The Fourfold Human Constitution

Human beings are more than their bodies. Their life processes, such as growth, regeneration and all healing processes, belong to their life organization (etheric body). As beings that move about and have feelings they develop an inner world of soul, which they may express through language and facial expressions (soul or sentient organization, astral body). As self-aware and self-determined individualities, they live as spiritual beings (the “I” ) in the organism, which we may perceive through language, and they shape their individual biographies and destinies.

These four entities constituting the human being become immediately evident when we encounter a patient. The patient reports on her physical symptoms (body), her exhaustion and loss of vitality (life organization), her sensations and psychological complaints, e.g., anxiety and pain (sentient organization) and as an “I” she has questions about the meaning, perspective and significance of the disease for her individual biography. The epistemological foundations and thus the scientific basis for this anthroposophic understanding of the human being in Anthroposophic Medicine have been presented and elaborated on in detail (1).

The human body

The visible body, i.e., the materially constructed form that can be analyzed with scientific methods, is the physical body. This physical organization extends from the bones to the genetic material in each cell. It determines our external physical appearance, weight, density and balance of physical forces. This physical body has been exceptionally well researched in modern times, as a purely scientifically oriented medicine is primarily concerned with processes that can be explained by the laws of chemistry and physics.

The life organization

In addition to chemical and physical laws, there are forces that we know as self-healing forces, as vitality, or as the ability to regenerate. These are dynamic life processes which can vary greatly in their activity and intensity in the individual organs and tissues. The regenerative capacity of liver cells and the gonads is different from that of brain cells or the corneas. These various dynamic life processes belong to a life organization that enables harmonious and meaningful interaction between the various life processes. Every human being has his own life organization, just as he has his own physical body. Rudolf Steiner also called this life organization the life body or etheric body, whereby the term “body” always means something that has shape and form (2, p. 15). Etheric forces are the basis for all inherent healing and capacity for health. The life organization needs an epistemological approach to recognize its independent reality as distinguished from that of the physical organization (1).

The soul organization

Different feelings such as suffering and joy, sympathy and antipathy, the ability to perceive something consciously, the faculty of being able to wish for and want things, these are all expressions of different powers in the soul. They all belong to the soul organization that enables the harmonious and meaningful interaction of our various soul impulses. Every person has their own soul organization, just as they have their own life organization and their own physical body. In anthroposophic anthropology this is known as the sentient organization or astral body.
The soul organization creates an inner space in us and at the same time a new dimension of the ability to relate; it enables affection and aversion, self-awareness and compassion, and allows us to develop attachment and autonomy. 

The human individuality

Every person, every child is an individual: unique and one of a kind, irreplaceable and indivisible. This is what the concept of human dignity refers to. All ethics in medicine is based on this fact. This is fundamentally different from the activities of soul and of sentience that we find in animals. The term “individual” is derived from Latin and means that a division into further subunits is not possible (in-dividere = not divisible). It thus refers to the essence of the human being. Each of us can say “I” only to ourselves. The “I” corresponds to the spiritual in us, it forms the center of our personality, enables self-awareness and a lifelong capacity for further development. It not only shows itself in our thinking and our cognitive faculty, it also penetrates and shapes our soul and body. We all experience in our inner being that we can influence our thinking, our feelings and our will activity. This ability is a prerequisite of any consistent ethics. Thus, the human “I” is the basis for the freedom that we human beings experience when we act independently or make decisions. The intervention of the “I” in soul and body is made possible by the “I”-organization. This “I”-organization coordinates and integrates all the individual processes of the organism, whereby the individual “I” can increasingly influence and shape thoughts, feelings and action. The “I” is the immortal spiritual entity in the human being. The element that the “I”-organization primarily uses to connect with the body is warmth.

Chart: The constitutional entities of the human being (3, p. 16)

Sleep and death

The subtle entities of the human being stand in changing relationship to each other. In sleep, the soul and spirit detach themselves from the life organization and physical body and then reconnect again with the body upon awakening. Dreams occur mainly in transitional phases, when these different entities begin to penetrate each other more strongly again. With death, there is a complete separation of the higher entities from the physical body, which then remains behind, lifeless. In this regard sleep is the little brother of death: in death it is not only the soul and spirit that detach themselves from the physical body, but also the life organization. These aspects have far-reaching consequences. Death, with its decay processes, is a process that belongs exclusively to the physical body. The living being of soul and spirit is not affected by death because they exist after death and before birth. This has decisive consequences for obstetrics and pediatrics, as well as palliative medicine and our accompaniment of dying patients.

The human “I” can also be connected to the body in very different ways. Thus, a person’s gaze can be perceived as “empty” or can be filled with the power of their individuality. We speak of the person being either present or absent in English and thus point to the difference in the presence of their “I”. Drugs and addictions, for example, lead to a weakening of the presence of the “I”.