A Case of Grief and Irritability

Female: 22 y.o.

Weight: 60 kg

Height:  175 cm

1^st visit September 12, 2011

The patient’s main complaints are grief (3) and irritability (2). She is sighing (2). She has the sensation of a lump in her throat (2). “I feel like I am short of breath, like I cannot breathe enough air.”  She cries (2), but sometimes with difficulty even though she feels deeply sad. She cries only when she is alone in her room. She has an aversion to consolation (2) and her mood is changeable (2). She is reluctant to talk about it. “I don’t want anyone to feel pity for me.”

Numbness of her fingers (2). Numbness around her mouth.

Further investigation

At this point it is necessary to investigate when the problem started and if there has been any particular factor or specific situation that might have a causal relationship with the manifestation of this emotional state.

Questions on this subject revealed that the patient had a quarrel with a friend of hers a month ago, after which they stopped talking to each other. “I am devastated by the fact that she doesn’t want to talk to me again.”

However, what was interesting during the consultation was the great intensity of the grief, which seemed to be a little disproportional to the incident that took place between the two young girls; so I decided to proceed into a more thorough investigation of the patient’s character and personal life, despite the fact that the remedy needed in this case was quite clear at that specific moment, even without repertorization. What was revealed next was quite unexpected.

The patient started to describe a very disturbed and painful childhood. She had a sweet and tender mother, but her father was an alcoholic who had many sexual affairs and was beating both the patient and her little sister – in front of her – almost constantly. “He was a womanizer, an alcoholic monster, always angry, breaking things and beating us up, but I was not afraid of him. I was never able to cry when I was a child”.

She was a rather reserved child with a lot of suppressed anger towards her father. She suffered many incidents of humiliation by other children throughout her childhood, “but I was striking them back, I was a fighter.”

She clearly recalls that she has been masturbating regularly since the age of 6, mostly after sneaking into her father’s room when he was watching porn movies on the TV, something that after a while became her own favorite activity as well. She masturbates almost on a daily basis since then.

She has an insatiable sexual desire (3). She loves being naked (2). Her sexual life includes many partners of both genders, all kinds of perverted activities (orgies, being beaten, cursing, outdoor sex etc.). She has multiple orgasms (3), 10-12 every time. She can be very easily aroused. She is engaged to a nice young man, but she is secretly having sex with other men as well “and I don’t feel guilty about it”, because her fiancée cannot satisfy her needs in sex, “he is too kind to me”.

She kept having her hand between her thighs or touching her genitals during the consultation. She has copious leukorrhea (3), odorless and without itching.

Fear of death (2), fear of feeling lonely (2), fear of looking at blood (2).

Her sleep is good. Her thirst is normal.  She is aggravated by warmth (2). She loves swimming in the sea (3), “The sea is my life, it makes me feel happy.”

Desires creamy sweets (3), whipped cream (3). No aversions.

Past history

Recurrent bronchitis with high fever until the age of 5, always treated with allopathic drugs. At that age she developed asthma which was treated allopathically as well. She has not developed any acute since then.

Family history

Her father had a cardiac infarction at the age of 55.

Analysis of the case

In this case we can witness the disruptive effect that the allopathic medication can have on the integrity of the defence mechanism. The suppression of both the frequent acutes and the recurrent bronchitis during the first years of her life led to the manifestation of bronchial asthma at the age of 5, which in turn and under the suppressive effect of the allopathic drugs, resulted in the complete distortion of the sexual sphere through all kind of sexual deviations, beginning with daily masturbation at the age of 6.

The fact that the disturbance followed this specific course is probably due to a combination of two factors: the disorganized sexuality inherited from the father and the exposure of the little girl to sexual stimuli (movies) at a very young age.

The recurrent bronchitis and the manifestation of frequent acutes until the age of 5 indicates that the organism belonged probably to Level 6 at that age, according to the analysis by professor G. Vithoulkas in his book Levels of Health: “ In level 6 are the cases that suffer from recurrent acute conditions, such as cystitis, bronchitis, pneumonia, etc. that have frequently used allopathic drugs, e.g., antibiotics, and yet the reoccurrence of the acute is so frequent that they may become sick almost every month and they end up taking allopathic drugs almost continuously. We often encounter these conditions today, even in children.” (Vithoulkas G.-Woensel van E., Levels of Health, International Academy of Classical Homeopathy, 2010, page 65)

However, after the administration of chemical drugs and the consequential suppression of the asthma, the patient’s defence mechanism has been further compromised; the absence of high fever, or any fever at all, since that age suggests that the organism has dropped to a lower level of health (level 8 probably, since at level 7 we should witness at least some incidents of low fever below 38,5 C). “Such cases are prone to drop to a lower level of health, levels 7 or 8, if they continue suppressing their acute conditions. They need urgent treatment but if they are mistreated (either by allopathic or homeopathic remedies or by any other suppressing therapy) then this event will mark the beginning of a chronic condition. In this junction the acute inflammation with high fevers – from 38,5 Celsius to 40,5 Celsius – will stop reappearing and a serious chronic condition will almost invariably manifest within a short period of time. The type of the chronic condition will be determined by the genetic predisposition of the patient.” (Vithoulkas G.-Woensel van E., Levels of Health, International Academy of Classical Homeopathy, 2010, page 65)

The presence of the copious leucorrhea reflects the effort of the organism to counteract any further deterioration by trying to maintain a part of the disturbance at the physical plane and, as such, is the only positive sign regarding the prognosis.

It is worth noting that the patient didn’t feel the slightest embarrassment or awkwardness during her narration; she had no difficulty describing all these details regarding her private life. This is an indication of the depth that the moral degradation has reached as a result of wrong treatment combined with hereditary predisposition.

Based on the above description, the differential diagnosis should include mainly the following remedies: IGNATIA, PLATINA, HYOSCYAMUS and MEDORRHINUM

Differential diagnosis

IGNATIA seems to totally cover the recent picture of the patient, as grief with sighing and the sensation of lump in the throat, along with the aggravation by consolation, are keynotes of this remedy. However, IGN does not cover the violent and perverted sexual desire of the patient.

PLATINA on the other hand, covers all the aspects of the sexual pathology of the patient (insatiable desire, perversions etc.); moreover, the numbness around the mouth and the multiple orgasms are keynotes of the remedy. Numbness of the fingers, fear of death and fear when looking at blood are certainly in favor of this remedy.

HYOSCYAMUS seems to be also another possible choice for this case, because of its affinity with all kinds of sexual deviations. The tendency to expose her nudity and the handling of the genitals are strong keynotes of the remedy. But when I decided to question her about potential feelings of jealousy, she clearly stated that she was not jealous or suspicious at all. On the contrary, she said: “It is quite sexy watching my boyfriend having sex with another girl” something inconceivable for a HYOSC patient, thus rendering HYOSC a less possible choice.

MEDORRHINUM is a very sexual and passionate person as well. The desire for the sea and the amelioration by it are strong keynotes of the remedy. The aggravation by heat and the family history of the father’s cardiac infarction are supportive of this remedy. The sensation of lump in the throat might be attributed to mucus stuck in the throat, which is also a characteristic of the remedy. However, the food preferences of MED are absent.

Finally, there are some symptoms of PULSATILLA (aggravation by warmth, fear of being lonely, strong desire for cream), but the aggravation by consolation and the thirst are contraindications.

I decided to prescribe one dose of IGNATIA 1M, because it is clearly the remedy that will remove the most recent and thus, the uppermost layer of the patient’s pathology, and it covers the main complaints of the patient as well, despite the fact that it does not fit the rest of the case. I was pretty sure that after IGN, a clear and complete picture of PLATINA would emerge. That would be the right moment to prescribe for the rest of the case.

To my surprise, things did not turn out as I expected.

Follow up 1

October 17, 2011

The numbness of the fingers and the numbness around the mouth are not present any more. The patient is reporting an obvious amelioration of her mental/emotional state. The irritability has improved by 50%. She can cry more freely and more easily now, but she is still aggravated by consolation (1). Her relationship with her fiancée is much better. They are thinking of getting married. Her sexual desire remains very strong, but she is now available only to her fiancée. “I stopped messing around. I don’t want to have sex with other guys anymore.” She has become sweet and affectionate and she suddenly has the desire to become a mother. She feels forsaken if her boyfriend doesn’t call her several times a day (2). She has a few minor pains in various spots on her body. Her thirst is the same. Desires pancakes (2).

Analysis

The significant amelioration of the mental/emotional state of the patient verifies that the remedy was correct. But the remedy seems to have organized the defence mechanism in a completely different manner than I expected. First of all, the numbness around the mouth – a keynote of PLATINA which I originally thought would become more prominent after IGN – has now disappeared; and instead of a burst of sexuality, I am witnessing a shift towards a much more balanced and healthy relationship, with characteristics pointing mostly towards the apparently less possible remedy, PULSATILLA. However, the fact that the aggravation by consolation has subsided but is still present, in conjunction with the patient’s thirst remaining normal (PULS is usually thirstless), suggests that it is better to wait and see if a clearer and more complete picture of PULS might be established or if the organism will shift towards a new direction.

Follow up 2

September 23, 2013

The main complaint of the patient now is condylomata. She is very upset with it and she is eager to get rid of them. “I can’t have them! Give me something! I will go to the dermatologist or the gynecologist!” Almost two years after the first follow up, her sexual desire remains very strong with multiple orgasms. She still masturbates on a regular basis and she has started seeing other men again, participating in several deviated activities. She and her fiancée are not married yet because she has doubts if this is the right decision. “I don’t feel any passion for him.

She feels anxiety in crowded places (1). She still loves the sea very much (3). Desires: salt (2), spices (1). Aversions: fat (2), okras (2).

Analysis

At first glance, it seems as if a relapse has occurred, regarding the patient’s sexual behavior. We have to evaluate if this is an actual relapse caused by the exhaustion of the action of the remedy or if the pattern of a new remedy is formed.  A real relapse should be accompanied by the reappearance of the keynotes or the symptoms of IGN on which we had based our initial prescription. Those keynotes are not present at all right now, and on top of that, new symptoms are being reported. The curative action of IGN effectively shifted the uppermost layer and temporarily alleviated the intensity of the violent sexual desire, thus giving the impression that it has acted on that plane as well. But what has really happened is that the organism used the boost offered by the remedy to rearrange itself in order to produce a more organized picture, which is now a little more evident.

At this point, the differential diagnosis should include mainly MEDORRHINUM and PLATINA.

MEDORRHINUM covers the pathology, since it is a specific remedy for condylomata and has a great desire for sea as a strong keynote. Desire for salt is in favor of the remedy, although it would be more fitting if the patient had a desire for fat as well, instead of an aversion. The strong sexual desire and the need for passion are also confirmatory of the remedy, along with the family history of heart problems.

PLATINA has strong sexual desire, masturbation and multiple orgasms as prominent characteristics, and it is also present in the rubric ‘anxiety in a crowd’. But the absence of both the numbness around the mouth and the fear of looking at blood (which were reported at the first consultation), along with the fact that it does not have an affinity with the main complaint (condylomata), renders PLAT a less possible choice at this moment.

The ideal choice might be to wait a little more in order to allow the organism to reveal the new pattern as clearly as possible. However, given the risk of having this case spoiled at this crucial junction due to the eagerness of the patient, I decided to prescribe one dose of MED 200C.

Follow up 3

November 22, 2013

Condylomata disappeared during the first 10 days. The patient suffered from a copious, thick, yellow and offensive leukorrhea, which lasted for 15 days after the administration of the remedy and subsequently stopped. But what was really distressful during the two months since the last follow up, was the exacerbation of her sexual desire to the point that she could hardly resist having sex every day in an almost compulsive manner, a fact that for the first time in her life made her feel uncomfortable. She admits that, during last week, this sexual turmoil has calmed down considerably and her overall condition is good.

Analysis

The prolonged and clear aggravation concerning the sexual function during all this time, along with the disappearance of condylomata, might lead the homeopath to the conclusion that there has been a suppression of the physical symptoms, resulting in a deterioration of the mental/emotional condition of the patient. However, a closer and more thorough examination will reveal that the remedy was correct and the reaction to it was a desirable one. The organism cured its condylomata after having shifted the disturbance to the mucous membranes, producing leucorrhea – a condition significantly less severe or dangerous than condylomata.

Another interesting development is the fact that for the first time we are witnessing a clear aggravation, in this case concerning the sexual desire, a sign of a more organized pattern and an indication that the organism is beginning to move slowly towards a higher level of health. The aggravation regards the sexual sphere because that was where the pathology was centered from the very beginning, since the early stages of the patient’s life.  This reaction to the remedy is clearly described by professor G. Vithoulkas in his book Levels of Health, in Observation 22 (The mental/emotional plane is worse, energy level and physical complaints are better after an aggravation): “Some cases, especially those that were originally centered on the mental/emotional plane, can present a long-term aggravation of the mental/emotional symptoms, whereas other smaller symptoms improve and the energy improves at the same time. The patient reports feeling worse due to the aggravation, but when he is asked the right questions and the homeopath understands the situation well he will not be misguided and tempted to give another remedy. This reaction shows that the remedy is correct and therefore we should wait. Deep mental/emotional cases tend to have aggravations that may last for more than two months, but after that the case will take a curative turn. These cases belong to levels 7 to 9 of group C. They are still able to react but it will take a long time for them to recuperate and they will need several remedies.” (Vithoulkas G.-Woensel van E., Levels of Health, International Academy of Classical Homeopathy, 2010, pages 135-136)

This is exactly the case here. The defence mechanism is still in a fragile state, vulnerable to the disorganising effect of stress factors, either physical or mental/emotional ones, remaining at risk of relapsing to its previous condition. The organism will probably need more remedies until it reaches a state where it can produce an acute with high fever, which will be the most definitive sign that the organism is moving towards its optimal state. So, what we should do now is simply ‘wait’.