Holistic medicine

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Holistic medicine or holistic medicine is a collective term for the concepts and methods in the field of medicine , which the natural look and the sick people in broad contexts and treat. Behind the term “ holistic ” there are various natural philosophical , religious, mystical, esoteric , system theoretical , psychosocial, ecological or political ideas. The World Health Organization has taken a holistic view in its definition of health since 1946 and describes it as "a state of complete physical, mental and social well-being and not just the absence of illness or ailment".

The more recent concepts see (somewhat generalized) the human being as a structured, outwardly open system , the parts of which are in mutual relation to one another, to the whole and to the outside world. The factors acting here are:

• the own person (understood as the unity of body , soul and spirit ),
• the social environment (fellow human beings, society)
• the natural environment (water, soil, air, climate)
• the artificial environment (technology and science)
• Supernatural (religion, belief).

Typical for "holistic" medical and nursing concepts are less concrete instructions than visions and ideals that correspond to a "need for a new 'clarity" "or ideological ways of thinking" as attempts to find an answer to the crisis of meaning in scientific-rational thinking " .

history

The question of the nature of wholeness and of the relationship between the whole and its parts has preoccupied philosophy since ancient times. The statement, often attributed to Aristotle , “ The whole is more than the sum of its parts ” was only coined in 1890 by the Austrian philosopher Christian von Ehrenfels .

In his work, Praise of Healing Art , as early as 1518, Erasmus of Rotterdam saw medicine as an activity that, like theology, is about the “whole person”.

In contrast to the later separation of somatic and psychological aspects, Goethe (1749–1832) still viewed diseases holistically.

With Romanticism in the early 19th century, something like a holistic movement with a clearly anti-Enlightenment affect had developed in Germany and France as a counter-movement to the social and cultural effects of industrialization . The heterogeneous group of scientists and philosophers involved felt threatened by an image of fragmentation and mechanism. This image was traced back to the laws of Isaac Newton , who, according to the romantic scientists and philosophers, created “the universe full of color, quality and spontaneity into which he was born, into the cold, unqualified and impersonal realm of a homogeneous and three-dimensional space in which the particles of matter danced like marionettes according to mathematically calculable laws ”.

Christian von Ehrenfels, on the other hand, pointed out that “what we seem to perceive in terms of phenomena are not the supposedly atomistic elements of which they are made, but their relationship to one another, the structured whole into which the elements fit”. He made this clear with an example from music: here one would not recognize the essence of a melody if one looked at the individual notes, but rather would recognize and hear the melody as a whole.

Term description

The neurologist and Gestalt theorist Kurt Goldstein was the first to develop a holistic conception of the “organism-in-its-environment” in his book The Structure of the Organism (1934).

Anne Harrington comes to the conclusion in her study that after the First World War there was an “infection of the German holistic doctrine with the racial ideas and their partial absorption into the politics and mythology of National Socialism” (p. 22) and that the concept of wholeness from the beginning stood in the area of ​​tension between science and rescue mythology (p. 19). But it also makes it clear that the history of holistic thinking consists of many stories and positions were possible that saw themselves on a democratic basis and that were criticized for National Socialism, such as B. with Kurt Goldstein and Max Wertheimer .

Medicine and nursing

In medicine and nursing science , roughly two types of "holistic" approaches can be distinguished:

• Holistic theories. They take the view that the properties of the whole cannot be explained by the properties of the isolated parts and therefore wholes must be used to explain complex systems - here the human being is described as a “bio-psycho-social being” with the other “system components ( …) Environment, spirit / spirituality and cosmic energies as well as (…) development-specific variables ”;
• More pragmatic approaches. There an attempt is made to see several problem areas with their links and to avoid one-sided emphasis on individual aspects. The aim of care and treatment is "the comprehensive consideration of all aspects of being ill, taking into account the living conditions of the patient, his perception of illness and health as well as his wishes to participate in the treatment process or to behave passively in it". Holistic focus is “essentially on the sick patient, being sick”, not primarily “the illness”.

There are therefore two directions: one that includes mystical, spiritual and cosmic energies, based on a pre-scientific, religious and ideological view of man, and one that sees man as a "non-reducible unit" that is interwoven with the environment and here makes use of the knowledge of psychology, sociology, ethnology or anthropology in general. Both schools of thought refer to the systems theory of Bertalanffy and start from the idea that the human being is an open system, i. H. a system whose boundaries to the environment are permeable, which affects the environment and is at the same time influenced by it.

The range of holistic therapies, like their theoretical basis, is extremely diverse. It ranges from psychosomatic medicine to various alternative healing methods such as traditional Chinese medicine to models that go far beyond this and represent a self-contained thought structure, such as the spiritual healing associated with esotericism or healing with crystals . It unites the different orientations of holistic medicine, which promises to see people as a unity, as a networked system, the longing for the "good, the true, the beautiful", the longing for a unified and closed worldview, for a harmonious embedding of the individual's fate in a larger context, according to the meaning, value and meaning of one's own life.

Machine and socialism versus wholeness and nation

People were getting better and better at the end of the nineteenth century - even if a large part of the European population continued to live in poverty, jobs were created with industrialization and the increasing use of technology. With the help of industrially produced fertilizers in agriculture, seasonal famine could be eliminated. At the same time, medicine developed by leaps and bounds. Shortly before the turn of the century, Robert Koch, among others, identified many infectious agents such as the tubercle bacillus in 1882 or the cholera pathogen in 1883, and with the discovery of the antibiotic penicillin in 1928 these could be effectively treated. Between the mid-19th century and the 1920s, the mechanical school of thought was the leading - yet holistic theorists have existed throughout the period. In Germany in particular, these were found among the conservative political forces and within the fraternities . These also saw a holistic approach politically. Just as the mechanists saw man and the states as machines that also functioned in this way, the holistic theorists saw the state as a natural, hierarchical structure that thrives out of itself.

It was not until the crisis of the First World War that there was a renaissance and a breakthrough of holistic ideas, since the war was viewed as a machine war, and as Jakob Johann von Uexküll put it in 1920, the first government of the parliamentary Weimar Republic had “the world ideal of the materialists , the chaos, transferred to the state ”. The holistic theorists around Jakob von Uexküll thus created a picture of chaos with democracy and all materialistic thinking was rejected here. So for them "socialism" and "Americanism" were just different varieties of a mechanical way of thinking. The “natural”, hierarchical social order had perished for von Uexküll with the First World War and the end of the monarchy. The subsequent “new”, “chaotic”, democratic republic was rejected by him and other holistic theorists. On the one hand there was a further development of modernity and on the other hand a new holistic movement in Europe. These movements were both parallel and influential to different degrees. In German politics from the end of the First World War to National Socialism , both currents can be demonstrated. Some of the holistic theorists such as Jakob von Uexküll, Felix Krueger, Erwin Liek and Viktor von Weizsäcker were personally and personally close to German National Socialism . These exposed representatives of the holistic approach in Germany expressly welcomed the National Socialist seizure of power, as they found the democratic republic to be unnatural and absurd.

Since the mid-1920s, the catchphrase of the “ medical crisis ” has been making the rounds in the healthcare sector . Erwin Liek as a representative advocate for a “holistic medicine” at this time criticized “the” technology, “the” mechanization and “the” bureaucratization of medicine, conjured up a “wholeness of soul, mind and body” and met with a lively response. Respected representatives of " conventional medicine " such as Ferdinand Sauerbruch or Ludolf von Krehl also took the view that "practical healing art" must be more than natural science. Around 1929 the term “New German Healing Art” appeared, which brought ethnic-national elements into the efforts to overcome this “crisis”. This tendency was willingly accepted by the National Socialist health policy in their criticism of conventional medicine, which was seen as "Jewish-Marxist" and too strongly oriented towards social medicine. Concepts of a “biological medicine” were formulated with doctors as “health leaders of the nation” using terms such as the “big picture”, “the whole of nature” or the “national whole”. Ruthless Social Darwinist “ racial hygiene ” became the new guiding ideology. It favored hundreds of thousands of forced sterilizations , the destruction of so-called "life unworthy of life" in initially ten thousand murders (so-called "euthanasia" - Action T4 ) and criminal human experiments, mainly in concentration camps by doctors ( see: Medicine under National Socialism ). The murder of several million Jews can be viewed as a horrific escalation.

After 1945, catchphrases such as “biological medicine”, “synthesis of university medicine and naturopathy” or even “ new German medicine ” were considered to be politically charged. Obviously, this did not apply to “holistic medicine”. With this word an attempt was made to make a disavowed current in medicine acceptable again. There were amazing personal continuities. In 1949 Werner Zabel , who had been available to Hitler's personal physician Theo Morell as a dietary advisor, carried out “advanced training courses for holistic medicine” in Berchtesgaden on behalf of the “Working Group of the West German Medical Chambers” and published an article entitled “Further training for holistic medicine” in the magazine “Hippokrates”. Karl Kötschau , who in the 1930s as Vice Dean of the Medical Faculty wanted to make “Jena a combat university for holistic thinking” and who in 1935 was appointed head of the “Reichsarbeitsgemeinschaft für eine Neue Deutsche Heilkunde” (Reich Working Group for a New German Medicine) by the Reichsärzteführer, propagated a “ Holistic medicine ”, whose foundations should consist of homeopathy , naturopathy , acupuncture and psychotherapy .

New Age

Through humanistic psychology and the New Age movement, the idea of ​​wholeness returned to Europe in the 1960s and 1970s. This founded and underpinned the then emerging environmental movement with a philosophically based criticism of technology and an accompanying new spirituality. In the USA and later in Western Europe, the generation of the new left and hippies, traumatized by the Vietnam War and alienated from the world of the elderly, discovered a “machine” in their midst - not the atomistic, decentralized industrial society, but the overly centralized authority of one advanced capitalist "military-industrial complex".

In the 1960s, attacks on science increased. It was described as a fundamentally oppressive institution in the service of the military and big business and as an epistemology that wanted to recognize reality with a fundamentally inadequate approach. A rift was perceived here and a new science had to be created that would overcome this rift and create a new wholeness.

Modern approaches to holistic medicine

On the part of scientifically based medicine, concepts of psychosomatic medicine are sometimes referred to as "holistic medicine". Biopsychosocial medicine and understanding psychology also pursue similar concepts .

The Medical Cybernetics involves the application of systems theory, news theory, connectionist and decision analytical concepts for biomedical research and clinical medicine. The aim of medical systems theory is to better understand the complex interrelationships of the physical system and their specific networked functionality. Physiological dynamics in healthy and diseased organisms are identified and modeled according to system theory. The Medical University of Vienna maintains its own institute for medical cybernetics.

Individual evidence

1. ^ Hagen Kühn (1989): Brilliant powerlessness - On the political content of the holistic claim in medicine . In: The whole man in medicine, argument special volume 162, 111–128, see literature
2. ↑ ^{a b} Quoted from Arnold Rekittke: Is holism possible? In: Gudrun Piechotta, Norbert van Kampen (Hrsg.): Holistic approach to care and health. Claim - Myth - Implementation. Schibri-Verlag, Berlin 2006, ISBN 3-933978-86-6 .
3. ↑ Erasmus of Rotterdam: Encomium artis medicae. 1518.
4. ^ Christian Hick: Ethics, medical (modern times). In: Werner E. Gerabek , Bernhard D. Haage, Gundolf Keil , Wolfgang Wegner (eds.): Enzyklopädie Medizingeschichte. De Gruyter, Berlin / New York 2005, ISBN 3-11-015714-4 , p. 373 f .; here: p. 373.
5. ↑ Frank Nager: The healing poet. Goethe and medicine. Artemis, Zurich / Munich 1990; 4th edition ibid. 1992, ISBN 3-7608-1043-8 , pp. 74-78 ( The holistic concept in Goethe's pathology ).
6. ^ Anne Harrington: The Search for Wholeness. The history of biological-psychological holistic teaching. From the German Empire to the New Age movement. Rowohlt, Reinbek near Hamburg 2002.
7. ↑ Arnold Rekittke: Wholeness as Ideology? Nursing diploma thesis at the Alice Salomon University of Applied Sciences, Berlin 2003.
8. ↑ Source with examples of similar connections: Robert Jütte : "Holistic medicine" versus "technical medicine". In: ders .: History of Alternative Medicine. From folk medicine to today's unconventional therapies. CH Beck Verlag, Munich 1996, ISBN 3-406-40495-2 , pp. 55-65.

literature

• Argument special volume 162: The whole human being in medicine , Argument Verlag, Hamburg, 1989.
• Claudia Bischoff: On the holistic concept in nursing . In: Krüger / Piechotta / Remmers (Hrsg.): Innovations in care through science. Alterna Verlag, Bremen 1996, pp. 103-129
• Anne Harrington: The Search for Wholeness. The history of biological-psychological holistic teaching. From the German Empire to the New Age movement. Rowohlt, Reinbek near Hamburg 2002.
• Renate Jäckle: Against the myth of holistic medicine. Konkret Literatur Verlag, Hamburg 1985, ISBN 3-922144-51-9 .
• Robert Jütte : "Holistic medicine" versus "technical medicine". In: ders .: History of Alternative Medicine. From folk medicine to today's unconventional therapies. C. H. Beck Verlag, Munich 1996, ISBN 3-406-40495-2 , pp. 55-65.
• Karl Kötschau: Medicine at the crossroads. Restoring order, wholeness and center of medicine. Ulm 1960.
• Karl Kötschau: Natural Medicine. New ways. Publishing house basics and practice, Leer / Ostfriesland 1978, ISBN 921229-11 .
• Martha Meier: The meaning of the term holistic with different authors. In: Pflege 2 (1989), pp. 27-35.
• Helmut Milz: Holistic Medicine. New ways to health. Athenaeum, Königstein 1985.
• Gudrun Piechotta, Norbert van Kampen (ed.): Holistic approach to care and health. Claim - Myth - Implementation. Schibri-Verlag, 2006, ISBN 3-933978-86-6 .
• Arnold Rekittke: Integrity as an ideology? Nursing diploma thesis at the Alice Salomon University of Applied Sciences, Berlin 2003.
• Viennese dialogue on holistic medicine. Documentation. Vienna / Munich 1988.
• Werner Zabel: The meaning and essence of holistic medicine. Stuttgart 1950.

Web links

• Walter Löffler: What does “holistic medicine” mean?
• Klaus Neftel: Holistic?
• Maria Wölflingseder: Esotericism and the Left