A 35 year old lady came to me on 4/1/2011 with chief the complaint of lichen planus, vertigo and fainting attacks.
Tell me about your complaints in as much detail as possible.
Pt – I have eruptions all over my body. They started 6 months back. I did take many allopathic treatments but of not much use. These eruptions are there all over. My legs, thighs, stomach, hands, everywhere except face. They are dark in colour and leaving marks very dark marks. You can’t see on my hands now as I usually wear full sleeves clothes and keep it covered. My husband says homeopathy can’t cure me and he was reluctant that I should not take your medication. But I don’t wish to take allopathy as I know it’s not doing much. I have been applying tacrolimus ointment on the patches, but not with great relief.
Also I am having one more problem which I need treatment for it’s disturbing me a lot. I get this giddiness attack and I just faint. This is disturbing me the most. I just fainted yesterday it’s not good. This has been happening very frequently to me. I get giddiness, I feel numb in the body and I just faint. I don’t even realise.
Talk about this giddiness, faintness, numbness.
Pt- Whenever I hear any news or any tension I hear like if anyone has cancer, I feel the same, giddiness, faintness, things fall from my hand as if I can’t hold, things get released from my hand.
Talk about release.
Pt – I see blood and I start feeling some numbness and things just fall from my hand. I try to control myself. I tell myself I need to come back and that it’s ok but yet I feel I am losing control of the body, I feel giddy and I will faint immediately. Especially when I go to hospitals or if I hear that my friends are sick, or hear anyone’s death, I get very tensed. I try my best to control but I just faint. I get very tensed. I get very tensed if I hear about anyone having cancer or any disease. I get very nervous hearing about various diseases happening to anyone.
What do you feel hearing of cancer?
Pt- Afraid as I might get that disease as it’s so dangerous, it can kill anybody, and there is no hope, it’s troubling and it has no treatment so it creates a little tension. It may happen to me. I get up in the morning and I get irritation in the throat so I feel something is wrong, hope I don’t have cancer, I am afraid of dying. All this started after delivery:nobody was there to help me. It was a critical period for me, my parents were not there and my MIL also refused to help me, so I did not have any support from anyone. I went in to a depression that if I get a disease who will be there to take care of my kids? If I get on to the bed or if I get any disease who will take care of my children. I had no help that time. My husband also was non supportive. MIL did not support. So was afraid for the kids.
What was your feeling?
Pt- I felt very helpless, no one there for me who can help me. I felt there is nobody for me. I have no one. I am all alone to face problems. Before marriage I had lots of friends and if I had any problem I would discuss with them but after marriage I didn’t have anyone. Husband also never supported, so friends became very limited, very narrowed down.
Talk about no support.
Pt- It’s helpless:I can’t do anything, what will happen if I get on bed.
What will happen?
Pt – Not sure what will happen but felt nobody is there now after marriage:I feel why i am here, you are living in a social environment where there is no one for me then why I am surviving here. What will happen if I die? Will anyone miss me? (hand gesture in round shape)
What is this hand gesture?
Pt- This is my area, my comfort zone. I am in the center with me and my family and I want them. I can’t do without them, I will miss them if anyone goes.
Pt – Yes its very comfortable here, I can do anything, I can express anything, I can share thoughts, I am enjoying, it feels safe within here .
Pt – Safe…. I can just relax, don’t feel like as if something can go wrong here ….I need not worry as someone is there to take care of that.
Just focus on the hand gesture and tell whatever comes to mind.
Pt- Here inside this I am safe. It’s like, I am totally relaxed, it as if a bubble is there and if I am safe and someone is pinching to that bubble then also its not hurting me.
You are sitting in an area and something is covering you and you are safe and you need not bother for anything.
Pt- It’s a feeling like when you are tensed you just go into your husbands arms and feel relaxed yes but that depends on his mood. It’s like when you go to the temple, you are yourself totally and there I feel some covering is around me. As if somebody is there. A hand is there on my head and it says I am there for you. It’s just a covering. It’s a totally relaxed feeling as if somebody is there to take care of me I don’t need to bother about anything
Pt- Safe, it’s not unsafe.
Pt- When I got married my SIL was living with us and my husband was always on her side, always on in-laws side. If something went wrong between me and my SIL, he would take his side, I would then think who is there for me? So that was the unsafe feeling, felt who is there for me? I left my parents and came to this new house which was a total new environment. But whatever was happening to me, who is there to help me out?
You left your family for your husband and in-laws, when you get married you don’t know how the environment will be. I totally left my family and here also I felt very alone, I felt Unsafe, nobody with me, felt why I left my family. I dint want to be there. I can’t survive in this environment.
I can’t survive in this environment means?
Pt- With me the problem is If I have my close friends , I can’t share them with anyone, so when got married , my SIL was very close to my husband , so I felt he is on their side more than me and that he is more close to my SIL than me. I did not like the feeling that somebody is sharing my husband, and then I started losing the trust and faith of my husband and felt he is not for me. Hence I felt UNSAFE and When I can’t share, I will try to pull him which I can’t do it (HG) then I feel I should leave him.
Pt- Pull him totally to my side but I can’t, I could not pull him to my side and then I feel I should leave him and let go of him and then he should also not interfere in my things as then I had no faith on husband, felt will he help me? It was always question mark….so I myself take a step back (HG GAP BETWN 2 HAND )
Pt- For eg. if I was very friendly to anyone like my very good friends and If they leave me and go to anyone else, then I need to take step back.
Pt. It is when I know I will lose someone then I take a step back as I have shared so much with the person, so many good moments with him and then when he behaves that way then I get irritated, and I pull back (AGAIN SAME HG)
Tell about this pull back
I feel depressed like you are not so attached to that person now
Focus on this hand gesture and talk about this. Describe this hand gesture of pull back
You are trying to pull. I am trying to control my emotions. I want to leave that attachment and take a step back (HG OD HANDS GOING AWAY FROM EACH OTHER). You walked together earlier and now you take a step back and think you don’t have those things.
Tell me about this attachment … (hg of hands together and then going away)
When you are there you feel safe (HG OF HANDS TOGATHER), someone is there. You are emotionally attached. But when I come back I feel why I have to leave this relationship? when pull back I feel I have to go away.