Recently I met a homeopath with years of experience and an obvious deftness of expertise. When I told her I was a psychotherapist, she said with a combination of empathy and pity, “Oh, you have to deal with all those mentals. ” Of course, she meant the symptoms, not the patients.
But I understand her sentiment. Overall, as a culture, we pay a great deal of attention to what we feel in our bodies. We work out. We worry about our abs and sagging jaw lines. We are bombarded with pharmaceutical ads urging us to be aware of ominous “new symptoms.” As a result, we can describe physical sensations with some accuracy. Mentally and emotionally, however, we are losing the ability to know – much less express – with precision what we’re feeling or why we’re feeling it.
For instance, I recently counseled one 68 year old who came in quite full of energy and sat with legs crossed, one foot moving back and forth, hands tapping on her knee. I asked, “How can I help you?” And she said without batting an eyelash, “I have major depression associated with old age.” I asked how she knew that and the reply came quick as a whip: “Because I’m old.”
I could not hold back my laughter, at which point she laughed too. In that moment of intimidation that comes with looking honestly at the truth together (the truth being the way she sounded like a Pfizer commercial), the case took its first real step. Then with a couple of hours of careful questioning, we found out that she was not really all that depressed. She was bored. If I had taken her at her first word, I would have been led down a rosy path to nothing but a long series of the wrong remedies.
There are two difficulties with taking a homeopathic case in this more psychotherapeutic and lengthy way. The first lies in our culture and the emotional inattentiveness that makes it hard to access this level of truth. The second lies in the medical system’s entrenchment with insurance forms, diagnostic modalities, and the need to “move things along.” Anything solid-especially healing and developing a therapeutic relationship-takes time. And no one in America ever has sufficient time.
Going Down the Rabbit Hole
For this reason, our curiosity is the cornerstone of good case-taking. If the patient comes in and says “I’m depressed,” we do not have to rush to look up that particular symptom in the homeopathic reference known as the repertory. The rubric, “MIND; Sadness,” has 631 remedies listed in the repertory I use. It would do us very little good to use that as the underpinning of our case analysis due to its breadth. In representing so many remedies, it actually points to none in particular.
One of the things we social workers are ultimately trained to do is “diagnose.” A patient comes in, an insurance form is produced, and a psychiatric diagnosis is given so that the session will be reimbursed. From day one in graduate school, the emphasis is on the syndrome, not the patient. We want to know what he’s “got” or what she “is.” Does he have obsessive compulsive disorder? Is she a “borderline personality”? After more than 25 years of practice, I have not seen the precise value of knowing these things, except that they get us a fee from the insurance company. Never once has knowing a patient’s diagnosis really guided me to healing them. Understanding their individual pains, their unique losses and gifts, their needs and longings, their fears-that’s what’s useful in my counseling work.
The same is true in homeopathy. Instead of relying on broad terminology (“depression” or “sadness”) we have to ask and ask and ask: What do you mean by depressed? When? How? What triggers it? When did it start? What do you mean by sad? What do you mean by angry? What happens when you feel that way? And even further down the rabbit hole: how do you know you’re angry and not hurt? What’s the difference for you?
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 can not get 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 fortunately 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 you have 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 defending any of them?
General Symptoms to the Rescue
One master 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 are not 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 Sulfur unless they are very old or very sick. I’ve rarely met someone needing Arsenicum who does not keep a jacket or sweater with them regardless of season or a bottle of water within reach.
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 that are juggling, can not isolate a single craving or a strong preference for heat or cold?
One patient answered “I do not know” to almost every question I asked for nearly two months until she trusted me enough to say “I hate that” or “I want that” or “I want that.” I had another for everything 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.
The Importance of 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 status, 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 cruel 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, although important, was less important than the WAY the patient received it. David was also asking us to pay close attention to the brutal moment when the problem started at the emotional and spiritual level, not just the beginning of 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’s not enough to say, “Ah ha! You’ve got a 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 ones with 631, although all of that is good and necessary. 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.
One Man’s Vow
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 deaf or more intense emotional involvement with her, but he could not. 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 during his youth he had suffered with severe acne. Otherwise, his appearance seemed normal. His mental status did not reveal any overt psychosis or cognitive disadvantage. He called himself “healthy as a horse.” He could not understand why his marriage was failing.
I asked Keith about his childhood. He described an alcoholic, violent, and unpredictable household in which he 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 marriages 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.
And, truth be told, that vow served him well in many ways. It allowed him to grow up in a tough neighborhood, compartmentalize the grief of losing his father, and become an outstanding police officer with a clear sense of valor and unwavering integrity. However, his vow was an intense obstacle to intimacy.
The Remedy Opens the Way
This information came out over time and Keith was given more than one homeopathic remedy as we started the case. But after the first dose of the remedy Natrum muriaticum , the real movement began: he developed several colds and a couple of rather annoying acne outbreaks, which he loathed (sometimes a well-acting remedy can bring back old symptoms, but in a more minor way). But most importantly, his relationship with his wife changed.
Natrum muriaticum can treat retention in both the physical and emotional sense and is known for addressing a denial of deeply held emotions and what we colloquially call the “stiff upper lip.” Even though someone who needs Natrum muriaticum can appear quite carefree, this is often a posture they use to mask inner pain. They bear great suffering and harbor a deep longing for love, but they dare not ask for help or companionship, because in their experience what is loved is almost always lost. In vowing not to cry, Keith had adopted the mantra of people who need Natrum muriaticum : “I will never hurt like this again.”
The problem with vows when they are made unconsciously in critical situations is that while they may work in the moment, they do not always serve us long-term. It is impossible to love and avoid pain. But hurting, frittened little boys do not know this and can not prepare for it.
Keith’s Natrum muriaticum did its work slowly and subtly. At first he barely noticed any changes except for the nasty cold he got, which he was not nearly as happy about as I was, because I have often seen this kind of thing happen when a remedy is beginning its work. Soon, though, he found himself hanging around the kitchen as his wife was cooking, helping a bit with this and that, instead of sequestering himself with a scotch and a book. After a while, their sex life was revived. They started going out together, and he thought there might be hope in saving his marriage. Finally, most importantly, he began to talk about the pain and fear that had been locked away inside him for decades. He wept. He ranted. And finally, he released.
The vow is not only where the road gets bent, but the wound that needs to be healed. Every event brings us a potential lesson. How we interpret it determines how we proceed from there. In this case, the terrified boy’s promise-I will not cry-had to be erased and rewritten with the hands and heart of a grown man.
Revelations in the Fullness of Time
Because of the nature of my work, I sometimes have the luxury of waiting weeks to suggest the first remedy. In the meanime, I work in the ways I was trained as a social worker and crisis counselor, using cognitive behavioral techniques, trauma treatment or hypnosis. While the truth gets revealed in the fullness of time, it is also essential that the questions-the right questions-are asked.
For instance, a beautiful young woman I’ll call Ruth came to me complaining of “depression.” She was constantly “sad” and weeding. Her sadness was worst at night, and on waking in the morning she felt despair engulf her. She was isolated. Although bright, attractive, and particularly friendly, she had no boyfriend or close friends. She smoked pot nearly every day and associated with people she did not like at all. She danced and felt better than it and was fairly competitive. She likened being “spectacular,” she said. She was somewhat haughty and held deep grudges.
Ruth’s story took approximately two months to unfold. Her sadness had a very clear etiology: it began when her father suddenly declared his love for another woman and left Ruth’s mother and siblings without an income. His behavior and rejection caused them to lose their home, which Ruth loved. Whenever asked to clarify the “sadness,” she spoke about this home and her longing to be very little again.
Initially, Ruth’s mental and general symptoms were unfortunately not unusual or individualized enough to be useful in helping to find a homeopathic remedy, and her physical symptoms were nearly non-existent.
A Vow of Homesickness
The first remedy I gave Ruth was Carcinosin because it appeared to fit her symptoms of dancing and chronic grief. The remedial affected her-she slowly stopped smoking pot and seemed more generally centered-but not nearly the way I had hoped. After several months, Ruth’s progress stopped despite repetition of the remedy. She was still sad, angry, resentful, and despairing. I was confused. I had been so sure about the Carcinosin . What was I missing?
I had to step back and think: What really was her vow? What had she told herself? And perhaps more to the point: What had she told me that I had missed? Sometimes when I get to a point like this in a case, it helps to actually spread out my notes on a table and look at every page, then at the whole gestalt, looking for repeated words or expressions. That’s when I saw it. It was not just grief. She was not just mourning a loss. She was IN the loss. She was like a bee in amber. What she talked about-all she talked about really-was her home, her home, her home.
So I asked her, “What is it you tell yourself when you get sad like that?” Ruth answered in a whisper so plaintive, “I can never go home.” She wept for nearly 15 minutes. Her “vow” was an erroneous belief formed when she was a young child in the grip of a broken heart. She lost her home when her father left and she (mistakenly) decided she could never replace it. Thus, when the opportunities for intimidation that felt like “home” were made available – a good boyfriend or a sense of belonging or good friends – she failed to take them. She either chose people who were unavailable or she simply avoided relationships altogether. She never allowed herself to feel at home.
Ruth, I realized, was not just amorphously “depressed” – she was homesick.
I restrained the case and considered some different rubrics:
MIND; Ailments from, neglected being, father, by one’s
MIND; Ailments from, rejected, being
MIND; Ailments from, bad news
MIND; Sadness, pining boys; in (this is useful even though she was female)
MIND; Despair; lost, thinks he is
MIND; Anger; absent persons, at, while thinking of them
MIND; Censorious, oneself, toward
GENERALS; Lassitude, morning, bed agg., In
GENERALS; Uncovering, aversion to
Aurum metallicum was in every one of these rubrics. Why had not I seen it?
I wondered whether my inability to see her need for Aurum metallicum straight away was because of my own bias about the remedy: Aurum is generally considered the default remedy for “depression” and suicidal thoughts, which were not an issue for Ruth. But Aurum worked for this young lady because it addresses a very particular kind of depression that includes not only deep linging (her homesickness) but also being worse at night and waking with despair and resentfulness. Like Ruth, people who need Aurum can be haughty even though they are also very hard on themselves; they criticize others because they criticize themselves. Due to their high standards, they have to be the best they can be-her her word “spectacular.”
After taking Aurum 200c , Ruth spent a week with a cold, and then her sadness cleared like an elementary school blackboard on Friday afternoon. We repeated the Aurum 200c twice more over the course of two months when she had reached a plateau or felt some twinge of the emotional ache returning. But after the final dose, she appeared to hit her stride.
Thankfully, Ruth has been well ever since. It has now been two years. I heard from her a while back and she was happy, has stayed off drugs, has a boyfriend, joined a dance troupe, and lives with fullness so that she can make her home wherever she finds herself. She has begun to work on the task of forgiving her father.
The Magic of Homeopathy
I have been practicing a counselor for a long time. I’ve lectured on mental health issues and worked with patients all over the country on everything from addiction to trauma and anxiety. I’ve learned and used techniques from hypnosis to eye movement desensitization and reprocessing to cognitive behavioral therapy. My tool kit was by all accounts full. But it was not really effective until I added the practice and philosophy of classical homeopathy. Even when I do not use a remedy, the work I do and the questions I ask are different and better because of my training in homeopathy. In learning to be curious, to seek out answers instead of waiting for them to be delivered, I have learned to see not only the pathology but the person.
Homeopathy is not just a matter of memorizing the remedies or being a clever clever about using the repertory. The really important, difficult work is about seeing the truth. This is still a much harder task than I would like. But it is easier when I am truly present with someone and can listen to what every part of them is telling me.
The Music of Homeopathy
I often explain it to my patients this way: “Think of a light moving through a prism. It comes out as a full array of colors … that’s you. , in the way you wake up as much as in the way you dance (or do not!). But it’s always you. cellos or the piccolos-the melody runs through every note. ”
That is what a vow does. It shapes us over the course of a lifetime. It determinates not only what we do and say or how we love and play, but how we receive the world around us. So, where some people only see a mound of diffuse mental symptoms, I see the notes and pauses of a score scribbled over a lifetime. When I listen carefully, I hear music.
(This article by Judith Acosta originally appeared in Homeopathy Today , the magazine of the National Center for Homeopathy in Alexandria, VA, and is used here with permission. Judith Acosta is the sole author of this article.)