How confident are you? How confident should you be?

Organon pic

On confidence:

How confident should we be as practitioners? This is a question which worried me greatly when I started out. I felt uncertain (not surprisingly as I was entering the world of sickness and health armed with a copy of Kent’s repertory – a copy of which a colleague justly through out of a window in a different continent – and some basic core delusions about Sankaran’s teaching.). I was qualified, I had the grades, supervised clinical work and diploma to prove it. And after all that training, I did not feel confident.

It will come, some said. The more patients you work with, the more confidence you’ll feel. Until a cold voice cut through the general internet babble, as a colleague (armed with a handbag full of plumbum crude – if you’re reading this, you know who you are) said sharply “if you’re not confident in what you’re doing, you shouldn’t be practicing.”

I see my own inner debate of that time reflected in many forums, where some few honest souls admit to worry and lack of confidence. With hindsight and its freedom of constraint, I see that confidence, for a homeopath, actually relates to at least two separate issues.

We must feel confident in our tools. If we do not feel confident in the principles of homoeopathy – not a blind faith but a clear understanding of the rationale of our practice, if we only know how to parrot “like cures like” without understanding what that means and more specifically, what that demands of us – we really should not be practicing. If we do not grasp that there is a quirk and a default in nature, whereby a stronger similar disease can annihilate a weaker one and will always do so unless something else is standing in the way of cure, whether it is a maintaining cause or a deeper inherited miasmatic taint – if we don’t get that then we really should not be practicing. We’re not talking about confidence in our ability. Here this is the confidence that our tools work. That “like cures like” is a prescribing principle, not a holistic “airy-fairy” slogan.

Personal confidence is another thing altogether. We have to get used to working with patients, to eliciting the information we need for prescribing, to listening to our patients without interrupting, to allow the picture of the disease to take shape before our eyes. We have to keep studying Organon, materia medica, provings, Hahnemann and Boenninghausen’s writings and works of similar value to keep our abilities honed and our homoeopathic knowledge checked and re-checked. We have to gain confidence in prescribing, in case-management, in effective follow-up.

Personal confidence is something every practitioner gains in time – in any field. But without confidence in our tools, that personal confidence is worthless. It’s worthless in the sense that if we are genuinely trying to work according to principle and don’t understand it, our confidence is a thin shell, a shiny veneer covering a world of insecurity in practice.

However, the worst expression of the worthlessness of personal confidence without true professional conviction is that those bumping up their levels of such personal confidence to overcome the lack of professional conviction are drawn to the new and the shiny, to developing their own new and shiny theories to astound the world.  As a result, they never investigate the tools properly, and learn to work faithfully and honestly to principle.

Something Hahnemann said in the Organon within a slightly different context seems an apt quote to close this post:

“A true homoeopathic physician, one who never acts without correct fundamental principles, never gambles with the life of the sick entrusted to him as in a lottery where the winner is in the ratio of 1 to 500 or 1000 (blanks here consisting of aggravation or death)…” (note to Aphorism 285).

Homoeopathy – on one leg…

Pulsatilla, anyone?

Pulsatilla, anyone

“If it’s so easy, why isn’t everyone working this way?”

I was asked this question at a seminar I gave several years ago. This is a question that frequently puzzles us at the IHM. Because it is easy.

True, a lot of hard work is needed to get expertise, and then to improve expertise. To read, re-read, and analyze materia medica. To read and discuss cases. To comb the Organon and Hahnemann’s other writings for better understanding of the underpinning of homoeopathy – essential for prescription and case-management; for case-taking clues; for accurate work with remedies. It’s not always easy to get rid of our preconceptions regarding remedies, to learn to be able to prescribe Pulsatilla on prescribing symptoms whether the patient is a sumo wrestler or a petite, sweet blonde. It’s not always easy to focus on absolute, presenting symptoms when our learned “knowledge” is giving us all kinds of useless hints regarding constitutionals, core delusions, sensations and similar.

Jewish tradition records a story of someone who came to a venerable Rabbi and asked him to explain the entire teachings of the law while standing on one leg.

Well here’s homoeopathy on one leg. Take your case. Take only what has changed and is presenting for prescribing, against the backdrop of the patient’s life and habits. Only use symptoms you could swear to in a court of law. Use symptoms which show the individual expression of illness in your patient.  Look for a remedy that can produce similar symptoms in the healthy, and thus create a similar, slightly stronger, artificial state in your patient. Find the core of that information in the proving. Prescribe.

Still standing here…

The thing is, once you drop the theories, the speculations, once you move away from trying to be clever and insightful, you start looking at what is in front of you. You work with the information the patient gives you about his state of illness (morbid state) – not with your speculations about his personality, or information about whether he’s always loved chicken, or whether he played with Barbie dolls as a child. You work with what you can know about remedies – information contained in the provings. You work with some information gleaned from poisoning and clinical work.  Some of this information was chosen by Hahnemann for inclusion in his provings.   This information should only be taken from the most reliable practitioners (in case you didn’t get it, at the IHM we focus mainly on Hahnemann and Boenninghausen’s work). You put it together and prescribe.

Aphorism 3, my friends. And as the learned Rabbi is reputed to have said, now go and learn the rest…

Homoeopathy in acutes – some points for ponderation…

sconesI received an invitation to a homoeopathic conference on acutes. Nice, I thought, as I perused the program, with coffee breaks and lunch artfully sandwiched between urinary tract infections, diarrheas, sunstroke and the like. I’ll have that coffee and cake thank you, with a nice heat rash on the side…

Which got me thinking about basics for treatment in acutes. Of course. So I’d like to offer up a few points for ponderation, alas, without sandwiches. Or cheese butties. Or even pita bread. But I digress.

  1. You may not be able to help someone in an acute. You may be all they’ve got, so you should definitely improve your skills and keep a stock of remedies on hand. But you have to be able to assess your skills and tools effectively, and not try to treat if you should be sending the sufferer off to someone else or even to the emergency room. And then of course – there’s common sense… no amount of Arnica in any potency, dry or in water, is going to stitch the wound or set the bone…
  1. Even if you can’t help – do not abandon the patient. Do not run off to hide in the corner, drowning in your self-loathing and disgust, or hightail it with a swagger and a “not-my-problem-anymore” attitude (even though admittedly, it can be a tremendous relief to shift the buck). This is not about you.  It’s a difficult lesson to learn, but often, even if we can’t help, the patient really appreciates us just being there. After all – we were the ones they turned to for help. Keep tabs on the patient, check in to see how they are doing, take an interest. If you couldn’t help at that crisis time, you may be able to help after the initial emergency, and they will want you to do so.
  1. There are a ton of books on what remedies to give in acutes, therapeutic directions, triads of remedies for treatment and more.   Perhaps my first major disappointments with homoeopathy were when I found that the books were… how shall I put it…fairly useless…  In acutes, as in all prescribing, look for what has changed. And in acutes, look often because things can change quickly. Are you really going to sit there wondering if your patient is yielding because they are blonde and blue-eyed, and do blonde highlights count anyway – when the patient is presenting Pulsatilla symptom after Pulsatilla symptom in ever increasing intensity? Are you going to ignore the presenting symptoms because “the book says”…? I think not. Forget all prejudice, there is no time for that. Focus on the presenting symptoms. Focus on what is there – not what is absent. The resulting remedies may surprise you – if you’re sure of the symptoms you’ve used and the materia medica you’re using, give them anyway.

Acutes can be the joy and the bane of a homoeopath’s practice. Witnessing what homoeopathy can do in acutes has brought many a doubter into the fold, and I think has kept many of us fascinated with the tool we have learned to use. On the other hand, treatment of acutes can involve a tremendous amount of nail-biting anxiety and frustration, when sometimes we see a case that has been progressing well turned over to allopaths and then relapsing, or when we hear the oft-repeated words “I think I was feeling better just before I started taking your remedy” or “I don’t think it was the remedy, I think it was Aunt Florence’s tonic of gin, mangoes, paprika and eye of newt which did the trick…” (perhaps less oft-repeated but you get the general idea).

Here endeth the soliloquy. Back to scones and sunburn… or perhaps just scones…

Aphorism 273: If something is not necessary it is not permissible…

just another IKEA philosophy statement...

just another IKEA philosophy statement…

As I think people reading this blog are aware, I have no patience with those who relegate the Organon the status of philosophy, and thus consigning it to dusty shelves rather than using it as a manual of practice. It’s a bit like calling the instruction leaflet you get with your IKEA kitchen / bookshelf / cupboard “the IKEA philosophy statement”, and not referring to it when you try to build the darn thing.

Continue reading

Finally…a comprehensive, concise manual for Homoeopathic practice and methodology

doctor with bookTroubled in your practice of homoeopathy? Tried some books but nothing really helped?

Wouldn’t it be wonderful if there were a straightforward, short and to the point manual of homoeopathic practice and methodology which related to the following issues:

How to choose symptoms for repertorisation?
What kind of questions should we ask in case-taking?
How to get the best information in order to prescribe the most homoeopathic remedy?
What to do if the patient seems to be getting worse?
What to do if new symptoms come up – how do we deal with them?
How to work with mental symptoms?
How to work with LM potencies?
How to avoid “favourites” – remedies we always seem to prescribe?
How to work with the mentally ill?.
How to prepare remedies?
How often to repeat remedies?
When to change the prescription?
How to find the next prescription?
What is the probable healing mechanism involved in homoeopathy?
How to relate to issues of lifestyle and diet during homoeopathic treatment?
How do we run experiments to find out what remedies can do? What is the experiment protocol?
How do we treat intermittent fevers?

To name but a few of the questions constantly confronting us as homoeopaths (shown here in completely random order).

I wish someone would write a really clear manual of practice for homoeopaths, which answers all the above questions and more.

Oh.

Wait.

Someone already did. He’s called Dr. Samuel Hahnemann. You can find the book under the title “Organon of Medicine” – 6th edition. Amazon probably has it. Go read it.

Priscilla Rowbottom on Homoeopathy and the Nation-State

Now where did homoeopathy go, I'm sure I put it down somewhere...

Now where did homoeopathy go, I’m sure I put it down somewhere…

And now another post from my highly erudite colleague and close – but not too close – friend…to be taken with many grains of salt while the tongue is firmly embedded in the cheek…In the interests of political correctness, no offence is intended to any nation, state, or to anyone who happens to be called Priscilla Rowbottom…

Well, the day has come! I have finally had my homoeopathic epiphany! The trumpets sounded, the sea of confusion parted, and the glorious light of …enlightenment seared my vision… Continue reading

The “Aggravation Quiz” results

First of all, I acknowledge that the quiz I posted was essentially superficial.  My objective was to see what people out there think about aggravations in homoeopathic treatment.

Over the years I have heard so many people panic over new symptoms (OMG! it’s a proving…!), over extreme aggravations (what do I do?! what have I done?!) and more.  I have heard people express sentiments like “it’s just an aggravation, it will get better..” without thinking properly about what is happening to their patient.  I have heard of situations where patients were told “it’s just an aggravation” and landed up in the emergency room.  None of this does homoeopathy any good. Continue reading