Practice and meditation

The meditative path to knowledge builds on the six exercises described above (see “Inner development”) and concerns the inner development of medical professionals (1, 2, 3). Meditation requires inner quiet. The hustle and bustle of everyday thoughts and feelings, with their worries and needs, must be silenced to create an inner space. Even our “everyday” personality, with its dependence on success, career, failure, happiness and suffering—as the outer shell of the actual “I”—stops short of the threshold of this inner space. It is by no means simply relaxation that we are seeking, which results from silencing the stressful content of our conscious everyday occupations and establishing inner quiet. Now it is important to open our inner being towards the spirit, to go from the world of appearances to the world of spiritual existence, thus from a “life of the soul in thought” that expands more and more to a “life in spiritual existence” (4, p. 38). This can lead to deeper relationships with our patients, to an ability to find inspiration for treatment. It can strengthen our therapeutic will to heal.

The importance of meditation for therapeutic empowerment and healing processes

This idea of there being a connection between internal development and medical practice is unusual for contemporary medicine. These are two areas that must not be mixed and yet are closely connected. How do these two “separate” worlds work together? What significance does a meditative path of development have for therapeutic practice?

Understanding the human being and human illness

An initial answer comes from our encounters with patients. We often feel a kind of powerlessness when a patient introduces himself with a complex disease and we do not come up with the right thought that would lead to a diagnosis and therapy. Conversely, we are filled with joy and gratitude when we determine the next diagnostic and therapeutic steps with the right inspiration. How do we find the inspiration to make everyday decisions? Often necessary insights cannot be forced. Rather, they require intensive effort, but also an ability to let go, so that the desired thought can come into our minds. Solutions come as a surprise and not necessarily at the moment when we seek them with all our strength. Insight requires inner activity, yet on the other hand it has to do with grace. We must become inwardly quiet, learn to refrain from being occupied with ourselves, open our soul in reverence and learn to hear, so that inspiration can occur. When the hoped-for thought appears, it is a merciful release from the oppressive search for a solution. So how do we become capable of inspiration in our therapeutic relationships with patients? Is this ability simply given, to varying degrees, or can it be developed?

One of the first fruits of meditative work reveals itself in this context: meditative opening of consciousness to the spiritual world of existence enables us to be receptive to the right idea at the right time. In presentations for the teachers of the first Waldorf School, Rudolf Steiner described how helpful ideas for the pedagogical advancement of one’s pupils arise the next day through meditative deepening the previous evening.

Developing therapeutic relationships

When we have only considered what would be an effective and evidence-based therapeutic measure for the diagnosed disease, we will certainly recommend something that makes medical sense in accordance with medical guidelines, but without precise knowledge of our patient. Patients perceive such patient-doctor relationships as “medicine without respect for the person”. The question of how to treat does not only refer to what is medically effective, but also to what is good for the patient. Much of what is medically effective is not necessarily good for the patient. For example, many therapies are certainly assessed differently by 90-year-old patients than by 35-year-olds. A meditation that is central to Anthroposophic Medicine therefore refers to this and starts by asking the question: “How do I find the good?” (5) This meditation focusses on warmth, so it is often referred to as “the warmth meditation”.
The answer to this question requires an intensive relationship with our patient, who wants to feel perceived as a unique being. The spiritual substance of this encounter of beings is love, which does not make us “blind”; it makes us able to see the essential being of the other person. From this quality of encounter the general validity of a medical measure can adapt itself to the individual experiences, points of view, values and needs of the patient (Peter Matthiesen). Such a path requires courage. One must often leave the safe ground of the “usual” and find and proceed along an individual path. Here, too, the question arises: is it possible to train, develop and increase our courage to heal and our ability to encounter patients? Or is this something that we are “born with” to a certain degree?

This is another fruit of meditative work. It can considerably deepen relationship culture, in that our attention does not only stick to external findings but learns to focus on the soul-spiritual being in front of us. Sometimes, during a patient encounter, a completely new aspect appears which gains immediate and common acceptance for both the patient and the one acting therapeutically. Here, too, we need the ability to refrain from focusing on ourselves while perceiving the other person. Especially challenging in this respect is our accompaniment of patients whose consciousness is reduced. How do I find the proper, ethically justified decision here? How do I arrive at “Your will be done”, modified for him?

Ethical decision-making

An ethical decision-making process has different stages. In the first there are known guidelines, rules and medical expertise. These often have great suggestive, normative power and they urge us to make decisions that are not always good for the patient in this situation. That is why it is important to move on to a second stage of decision-making in which we form a picture of the therapeutic possibilities. What are all the conceivable possibilities and alternatives? The advantage of this step is that it frees us from pre-existing judgements. The disadvantage is that no decision has yet been reached. Now we arrive at a third level which is very important in clinical practice and which Rudolf Steiner calls “healthy intuition” in another context. We can become capable of inspiration for a certain solution and decision, and we can have a certain feeling for the evidence of its correctness. However, this prescient feeling is susceptible to disruption. Fear, worries about possible legal consequences, and also illusions can lead to distortions. Here, too, there is a need for a meditative path of development that allows feeling to become an organ of perception in the sense of a healthy intuitiveness. It can then lead from the inspiration of the solution to initial inspirational insight, in which the accepted option is examined and finally—on a fourth level—“recognized”. Then it becomes an ethical decision, ideally an action out of moral intuition (6). Often, however, this decision will be very preliminary, even wrong or too short-sighted. Yet it comes from a search for what is good for the patient. Like every decision, it creates destiny by closely connecting the therapist’s actions with the patient’s fate in a good or detrimental way. As health professionals, we need an awareness of these consequences of our actions and the strength to deal with them. Rudolf Steiner referred to this broadly conceived dimension as “karma will” (3, p. 121–122).

The will to heal: meditation and therapeutic efficacy

Another effect of meditation relates to therapeutic practice: what significance does my attitude towards a medication have for its efficacy? We may consider some well-documented contextual effects in this connection. They are often discounted as placebo effects, but they are not non-specific active principles but specific ones—namely the therapeutic attitude of the doctor or therapist. Especially in pain therapy, the inner attitude of the patient and the practitioner is surprisingly important for the efficacy of an analgesic. We should therefore not engage in treatment with medicinal products without cultivating our therapeutic attitude towards them. Medicines must not remain abstract molecular principles of action; we need to relate to them as “friends”. For this purpose, we must know their material characteristics, but also the processes connected with them and finally the essence of the substance that expresses itself in them. In the sense of Hans-Peter Dürr (1929–2014), we must conclude that matter does not consist of “matter” (7). Substance, as “underlying matter”, has several dimensions (8, p. 91ff) which “overlay” it and which the therapeutically active person connects with through inner meditative work. We have to consider not only external, but also internal pharmacology in medicinal therapy. Just as the former is obviously decisive for efficacy, so is the latter. It makes a difference whether nurses and doctors connect with the substances they use in treatment, make them their extended “hands”, work therapeutically with and through them, or whether they use them distantly as “active substances”. Meditative work is therefore directly related to medicinal efficacy itself. It is through substances that forces arise that can be medically helpful—as Rudolf Steiner described it in his fundamental descriptions of the inner development of the physician (3).

  • Thus, these are the three levels that directly relate to meditative work. If we describe them qualitatively, as well as in terms of content, we find that they are connected to three central dimensions.
  • The first level refers to the correct diagnosis. This allows a previously unclear complex of symptoms to be illuminated and understood. It is a quality of light that develops in the therapeutic relationship with the patient.
  • On the second level of the therapeutic relationship, warmth and a capacity for love are needed in order to perceive the essence of the ill person comprehensively and to find together the decisions that are “good” and not merely effective in this situation.
  • Through the third level of therapeutic efficacy we therapeutically influence the sphere of life and the healing life processes. In this respect, the three qualities of light, love and life stand before us like the “Three Wise Men” of the patient-therapist relationship, helping to make new steps in becoming healthy possible, i.e., facilitating autogenesis or human becoming.

Meditation should, with the inner development of the medical practioner, enable us to be practical and directly help the ill person. For this reason, each of the professions created out of anthroposophy have their own specific professional esotericism. In the field of medicine, an overview has already been published (9).

1 Glöckler M (ed.). Meditation in der Anthroposophischen Medizin. Ein Praxisbuch für Ärzte, Therapeuten, Pflegende und Patienten. Berlin: Salumed Verlag; 2016.

2 Steiner R. Die Geheimwissenschaft im Umriss. GA 13. 30th ed. Dornach: Rudolf Steiner Verlag; 1989. English translation: Steiner R. Occult science. Great Barrington: Anthroposophic Press; 2009.

3 Steiner R. Meditative Betrachtungen und Anleitungen zur Vertiefung der Heilkunst. GA 316. 5th ed. Dornach: Rudolf Steiner Verlag; 2008. English translation: Steiner R. Understanding Healing. Meditative reflections on deepening medicine through spiritual science. Forest Row: Rudolf Steiner Press; 2013.

4 Steiner R. Wie erlangt man Erkenntnisse der höheren Welten? GA 10. 24th ed. Dornach: Rudolf Steiner Verlag; 1993. English translation: Knowledge of higher worlds. How is it achieved? London: Rudolf Steiner Press; 2009.

5 Selg P. Die “Wärme-Meditation”. Geschichtlicher Hintergrund und ideelle Beziehungen. Dornach: Verlag am Goetheanum; 2013. English translation: Selg, Peter. The Wamrth Meditation. A path to the Good in the service of healing. Herndon: Steiner Books; 2016.

6 Steiner R. Die Philosophie der Freiheit. Grundzüge einer modernen Weltanschauung. GA 4. 16th ed. Dornach: Rudolf Steiner Verlag; 1995. English translation: Steiner R. Intuitive thinking as a spiritual path - a philosophy of freedom. Hudson: Anthroposophic Press; 1995.

7 Dürr HP. Warum es ums Ganze geht: Neues Denken für eine Welt im Umbruch. Munich: oekom verlag; 2009.

8 Girke M. Innere Medizin. Grundlagen und therapeutische Konzepte der Anthroposophischen Medizin. Chap. IV Arzneimittel. 2nd ed. Berlin: Salumed Verlag; 2012. English translation: Girke M. Internal medicine. Foundations and therapeutic concepts of Anthroposophic Medicine. 1st ed. Berlin: Salumed; 2016.

9 Glöckler M. Heine R (ed.). Führungsfragen und Arbeitsformen in der anthroposophisch-medizinischen Bewegung. 2nd ed. Dornach: Verlag am Goetheanum; 2015. English translation: Glöckler M, Heine R (eds.) Leadership questions and forms of working in the anthroposophic medical movement. Dornach: Verlag am Goetheanum; 2016.