A Case of Bronchitis and Addiction

This case examines the themes of addiction and its sources, and the poetry of “growing up and out” of dysfunctional family dynamics, and the patience we as homeopaths need to develop in order to allow our patients their full healing.

D first came to see me in June of 2009. She is in her early 20’s, and has a husky quality to her voice and an intensity in her eyes. I notice she often looked up at the ceiling while speaking.

Her story delivery was “eloquently locquacious” and concerned her quest for awareness, theories about her struggles, and drama from her family. The major themes she presented included struggling to find balance, addiction to alcohol, marijuana, and nicotine, and extremes of behavior around striving, perfectionism, and body image. Her drug use of “weed, cigarettes, alcohol and coffee” began in 6th grade (age 12.) Her parents also used all of the same substances.

The patient’s chief physical complaints were a recurrent bronchitis with coughing and exhaustion that affected her for months at a time, painful menses, and ovarian cysts.

June 19, 2009

S: “Dad is able to moderate, but I am like my mom; I am extreme. If I could get away with it I would be intoxicated all the time. With weed I try to stay high all the time, alcohol is at the end of the day, and cigarettes break up activitites. I substitute them as a form of meditation. I call it the friendly five; sugar, caffeine, tobacco, marijuana, and alcohol; like friends, when one shows up the others are there.

It’s frustrating not being able to stop. Seems related to stress, putting too much on my plate. I tend to be really achievement motivated. Don’t give myself enough rest and relaxation. I don’t know how to be reasonable about my expectations. Those substances represent checking out for me; I’m going to disassociate from that part of me that is motivated.

I get a chest cold when I get sick. I know lungs are associated with unresolved grief. I don’t want to feel myself. Part of smoking is about not feeling, an avoidance of being present with whatever is there. Whenever I quit I cry a lot. I get sick of my behavior not resembling what I want in my life. So easy to become dissociated; then I come back and it’s overwhelming relief. Wanting routine and stability and sobriety are the biggest things.”

“I have an ovarian cyst resting over my right fallopian tube from years ago and I don’t feel it’s gone. Feels like pinching, grabbing or tightening, can be all of a sudden painful around my cycle.

In general I have emotional instability with a lot of sadness, self doubt, devaluing myself, anxiety about abandonment, thinking people are not genuine in their care for me. I have had sexual trauma; when young, I dated a guy who was far too old for me. He told me I was a tease and I let him do things to me…now I’m not always comfortable with being touched. I had more negative sexual experiences in college where I would be crying and the partner continued to have sex. Things that felt like violation, but it was consensual.” (begins weeping) I have body image issues; trying to move towards feeling beauty vs. looking at beauty.

I have a teacher and a meditation practice but they are not working. I’m trying to not be terribly mean to myself, but I’m really hard on myself. Now it’s all out on the table.” (giggles, weeping) I’m going through a life transition. I just moved and my partner lives an hour away. I’m going back to school to get a doctorate in psychology. I want to work with kids in juvenile detention centers. I was not using for 6 months and two weeks after I moved I started using again. Being in class, working fulltime and transition, had way too much on my plate, wasn’t able to gracefully move through that.”

Food really affects me. Cravings get so strong and I just want a break from the dictatorial diet I’ve laid out for myself.”

Her mother’s family was described as patriarchal, bigoted, racist, sexist, and homophobic. Her mother grew up where women “were seen and not heard” and is alienated from family. She and her mother argue a lot, are both prone to extremes. Her mother calls “incessantly.” The relationship with her father is easier and they communicate similarly. The patient and her parents are the “black sheep” in the family.

“Mom asked me to be her mom. She is immature in a lot of ways, asks for my love and reassurance. Don’t feel I ever really got to be a kid. This rebellion against responsibility and maturity is part of me that is doesn’t want to grow up b/c never got to have that phase.”

“Sleep is problematic, even as a teenager. “They took out my tonsils thinking I had sleep apnea. With my partner I can sleep 6 or 7 hours. Get a lot of nightmares, always have. Some are violent and sexual and have abandonment issues, people leaving, social humiliation, people treating me badly, issues in relationship, afraid of infidelity. I’ll wake feeling really sad, or irritated; I even wake myself up with the idea of what I need to get done. Sometimes I wake myself up laughing; have also woken up crying before.”

“Even when I am healthy and balanced, I’m kind of manic in what I try to do; yoga, meditation, chanting, mantra, running, weight lifting, cooking all my meals, work, homework. Doesn’t really fit into a day. Don’t know if I’m clear about what is reasonable. I lived in an ashram in India for three months where I slept 6 hours at night. Woke up at 3 and was very happy doing sadana all day long. That set a standard in my mind of what I could do, but it’s not realistic.”

Physical complaints include a cough that is deep and scraping, < from drinking and smoking. Coughing begins when catching a minor cold and continues when the patient smokes and drinks. When the primary infection is gone, mucus and congestion continue in the sinuses, throat and lungs. Mucus is mostly yellow, green or grayish, at times with gray spots. Breathing is tight and heavy, like someone is sitting on her; breath is shallow. She can hear the phlegm rumbling, and a hard exhale produces wheezing. There is a history of recurrent sinus infections in elementary school.

Headaches are pounding, heavy, with pressure in the eyes, ears, along cheeks. The patient says she can hear her heartbeat during headaches and sometimes becomes feverish. Illnesses always go to the chest. The patient has low blood pressure and get dizzy; things “go black” if she stands up too suddenly.

The patient desires vegetables, salad, dark greens, spicy foods, and sugar. She retains water and gets sleepy for 20-45 minutes after eating sugar or refined flour. She has an aversion to eggplant or anything slimy or too spongy, rubbery.

Family history

pgm: dec’d from a “tumor that pulled organs towards each other”

mgm: breast cancer, still living

mgf: dec’d from colon cancer

mother: htn, hypothyroidism

7.3.09

The interview is continued in a second appointment due to the length and detail of conversation. I didn’t need to ask more than a few questions during each intake.

S: “On the first day of being clean I am so sad; grieving so much wasted time, feel I am dulling down my ability to be in my full potential. I am sad. It’s hard to let the evolution happen. I can’t feel myself when I am high. Why would I use a drug when I can’t feel myself?” (weeping)

“It’s unbelievable to me; I can picture how it could go bad if I allowed myself to (get really addicted/ homeless.) It feels like I’m playing games with myself.” (weeping)

Note: The patient has a strong poverty consciousness, and adds “all my friends are in the same position as me.”

“I see my friends using, they are innocent and weak. It makes me feel their humanity and mine. A lot more real than people who are righteously health conscious and politically conscious and everything should be pc and if you buy coffee at Starbucks you are the devil. If I’m around people like that I spin out of control, the expectations I have for myself keep building and I never meet them. My boy friend and friends remind me to not take things too seriously. When I am sober I get really manic. Part of my medication is for my mind – I’m too revved up. I have a friend I can be totally raw with; it would be like stabbing my own heart if I distanced myself from her.

When you have self hate you attract people’s negative energy. Takes two to tango; I recognize some of those qualities in myself. Flightiness, projecting that someone is judging you and wanting to isolate. I’m working with clients that have BPD and they remind me of my mom a lot.

I tend to take on too much, hard to say no, martyring myself. To cope with overwhelm I’m using, but it feels like a form of self abuse.”

O: Patient’s speech goes up at end of sentences. She leans on her mouth with her fingers. She plays with the skin on her bare feet.

A: Manic, desires balance + evolution, body image focus –> human source remedy. High achiever, addiction, sexually abused, lacks boundaries –> (drug) plant. Fhx cancer, codependency, htn, hypothyroidism, extremes –> cancer & other miasms.

I felt that the issues around addiction, history of abuse, co-dependent behavior, and attraction to working with teen addicts indicated a primal wound that needed healing, and thus a plant remedy. Her ambitious nature, disassociation/ lack of boundaries, and tendency towards impossibly high expectations for herself pointed to the “drug” family of remedies. Information on Diamorphine was presented in one of Lou Klein’s seminars.

P: Diamorphine (Heroin) 200c one dose DDX: Naja, Falco, Lac Del, Med, Bacil

9.11.09 FIRST F/U

S: “I have to admit that I was doubtful, but I was blown away by the result. It took about a week to have an effect. Took it as a ritual on my birthday. I meditated after taking it and noticed immediately there was a lot of self acceptance. Use started decreasing, then increased for a couple days over the weekend. Now, haven’t smoked or drunk in over a month.”

‘I experienced more exhaustion but am allowing myself to rest; not my usual pattern. Normally force myself to go until I have no choice. Feeling more flexible in my schedule. Self acceptance, felt a huge rise and loving self regard. I was thinking more positively about myself in general. Aware when negative self talk began right away and able to stop it. Actively and spontaneously using positive affirmation. Energy level going up.”

“Anxiety about my relationship, jealousy and fear was lessening a lot. First weekend after I got clean, noticed a lot of rage started surfacing. I have made all these sacrifices for the people I love. Angry for them not giving back. Mom violated all my boundaries, didn’t allow me to be a kid, she needed so much from me. Sensing a hollow pit feeling that has been there a long time, unending sense of need for love and attention I don’t think I got. Seeing all the ways I try to fill that in my life. Sadness, rage..I was dealt an unfair hand.”

“Stopped talking to my mom for a month, was so angry hearing her voice. At the end of the month called her. Parents gave me an emergency credit card when I went to college and it’s become this way for my mom and dad to maintain a co-dependent relationship. It’s also my way of not breaking off and stepping out on my own. I called and said I was cutting up the credit card and was going to start making payments. Then I told her don’t call me obsessively, I am the kid, I need to be reassured. I set a bunch of boundaries with her. In general I am saying no more often, telling people right away instead of swallowing it and feeling bitter about it. That feels really healthy even though I am like a kid learning to walk, stumbling a little bit.”

“Approaching my cycle, the positive self regard and body image started disappearing. I only have as much control as I am conscious of my own mind. Felt unbearable to be around, angry for really dumb reasons. Food is somewhat taking the place of substances.”

“Struggling with bad dreams around my cycle about abandonment, infidelity of partner. In the dream he was telling me you are over reacting, made me feel angry. Got dropped off in a wierd dangerous neighborhood and was trying to contact him; couldn’t take care of myself because I didn’t have what I needed. End of dream was wanting to apologize, I couldn’t forgive myself. Then was trying to get a ride back out of this neighborhood without money or phone and teenage guys in a truck drove by. Then I was a teenager and prepubescent, wearing nothing on the lower half of my body. Looked down and had no hair, like a little girl.”

“This last week kind of rough, learning and self awareness that feels joyful and really hard, painful, overwhelming, a lot of emotionality. I literally felt I turned 180 degrees in the opposite direction since taking the remedy.”

“I can see people are using to escape their experience, so sad to me. Earth is a beautiful place and we are all trying to experience some alternate reality; we have to escape to a mushroom trip or cocaine binge. I feel my generation is really playing with monogamy as blasé, rigid, and controlling. To me it feels safe; sexuality is an expression of higher emotions. The primitive sexuality, I feel it’s easy to stay in the lower chakras and I want to move up. I don’t know if I’m controlling myself based on my mind or I want to reach my highest potential. I want to experience lasting blissful union; sexuality is beautiful but it’s not permanent. It can be another addiction if not approached with reverence. I don’t want to be judgmental of what others do but…people are fooling themselves that they’re doing something loving.”

A: Correct prescription. The patient is confronting issues that are appropriate for her self-individualization, even in the face of emotional pain. She is returning to address areas that were neglected in parenting.

P: F/U in 2 months; call prn.

10.23.09

The patient continued to improve. She replaced using substances with obsessive exercise and felt guilty if she wanted to sleep more. Food became the last remaining place of excess. She struggled with self-judgement. She listed every food she was eating to show how healthy she was. Theorizing about food, obsessing on what she eats, yet says she doesn’t want to be “a Nazi about diet.”

S: “This year has been hugely stressful; my boyfriend was traveling for 7 months and it was hard to trust him because of past experiences with infidelity. My job is teaching me to be more loving and caring but also about boundaries. Otherwise can’t be present with people who are suffering; my heart is too open. I’m learning that it’s not my responsibility to save everyone.

Keep finding myself being honest all the time with everyone. That is a violation of other’s boundaries when it would be more appropriate to ask, “Can I share?”. Noticing I am invading their space by talking because I want to be heard. I think of a cell wall, openings and perforations. My consciousness is that wall and gets to be aware enough of what is coming at me and what I want to let out. Better at not taking in as much; so far it’s still rushing out.

I’ve been extraordinarily healthy, and I’m not getting sick at all. I worry I’ve done permanent damage to my lungs. Feel I’m getting angry all the time at little things. Then I feel like I’m going to cry. I’m judging myself for being angry. I see shallow sides of myself, superficial desires. I think to myself, “Oh my God, that is 5 minutes I could have been saying my mantra”.

Just like a snake shedding skin, it has to detach and leave it behind. Living it is a whole other thing, you don’t rip it off. I can see women past 30 all have this powerful knowing that I know I don’t have yet and want so bad. I fear that I’ll get bitter because I never had my youth.

O: She looks like she is on Heroin: eyelids drooping and shaking head.

A: Patient continues to do well. She realizes she doesn’t have to save everyone; this is the core theme for Heroin: the Hero.

January 15, 2010

S: “Took more of the remedy end of December to help me connect with myself. It made things more intense. It was helping me connect with myself by realizing these are all the ways I’ve abandoned myself. Last night had so much clarity because I could feel the planets move.”

“It has been hard to stay sober in the past few months. Feel so much more driven and passionate; when I drink I feel unmotivated. I love changing my state of mind, that’s why I like meditation and exercise. It seems like the substance opens the door, but why not do it without the substance? With homeopathy, you’re not taking the plant, you’re taking the message.”

“I feel like I don’t need to compete or prove myself. I feel softer in myself; acts feel tender, mothering. Since the remedy haven’t been able to answer (mother’s) calls, can’t even hear the sound of her voice. I need to stay with something that is emerging. I know at some point I will be able to hold her energy and mine in the same space but now hers starts to throw mine out the window. I get worried, anxious, totally identify, I soak it all up.”

“I am preparing for grad school. I don’t feel worried about much of anything right now. Anxiousness is decreased.”

A: The patient continues to make progress. I notice an “intensification” of her mental and emotional patterns, as often occurs in the healing process. This remedy in particular has “intensity” as a signature. There is an underlying state that begins to peek out from underneath the addiction that will need to be treated in the future.

P: Wait

EMAIL OF 3.17.10

I feel right now like I am living into the lessons that the remedy has brought to light… I am practicing self-love, self-acceptance, setting boundaries and respecting the boundaries of others, expressing my feelings with less self-judgment and letting others move towards me instead of abandoning myself in order to be in relationship with others. I am forgiving myself more easily when I make mistakes, and I feel less afraid of being abandoned. I am taking full responsibility for my own feelings and taking less responsibility for others. I am so completely aware of when I am feeling needy and I’m doing better at soothing myself…but that seems to be where there is the most work left to do…faith in the unknown.

April 6, 2010 Phone call

The patient is moving in with her boyfriend, starting school, and drinking a lot of tea with cream and honey instead of drugs. She has had no lung problems. As she begins to step up as an individual, she is challenged by her old patterns, but persists.

July 14, 2010 Phone f/u

S: The patient went through a relapse and started smoking and drinking during school, at the end of the day. She stopped two days later. Was feeling much better but still having cravings. She was able to remind herself though she felt tempted.

“When I first got clean was having violent sexual dreams about killing people, and it was satisfying and scary. Boyfriend woke me and said I was cussing in my sleep. The detox process this time was really hard. I was emotional and snappy with him, impatient. I was doing the killing, couldn’t see who it was. It was like I was defending myself, I was being wronged and was fighting back. In the past it was more random, like I’ll watch an action flick and then dream I’m in a shoot up scene, but don’t see anyone die. I know I’m shooting a gun but don’t see it. The recent dreams I was telling people I was going to kill them, moving towards hurting them and waking up. All the times it happened it was about s/o sexually assaulting me and then me hurting them. Alarming, weird and uncomfortable; felt angry and justified.”

“A lot of clarity with boyfriend and we’ve had good communication about things, able to hold my ground and reflect what I feel is my part. Experiencing a lot of independence. Am intentionally spending more time alone. Trying to encourage more positive self talk and do what is in front of me.”

“When got clean, a lot of self doubt and fear and not valuing myself and fearing others not valuing me. Seeing how it plays out in my professional life, taking things personally because I feel not good enough. Feel burnt out from my unrealistic expectations of myself, not giving myself credit or standing my ground. Scared I get taken advantage of, then resentful or bitter and that’s not healthy.”

“I am building faith in myself, but at times feel…part of letting go of the future is remembering what I’ve done so far. I forget that.”

A: The patient is assimilating new awareness of how she depends on others and learning to hold her own ground. Her dreams reveal she is moving from passive acceptance to self-assertion. There is also animal energy emerging from her dreams.

P: I suggest she call prn after school starts.

October 1, 2010 phone f/u

The patient reported that she is having a “relapse,” drinking a lot of black tea with cream and honey, associated with returning to school. She is aware of her mood swings and can be more of an observer of self-judgment. She struggled a bit with sleep and having very full days working full time and going to school. She is commonly aggravated in the Fall and exercise helps, but she has not been consistent. She feels less restless with her cycle but would like to see more progress, as it leads to sadness and frustration.

She reports no anxiety about her relationship, a brand new experience. Is trusting her partner and feeling safe; a “big growth sign.” She feels more confident and strong in herself. She says the emotional swings happen when she’s more aware of herself. She appreciates her ability to establish appropriate professional boundaries with coworkers and clients. Things are “really good now.”

Her face and neck skin has been breaking out lately, affecting her confidence.

A: Patient is experiencing an up leveling of stress with new responsibilities. She is now on a 1M dose and knows when to repeat as needed. I feel the next remedy will be needed in the next several months.

P: 1. eat protein at breakfast 2. exercise: short sessions with bursts of intensity 3. call to check in early December prn.

December 2010 phone call

The patient reports increased stress from school and occasional pot smoking recently, but sounds calm in spite of this. Patient has been healthy from respiratory infections, her cycle has become easier, no symptoms of ovarian cysts. She reports feeling more grounded and boundaries are being established professionally as well as with her family and boyfriend.

I feel the next remedy layer for this patient is up for treatment, so this is not a completed case. With the depth of healing that has occurred in the last 1 1/2 years, I felt it was significant enough to share for enhancing our understanding of Diamorphine. I also chose this case because addiction is so prevalent in our time. I feel it’s a symptom of our struggle to find ways of connecting with Spirit. The patient’s words and actions illustrated this struggle in a profound way and taught me a lot about the importance of allowing the healing to unfold organically.