must be to prevent or avoid the progression or relapse and to give strict guidelines to the patient in regards to lifestyle and preventative measures.
A great deal of literature about these three areas of prevention is available. What has not been described up to now, however, is the constitutional disposition of the individual. Why, for example, tobacco causes bronchial cancer in one person, but not in another. What health really is, and the laws that underlie it, has barely been researched. It is not surprising, therefore, that in the last few decades more and more articles deal with just this question. Over time, it is becoming more obvious that the health of a person is not merely a physical problem, but is decidedly influenced by his psychological and mental state. Modern neuro-immunological research, psycho-oncology, and research into psychosomatic illnesses have already produced far-reaching results—particularly in the English- speaking world. There has been enough thorough research to make it quite clear that research into health and illness can only be fruitful if the psychological and mental health of the human being can be as seriously considered in prophylaxis and therapy as laboratory results and physical symptoms.
Already at the beginning of the 1980s, Meinrad Scher offered the following observation: “What has up until now remained very much on the periphery in the treatment of cancer (and in the realm of prophylaxis is not at all integrated), are the theories that stress the psycho-social components of the causes of cancer. However, since there is a greater demand for a more unified view of the ill person, one can hope that this realm of peripheral medicine will come to deal with prophylaxis, early detection and the treatment of malignancies.”
It becomes quite clear that a certain disposition for health or illness is something particularly individual, and to make a comparison between two people is only possible from a highly abstract level. For example, if two women aged 44 years develop breast cancer, this can be considered comparative fact. Yet how much of each person’s biography, development, circle of close acquaintances and so on, can be compared? Do any of their physical, psychological and mental characteristics have anything in common? The more closely one investigates such matters, the more pronounced the differences prove to be.
It becomes immediately clear that just in the last couple of decades, treatments such as psychological counseling, psychotherapy and biography work have shown themselves to be just as important and relevant as surgery and radiation within the context of acute care.
This is still not given enough credence in the field of preventative care. It becomes ever more urgent to begin to estimate just how psycho-social preventative care could be formulated, as we find more and more how limited the therapeutic possibilities are for the treatment of many forms of cancer. The following sober conclusion is repeatedly drawn by professionals during medical conferences: “Despite considerable scientific progress, a true breakthrough in the fight against this much-feared illness is still lacking. Should more effort be put into prevention rather than merely in diagnosis and treatment?”
Cancer is the second leading cause of death in the industrialized western nations, after heart disease. In the US more than half a million people die annually and in Germany more than 200,000. Statistics in the US show that the fight against cancer, legally sanctioned since 1971, as well as all the preventative measures against cancer, have done nothing to lower the death rate. On the contrary, the statistics rise continuously from 1950 onwards.
It is an astonishing fact that in Germany the death rate from cancer continues to rise in males, but it continues to decrease for females since 1950. (Tim Beardlsey in “Spektrum der Wissenschaft” March 1994 page 49)
Does this declining mortality rate in women relate to the fact that for women in our present society more opportunities for a satisfying and freer lifestyle have been created?
The intention and purpose of this article on preventative medicine is intended to try and make the causative factors of cancer and the ability to overcome it understandable from various points of view. Anthroposophy can be primarily considered as a science of the healthy human being and one’s conditions for development. It can make an essential contribution from different perspectives in the debate on preventative medicine.
The following excerpt will give an illustration of this. It deals with a modern researcher in the psycho-social field, whose article is representative of many related endeavors which have appeared in this realm in recent years. Medical psychologist, Rolf Verres describes the following in his book on the relationship between cancer and the psyche:
“In my experience 80 to 90 percent of the adult population personally knows at least one person affected by cancer —either in the immediate family, the neighborhood, amongst colleagues or in their circle of friends. About every two adults knows several people affected by cancer. What people think about prevention, early detection, treatment and the psycho-social consequences of cancer, is intrinsically characterized by what the acquaintances of someone with cancer experiences by sympathetically accompanying him through his continued medical, psycho-social course of life. In other words, to learn firsthand. This firsthand learning is an essential path to the appropriation of knowledge, opinion and motives. The thoughts regarding cancer prevention, early detection and therapy are strongly influenced by how the memories of the course of illness are experienced by someone who knows a person affected by cancer.”
Verres rightfully calls for the creation of a research institute for psycho-oncology which would concern itself conceptually with the relationships between preventative care and post-treatment care. He formulates his challenge in nine theses which focus on a wider general explanation, and better communication between doctors, therapists and those affected by cancer. It is also stressed how important it is to revive people’s capacities to deal with the chronically ill and dying and to care for them within the context of the family, rather than to delegate their care to professional medicine.
Already in 1920 Rudolf Steiner challenged doctors to become “hygienic teachers” to the people around them, thus contributing to an education for the layman which could ultimately lead to a “democratizing of health.” Steiner saw the greatest enemy to this education of the layman in widespread authoritarian scientific medicine which discouraged the individual from dealing with his own illness, rather than addressing the patient himself as the main character and the person most responsible in the healing process. Here too, the conversation between doctor and patient as partners in discussing incurable diseases and death is as yet not a matter of course and is not firmly anchored within the medical framework. Self-help groups and the hospice movement have done far more and have worked positively and provided stimulus to professionals in this field. Steiner challenged doctors to help make it possible that the general population becomes more and more educated about the healthy human being and the conditions for human development. He felt that this knowledge of the conditions of human development regarding health would touch a nerve in each person as far as the prevention of illness.
The founding of the Waldorf School in Stuttgart in 1919 is marked by a teachers’ curriculum that orients itself quite concretely on the healthy development of the child, thereby providing a decisive change in the history of preventative medicine.
To begin with, primary prevention becomes the basic concept of general education. Prevention leads to the general encouragement of a healthy disposition, and no longer depends on simply recognizing and excluding certain substances and processes that may be injurious to health. Even if this pedagogic-psychological prevention is not easy to realize, the visible positive results that have so far been observed have led doctors to refer children with difficulties or health problems to Waldorf schools, with the impression that they will better thrive in such a setting. It will most certainly be some time until that which is striven for in more than 500 Waldorf Schools worldwide and over 1,000 Waldorf Kindergartens, will be recognized in its preventative-medical aspect, and will be adopted more and more in other schools.
Verres continues: “Whereas in earlier psycho-oncological research the patient’s condition as a reaction to stressors was examined, the tendency today could focus more strongly on clearly defined and planned treatment of health, leading in the long run to a paradigm shift—i.e. the knowledge that people have regarding health and illness as an element of the ‘art of life’ and the ability to differentiate and deepen this knowledge.”
Unbeknownst to most people, Steiner theoretically already introduced this paradigm shift in 1907 in his work “The Education of the Child from the Point of View of Spiritual Science.” This work was put into practice twelve years later with the founding of the first Waldorf school. He postulated that education is a gentle healing, and is in itself a healing process. It is the task of education to provide health for the child’s whole life, and not merely to impart knowledge and skills. Pedagogy can become a science of the healthy human being that wishes to support not only psychological and spiritual, but also physical development.
Translated from the German by Anne Sproll.