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.
In HG OF HANDS TOGETHER, it surrounding me, it’s safe is there but when you are there coming back I feel it’s not safe something is gone out of my life, its moving out of my life
What’s the experience of moving out, losing, something gone out of my life?
It is like, how can I survive without him? How can I live without him.
Thought of living without him is?
Taking step back…
Tell about the dreams you see
Dream I see a hand on my head. It says don’t worry I am with you …and then I see that hand is moving out from my head …and then I feel that nobody is there, I am alone ….
DESCRIBE THIS FEELING OF NOBODY THERE AND I AM ALONE.
When you ask this question I see a kid is sitting in a corner. He is scared sitting in a corner (HG BODY SHOWS COMPRESSION HANDS AND LEGS TOGETHER DRAWN) (dara hua or sehma hua sa) I am seeing one person sitting in a corner, he is alone and very scared, nobody is there for him. He is too much afraid he does not want to talk to anybody looking for help and saying someone take him in his arms. He is trying to hide himself in that corner.
He compresses himself as much as he can do sitting so that no one can see him. He is very fearful. He has taken a step as he has done something wrong and feels guilty hence don’t want anyone to come to talk to him….he has already taken a step what he has done is wrong. He was having a comfort with the relation. He was relaxed now that’s not there he don’t have anybody.
WHATS THE EXPREINEC OF LOSING THIS RELATIONSHIP….
Loneliness….eg—graduation time I had a friend … we shared lot:I was very close to her. We would discuss everything and suddenly she had another close friend and I went to home time and when I returned I saw she was so attached to him. I was feeling she was shared with that person. She is not now my 100%. Your devotion to relationship is then not there. I had no problem if it was her parents, mother but we were 2 people with her on similar kind of relationship… as when she was with me still she is talking about him so I felt as if somewhere a gap is coming between our relationship (HG SAME AS BEFORE) I was TOTALLY ATTACHED WITH HER …in between one more person came so felt like that initially, but later we all three became friends.
TELL ABOUT THIS GAP
Let me come back ….let me take step back silently come back as I knew I was losing her.
DESCRIBE THIS EXPEREINCE OF LOOSING SOMEBODY. JUST TALK ABOUT LOOSING
I seeing myself sitting and crying, I don’t want to lose…. lose means be away …she is going away from me …….
TELL ABOUT THAT CHILD THAT YOU SEE SITTING IN A CORNER WHO IS SCARED
It’s like that child is sitting in that corner scared as if it’s been hit. When u hit the child how would he feel, If he tells more he will be hit more so he is scared he is shouting that don’t hit me don’t hit me and he is afraid and hiding that don’t hit me now, he does not want someone to hit him again
WHAT’S THE EXPERIENCE OF BEING HIT?
He is having pain he is just very afraid and having guilt he has done something wrong and so he is getting this hits and he is scared nobody can ask what went wrong…….
TELL ABOTU THIS HIT
He has been hit with the stick and he is shouting and crying … what mistake he has done
WHAT’S HIS FEAR?
Fear of being alone
BEING ALONE MAKES HIM FEEL HOW?
No idea what to do next
He has the regret why is this happening not in thinking mode what to do next. All the fight is going in his head he is sitting in a corner and is totally blank, not taking any action just thinking what has happened and afraid about the fight that happened.
WHAT’S THE EXPERIENCE OF THE FIGHT
He sits completely squeezed and compressed (HG ___takes all his hands and legs together.) Compressed, he is alone no one is there and he is trying to recollect his energy, when he had a fight you lose the trust of the other person. There is a break in the relation so you need to do something for yourself
WHATS HIS EXPERIENCE WITH FIGHT AND SHOUTING
He is AFRAID, U HAVE NO CONTROL ON THAT you have no control on that fight .
EXPERIENCE OF NO CONTROL
He is not able to remove it from his HEAD of what has happened….
NO CONTROL ON HIS HEAD and mind so not able to stand up again and go to work as he is just sitting and thinking about that. He feels Helpless that he is not able to control his head in fear so He is trying to compress himself, hide himself, squeezing as much as possible so that no one should touch him, no one should see him. He is scared of that other person who hit him but at the same time looking for someone who can pamper him…..
WHAT’S FEELING IN PAMPER
Somebody can come and hug him nicely.
EXPERIENCE IN A HUG
Leaving out his tension, throwing away his tension (HG), giving to the other person whatever is running in his mind
Giving it to a person to whom he trusts and it feels very relaxed
COMPLETE OP OF RELAXED?
FEAR, STRESSED, RESTLESS.
Heaviness ….head heavy, something is running in the head, round and round heaviness… just want to come out of that, get rid of that
ROUND AND ROUND?
Head is heavy
Different sensation on head, sensation on eyes pain in eyes as if something is STUCK in eyes
As if blood is not flowing
Kuch fas gaya hai and not moving out … normally its flowing but I feel its stuck. Then I feel it needs to move out and I try to press here and there and it becomes normal.
TELL LITTLE MORE ABOUT STUCK
It’s a different sensation mostly at time of cold I have headache and pain in the sinus portion
DESCRIBE STUCK, PHASNA
Something has held my head and said you can’t be relaxed …….something on forehead and tight feeling there you try to massage, try to concentrate on this portion and stretch it out
TELL ABOUT YOUR FEARS
I am nowadays getting many fears I feel even when I am in house, if earthquake comes what will happen? Before I would never get scared, Earlier I was brave and was able to control husband now I am afraid of everything scared on 20 speed when I am driving. If lift gets stuck what will happen so does not go in lift son just fell down I started think of all negatives swine flu …I am always thinking about big diseases ….
I would never go in lift especially when alone … I would always see number if I get stuck what will happen?
Yes I am scared of being stuck, I feel SUFFOCATION I will not able to breathe I will die … I am afraid of dying also
I am not able to breathe properly as if oxygen is not there, I just want to run away from there … I feel like that in a closed room too. Once doctor wanted to do ECG felt very suffocated and wanted to run away from there, also in office in an AC room everything is close so I was not able to breathe properly ‘felt I am closed somewhere, I can’t see anything I closed somewhere it’s a closed box (HG) in which I am there, if I am outside its ok but if I am closed not able to see outside so felt I was trapped and not able to go out
Closed you can’t do anything you r in a closed compound ….If lift gets stuck you can’t do anything you can only ring the bell if nobody listens then you can’t do anything
I was in in-laws place, my family member trying out go on staircase so we both were following me and my aunt was trying to push me from the roof and I was very scared and was shivering …
I was very afraid
TELL ABOUT PUSH ……HG
She was trying to push me with her hand coming close to me
EXPERINCE OF HG
Afraid, shivering you know I was trying to keep my body close ..(SAME HG OF A BABY)
WHAT IT REMINDS U OF?
When I feel afraid, when I get very scared I do that posture
WHAT’S THE FEELING WITH THAT POSTURE?
Closeness to your own self you feel tight (HG) you are trying to control sort of you are trying to control your body your emotion very angry, you are trying to release …release the fear and I tighten up or squeezing body …I try to be in myself
EXPERIENCE OF TIGHTNESS
I even press my teeth throw things I am trying to break myself…HG it’s like something is going out release the tension….
EXPERIENCE IN RELEASE?
Release body is totally relaxed
In tight everything is tight and feel like to break everything want to get out
When I tighten up I control the mind you will try to control it is pain when I do that control I will feel better when I control sometimes I shout and cry for the release
ANY OTHER PHYSICAL PROBLEM YOU HAVE APART FROM YOUR SKIN LICHEN PLANUS AND GIDDINESS.
Past 2-3 cycles heaviness in breasts. There is a little bit pain, a sense of tightness on breasts. It feels hard as if something is filled up over there and also some gas is there which make me feel very heavy in the chest.
It like something got stuck as if something stuck in the chest it’s a feeling of heaviness and uneasiness, which is trying to come but not able to come out
DESCRIBE THIS FEELING OF BEING STUCK IN CHEST
It feels Ghabrahat, its suffocation as if some weight on the chest as if something is stuck in chest. It wants to come out and is not coming out I can’t breathe or feel I am breathing very fast. If windows are closed I want to open the windows, I can’t breathe as if someone has tied me up I need more space. It gives a vomiting sensation and gas will be released that time and nausea feeling, vomiting sensation and when gas is released then it helps me out and it helps me to relax little bit and that time I feel very giddy, you are restless, heaviness and can’t sit and when the gas comes out I feel very relaxed, your body becomes light and not heavy. I feel weak something lost from body and weak and then normal.
HOW IS THE FEELING OF LIGHT
Feeling of light is like as if burden is gone and nothing is there.
HOW IS FEELING OF HEAVINESS
I try to control myself that nothing will happen to me and I get scared if I fall down as I feel I am losing control on body
TELL ME MORE ABOUT UNSAFE
There is no one around you. If something goes wrong who is there to take you to the hospital.
Who will be there to protect me If I am getting this feeling my husband will try to divert my mind. He knows how to bring me back. He will say don’t worry if anything goes wrong “I am THERE”. So I know he will take care. I will be closer to husband I want to lie down in his lap and then I get a very relaxed feeling. I am tension free and relaxed when he is near to me
Hard, tightness come to me, someone has tied me up, they want more space heaviness……
21/1/2011 —I have stopped applying the cream. Mentally I am feeling a bit better now in this 15 days time I never got any fainting attacks. No significant change in the eruptions just an episode of gastric problem where I had started getting chest pain on left side.
4/3/2011 – Depression is better giddiness is better, eruptions are settling down. They are slowly reducing, gastric problem once in a while, and not very severe nervousness better.
30/5/2011 – An episode happened where her cousin committed suicide by hanging. That incident shook me up. Again I went into a bad shape but could manage myself went alone to visit the house which normally I don’t keep my cool. But fears again came up. I was getting irritated and angry with similar heaviness in the chest gastric problems came up as if something is stuck but no fainting attacks and giddiness also breast heaviness, tightness in the chest.
While taking the medicine I don’t feel nervousness. Earlier I felt like no control, feel like faint down, something got in chest and it is not coming out, I want to take off but it never came out. Hotness in hands, losing control in hands and legs also gone and was able to cope up with situation
DESCRIBE LOOSING CONTROL?
When you are fainting, you are totally losing control and you will not be able to move your hand suppose a glass is there and you would feel like you will not be able to hold that glass. Experience of stuck is like something is here which is being forced from down. (HG)
It is lot better but there is so mental stress, negative thoughts are still there but not like depression. Gastric trouble comes once a while. Feeling Numbness in hands and leg, giddiness, heaviness in head is also not there. There is little heaviness of head. In last 2-3 months no new marks have come but old marks are still there. Earlier, if new marks started coming it will take 2-3 months to settle down and it use to come all over body. Now no new marks.
Skin marks have faded but not gone completely and no new eruptions. Gastric trouble, numbness and giddiness and feeling of fainting is occasional and it more before periods. The reason for coming now is that I am not able to concentrate, it is like there are multiple things in your plate and you unable to concentrate on one thing as other things keep running into your mind and then I go into that mood not into the worst mood. Previously I use to feel suffocating and feel like run away from home or sit in a balcony where fresh air is coming and I feel like fainting. This feel was alternate days but nowadays it rarely happens once a month. If I hear something bad feel like weakness, like you are having fever for many days and then you don’t have any energy. Sometimes I am not able to bear the tension and feel like something got stuck here (HG) and then I went and sat in the balcony and that gas was stuck with vomiting sensation and with vomiting all gas came out and then felt relaxed. Majorly was suffocative feeling and after that vomiting I feel like nothing is there in my body and next day I need to take a break.
Skin has totally gone, in 3-4 months new marks have stopped coming and then it never came. It was every were except face and now only marks are left, new never came
Patient with Lichen planus and fainting attacks and giddiness. There is nervousness and things fall from her hands, she faints easily when hearing bad news, seeing blood, hearing about someone having cancer, cannot control herself , feels giddy, loses balance and faints. She has fear of dying if things happen to herself. Problems started after her pregnancy when she needed SUPPORT and didn’t get it from anyone. She felt: HOW WILL I SURVIVE? Felt Unsafe without comfort zone .
This tells about her need for SUPPORT without which she cannot survive
HAND GESTURES of hand in a round shape which was her comfort zone which she described as being in a BUBBLE, which provides her safety, protection, something covering you.
This is the source where she sees herself in a BUBBLE . we need to understand this bubble.
But at the same time, she does not want this protection as its not reliable, not trustworthy ( as she feels her husband will not be her side always) so takes a STEP BACK. She says she wants to leave the attachment and take a step back
But taking step back, she again she feels UNSAFE , as: How can I live without that support, attachment? She sees an image of a frightful child, sitting in a corner , ( V V scared with hands and legs drawn together in a box and very scared of being HIT.
So inside the bubble she feel safe but as its unreliable and there is fear of being hit, unsafe , she does not want that bubble. But then outside is more dangerous as you are alone and again unsafe.