have we really been reduced to prescribing for characters in a movie?? anyway, how about a real, if not homeopathic, case?

This case profile is based on 3 therapeutic interviews. due to familiy circumstances, i was not able to continue working with him. also, please understand that these unstructured interviews were not conducted with a view toward gaining a clinical history or assessment, so the information is pretty sparse. I am most interested, however, in ideas that will help me to look at this boy through the homeopathic lens:

* what rubrics suggest themselves from the information that is available?

* What remedies suggest themselves, and why?

* What questions would you follow with in order to narrow in on a more fully-informed opinion of a possible remedy?

To repeat, I know that this information is very limited, but hope your responses will hellp flesh out in my mind the ways in which one looks at a (real) patient homeopathically.

Peter's parents separated a few months before his first appointment. Peter presented as slow moving, depressed, slouched in posture, overwhelmed, and, when he exhibited any energy at all, extremely frustrated at mother's demands, inconsistencies, contrariness, and illogic. "HOW CAN SHE SAY SUCH A THING??!!" he would shout, unable to make any sense of her irrational claims, and barely able to tolerate the frustration of not being able to make her see how wrong she was (specific examples escape me, but she did sound pretty irrational, very possibly experiencing something of a psychiatric crisis; further, it seems likely she had adopted a hyper-critical and arbitrary pattern of communication with peter for some years, at least).

peter was a bright youngster, enrolled in all honors classes at his school, but failing or near failing in a number of classes, largely due to his inability at the time to complete assignments. he was dropped to some lower level classes to relieve the pressure on him, and he felt this was a good thing, a break that he needed. he seemed 'dazed' much of the time, but his eyes showed a sharpness of focus at times that reflected insight and response to interpretations i made that he understoods, grasping, for example, the idea that not everyone is like mother, that he can express himself to other people in the world and they will understand, and that he is growing out of his childhood stage, where the center of his world is with the parent, to a stage of young adulthood in which he can perceive the broader social setting and his place in it. of great concern is the fact that he still had, however, many years left before he could emancipate himself.

he derived some relief from such interpretations, some ability to put that distance between himself and the ambivalent and hostile mother, and to increase his closeness to more appropriate social connections. but he remained terribly isolated from, though well-liked and even sympathized with, by his peers. and in all three sessions he had been preoccupied with the mother's behavior, talking about virtually nothing else. he felt controlled in every thought; complained that mother tells him how he feels even though she has no idea how he feels. he insisted that "we are two different people and feel totally different about most things but she doesn't know it!" its as though she wouldn't let him have his own identity, and he couldn't believe in it himself without affirmation from her.

that's all i have. therapeutic interventions were in a crisis intervention/stabilization mode, as he had become increasingly depressed and withdrawn in the last month or two before being referred to me. by reports especially from school, he did begin to show some indications of improved mood and interaction, but he was pulled from therapy before these impressions could be clarified, or a judgement could be made whether the improvements would be lasting. if uncorrected, the ongoing stress in the family would certainly have been very hard on him.

bach

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"The need to perform adjustments for covariates...weakens the findings." BMJ Clinical Evidence: Mental Health, (No. 11), p. 95.... It's that simple, guys: bad numbers make bad science.

Not "reduced", really, but the idea is to play with the materia medica and compare the various perspectives of each person who has had an equal opportunity to perceive the individuals in question--in a totality! It's very different from case-observation in that...well...hey, I'm not in the room with you observing your patient when you are working with them.

It's an exercise to get us all to think about remedies and "see" them in ways which are not stereotypical.

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Who looks outside, dreams; who looks inside, awakes.<br />C.G.Jung

Hey Bach,

Okay, first of all I don't think any of the reactions you've described for this child are extraordinary given his situation. So there's no usable information there. Unless there is something that you noticed was UNUSUAL in his reaction--something you would not expect to see in this kind of intervention situation. Remember, look for what is strange, rare, and peculiar.

It's clear he's quite preoccupied and depressed--which is fitting in a case where he's dealing with relatives who are very ill and his life is in a turmoil as a result. That turmoil will be a maintaining cause, so until some measure of stability is restored to him it may be hard going to help him turn things around. However, perhaps a good remedy might enable him to find some stability despite what is happening in his family life.

Another place to look: has this situation brought about any physical symptoms--such as an inability to eat, or pains in specific places, or a drastic change in sleep/waking patterns?

[ 14. January 2004, 13:35: Message edited by: ChaChaHeels ]

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Who looks outside, dreams; who looks inside, awakes.<br />C.G.Jung

thanks, cha cha. re the movie thing, i understand, was just poking fun, not at you but at the current state of cases, or lack, on the bb. but maybe when mrc agrees to take ars 1x (i still prefer tincture! ) things will pick up.

anyway, with regard to 'peter,' i have no physicals. i know he stayed home from school increasingly, but am not sure that was really flu or cold or anything ... he just looked dragged out. i think this was by now a fairly chronic state of affairs, so we had an acute depressive reaction with mental confusion and heightened frustration, etc., which was really an overlay on an already existing depression; before the split, though, it did not interfere as much - e.g., he maintained good enough functioning as to be enrolled in honors classes and perform well there. seeing him in the crisis, though, i'd have to say this whole state of mind exaggerated the normal state, but none of it was really "new."

so, maybe we're looking at an acute situation, but the chronic condition was certainly present as a template.

once again, i apologize for lack of details, but given my limited contact this is all i have, so i know this is pretty speculative ....

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"The need to perform adjustments for covariates...weakens the findings." BMJ Clinical Evidence: Mental Health, (No. 11), p. 95.... It's that simple, guys: bad numbers make bad science.

Okay, but here's my real issue:

Who would not respond to a similar or identical crisis facing this boy in exactly the same way he's responded? There's nothing discernibly pathological about his response--he's a caring child who loves his parents and is traumatized by the events following his mother's illness. He's also quite young to comprehend that much of what is happening to his mother will be expressed in ways which will be shocking to him; in other words, he doesn't quite understand that when his mother says things about him, she's demonstrating her illness and not her personal opinions and feelings about him.

Yes, he's suffering a huge number of setbacks--but there is a great deal of turmoil in his life right now. The illness in the family seems to create unrelenting change, drastic changes, in his daily life. He's trying to "live a normal life" in the midst of constant crisis. Anyone in his situation would be affected in almost the same way he's been affected.

There's no doubt that he can be helped, even at this point, with a good remedy. It's one thing besides a bunch of other supportive measures that need to be put in place for him to really help him. But there's little in the description above that would help a homeopath determine what remedy he would need.

I would say, however, that if I were to consult with him, I would try to observe and make note of things like physical gestures--is he fidgety? Is he crying? Is he avoiding eye contact? Is he exhausted? Is he loud and unruly, angry? Is he quiet and sullen, non-responsive, and not talkative--or the opposite.

Watch what he does with his hands and feet, watch his posture, his facial expressions, any repetitive movements he makes--chewing his lip, or biting fingernails, or twitching, or tearing at things with his fingers, for example...

Perhaps even try to engage him in some games (do you have a chess table set up in your office, for example? They are handy to have around...as well as all kinds of other toys you can observe their play at).

If you can get him to talk specifically about the relationships in his family and what he thinks about them now, that would be good...

this kind of information would be a good start to finding a remedy

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Who looks outside, dreams; who looks inside, awakes.<br />C.G.Jung

no fidgeting or the like, more like someone who has been 'cowed,' defeated, sitting there not having a clue how to react in his environment in order to be, or to experience himself as being effective.

even with this bit of additional detail regarding this boy's manner and disposition, there may not be enough to suggest a specific remedy, even though i'm not looking for a prescription, but general reactions or 'thought highways." in any case, what about rubrics? that would do nicely for my purposes in putting the case on the bb.

btw, as indicated, the boy was withdrawn from treatment after three sessions, so gaining additional information is not possible.

[ 14. January 2004, 22:37: Message edited by: bwv11 ]

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"The need to perform adjustments for covariates...weakens the findings." BMJ Clinical Evidence: Mental Health, (No. 11), p. 95.... It's that simple, guys: bad numbers make bad science.

hi bach, i don't see there is any indication of disease in the case of this lad. the whole thing could be attributable to the maintaining cause of the home situation.
homoeopathy can only cure disease. consider this - *if homoeopathy could make that lad happy in that situation it would remove the drive for him to escape a negative life situation. that would do him no favours.

well, my judgement on observing the boy is that his reactions are symptomatic, not at all the kind of reaction that one would expect from most people. perhaps i have not adequately described the severity nor depth of his symptoms. nor the fact that the acute reaction appears likely to overlay a chronic depression. and don't assume my goal is to make him "happy;" better, to make him or help him become better able to cope. as it stands, he is at risk for chronic psychological problems.

in psychological conditions, exciting and maintaining causes often cannot be removed, because they have become internalized, so that one has the "real" maintaining cause out there in the environment. but the parallel, internalized relationships and emotional patterns persist, even when the external circumstancds improve: characteristic of symptomatic behavior and affect is that they are not correctable by normal experience, simply because they have become a part of the 'personality.'

its a little like the problem of "hyperactivity." if symptoms of this "disease entity" have been caused by maternal smoking during pregnancy, for example, i would still consider the fidgetiness and distractibility to be symptoms of a "disease" or disordering of the vital force, even though there is no change in state: arguably, the 'behavior' or tendency existed from the moment of conception.

[ 14. January 2004, 23:19: Message edited by: bwv11 ]

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"The need to perform adjustments for covariates...weakens the findings." BMJ Clinical Evidence: Mental Health, (No. 11), p. 95.... It's that simple, guys: bad numbers make bad science.

Do you think his delusions of being dominated are unreasonable? Was his mother domineering, suffocating, bossy?
Another question; does the boy isolate himself from school friends intentionally, or was he kept at home largely by his mother.
He seems struggling between two emotional states - thinking that he is being controlled entirely, by someone with different wishes to him - recognizing this doesn't sit right with him but still yielding.
This immediately made me think anacardium - also del=under a powerful influence; maliciousness towards that influence; indifferent; antisocial; dullness; confusion... but then he doesn't seem to have the nervousness; timid fidgeting, and apparently doesn't avoid challenging his mother..?

Sorry to be of such little insight

hi lilith -

thanks so much for your response:

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"The need to perform adjustments for covariates...weakens the findings." BMJ Clinical Evidence: Mental Health, (No. 11), p. 95.... It's that simple, guys: bad numbers make bad science.