The debate regarding emotional case-taking (double entendre fully intended) rages (or meows) around mistaken understanding of the therapeutic and seems to coalesce into the belief (equally mistaken) that one must choose between two approaches:
- that case-taking must focus primarily on mental/emotional symptoms (mistaken view of homoeopathy espoused by some of the “luminaries” in homoeopathy today)
- that emotional symptoms are of secondary importance in case-taking (mistaken view of the way in which those opposed to approach no. 1 work with Hahnemann and Boenninghausen’s teachings, often expressed by adherents of approach no. 1 in rebuttal of practitioners of ole-fashioned homoeopathy)
As a result – perspective of what an emotional symptom really is, together with its natural place in case-taking and analysis, has been totally obscured. This strongly reflects the mistaken approach in modern medicine of separating between the “physical” and the “psychological,” as if each area is capable of existing independently of the other.
Worse yet, if you look at definitions and synonyms for the word “physical”, you’ll inevitably come across the word “real”. And in one simple move, the psychological becomes the “unreal,” the first step on the path towards dismissive, delegitimizing diagnoses like “psychosomatic”…
We live out our existence within the physical world and use physical organs for the management and expression of our thoughts and emotions, much as we use our physical bodies for actions and activities that can reach far beyond our own environment. In order to treat mental and emotional symptoms we must investigate them as we would a physical symptom, and constantly keep focus on these symptoms within their physical context and expression.
There is a tendency, in cases which are heavily emotion-based, to look out for remedies which, for many if not most of us, our training identified as “emotion” remedies. Pulsatilla, Ignatia, Nat-Mur and many others fall into that category. As a result, it is easy to miss other remedies which are less identified for us with mental and emotional symptoms.
The symptom Mind, Disposition in P&W’s Boenninghausen’s Therapeutic Pocket Book contains 124 remedies. That’s almost all of the remedies that appear in the TPB. So to reduce cases where the changed emotional state is predominant, to a choice few remedies which we identify as “mental/emotional” may lead us to overlook some of the best remedies for such cases.
Hypochondriasis is also an example of a physical expression of a mental state, where a patient’s intense focus on their ailments “becomes of itself an important symptom in the list of features of which the portrait of the disease is composed.” (Organon Aphorism 96). The following 84 remedies are from the rubric Hypochondriasis in P&W’s Boenninghausen’s Therapeutic Pocket Book. The broad range of remedies speaks for itself.
Acon, Agn, Alum, Ambr, Am-c, Anac, Arn, Ars, Asaf, Asar, AUR, Bar-c, Bell, Bov, Bry, Calc, Cann-s, Canth, Caps, Carb-an, Carb-v, Caust, Cham, Chel, Chin, Cic, Cocc, Coff, CON, Croc, Cycl, Dig, Euphr, Ferr, Graph, Hell, Hep, Hyos, Ign, Iod, Ip, Kali-c, Lach, Lyc, Mag-c, Mag-m, M-arct, Meny, Merc, Mez, Mosch, NAT-C, Nat-m, Nit-ac, Nux-m, NUX-V, Op, Ph-ac, Phos, PLAT, Plb, Puls, Rheum, Rhus-t, Ruta, Sabin, Sars, Sel, Seneg, Sep, Sil, Spig, Spong, Stann, Staph, Stram, Stront-c, Sulph, Sul-ac, VALER, Verat, Viol-o, Viol-t, Zinc
So lets say we acknowledge the presenting emotional symptom as we would a presenting physical symptom. As such it can receive exactly the same treatment in case-taking – with or without empathy…:
- Is it part of what has changed?
- If it has not changed, has it become more marked, and if so, when did that start?
(If the answer to the above two questions is “no”, the mental symptom may be marked more as a confirmatory than a prescribing symptom. If yes, move right on)
- When did it start?
- When is it better? Worse? Standing, sitting? Walking? Talking to other? Spending time alone?
And you continue to ask all the other modality questions – time of day, better/worse with regard to menses, food, before sleep, after sleep and more, as you would do with any other symptom.
Essentially in case-taking, while we are going through the process, we are looking for prescribing symptoms. We are not looking for remedies at this stage, and to do so prejudices us against remedies that may have great value in our case. To treat mental and emotional symptoms as any other symptom, including a full modality check, will help prevent our prejudices in favour of specific remedies from determining the prescription. It will narrow the field to the best small number of remedies – which must then be studied carefully in the Materia Medica to determine their usefulness in the case before us.
So really, in cases with mental-emotional symptoms, we must start out by treating ourselves for any symptoms of that damaging mental-emotional symptom of PREJUDICE… and then it’s time to roll up our sleeves and get to work…
I remember my teacher making us prove Nat Mur by titrating it into a 1C, and that night I spent an hour crying over something that didn’t usually bother me! The physical and psychological are equally important.