First cycle of analysis
Anne’s experience of coming into the world had been disrupted by the trauma of being born in prison, followed by an abrupt separation from her mother, followed by being cared for by a nanny with a distant rich materialistic adoptive mother. In conventional psychotherapeutic terms there had been an absence of maternal mirroring (5), a ‘lack of a chalice of thoughtful perception of the child’, of ‘compassion and joy in the dedication to the child’ and of ‘warmth in the gestures of holding the child’ (6, p. 8). She had not experienced a warm, secure and containing ‘attachment base’ (7).
Second cycle of analysis
My understanding of the pathogenesis of Anne’s problems was based on the anthroposophical principle that we enter the world in four stages. At birth our physical body is born, at around the age of seven our life force unfolds [I], around the age of fourteen we begin to experience our independent soul life [II] and, if all goes well, around twenty-one we experience the force of our individuality.
I thought that Anne’s early life traumas prevented her life force, soul and I from connecting to her physical body and remained dissociated. Instead of her life force fitting into her physical body when it unfolded around the age of seven, it began to embark ‘on its own adventures, endeavouring to live and create its own disordered, muddled life by opening out into the world’ (8, p. 99). Similarly, her emerging soul life was unable to connect with her physical body and so became driven by ‘volatility of ideas and lack of cohesive thought’ (8, p. 97). This could have resulted in serious mental health problems. But I did not make this judgement as in many respects Anne remained coherent, cogent and grounded. I did however come to the view that her early life problems had had some effect.
I thought that Anne’s difficulty in connecting her supersensible bodies with her physical body and subsequently the world was the reason for the confusing and powerful nature of the events she shared such as the tall ships race. These events seemed to be driven by the force of her dissociated life body in a ‘disordered, muddled’ way which produced a collage of vivid experiences which lacked ‘cohesive thought’. Initially it was difficult to find a focus in the sessions. I viewed the strabismus – a condition in which the eyes are unable to focus because they point in different directions – as a somatic expression of this.
The cumulative effect of this prevented Anne’s I from fully connecting with her physical body and her her ‘ego [I or individuality] was let loose on the external world, instead of remaining bound’ (8, p. 94) meaning that her life did not have a clear future direction. Instead, she wandered around the world. We initially met in-person in the UK, then a break, then online when she was in Brazil, then in-person again, then online when she was in Italy, in Portugal, in Brazil, in Portugal and in Italy.
I postulated that the lack of form and direction in Anne’s life was mirrored in the endometriosis which arose since her life body was unable to give form to the physical body resulting in cells multiplying outside the uterus.
Third cycle of analysis
As the therapy progressed, I referred Anne to a colleague who was an anthroposophic doctor who happened to be Brazilian and was familiar with the politics of the south of Brazil, with Operation Condor and its relevance for the present times. He spoke about how many leading businessmen farmers from the south were responsible for destroying the Amazon forest to develop the land for cattle. He also spoke about Brazil’s potential for developing fraternity because of its strong energy and life force. Indeed, it seemed significant that Anne spent her childhood in this environment especially as she was not at all inclined to adopt such an exploitative attitude. It was as though she needed the opposite experience – an environment of anti-fraternity – to enable her to develop fraternity.
Around the same time Anne gave wonderful descriptions of how she could move freely between the right-wing members of her family and left-wing teachers without any problem. She could easily enter the different points of view – a situation that Rudolf Steiner experienced in his own life as described in his autobiography (9, p. 62-63).
This led to a completely different focus for the therapy. The first two cycles of analysis concentrated on the origin of Anne’s problems. But from this point we began to focus on what was unfolding for the future in Anne’s life – what some psychotherapists would call our human potential or organismic self which emphasises that human beings have ‘an inherent tendency towards actualizing his or her organism’ (10, p. 29), but I would call Anne’s destiny or karma.
This change of focus corresponded to the fact that Anne was facing the challenges of her age in the 40s which has been described by an anthroposophic psychiatrist as presenting a ‘fork in the road’ which either ‘leads downhill’ or into ‘totally new territory in which quite different creative powers are awakened’ (11, p. 84). I saw Anne moving on to new territory with a great deal of persistence.
In accordance with this new future perspective, it was no surprise to me when the doctor said that in his view Anne’s destiny (or karma) was to develop brotherhood and sisterhood and that the psychosomatic symptoms were an expression of the fact that she was unable to do this.
Pericarditis seemed to mirror her struggle to do this. The pericardium has two layers (inner and outer) around the heart and in the illness becomes inflamed if blood or fluid leaks between these two layers even though there is no fever. From an anthroposophic point of view the inflammation indicated that her I – a warmth body – was active and trying to take hold of her life but so far failing to do so.
Over the course of the therapy, initially weekly and latterly fortnightly, Anne had several medical consultations to address her plethora of psychosomatic symptoms and the problems with her life direction [III].
Fourth cycle of analysis
The profound change in the direction of the work came about because of the interaction between anthroposophic psychotherapy and anthroposophic medicine. Our emergent future focus reminded me of the statement by Rudolf Steiner, quoted earlier, that our ‘thought shadows’ which are attached to the physical body were, in Anne’s case, regaining ‘life’. This seemed to express Anne’s experience and the perspective that I have previously discussed – the ‘disordered, muddled’ nature of her life body – was not the full picture. Much of what Anne shared with me had a future direction. Anne’s capacity to develop brotherhood and sisterhood now became a central focus of her life and the therapy. Her life was preparing for a future where ‘civilized human beings will quite naturally meet each other as brothers and sisters’ (12). What had previously been survival now became a clear future direction.
At this time in her life Anne was working with horses which she loved. She seemed to be working in a different way to most equestrians. For instance, instead of forcing the harness on to the horse’s head she typically calmed herself, inwardly observed her somatic state and connected with the horses who then responded to her calmly. She could, in my view, perceive the way in which the horses connected with each other and with Anne in a mood of brotherhood and sisterhood.
On reflection the events she described (the tall ships race, forgetting where she had left the car) and the dreams all had an element of fraternity. So, I now thought of them as pointing to the future as well as being a reaction to past traumas.
I now took the view that Anne was developing a state of consciousness that many people will develop in the future. Her consciousness was coming alive – ‘regaining life’ to quote Rudolf Steiner. It was future-orientated, was full of life and could be ‘described variously as morphological, organic-morphological, imaginative, and etheric thinking’ (13, p. 7). Put differently, she was developing a way of thinking which ‘lives within the medium of time in the same way in which ordinary thinking lives within the medium of space. This thinking does not link up one thought with the other; it sets before the soul a kind of thought organism.’ (14)
Fifth cycle of analysis
After this deepening, the phenomena of her life confirmed her future direction.
In April and May 2024 she was visiting the southern Brazilian state of Rio Grande do Sul, where she had been born. Whilst she was there the state was overcome by devastating floods in which many people were killed. Many people volunteered to help, as did Anne. There was no leadership or organisation. She reported how people just came together like a brotherhood/sisterhood. Whilst she was helping the flood victims all of her symptoms disappeared thereby confirming the doctor’s insight. This happened even though she was not resting at all. Each day her body was tired since she was not resting and travelling 20 kilometres each way. But, despite this, she was energized.
Anne’s experience reminded me of the future consciousness when we will ‘create a distinctive ethical and moral foundation for humanity, one much more alive and vibrant than morality is today’ (15, p. 77) when we will have an awareness that ‘living at the expense of others […] is the same thing as if a particular organ developed inappropriately and lived at the expense of another bodily organ […] a feeling that the whole of social existence is an organism’ (15, p. 78).
Sixth cycle of analysis
During June and July 2024, Anne was back in Europe visiting Italy and the somatic symptoms returned. She and her husband were not at all in tune with each other. This was not new but had intensified. Her husband prompted them to drive from the north of Italy to Sicily which was exhausting for her. She spoke of needing to be ‘clear from his rhythm’ and ‘his speed’. As usual her body reacted strongly, and she developed debilitating cramps.
In this session she said she had ‘escaped’ her husband and was in Tuscany in a remote place on her own. This part of her trip both confirmed the direction of the therapy and placed her life within a broader historical context as she spoke about the Etruscan civilization and architecture which seemed to me to be relevant to Anne’s unfolding story, but which is a topic for further investigation.
Seventh cycle of analysis by Anne
As I stated earlier the methodology of this study is based on a cyclical as opposed to a traditional linear approach to research and involves a process of reflexively analysing the emerging data. There are many forms of reflexivity. The approach I have adopted is what Steier (16, p. 2) refers to as ‘a turning back of one’s experience upon oneself’ or Freshwater and Rolfe (17) refer to as ‘turning thought or reflection back on itself’. The levels of analysis in this study illustrate this process. They show how my thinking about the case evolved in a cyclical manner over time. First, I reflected on Anne’s experience in the light of her early life traumas (first and second levels of analysis). Then I responded to new data (the doctor’s comments about Brazil and fraternity and Anne’s comments about rising above left-wing an right-wing disputes) by turning my thoughts and reflections about Anne’s experience back on themselves and adopting a future orientated approach (third, fourth and fifth levels of analysis). Then there was a pause (sixth level of analysis).
All of this only had therapeutic value if I could communicate the emergent coherent salutogenic picture to Anne. I did this in the sessions themselves. But to reinforce both the research and the therapy I concluded the research by member checking – a a form of participant validation which, in this case, enabled Anne to check the data and the first six cycles of analysis for their accuracy and resonance with her own experience (18). Accordingly, I sent the results of the first six stages of analysis as written in this report to Anne.
Anne agreed with what I had written but made an important comment which constitutes a seventh level of analysis. She referred to how in her early life she felt ‘needy’ but had now overcome this. This transformation had been assisted by many of her experiences, such as her experience of the tall ships race in the Baltic Sea. This experience helped her to connect with nature and with a harmonious community involving both Russians and Americans. It filled her with love and energy. She felt safe and had a sense of belonging. Without such strengthening experiences she thought she might still be needy. In this reflexive cycle of analysis Anne turned my first and second levels of analysis back on themselves by showing that I had failed to notice that they had a future orientated healing perspective as well as a past orientated psychopathological perspective.
