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62ALTERNATIVETHERAPIESjulaug2011VOL.17NO.4TkEurythmyTherapyinAnxietyanditscharacter.Suchrapidimprovementislessli-elyduetoanongoingcounselingalreadyproceedingformonthsthoughitmightstillhavecontributedtotheimprovement.SimilarconsiderationsmayalsoapplytotheAMmedicationbeforeandduringEYT.Insystematicreviewsherbalinterventionwasnotfoundtobeveryeffectiveforanxiety.28MassageandrestingbeforeEYTmayhavecontributedtotherelaxanteffectofEYTbutdidnotcauseitalonesincethepatientwasstilltenseatthebeginningoftheEYTsession.Improvementoftheanxietysolelyduetospontaneouscourseofdiseaseisunli-elyinviewofthedescribeddynamicoftheclinicalpictureandcomplaints.Particularlyitcouldnotexplaintherepeat-edlyobservedimmediateimprovementsinthepatientx19smovementandgesturepatternswhendoingthespecificallycorrespondingEYTexercises.Furthermoreanxietydisorderisachronicdiseaseandspontaneousremissionisnotcommonincontrolledclinicaltrialsuntreatedpatientswithanxietydisordersdidnotshowsub-stantialimprovementoftheanxietysymptoms.30Inadditioncon-texteffectsmayhaveinfluencedthecourseofdiseasebuttheywouldberegardedasanintegralpartofthetotalAMapproach.31Alimitationofthecasereportisthelac-ofaformalinstru-menttoassesstheseverityofthediseaseanditsimprovementdur-ingfollow-up.Howeverthiscasewasdrawnfromaroutineprimaryoutpatientsettingandthereforemirrorsmedicalreality.Someoftheavailablequestionnairesusedinclinicalresearchmayalsobeusefulforclinicalpracticeandfacilitateamorequantitativeassessment.32-35Stillasanxietyisasubjectivelyexperiencedillnessthepersonalaccountofthepatientiswhatmattersintheend.Inthispatientanxietydidsubstantiallyimprovebutwasnotcompletelyresolved.Anxietyisachronicdiseaseand6yearsafterthetreatmentperiodthepatientreportedrelapsesandunderwenttreatmentswithcognitivetherapySertralineandEYT.AgainEYTwashelpful.Altogethertheanxietyrelapsesbecamelessintenseandthepatientnowisabletofullyparticipateinsociallife.Thisclinicalobservationfromaroutinepracticeisconcordantwiththeresultsofamajor2-yearprospectivecohortstudyconduct-edinGermanythatevaluatedAMtherapiesinchronicdiseasesin141AMpractices.Sixty-fourpatientswithanxietydisorderwereincluded33ofwhomhadbeentreatedwithEYTasprimarytreat-ment.Theseconsecutivelytreatedandprospectivelydocumentedpatientsshowedastatisticallysignicantandlong-termimprove-mentofsymptomsandofqualityoflifeFigure.22ComparedtothatstudythepresentreportgoesintomoredetailabouttheconceptandtheimplementationofEYT.ItsuggeststhatproperlyappliedEYTcanbehelpfulforanxietypatientswhohaveapreferencefornonverbalandartistictherapiesdonotimprovewithstandardtherapyndthesetherapiestobetoopas-siveanti-anxietymedicationtoointrusiveortooverbalpsycho-therapyorsufferfromadversereactions.Anxietydisordersareamajorhealthconcernwithsubstantialimpairmentofqualityoflife.Manypatientsdonotoronlytempo-rarilyrespondtoestablishedtreatmentsandprefercomplementaryinterventionsparticularlynonverbalandartisticapproaches.SinceEYTshowspromisingresultsforthisindicationfurtherstudiesshouldbeconducted.Noadverseeffectswereobservedinourpatient.Stilltreat-mentofpatientswithEYTshouldberestrictedtotrainedEYTther-apists.FurthermoreEYTmightnotbesufcientasasoletreatmentandotherinterventionsmighthavetobeaddedorappliedlater.Patientsshouldbecarefullyandregularlymonitoredbydoctorsregardingthecourseofanxietyaswellaspotentiallyoverlappingcomorbiddisorders.CONCLUSIONInapatientwithstress-inducedanxietyEYTseemstohavebeenaneffectivetreatment.Thiscasereportoffersinsightintotheanthroposophicconceptualizationoflifefunctionsandtheirpathologicaldeviationsandthewaytheyareusedfordiagnosisdexterityprevailalongwithapredominantdifferentiationofthenerve-sense-system.Duringthesecond7-yearperiodthegrowingawarenessofthechildx19sownemotionsandincreas-ingexperienceofhisorherownseparateinnerworldpre-vailsalongwithadifferentiationoftherhythmicsystemegthepulsebreathingratio39.Duringthethirdperiodthedevelopmentoffreewillandautonomouspersonalityadult-hoodprevailsaccompaniedbythenaldifferentiationofthemotor-metabolicsystemstartingwiththesexualmatura-tionatthebeginningofthisperiod.Specificvulnerabilitiesareseenintheseperiods.Forexampleinthesecond7-yearperiodthechildisoftensensi-tivetoouterpressureandreactswithsymptomsinthemeta-bolicsystemstomachacheandorthenerve-systemheadachesincetherhythmicalsystemisnotyetstrongenoughtobalancethetwoothersystemconstituents.Inthisperiodtherhythmicalsystemx19sowndisturbancesneednotresultingrosslyanatomicaldefectsbutratherinmentalemotionalsymptomsegdepressionoranxiety40-42.IV.x0Dislocativex0Pathogenesis43x0andx0thex0Breathed-in-upwardsx0SyndromeAsamatterofpathogenesistheregion-specictypesofthefour-levelinterrelationscanbedislocatedintootherareasoftheorganism.Forinstancethespecictypeofthefour-levelinterrelationsthataccompaniesthelungprocessofinspirationcanshifttowardstheupperregionsoftheorganismbreastnec-andhead.Insuchacaseonewillencounterapathologi-calstatewhichiscalledthebreathed-in-upwardssyndromeinthepresentarticle.44Thisdislocationndsitsexpressionintherespectiveper-sonasbeingalertlightlivelyengagedwhenmoreintensiedthepersonbecomeswounduptenseoverexciteduneasyandnervous.Inanextremecaseonemayfeeloutofcontrolorevenpsychotic.Withthecontrarydislocationiethebreathed-out-downwardssyndromethepersonwouldfeelli-elettinggocenteredgroundedandrelaxedwhenmoreintensiedthepersonmayfeelheavydullindifferentanddepressed.Inextremecasesthepersonmayloseconsciousness.