Sometimes this process takes more than one session. I am not
bothered. I am pleasantly relentless. It takes as long as it takes to peel away
the veneer and see the whole person as a whole person. Without this, we cannot
find the right remedy. Some homeopaths have a gift that gets them to the heart
of the problem with uncanny accuracy and speed. I admit that I do not. However,
I am fortunate in that I am a psychotherapist and have the blessing of more
time with my patients. I can see people weekly and acquire a unique perspective
on their pathology.
Finding the right symptoms to guide me to the best remedy is a process of refining and refining and refining my understanding of the person. In homeopathy, physical symptoms can be delightfully clear; when your patient has right-sided knee pain that shoots upward, or loud eructations after eating green olives, you have a fairly straight shot to your target. But what do you do with mostly mental symptoms and a patient who has trouble defining any of them?
General symptoms to
the rescue
One skilled homeopath, Karl Robinson, MD, advises: "When in doubt, look for the strong generals." That is very good sense. General symptoms are those that apply to the person as a whole. What he meant and what I try to do is to refine the case by finding out whether the person is warm-blooded or chilly, thirsty or thirstless, sensitive to pain or temperature changes, and so on. General symptoms aren't the only pivot point in the case, but they are at least clarifying and they do help us differentiate between remedies. Rarely does a persistently chilly person need Sulphur unless they are very old or very sick. I've seldom met someone needing Arsenicum who doesn't keep a jacket or sweater with them regardless of season.
But--so many "buts" in my end of the business--what happens
when there are few strong physical symptoms (including generals) or when the
patient, because of their pathology or the insane quantity of allopathic drugs
they are juggling, cannot isolate a single craving or a strong preference for
heat or cold?
One patient answered "I don't know" to almost every question I asked for nearly two months until she trusted me enough to say "I hate that" or "I love that" or "I want that." I had another for whom everything was "random." She was hot. She was cold. She was tepid. Her pathology had so concentrated itself in the mental and spiritual and emotional spheres that she had disconnected from her own body. As it turned out, she had reasons for that. Good reasons. Which is where my real work comes in.
Find the vow
I studied for about five years with David Kramer in the Hudson Valley School of Classical Homeopathy, an experience that not only ushered me into the serious practice of homeopathy but changed my entire psychotherapeutic stance, particularly my point of view on the importance (or lack thereof) of standard diagnosis. David taught us to see the whole person clearly, but one aspect of his teaching resonated with me most. His challenge to us with every patient who came into the clinic was: find their vow.
By "vow" he meant the way a patient processed or received a
crucial moment in his life and what decision or promise he had made to himself
as a result of that event. In other words, the event, though important, was
less important than the way the patient received it. David also asked us to pay
close attention to the crucial moment when the problem started at the emotional
and spiritual level, not just the physical one. At what point in the patient's
life did his energy shift? What happened at that moment? What decision did he
make? How did the road bend from that place forward?
This new approach was pivotal in my understanding not only of homeopathy but of psychotherapy. It is not enough to say, "Ah ha! You've got post-traumatic stress disorder" or "Bingo. You're bipolar." Our job is not only to pinpoint the source of the problem (which is almost always mental/emotional when a patient comes to me for help), nor is it solely to feather out and further clarify the person's cognitions and emotions until we are looking at the repertory rubrics with 9 remedies listed instead of the rubrics with 631 remedies. The most important part of our job is to see the patient fully. What is the engine that drives their compulsions, their delusions?
For instance, the issue is not solely whether there's been a
trauma - but how that person received that trauma. I've seen families with
numerous children, and each one comes away with a different version of what it
was like to be in that family. No two people see the same event the same way.
Detectives have known this since crime scenes were first investigated. So, the
vow is actually a double gift: it tells us how a person received an event and
it also tells us what he was like when he came to that event.
"I will not cry"
A patient--we'll call him Keith--came to me many years ago because his marriage was falling apart. His wife complained that he was taciturn, laconic, withdrawn. He acknowledged that he was numb. He said he tried to rally a deeper or more intense emotional involvement with her, but he couldn't. However, at work as a detective he was a different man--engaged, active, curious, loyal, and determined. He was well-respected and had a few male friends. He had been unfaithful to his wife in the past, but claimed he was not involved with anyone else at the moment.
Keith had no physical symptoms whatsoever except that one
could see from his skin that he had once suffered with severe acne. He called
himself "healthy as a horse." His mental status did not reveal any overt
psychosis or cognitive impairment. He couldn't understand why his marriage was
failing.
I asked Keith about his childhood. He described an alcoholic, violent, and unpredictable household in which he had tried terribly hard to be good, worked at staying quiet, and longed for affection from his father and peace for his mother. I asked him, "What's your earliest memory of your parents' relationship?" He described a moment in which he was standing by a window in their tenement apartment. He was eight years old and minutes before, he had wedged himself between his mother and father as his father wielded a knife against her. After his father dropped the knife and left the apartment with a few belongings in a bag, Keith stood by the window, clenching his fists and swallowing. As he watched his father walk away down the street, the boy thought, "I will not cry."
Even though he had only meant that he was not going to cry
at that moment, that vow had become Keith's unconscious commitment ever since.
"Not crying" made him feel safe as a little boy. Because it gave him a modicum
of control in a horrific situation, "I will not cry" subtly, stealthily became
his life's operating system.
