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| Hpathy Ezine - March, 2009 | ||||
Repertory of Mental Qualities-- Jeremy Sherr |
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| Jeremy Sherr has created a new repertory, ‘The Repertory of Mental Qualities’. Here he introduces the repertory and talks about its philosophy and underlying methodology. --------------------------------------------- I will introduce this new repertory with a short case: A woman feels she is 'falling apart’. ‘I am broken into tiny fragments, I can't get the pieces together. I feel totally stupid and have low self esteem’. She has dreams of water and falling from high places. She also hates being in water. There are problems with menses, with diarrhea during menses and bad premenstrual tension. She gets headaches in the forehead, worse for tension. Generally when she is not down she is bubbly and happy-go-lucky, feels graced. Her family calls her ‘the Queen’. Naturally, there are several ways to approach this case. You can dig deeply into the psychology, feelings, history etc, and you may find gold. Or you may not, in which case it will be ‘fools gold’. I understand the essence of the case to be a ‘broken vessel, high water flowing downwards'. This includes the dreams of water and falling from heights, the low self esteem, the broken up feeling and the diarrhea during menses.
Having identified the main issues of the case, I choose four rubrics from the Repertory of Mental Qualities to represent these ideas:
Although each rubric is quite large, the end result is only 40 remedies! Adding ‘Diarrhea during menses’ leaves 12 remedies. Now I need to choose the most appropriate remedy to the centre of the case. I select Iridium (see the proving in ‘Dynamis proving Vol I’) Rx: Iridium-metallicum Within 2 minutes of the remedy she is smiling, 'I feel more together, it’s like my whole body is coming together physically', 'I feel happy' ‘amazing', a state which continued for quite a few months. I compiled the Repertory of Mental Qualities because I needed it in my practice. This work took me 4 years, yet it has only 26 main rubrics and 26 sub rubrics. But I can honestly say it is the most useful tool I have for prescribing since I purchased my first computer repertory in 1984. This repertory has been even more useful to me since I have been working with AIDS in Africa, because most cases have very few strange, rare and peculiar symptoms, and this is where the Repertory of Mental Qualities becomes even more useful. It has also been a great help in finding the ‘genus epidemicus’. In short, I am very grateful I have it! To use this repertory successfully, you need to understand some of the principles behind it. The reason there are so few rubrics is that this is a repertory of Quality and not Quantity. By Quality I mean 3 things:
The following is a discussion of the philosophy behind this repertory, the methodology of its creation, instructions on using it and other useful information. If you understand this repertory and use it correctly, I have no doubt you will solve more cases, often with remedies you may not have considered previously. You can also watch the demo video on following link: http://www.wholehealthnow.com/homeopathy_software/sherr-repertory.html What led me to develop this repertory How often have you seen a case where too much caring about others was a major issue? Have you had difficulties finding the most appropriate rubric to represent this idea? I certainly have. Should I use "Cares, full of, others about", "Sympathetic" "Nursing the sick" or perhaps "Anxiety others, for"? How often do we see a case where the patient presents a variety of issues related to money, resulting in a dilemma if to use "Fear of poverty", "Avarice", "Ambition, increased money to make" “Extravagance” etc. How many times have you tried to repertorise low self esteem, victim or obsessive compulsive disorder, but found that the rubrics are too small, inappropriate or just not there. Many of our patients have major issues, which don’t always represent well in the current repertories. I remember many cases where I had to combine “Fear of snakes”, “Dreams of snakes”, “Delusion of snakes” and then add a materia medica word search for ‘snakes’ and still add all the snake remedies. It was repetitive work and a waste of my time. For many years I have been continually combining rubrics, or being frustrated over ones I could not find. I decided to solve these issues by creating ‘The Repertory of Mental Qualities’.
What is the ‘right’ rubric? My definition of the right rubric is ‘The rubric that has the right remedy in it’. This might seem obvious, but it is certainly true. Holding this guideline in mind has helped my students and myself choose the most appropriate rubrics. If all the rubrics we use in the case have the right remedy in them, then this remedy MUST come out in the final result. Simple logic I know, but one worth focusing on while repertorising. Whenever I choose a rubric I ask myself this question: ''What is the chance of the best remedy being in this rubric'. Bearing this in mind, it is easy to understand why larger and more inclusive rubrics are more likely to lead you to the right remedy. The smaller (or 'newer') the rubric, the more precise the remedies in it must be, and this is often not the case. Hence with small rubrics you decrease your chance of finding the right remedy. For example, take the rubric "Desire to be in the country". Depending on the repertory you are using, there are between 7-16 remedies. Assuming we have 3000 remedies in the repertory, that represents approximately a 1/3 of 1 %. Yet a much larger percent of the general population has this symptom. Many people like to live in the country. Hence it must be used with care, as a possible indication, and certainly not to eliminate. It is for this reason that so many homoeopaths prefer the Boenninghausen method. Using large rubrics where the remedy has a higher chance of being included is more certain, more fail proof. The price you pay for this certainty is more remedies to wade through. This is a small price. There are too many uncertainties in choosing rubrics and too many inaccuracies in the repertory to take chances on this! Any slight mistake could lead to the loss of the remedy. As a result I much prefer to have more remedies in the end result, but I want to be sure the right remedy is there. I can then go through the final repertory result, remedy by remedy, and choose the most appropriate one according to the totality of symptoms, strange rare and peculiar symptoms, and my perception of the case. You may be familiar with my statement "The Mind is a mine field". There is much room for mistakes in understanding the patient’s mental issues or choosing mental rubrics. There is no point using a fancy delusion or keynote that looks artful but does not deliver the solution. It is better to narrow down from a bigger and more certain list of issues and remedies, then to try to narrow down by choosing small and dubious rubrics. It is like the difference between walking a tightrope and walking on a safe road, and when it comes to my patients, I prefer the road. Therefore I favor the Boenninghausen approach to repertorisation, using bigger generalized rubrics, where I am as certain as possible that the right remedy is included. If I am not sure of a rubric I combine all the possible rubrics representing the morbid quality of the patient, and if I need to I add materia medica searches. I also tend to combine similar rubrics from ‘Synthesis’ and ‘The Complete’ repertories. As the Irish say: ‘To be sure, to be sure’. After this I choose the best remedy according to the essential features of the case and the peculiar symptoms. A bit more work, but more certain results. This method is particularly useful in one sided cases or cases lacking well defined symptoms. However, the current repertories are deficient in this regard. While the Boger/ Boenninghausen repertories are well developed in the Physicals and General sections, they are lacking in the mentals. Kent developed the mind section, but he put more of an emphasis on particulars and modalities, and less on big generals. Most new repertories are based on Kent, and therefore do not always have modern mental themes. Furthermore, because of my many provings and my exposure to new provings conducted by others, I wanted to include this new information in the repertory.
A new repertory I decided to compile a new repertory that would address all these issues, a repertory that would save time, be simple to use, and increase the chances of finding the right remedy. In order to make sure the right remedy would be in each rubric, I put great emphasis in being as accurate as possible, by personally checking every entry at its source to evaluate the quality of information. I did not simply combine rubrics and materia medica searches. With a team of homoeopaths we checked every remedy individually, going back to the original references, checking each proving, cases and author. The result is accuracy you can rely on. Another aspect was attention to the quality of the symptoms, rather then the quantity. For example, in the rubric ‘Knives and Points’ in my repertory, Platina, Alumina and Silica are well known as major remedies of the highest degree. But I have included Lac-felinum and Crotalus-cascavella in the same degree, because knives are major issues in these remedies as well, even if they are small remedies. Likewise, while we all know Baptisia or Thuja for 'divided', I have included Zirconium-met and Phytolacca in the highest degree, because this quality is a major issue in both. This data is often derived from new provings, some of which are not yet published. The result is that you should be finding more small remedies to fit your case. Because you are using larger rubrics, these remedies won't 'vanish' in the repertorisation.
Using the ‘Qualities’ The idea was to create rubrics representing major mental themes, large rubrics which have a very high (95% and up) chance of having the right remedy in them. This is based on the Boenninghausen concept of generalization, and also on the concept of affinities. For instance, a case has definite issues of being a ‘victim’. The patient might have delusion of being persecuted, have suppressed anger and feeling always taken advantage of. If the same patient deals with this by always wanting to be at home: Fear out of the house and homesickness, then I will also use the rubric ‘home’. Now let’s say the main physical affinity is bones. I now use these three rubrics in my repertorisation.
The result: 68 remedies. This is an easy number of remedies to go through and choose the most appropriate one. Many remedies that would have vanished in normal repertorisation, such as Vipera or Lac-delphinum, will come through. There is a very high probability that the right remedy would be in the end result. This system is much simpler to use, as we do not have to choose a precise small rubric, which may look good in theory, but still be inappropriate, if only because the remedy is not in it. I started by creating a list of Mental Qualities that came up frequently in my day-to-day practice. As well as the themes of caring, money, self-esteem, victim, obsessive-compulsive and snakes, I chose qualities such as perfectionist, control, divided, guilt, clairvoyance, failure, embarrassment, opinion of others, knives and points, home, water, music etc.
Primary rubrics I am also a fan of the Phatak Repertory, which is based on Boger’s Repertory. In these repertories only the remedies that have the rubric’s theme as an essential part of their makeup are included. So for instance, in Phatak’s Repertory the rubric ‘white discharges’ contains only 20 remedies, far fewer then in Kent or Synthesis, but you can be sure that the remedies included have white discharges as a major theme, such as Kali-muriaticum. This is true even if the remedy is small. Therefore I decided to create a ‘Primary rubric’ alongside each ‘Main rubric’. This represents remedies that have the theme as a major issue, even if they are minor remedies. We should use these ‘Primary rubrics’ only in cases where the issue is very intense or pronounced, or is an essential feature of our understanding of the case. By including the opposite approach of Boenninghausen, which contains all possible remedies in the generalized rubrics, side by side with the Boger-Phatak approach of rubrics with only the most prominent remedies, I have attempted to create a repertory that will span both trends and create more possibilities. AccuracyWhen creating a repertory of Qualities and concepts one must be very careful not to use automatic combining of rubrics or importing materia medica, without critically checking each remedy. For instance, if we search for the word ‘fall’ to represent the quality of ‘High and Low’, we may get the rubric ”Coma with falling of eyelids”, which is not appropriate. Furthermore, a materia medica search in Encyclopedia Homeopathica or ReferenceWorks using the search word ’embarrassment’ will yield remedies mentioned as ”NOT being embarrassed” or remedies listed under "Unlike Bar-c, embarrassment is not an issue in this remedy …." In a similar way, searches for the theme of ‘dark’ will bring up remedies with ‘dark thoughts’ or ‘dark urine’. While a search for ‘perfectionist’ might bring up many remedies from cases, many times this symptom was not cured, and therefore is not valid. If using materia medica searches to repertorise was a valid method, we could stop using our repertories. But for the above reasons it does not work well. Other inaccuracies came from some clinical materia medicas, which tend to be relaxed about adding remedies under collective themes. For instance, Cuprum-metallicum may have Obsessive Compulsive Disorder, but while this may be true for some Cuprum salts, it is not necessarily true for all Cuprum salts. For this reason I made sure to check each remedy individually from the source. The xx family groups Another innovation I incorporated in this repertory is the use of families, which I call the The -xx remedies (e.g. Carbon-xx or Gems-xx or Noble-xx). These represent families that are prominently related to a particular Quality. Rather than including all the remedies in a family, which may not be accurate for each individual remedy, I allow the user to decide. The fact that Kali-c is included in OCD does not necessarily mean that all Kali-salts have this Quality – that is a dangerous assumption. By creating the –xx remedies I allow for the possibility of a Kali salt having the symptom, until this is confirmed or denied by clinical experience. I have made no assumptions about families. If Arsenicum and Iodatum are present to a high degree in a Quality, it does not necessarily mean that Arsenicum–iodatum is, unless there are other factors to support its inclusion. However if the Quality seemed to be present in a few of the Iodatum salts, I have added Iodatum-xx experimentally. This gives the user an opportunity to check all the salts and to confirm or deny their clinical usefulness. For example, if you combine the Qualities ‘Money' 'Light' and Home', the 'family remedy' Radioactive-xx will come through. You can now search the radioactives to see if any particular remedy is appropriate, for instance Neptunium or Californium. In this way you will again come up with remedies you may not have thought of. I now use the Repertory of Mental Qualities in almost every case. I have no doubt that this repertory will increase the quality of your practice. It has done that for me and for all the homoeopaths who use it. I wish to thank Rafi Neu and the Dynamis -Minnesota team for their help with this repertory. For a detailed explanation of how I constructed the rubrics see: http://www.wholehealthnow.com/homeopathy_software/sherr-rmq.pdf Once again, you can watch the demo on the following link http://www.wholehealthnow.com/homeopathy_software/sherr-repertory.html
What experienced homoeopaths and old masters have to say about the art of repertorisation Boger made a serious attempt … to unite analysis and synthesis in one rubric…And it is, in my opinion, the safest, in that it is more likely than any other to include the desired remedy in the final group. Analysis…is a resolution of the data into the simple elements of the individual complex. Royal Elmore Swift Hayes, M.D I think before we condemn any repertory we ought to know how it is constructed and the background back of it. … unless you know how to follow it after the Hahnemannian manner of taking general groups of symptoms first and then going to particular groups, you can very easily get into a maze. The best prescribers prescribe on the high-grade symptoms, the mental and moral states, the reaction of the patient to environment, heat and cold, etc., aversions and desires. Take those groups, and you don't have to use so many of them. Three or four general symptoms will frequently lead you to the three or four remedies you want to study more carefully in the materia medica. Dr. Grimmer We have in Boger's repertory a compilation of remedies of highest rank from Kent's, from Boenninghausen's, and from some of the other repertories, taking about twelve of the most important remedies in each of those, those that have shown the largest relative values. That is all right so far as you are going, but they omit those remedies of lesser value in that rubric. The most absolutely sure repertory in this world is Boenninghausen's. As has been said, it is nearly fool proof. You get symptomatic and numerical totality. Dr. Roberts If the symptoms of the case are sufficiently characteristic, I usually use Kent because I can repertorize my case more quickly… When the symptoms are more or less common I turn to Boger or Boenninghausen. Moreover, most of them (the repertorisers-JS) were provers themselves. They had felt the action of the remedy in their very tissues, and they understood remedies a great deal better than we do. Dr. Farrington
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