Anthroposophic therapeutic speech works on physiological, mental/emotional and spiritual levels and is used in different ways in palliative care. Depending on the patient’s general condition, it can be done actively by the patient or affect the patient through passive reception. Via the air organization, spoken sounds modify the life organization (etheric organization) at work in the body’s fluids. The air organism that runs through the entire organism is specifically shaped by the formation of individual sounds. In the air, every sound formation gives rise to a typical shape (1) This sculpts the life organization and thus leads to the physiological effectiveness of anthroposophic therapeutic speech. The meaning of a sound sequence is therefore less decisive for its effectiveness than its specific sound form. Most therapeutic exercises make use of the proximal pre-verbal repertoire of syllables and sounds from which infants draw when beginning to acquire language. In addition to their connection with the body, language and speaking are related to mental and emotional experience. We "feel" the meaning of a word simultaneously with the information that it conveys. Thus, the expressions for one and the same concept sound very different in different languages. Finally, we use verses and meditations to provide spiritual content. Through them, the patient can develop new perspectives and internal sources of strength.

Therapeutic recommendations

Particularly effective are exercises with

• activation of the articulation point for the consonants "L", "N", "D", "T" above the incisors at the alveolar margin by conscious repetition of corresponding syllable combinations.

Stimulation of this point with the tip of the tongue leads to concentration and deepened breathing, with simultaneous emotional stabilization.

We can deepen the breathing and make it more rhythmical through

• sound breathing exercises such as "W–T", hexameter and "OM" both actively and receptively.

Deep and calm breathing helps the patient to feel warmth and expansiveness in the chest through strengthening vagal tone and through increased presence in the center of their body.

In non-bedridden patients,

• speaking rhythmic texts, accompanied by walking and gestures, can lead them into the here and now and promote self-assurance by experiencing their own voice.

The voice as an important factor in experiencing identity can be guided via the body from fear-induced blockages and weakness to the sound resources that it still possesses.

Self-efficacy in the act of speaking can be experienced particularly"well in the resistance of the body in

• exercises with the plosive sounds "B", "P", "D", "T", "G", "K".

They also help to improve the experience of presence in the body and to develop a sonorous voice.

• Text work with supporting or self-written texts.

An immediate improvement is often experienced on the level of rhythmic symptoms (life organization) and the "I" by using supporting texts.

Achieving a lasting transformation of often unconscious aggression into self-activity and strength takes several weeks and depends on the history and the severity of the symptoms. In cases of (social) phobias, panic or generalized anxiety disorder, it is beneficial to promote self-centering through words and gestures and to use symptom-centered speech-breathing exercises (see above).

The psychological phenomenon of fear has typical expressions in the four constituent elements of the human being. Anthroposophic therapeutic speech assesses and classifies the symptoms and uses appropriate therapy methods and means (2).