Clinical Cases

A Case of Lichen Planus and Alopecia Areata

The author describes a case in detail which highlights their method of Case Witnessing Process.

I have been practicing classical homeopathy for a decade now. It has been a constant process of new learning and development, as well as evolution for me as a homoeopath. The evolution has occurred in various ways, but more so in the way I have been taking my cases. For me, the process of case taking started as inquiring into cases (literally) as a beginner homeopath to a case-taker, (as I became more attuned with the finer art of homeopathy) to a case-receiver. This evolution has been very rewarding, getting deeper, refined and finer at each developing stage; I have developed from a curious homeopath to a responsible homeopathic doctor, to a mature homeopathic physician, to now a trustworthy homeopathic healer for my patients. My cases done at various stages of development reflect my own journey as a homeopath at that particular stage. Along this journey, specifically the teachings of the Sensation method by Dr. Rajan Sankaran and the Case Witnessing Process by my husband Dinesh Chauhan have come as a vital guide for me.

I saw this case in 2008, almost four years back. I would say that was the time when I started receiving my cases and experiencing its impact upon me as a homeopathic healer and on my patients, who came to me for their healing. I realised that when I became an instrument of receiving the cases, the patients were more comfortable talking to me and expressing their being beyond the conscious level. Having a comfortable zone between two of us really helped both of us; revealing their vitally disturbed self became more spontaneous for my patients and that really helped me to understand their deeper core experience. And the revelation of a patient’s deeper, vitally disturbed core occurred through the patient’s spontaneous non-verbal expressions rather than the verbal one. Understanding the patients at a deeper level really helped to bring long lasting healing in cases that suffered from difficult structural pathologies, such as lichen planus (Homeopathy for Lichen Planus), alopecia areata, psoriasis, arthritis, asthma, etc. The present case is one such example. I will put threads of explanation at various stages of the case so that readers can follow my chain of thought for the case and the action I took that helped me to reach to the core understanding of the case.

The case has been edited for brevity; italics are used to highlight the important phrases of the case; my explanations are given in green. D and P stand for doctor and patient respectively.

Case Presentation

A lady in her forties came and saw me on 14th January 2008 for the complaint of hyper-pigmented patches all over her axilla (bilateral). She said it started as itching; more so during night time; itching was followed by eruptions placed very close to each other. Over a period of time, eruptions vanished but the hyperpigmentation was left. She also suffers from hypertension and she is on anti-hypertensive medications since three years.

When I ask her to describe herself as a person, she says she gets tense easily on small matters. If her husband talks rudely to her, she feels injured* by her husband’s words (she makes a hand gesture of tightly closed fist with one hand) (*the word is English translation of a Gujarati word “GHAYAL” that she spoke). This upsets her for four to five hours or a day. She says “I get argumentative with my husband. His words hurt** my feelings. (**she says MAARI LAGANI GHAYAL THAI JAI- again- ‘HURT” is English translation.) Do I not have any value?”

She uses same word “GHAYAL” to describe how she feels when her husband talks rudely with her and also for the way her emotions feel. GHAYAL is a Gujarati language word; literally this word means getting physically hurt/ injured. It is very interesting to know her perception behind getting emotionally hurt; as if she is getting injured. Also, we note that she uses a peculiar hand-gesture each time to describe hurt. Her verbal language (tension, injured, hurt) and her non-verbal language (HG) are not in tune so far. Nevertheless, we make note of it since they are peculiar and continue with the case.

She gets tensed when she is expecting guests at her home (again she makes the same hand-gesture of tightly closed fist with one hand). She does not like if someone passes comments, or gives her suggestions for the daily chores – she says “It is my work, I know how to do it and I do not like anybody’s suggestions for my field of work. I do not like if someone nags me to do this or that, or if someone tries to check whether I have done it correctly. If I have done some work it is done well, no need to keep a check over that. In my work, (hand gesture of drawing a circle in air and showing someone entering the circle), no need to interfere. I do not interfere (repeats the same hand gesture of drawing a circle) in anyone’s life. If someone tries to interfere in my life, I say – ‘NO’ – not to do that (says strictly and putting pressure on the word “NO”). I like living independently without any interference of any kind. The interference makes me feel as if I have been watched / kept under a check (hand gesture of poking with her right index finger). If someone pushes me to work according to his wish, I do not like that. I want to escape from there.

D: Tell me about being watched /kept under a check.

P: (hand gesture of poking with her right index finger) Someone repeatedly tortures you. Someone dictates to you what to do or how to do it. For instance, how a mother in law behaves with a daughter in law; all the time insists how to do a particular work and how not to do it. (Hand gesture of tightly closed fist with one hand).


(She describes herself by revealing how she feels in several of her life situations. She experiences various emotions in each of them (getting tensed, feeling hurt and injured, interfered, watched, tortured, etc. etc. ; interestingly in all such situations, though there are various emotions and few delusions that she describes verbally, they are being accompanied by peculiar non-verbal expressions and the one that comes up repetitively is of a tightly closed fist with one hand. All her non-verbal expressions are very uncommon and peculiar and come with lots of energy. What bring these peculiar gestures in the case? We need to follow the relation amongst all these non-verbal gestures and their relation with her core experience. At this junction, I ask her a next question.).

D: How do you feel in all these situations?

(At, this stage of the case, we understand that this lady is at the emotional level of experience, meaning various situations of life are experienced by her emotionally. So, in order to go deeper in the case, it is required to ask a question that matches with her level of experience. If I ask her what is the experience / how is it like to be tensed/hurt, etc. etc, chances are she will not follow what to answer or there may be a lot of resistance to answer the question, because she will not have the experience of it at the moment. We need to take her slowly, steadily towards her deeper experience and not jump directly to avoid the resistance.).

P: Nervous (HG of tight closed fist). No interest in anything. It is better to be alone. But, you have no option, that’s how it is when you have your own house and household responsibility. If you live in a guest-house, then there is no problem. But, you are tied up in worldly life, your own house responsibilities. If your husband is late to arrive from office, you get worried. (Tells with a smile)

D: Anything else that you are intolerant about?

(This is not a good question from my side or rather, this is my mistake at this point. I ask her a general question, “how does it make her feel in all such situations?” to which she responds by saying “Nervous” with similar hand gesture. Now, I should be leading her on the same route by inquiring more about the nervousness. Instead of doing that, I changed the direction of my question all together. See what happens.).

P: If I get a reproach in front of a stranger. It hurts badly. If someone says something to me that I don’t like, my mood gets off. I will not weep in front of them but I feel heavy hearted, I feel hurt (hand-gesture of tightly closed fist with one hand). If someone troubles you, it feels heavy on chest, you feel angry, you feel like reproaching back, but you cannot. You cannot reply back, you cannot attack back because it will look bad on your part. You feel as if you are not free. As if you have to follow the commands of someone else all the time.

D: What is “Free”?

P: Tension-free, no load over your chest, free like a bird. Happy, pleasant, joyous.

D: What is the opposite?

P: Nervousness (hand-gesture of tightly closed fist with one hand). Weakness; you feel as if no stamina in the body. You feel tired. As if a bird’s wings have been cut. You cannot do anything. (Pause.). That’s it.

(Since she is at the level of emotions, she brings one more situation of her life that causes few more emotions to her (weepy, hurt, troubles, angry). Plus, there are few delusions (not-free like a bird with its wings cut, free like a bird, etc. etc.) but without any energy in them; she tells them more as matter of fact without any body language or weight in them. So, with my question, we have not gone a step deeper in the case, rather we still vibrate at the same level. But, now, my focus is to go deep with each sensible questioning from my side. Hence, I said it was my mistake at that point.

Nevertheless, she gets back to “Nervousness” in one more diverse life-situation of her with repetition of the same non-verbal expression of closing her fist tight, which proves that this gesture is not just anything accompanying her verbal narrations rather it has some deeper connections. And, now, it’s the time to understand that in and out. We also follow that in her expression of various emotions, someone is doing something to her-

someone nags me”, “someone tries to interfere in my life”, “as if I have been watched / kept under a check”, “someone repeatedly tortures you”, “Someone dictates you”, “someone troubles you”-

This is a typical expression belonging to an Animal kingdom remedy – feeling victim or a prey to someone else. But, again, these expressions have occurred at her emotional and delusion levels and we will only decide which kingdom the patient belongs when we follow their vital sensation and energy pattern. Until then everything may turn to be a false prediction.).

D: Can you describe this gesture (I repeat the hand gesture of closing the fist tight.).

P: long pause. Nodes “no”.

D: (I ask her to repeat the gesture and see what comes to her spontaneously.).

P: (She closes her eyes and repeats the gesture several times.). Someone is holding something tight? Again she repeats the gesture with her right hand looking at it. She starts laughing.). I do not know further.

(I stay with her for long, but she fails to go beyond to describe the experience further. This commonly happens with cases that vibrate at or below emotional level of experience. Hence, I decide to go to one of her subconscious area to see what lies there, and to see what pattern emerges there. If I am on the right track in the case, meaning I am on the right track of exploring the vital experience, her experience in the sub conscious area will also remain the same as what we have got so far in the case and that will help me to go further in the case. Let’s see.).

D: Tell me about your dreams?

P: I dream about snakes. Many many snakes.

D: Which other dreams?

P: I also dream about something is stuck in my throat and it is not coming out. Something very sticky and white is stuck in my throat. It makes me feel uncomfortable, restless; breathless (repeats the hand gesture of tightly closed fist with one hand). I feel as if my breath will stop. I am unable to breathe (she repeats the same gesture of tightly closed fist with one hand.).

(This is really important. At the conscious level, she could not describe what the tightly closed fist meant though that was the centre of all her emotions and delusions. But, no sooner, I enter her sun-conscious zone, she gives language to her peculiar non-verbal expressions that she repeats all throughout in her case. Now, I see an appropriateness of her verbal language with that of her peculiar, repetitive non-verbal gesture. Also, it is confirmed that I am on the right track because, even in her dream, the experience is described with the same hand gesture of tightly closed fist. Now, I miss no chance to explore this further.).

D: More about that experience?

P: It feels breathless as if someone has caught your neck (hand-gesture of tightly closed fist with one hand). You want to escape. (She looks at the gesture she makes of tightly closed fist and smiles at me.). That’s it.

(Earlier in the case, she said she wants to escape when someone tries to nag her. This is the beauty of reaching the vital experience of the patient. At the stage of vital experience, all the peculiar expressions that a patient has narrated in bits and pieces get connected in a single phenomenon. There emerges a meaning to all the strange sounding expressions. Also, at her level of vital experience, she experiences someone catching her neck- again someone is doing something-thus pointing at the Animal kingdom remedy. Now, we need to explore further to find the source in the case.).

D: Just stay with that experience.

P: What will happen to me? I feel breathless, as if being choked, as if my breath is stopping. She closes her eyes. She repeats the gesture of tightly closed fist. Then, she opens her eyes saying that’s about it.

(Since, she had nothing more to say, I explore one more dream that she gets; again, my focus will be to get her experience in that dream and see what further I can get about her innermost experience through that dream.

Also, it is important to know that in a given case, if the level of experience of the patient is emotion, the journey until source level and beyond happens in some cases and fails in some. We have to keep patience and leave no stone unturned to go further in the case.).

D: What do you see in snake dreams?

P: I see many cobras in my dreams (shows with hand gesture to describe cobra with hood). They don’t harm me. I just see many of them.

D: Tell me about them more to understand better.

P: What to say. (pause). These are the snake that we see in lord Shiva’s temple. We feed them with milk. They are quiet creatures but they don’t like someone interfering in their lives. If one does that (she make a hand gesture of hooded snake in biting move), it bites. It bites only when troubled (hand gesture of poking with index finger.). That’s it.

(So, she describes the cobra; the cobra does not like to be troubled or interfered. And when interfered cobra is ready to inject a bite and there is a hand gesture. This is something similar to what happens to her! She spoke about how she gets angry when someone tries to interfere in her life. And she uses similar gesture to describe how it feels to be interfered for the cobra as well as her own self. There is no difference between her experience and that of the cobra! Her vital experience (in all the diverse situations of her life) is as if caught by neck, being choked and breathlessness where she wants to escape. This is a typical experience of a Snake remedy. Also, she disagrees to being troubled / interfered, and then there is anger and reaction of biting. This is a typical experience of Cobra. Now we know the meaning behind all her peculiar hand gestures as well as expressions that came all along the case. Rather, now, all her strange looking, peculiar expressions can be followed through one single phenomenon; they are no more lying in disconnected pieces. She is describing the source behind her vital experience!

In a patient whose source /remedy belong to the animal kingdom, we need to be alert for not misunderstanding an image described by a patient as the Source. Only, when the expressions and the experience of an image described by the patient matches exactly with the patient’s own experience, carrying the exact energy then we can say that the image is the source itself. Not otherwise. In the present case, the patient uses image of bird, snake, cobra; but only the description of cobra pregnant with energy matched exactly to the patient’s own expressions and experience. At one point, it was difficult to differentiate whether patient is describing herself or the cobra because her description of both is the same. Hence, cobra is the source in this case.

D: How are you with snakes?

P: I respect them; because in my religion, it is also considered to be a protector snake for one of our God.

(I ask her further, but she has nothing more to say except that she experiences stiffness in her hands that lasts for 5-10 minutes. There is tightness; it is better by movement and exercise.)


Many Hyper pigmented vesicles over both axilla.

Diagnosis: Lichen Planus.

Understanding of the case:

All her expressions are described as someone is doing harm to her.

(Someone has caught my neck, hurts my feelings, someone nags me, someone tries to interfere in my life, as if I have been watched / kept under a check, someone repeatedly tortures you, someone dictates you, someone troubles you.). (This is typical of Animal kingdom.); her experience in such a situation is as if caught by the neck, choked, feeling breathless and she wants to escape. (Typical of the Ophidia suborder of the Class Reptilia from the Animal kingdom) And then she reveals the source herself.

Source @ Wikipedia

Also, cobra belongs to Elapidae family of Reptile (Snake) where one of the main rubrics is “Delusion-Injured she is” (Complete repertory)(She feels injured / hurt when her husband behaves rude to her)

Remedy given: NAJA 200 / One dose (since her level of experience is emotion, 200 potency was chosen.).


25th Jan 2008:

  • Skin is SQ.

  • Hopeful dreams.

Plan: NAJA 200, one dose repeated.

15th March 2008:

  • Axilla better in terms of itching and lichenification.

  • Itching on the scalp and occiput ++

  • Tension related to her son. Anxiety with heaviness.

D: describe heaviness.

P: Uneasiness, difficult to follow. Uneasiness in chest (repeats the gesture of tightly closed fist) as if my breath will stop.

Lots of negative thoughts.

(There is one more tensed situation in the patient’s life and again her experience remains the same. This time, it took very minimum time to let her express her inner experience of the entire situation. This is good news insofar as the healing process of the patient is concerned, because it suggests that the patient’s level of awareness is going deeper and close to her inner core. It is always wise to explore the experience of the patient in their follow ups on regular intervals to check weather our understanding about the case is correct or we have more to explore.).

D: How is your sensitivity towards reproaches?

P: It’s much better. I take life more easily now. Life has become smooth and joyous.

D: How is your energy level?

P: Good. Better than earlier.

D: Any dreams?

P: I see water, ocean. My son was drowning in ocean and I am trying to save him.

Plan: Naja 200 / one dose.

25th April 2008:

  • Eruptions on armpit reduced.

  • Eruptions in left hand became light.

  • Eruptions are converting into hyperpigmentation spots.

  • Itching has reduced.

  • Energy levels are good.

  • Dreams of relatives getting drowned in water (happened after reading the news of floods.

  • Warts SQ.

Plan: NAJA 0/3 od

(I choose to shift to LM potency, because I felt there was good improvement so far as her energy levels and mental emotions were concerned but her skin was responding slowly with present potency, her level of experience was still more or less at emotions and there was a need to increase repetition of her remedy. Also, my clinical experience with LM potencies with chronic skin problems and deep structural damages has been wonderful.).

23rd April 2008

  • All vesicular eruptions turns black spots over axilla; feels itchy.

  • Overall >>

Plan: NAJA 0/5 od

1st Aug 2008:

  • Hyperpigmentation has started vanishing.

  • Much better over all.

Plan: NAJA 0/5 od

20th Oct 2008:

  • Skin eruptions not there at all, much better.

  • The hyperpigmentation of the skin has also reduced.

  • No dreams.

  • Overall energy wise much better.

  • No other complaints.

  • Mentally / emotionally better. Does not feel sensitive to her husband’s remarks, takes them lightly and as matter of fact of life. Feels okay with life.

In this follow up, she showed me three alopecia patches over her scalp – that she had never mentioned to me earlier. She said she forgot to mention about the same because she had them since a long time and she had accepted them to be with her lifelong. On her daughter’s insistence, since she saw improvement in one of the patch, she decided to report me about them. She said, one patch has shown improvement and showed me all three.

Plan: Naja 0/6 od

24th April 2009:

  • All hyperpigmentation over axilla have gone by 100% over right axilla, 90% over the left axilla.

  • Occasionally there is stiffness in fingers in the morning that lasts for 5 minutes.

  • Alopecia areata is much better.

Plan: Naja 0/6 od

In a month’s time, her hyperpigmentations were gone and so were her alopecia patches over her scalp. Mentally she was much balanced and her energy levels were up to the desired level. So she decided to stop the treatment. She came to see me in April 2011 to get treatment for her grandson and she reported she has been doing well without much botheration at any level since she stopped the homeopathic medicine.

Today, I receive my cases guided by the art of case witnessing process (CWP). The art of case witnessing has really helped me to crack even difficult cases that would just resist getting deep in their being. Not only that, the art of CWP has really helped to know at what stage of case you are in, how much journey is still left, how to travel that journey, how much time it may take. It has brought so much clarity to the case receiving process. Having such clarity for your cases is almost vital especially when you are going to travel the vast realm of subconscious and beyond of your patients. This clarity helps you to not get lost in the vastness of deeper self and guides you straight to the innermost disturbed core of your patient with ease and success. And even if you fail to reach the innermost core of your patients in their first interview, you know at what level patient was reluctant to go deep and from where will you commence your journey ahead when your patient visits you for the next follow ups.

About the author

Urvi Chauhan

Dr. Urvi Shah Chauhan heads the Philosia publications. She is the Head and Director of Swasthya Homoeopathic Healing, along with her husband, Dr. Dinesh Chauhan. The creative head of Swasthya Homoeopathic Healing, she is a practicing homoeopath, yoga consultant, publisher, editor, book- designer based in Mumbai, India. She was the editor-in-chief of three books by Dinesh Chauhan, namely, A Journey into the Human Core, A Wander with a Little Wonder: Child-Centric Case Witnessing and The Scientifically Intuitive Case Witnessing Process: The Journey of Three Steps.. She designed all the illustrative art work and the cover pages for the latter two books. She compiled An Insight into Plants-Volume III for Dr. Rajan Sankaran. Since 2007, she has run Athato Brahma Jigyasa Foundation (ABJF), a not-for-profit trust, with Dinesh Chauhan, where they organise free, educative homoeopathic workshops for Indian homoeopaths. She is the designer and developer of two of their web sites and She is a Guest Editor for Interhomeopathy – an online international homeopathic journal. She can be contacted at: [email protected]


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