International Coordination
Anthroposophic Medicine
School of Spiritual Science
Medical Section at the Goetheanum

Arts Therapies

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Harald Gruber, Dietrich von Bonin, Viola Heckel

Anthroposophic Arts Therapies (AAT) have been developed in the context of Anthroposophic Medicine (AM) since the 1920s. They consist of visual, musical, and speech-oriented methods. From 1929 onwards, at the suggestion of Ita Wegman, the physician Margarethe Hauschka-Stavenhagen painted with patients for therapeutic purposes at the Clinical Therapeutic Institute in Arlesheim, Switzerland. Her aim was to create a therapeutic method to activate and stimulate the power of the soul and encourage vigour of thinking, feeling and willing. This enables individuals to attain personal recovery and freedom of action. The first pioneer in the field of Therapeutic Speech was Martha Hemsoth (1887–1936). She laid down the foundations of a method using sounds, syllables and poetics to activate and direct the patient’s breathing and voice, and improve psychosomatic disorders. The beginnings of Anthroposophic Music Therapy were closely connected with the development of education for special needs in Arlesheim in the 1920s (1). Ita Wegman supported the therapeutic use of the lyre, a stringed instrument newly designed by Edmund Pracht and Lothar Gärtner (1926). She also prescribed therapeutic singing with the Swedish singer and vocal therapist, Valborg Werbeck-Swärdström (1879–1972), founder of the School of Uncovering the Voice.
A fundamental description of Anthroposophic Arts Therapies was summarized for the first time in four volumes in 2000 (2-5). Currently, Anthroposophic Arts Therapies are used in many areas of Anthroposophic Medicine, in inpatient and outpatient somatic and psychosomatic medicine, as well as paediatrics and palliative care. Anthroposophic Arts Therapies have been recognized as a component of anthroposophic integrated care since 2006. A prospective outcome study (AMOS) demonstrated positive effects of arts therapies in a multimodal intervention setting. Substantial and sustained improvements of disease symptoms and quality of life were observed in different studies that included AAT (6-10).

Anthroposophic Therapeutic Speech
Anthroposophic Therapeutic Speech (ATS) positively influences heart rate variability (HRV) and cardiorespiratory coordination in healthy volunteers (11, 13, 19). Furthermore, ATS leads to a decrease in cerebral blood flow during recitation and to brain activation thereafter (17, 18).
A prospective exploratory trial using 6 interventions of ATS demonstrated positive effects on baroreflex sensitivity, whereby mean systolic blood-pressure did not change in spite of clinical observations, showing reducing effects of ATS on blood-pressure (14).
In a randomised, controlled trial with 49 outpatients, 11 sessions of ATS improved quality of life and asthma control in patients with asthma, while lung function and medication intake remained unchanged. A limitation of this trial occurred during patient recruitment, since outpatients willing to enrol were not severely affected (16). Qualitative observations will be published.

Anthroposophic Music Therapy
Anthroposophic Music Therapy (AMT) is practised both actively and receptively. Patients will either participate by playing instruments or singing, and/or listen to music played for them on various acoustic instruments by the therapist. The aim is to holistically reactivate the individual's resources for healing and to support his or her spiritual, mental, functional and physical self-regulatory abilities (26, 28).
Until recently, the focus was mainly on conceptual research, now, also empirical research has begun according to generally accepted academic standards. The conceptual research led to a model that describes a coherent, holistic understanding of music and people. Initial empirical studies focused, e.g., on the result of a specific lyre intervention in terms of respiration, heart rate variability (HRV) and mood (26, 28).
A pilot study by Wälti shows very well the inherent difficulties in music therapy studies and discusses possibilities for improving future studies (33).
The aim of a study by Bieligmeyer (27) was to evaluate the immediate effects of sound-bed music interventions with respect to subjective well-being, as well as body warmth and pain.
AMT has been scientifically examined in a variety of ways as part of the master's program in Music Therapeutic Research and Practice at Magdeburg-Stendal University of Applied Sciences (28, 30, 32, 34).

Anthroposophic Art Therapy
Anthroposophic Art Therapy (painting, sculpting) has so far been less systematically investigated compared to other approaches of art therapy. Meta-analyses of art therapy show, however, that a significant improvement can be achieved in various indication areas, for example in anxiety, depression and quality of life (Wood 2011; Boehm 2014; Archer 2015).
In individual Anthroposophic Art Therapy studies, basic questions were systematically investigated in many cases, such as systematic descriptions of images (Gruber 2003; Mehl 2018), patient competence (Born 2006) and effect factors (Gruber 2011, Oepen 2015, Gunkel 2016). Other empirical studies developed questionnaires on internal correspondences in people with fatigue syndrome after an oncological disease (Kröz 2019), on the improvement of depression in oncological patients through painting therapy (37) and  on the development of documentation for art therapy in individual case studies (35).


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  9. Kröz M, Reif M, Glinz A, Berger B, Nikolaou A, Zerm R, Brinkhaus B, Girke M, Büssing A, Gutenbrunner C: Impact of a combined multimodal-aerobic and multimodal intervention compared to standard aerobic treatment in breast cancer survivors with chronic cancer-related fatigue : results of a three-armed pragmatic trial in a comprehensive cohort design. BMC Cancer 2017; 17(1), pp. 166.

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  11. Cysarz D, von Bonin D, Lackner H, Heusser P, Moser M, Bettermann H: Oscillations of heart rate and respiration synchronize during poetry recitation. American Journal of Physiology, Heart and Circulatory Physiology 2004; 287, pp. H579-H587.

  12. Cysarz D, von Bonin D, Heusser P, Moser M, Bettermann H: Wirkungen von Sprachtherapie auf die kardiorespiratorische Interaktion. : Teil 1: Synchronisation durch Hexameter-Rezitation. Der Merkurstab 2005; 58(2), pp. 98-105.

  13. Bettermann H, von Bonin D, Frühwirth M, Cysarz, D, Moser M: Effects of speech therapy with poetry on heart rate and cardiorespiratory coordination. International Journal of Cardiology 2002; 84(1), pp. 77-88.

  14. Krüerke D, Simões-Wüst A, Frank M, Faldey A, Heusser P, Kaufmann C, von Bonin D: Can speech guided breathing influence cardiovascular regulation and mood perception in hypertensive patients? Journal of Alternative and Complementary Medicine 2018; 24(3), pp. 254-261.

  15. Scholkmann F, Rosenberger R, Wolf M, von Bonin D, Wolf U: The effect of arts speech therapy on cerebral oxygenation and low frequency hemodynamic oscillations measured using functional near-infrared spectroscopy. European Journal of Internal Medicine 2010; 2(4), pp. 214-215.

  16. von Bonin D, Klein SD, Würker J, Streit E, Avianus O, Grah CH, Salomon J, Wolf U: Speech-guided breathing retraining in asthma : a randomised, controlled cross-over trial in real-life outpatient settings. Trials 2018; 19, pp. 333

  17. Wolf M, von Bonin D, Heusser P, Wolf U: Speech therapy changes blood circulation and oxygenation in the brain and muscle. European Journal of Integrative Medicine 2009; 1(4), pp. 253.

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  26. Ben-Arye E, Ben-Arye Y, Barak Y. Eva: Between Anxiety and Hope : Integrating Anthroposophic Music Therapy in Supportive Oncology Care. Health Psychology Research 2015; 3(3), pp. 2199

  27. Bieligmeyer S, Helmert E, Hautzinger M, Vagedes J: Feeling the sound : short-term effect of a vibroacoustic music intervention on well-being and subjectively assessed warmth distribution in cancer patients. A randomized controlled trial. Complementary Therapies in Medicine 2018; 40, pp. 171-178.

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