The chief complaint in this case is an injury to the patient’s left elbow. While surfing she was hit by the board. She had some nerve damage with no feeling in the pinky finger of her left hand and some numbness and muscle atrophy in the forearm, hand and thumb. After self-treatment using complementary therapies and massages her injury seemed to have healed. Then she suffered a second injury to her left thumb, bending it backwards while lifting a heavy bag. Again, she felt it healed well. Then about 6 months ago she noticed a sudden atrophy of the muscle tissue at the base of the thumb, as if it had “collapsed” and hollowed out. She lost strength and mobility in her left hand, especially laterally and lost her range of motion and stability. However she felt no pain at all. The patient has a history of allergies and depression.
First interview September 2014
Just before the interview, Joanna begins to feel very nervous and anxious and hives break out all over her face and arms. Since this is a physical reaction that closely relates to her mental state at the moment and it is experienced acutely, we begin by asking her to describe her current physical sensations.
“I am not prepared; my skin is all itchy, I feel very vulnerable right now.”
She describes heat, redness, and itching. It turns out that she gets this reaction every 5-6 months when she is particularly stressed. It lasts for a day and goes away spontaneously. Still, she seems to be experiencing her state acutely in front of us, so we continue searching for her primary sensations.
How are you feeling right now?
“I’m being under attack. I don’t know how you escape, it’s your skin.”
“You” is a form of denial – she does not want to accept that it is about her and relates it to another person.
“There’s something violent about it and it’s coming from inside of me. Some violent energy that’s throwing me off balance. It’s unknown; there’s a mystery. “
“Something crawling, feels destructive – it’s my skin, it’s a boundary. It is threatening I think. Unpredictable.”
Here we can see interplay between her primary reactions and her mind trying to explain it. Her mind is strong and we need to keep her at the level of her senses in order to bypass her logical thinking and see her primary experience. But she also uses very peculiar words to describe this feeling – it [her skin condition] makes her feel “vulnerable”, “under attack” and she wants to “escape” because (it) is destructive”, “violent” and “threatening”. Later on she compares it to “war as if it is conquering”. These descriptions come out spontaneously and reveal the theme of an animal kingdom. It is too early in the case to make conclusions, but we will definitely keep in mind that her source could resonate with a substance from the animal kingdom.
When you feel it starting — what does it feel like?
“It is the sense that I’m being attacked from inside – it is violent. Even the act of scratching is an act of violence.”
She goes on to describe that last time she had this itching with hives it happened when she was dancing. Since we would like to break her from “thinking” about these physical sensations, we distract her by changing the topic and ask about her dancing.
“I dance the tango a lot – it keeps me sane. Once I started I was so hooked. I like music, moving. I’ve liked dancing my whole life, but this is the very first time I’ve been social. What’s not to like about it? It’s like having this conversation with another person, without words, having it with your body. But the tango, you have to do with another person – it’s intimate.”
She is making an interesting connection between music, moving and “conversation” with her body. This could be a bridge to connect to her body and her physical sensations, so we explore it.
“Like you are right in the moment. I used to surf. It’s like when you jump on the perfect wave, you respond, and all goes well. Surfing is wonderful because you’re in the water – an amazing feeling – happy, uplifting and intuitive with nature. Not thinking – in the moment. The wave can crush you, but it’s fun.”
She brings in “water” spontaneously by comparing it to music. At this point, we don’t know if surfing and riding a wave is a metaphor or resonates with her primary experience, so we need to go deeper by asking her to keep describing her experience in the water.
Surfing in the water?
“In order to catch the wave, you gain the speed of the wave. It’s intuitive. You have to intimately know the wave, what’s happening. “
She shows a strong emotional connection to the water and reveals:
“I feel comfortable in the water – the element of water makes me feel comfortable. I especially like salt water — I don’t enjoy swimming in rivers or lakes.”
Emotions are still a somewhat superficial level of experience. We need to bring her deeper into her experience by asking her to explore it through her senses.
There is something about “water” that goes beyond her feelings because she describes water as an “element” and likes especially “salty” water. The later also gives a bridge to explore her experience in the water through her sense of taste and ask her to describe “salty”. However, she does not respond; her mind is a very strong barrier at this point. Instead of describing “salty”, she says:
“You float (in salty water)… easy to swim, tastes great – the smell of sea and whatever is in it. Peaceful about the immensity and being part of that. In rivers you don’t see what’s going on – there are snakes and frogs and argh! I’m not sure you could swim well. I think there are dangers.”
We can see here that she is going back and forth between senses (taste and smell of the water) and logical connections (“I think”). Her primary experience is poking through, but her mind is like a wall and does not let her see through.
We keep asking her to describe the difference in taste between salty water and rivers, but she keeps telling us stories about her childhood near the sea coast, until she says something peculiar:
“There’s a different scent – a bitterness; the ocean is almost metallic, maybe less sweet.”
She is finally talking “nonsense” which means that we managed to bypass her logical mind and have a better chance to explore her senses and get to her source experience:
What is bitter like as a taste?
“Broccoli rabe, radicchio – it’s not something I don’t want to experience. Someone brought me radicchio from their garden and it was delicious.”
The taste does not take us anywhere – her mind is too strong and protects her unconsciousness.
When we asked her about “smell” she gave us a peculiar aversion:
“The smell of milk – yuk – something that makes you vomit. If you give me hot milk and tell me to smell it, I would rather not. The texture is oily – the idea of drinking a glass of milk fills me with horror.”
She is using gestures and sounds to describe her aversion, but not an actual experiential description; still everything is very logical. Then, she brings out spontaneously another aversion:
“You know what hopped in my mind and is related to my skin? It’s milk and peeling tomatoes… [she uses gestures and facial grimacing]. It makes my skin crawl – like goose bumps all over my skin. The separating of the skin from the rest of the tomato [grimaces].”
“That separation of skin from the meat – it’s like how people feel about heights or water. That moment of separation – because the skin is so shiny and underneath it’s like peeling it off from something that’s attached.”
Here, she is “getting close to the wall” as Divya Chhabra says, and we can hear strange descriptions such as “the skin is shiny” and “peeling it off from something attached”.
We continue asking her to describe peeling tomatoes, but she snaps out of it and starts telling us a story about her friend teasing her about peeling tomatoes.
To keep her close to the source, we ask about her fears:
“I don’t like small spaces – I’m slightly claustrophobic.”
What would that feeling be like?
“Constricted – tight, suffocating, something is on top of me. Just being in that little space— suffocated not enough air, not having a view beyond the walls, they’re so close to me. I would feel like a panini in that machine, pressed. A sense of pressure.”
“Not being able to move. Almost tied or something. Not having freedom to move. Just really that fear of being squished.”
Squished and pressed?
“Not survive, deformed, damaged, not able to breathe. Feels like danger.”
“I can’t expand. It almost feels like — when things start pressing, I’m afraid I won’t be able to escape.”
“Not fond of heights, but I love flying in the airplane. I am never afraid of flying, because you’re in that shell.”
This is very peculiar – she is uncomfortable in narrow spaces and not fond of heights, yet she loves flying. The interesting part here is that she sees the plane as a protective “shell.” This word “shell” may be relating to her source.
So far in the interview, Janna clearly experiences the world as “danger”, “attack”, “threatening”. She needs to feel safe, comfortable and able to escape. Having a “shell” gives her a sense of safety.
When we asked her about her physical complaints, she used similar descriptions to describe the lack of sensation in her finger, lack of muscle movement and depression:
“Not being able to move, being too heavy to move, not having energy to move. Paralyzed, like Panini image – there’s something outside squishing me and I don’t have energy, I don’t have the ability to run away to save myself if someone attacks me. I can’t react. I need my body to relate to surroundings. I need my senses, my body to figure out things, what to eat, how to escape the animals. It’s very primal, it feels close to survival. Like I live in a cave or something and those are the things I’m dealing with. I can’t survive. “
Here, Joanna is describing the feeling of depression; yet, she talks about the need to “escape the animals”. This is the kind of “nonsense talk” that indicates her being closer to her source.
Feeling of being drained?
“Heaviness of the limbs. Simply cannot move, heaviness, complete disconnect with my body. This is scary for me – I relate to my environment by doing things with my body.”
We kept asking her to describe the experience of being “heavy”, “drained”, “paralyzed”, but she moves away from the nonsense talk and back to her logical mind. So, we change the topic to dreams. She shares two dreams – a recent one and a recurrent dream from her childhood. Both dreams revealed the theme of water again.
“There was a big body of water, and I was this creature in the depths of the water, moving that way and covering a lot of space. I was moving and all these things were coming out of me. I was moving in a swift, skillful way, avoiding things rushing toward me, like clusters of stuff, and objects and danger. There were things floating and rushing in the opposite direction in the depths of the water. I don’t want to be hit with the clusters. Not floating, but rushing in opposite directions like being in traffic and things are coming toward you. I was going somewhere, I was on a mission. Swimming toward safety.“
Interestingly, she associates herself in this dream as a “creature in the depth of the water”. There is also the element of “moving” in the water. Previously, she describes her state of being “drained” and depressed as “not being able to move”. In this dream, she is able to move and this helps her to avoid danger. Could it be that her source is a creature in the depths of the water (salty water, big body of water) and that moving and avoiding danger is essential for its survival?
She has been having the recurrent dream since childhood – and always when she had a fever.
“They were about things that were becoming small and small, or large and large. Those were true panic attacks. I would always see little dots, little dots. Movement of little dots that get smaller and smaller and smaller, and at one point I couldn’t stand the smallness of it. And the opposite, the larger, I couldn’t stand the enormity of it.”
It is very peculiar that “small dots” could be perceived as a “nightmare”. She keeps using repetitions, which gives these “dots” significance. Further, she says that “the process of something becoming small and the process of something becoming large is what freaks me out.”
But what is this process and does it have any connection to the “creature in the water”? We cannot speculate about this; her source can be any sea creature. Instead, we need her to keep describing it to us. She is almost in a trance-state, and her logical mind seems to allow irrational talk when describing dreams. After all, dreams can easily be perceived as irrational.
Yet, she did not go any further. Her mind, being on a guard, took over and she switched to:
“I often have beautiful dreams about water – romantic landscapes, I wish they lasted longer.“
So, we decide to use word association as a tool to break the logical connections that her conscious mind is using so effectively to protect her from revealing her unconsciousness.
We ask her to describe an image that spontaneously appears to her on hearing the word “blue”. She associates it with sky and water (not a surprise!), but then she moves to “rocks, sticking out of the water; the bottom of the water:
“Algae, and grass that move nicely in the water. Not a sand bottom, a rocky bottom. Urchins. Little fish. I’m in it. Immersed in it. Fish are silvery blue, scattered. Little groups moving around. Very beautifully, fast, stop and move. Larger rocks – white and grey, part in the water, part outside. I can walk on them, climb them.”
She had her eyes closed (without being asked) and seemed to be completely immersed in the experience she is describing.
Notice that she uses “I am in it, immersed in it” when she describes this image in detail, which tells us that she resonates with water.
Then she associates “heavy” with the following image:
“I see cement, rocks on the coast; with the cement and rocks and beach. You can bring your towel and lie down and sun bathe. Heaviness feels right and comfortable, feels good to rest on it. It’s there supporting me, safe.“
“Heaviness feels right” is very odd, because she complains that she “feels heavy” when depressed and exhausted and previously she described it as very uncomfortable feeling. So, we keep asking her to describe the image.
“Some sort of – soil, if I put my towel down and there are bugs underneath, crawling. (this is her logical mind trying to stay in control). Even sand – it would feel like I’m sinking in. Like I’m not being supported. It, the water, a wave, can come and take a layer of the sand away. Have to be cautious, alert.”
Notice that she is no longer using complete sentences. Her speech is broken, her voice very low, as if she is at some “altered state”.
She keeps saying that lying on the sand is not safe, while lying on the rock is “supportive, enjoying the warmth coming through the stone”. It is clear that this is a very illogical description – usually, we feel more comfortable to lie on sand than on a rock!
The next word association offering is “small” and that takes her back to the “dots” in her dream, which become “smaller and smaller” and then “larger and larger”, but this time she described the dots as:
“like tapioca but much smaller – small and many of them, something slippery and fluid rather than a chunk of something. They’re tight and touching. Perfect, round balls, maybe see-through, stuck together, connected together, touching. Not random, floating in space, grouped together. Smaller and smaller, closer and closer. As they get smaller, they cluster. They’re becoming smaller and further apart, but still in the same grouping. That’s what unsettling, there’s always movement. Because it’s so small I can observe it precisely.”
Now she is “observing” instead of “thinking” – this description is coming from her unconscious and it is a source description. The “dots” that she sees in her childhood dreams fit the description of fish eggs.
We use another of her previous words for a word association question:
What do you see when I say, “Expand”?
“Stretched out fabric, like animal skin that’s stretched out. Frame, pulled inside the frame and pulled in different directions to be tight. And thin like the balloon that’s getting thinner as its stretched white. Wooden frame like a tennis racquet but it’s huge . . I feel my head resting on a pillow.”
This is completely irrational talk from the patient. But then, her logical mind comes back and takes control, not allowing her unconsciousness to completely reveal the source of the remedy. At the end of this interview, it is clear that her source is a “creature in the depths of water moving toward safety” and based on her description of the “dots”, it seems that it is a type of fish. Then, her descriptions of “being pressurized like in a panini” and the last description of “stretched out fabric like animal skin stretched out” along with “lying on a rock is comfortable and supporting”, while “laying on a sand is uncomfortable”, because “something can come and wash it away” led us to choose stingray as a remedy- largely because of a sting ray’s way of burying under a layer of sand for sleep and protection, and the image of being stretched out like a fabric, like an animal skin. Her use of “you” throughout the interview indicated strong denial, so we choose 1M of this remedy.
She took four doses of Urolophus Halleri, 1M (round stingray) during the next four months with very minimal effect on her chief complaints. However, during this period of time, her focus shifted from the numbness in her hand to her state of being depressed and extremely tired. Also, her logical mind seemed to weaken, and she was more in connection with her body and her intuitive feelings. These subtle changes turned out to be quite significant during the second interview, when she was able to jump into the experience of the source of the remedy she needed. She was almost unprompted by us and gave us a clear description of the source.
It is important to mention that sometimes when a patient gets close but does not fully reveal the remedy during the first interview, we give the best indicated remedy anyway. That remedy which is close, but not correct, will likely affect the patient enough to make them better able to fully reveal the exact source during the 2nd intake.
Second interview December 2014:
When Janna came in for her second interview, her primary complaint was extreme tiredness, which she describes as being “drugged, withdrawn, inside a fogginess” and said her thumb was “collapsing and disappearing”.
We noticed that unlike the last interview, she is not theorizing and her logical mind has lowered its guard, allowing her to describe her primary feelings unedited by her logical mind. She uses phrases instead of whole sentences and keeps describing images without us prompting her.
“Fallen apart. Collapsing into dust. In the nature, soil – reddish, but not too red, fine, grainy, dryness, staying on the skin, slips on the hand, doesn’t fall off. If it’s moist, it sticks – dirty – something foreign – sticky, stains, molded, make it into shape, parts of it that stay on the skin – shape of it – irregular shape…maybe paler and surrounded of that matter, soil…not even, like looking in a marble…”
Here, Janna is describing her feeling of tiredness as “collapsing” and further she is describing something using her senses; she sees color and shape, and feels the texture as if it is between her fingers. All this sensual description indicates that she is at an experiential level. She does it spontaneously and we need to keep her at this level by asking her to “experience it” using her senses.
“Dry, earth color, soil, reddish – if in the pile- heavy, if little it gets blown…needs protection…”
“Needs protection” is a thought and it means that she is slipping away from experiential descriptions. In order to keep her there, we bring her back to describe her “tiredness” and the “fog”.
“Intoxicating, but comfortable”, (this is a contradiction), can’t move or lie down…heaviness, no pain or dizziness…heaviness and slowness…”
The need to “move” was one of the main themes in the first interview. Heaviness comes back again, so we explore it:
“Not being able to move fast through space…capacity of being active in the world is being diminished. Slowness. Pulled back, chained, stranded. Something else in my body. Foreign element, not me.”
“Connected with heaviness and cannot go fast. Intoxicated. Slower, it takes me longer to finish a project, physically, mentally I’m changed. It’s invading me because I am watching this happen. I see the change, the reactions, the movements, the need to sleep so much.”
This thread of thoughts is all logical mind. She is slipping away from the experience of “heaviness”, so we go back to the word that brought her to heaviness:
“Invading my body to be numb and slow. Fog entering me.”
Numbness” in her hand is her chief physical complaint. Now, she describes her tiredness as “numb”. We cannot ask “numb”; instead we need a “stepping stone” so that she go to her source spontaneously.
What is invading your body?
“Toxin, foreign and I can’t fight it. It is stronger than me. Not solid, like a vapor, mist, fog, sort of energy that is making my body feel different.”
These are thoughts, so we ask her again to describe it:
Tell us what you see?
“Finer than a fog, it’s energy…almost like a metallic image…Oh! When I was on Shelter Island there were these animals that look like huge crabs and big and black…looks like an alien, prehistoric, a shell – a round shape and I guess legs, on the beach, they get washed out, very black, I want to see them as metallic, but they are not… they are prehistoric like bugs with a hard shield…have a tail on the back, pointy…black, hard on the outside, grounded, has the tail and does not move, they are washed out on the beach and does not move…some sort of a crab…freakish, like inspiration for aliens in movies… made of metal… very old, do not belong to this time and age…couldn’t move, just stay there and dry up, cannot go back to the water…
Wow – I haven’t thought of or seen that animal in 15 years!”
This is a leap to a wonderful place where she describes the source of the remedy. She begins by experiencing her tiredness as “being intoxicated” and a “fog”, which is “heavy” and “unable to move”, “numbness” (her chief complaint), a “toxin”, which becomes “an energy”, “invading her”. Then she leaps from the “fog” to a “metallic shield”, which then becomes a “huge crab”, which she can describe in detail. (note: She never said horseshoe crab- she didn’t know the name of this creature until she asked us later on, as English is her second language).
Janna entered this experience spontaneously. She appeared to be in an almost trance-like state – her eyes closed, her voice very soft and low, her speech broken into phrases and words. More importantly, her description is entirely experiential – she describes shapes, colors, texture.
At that point we knew that she was describing “her source” and we kept asking her to describe more so that we can have a better confirmation.
Tell us more about what you are feeling right now?
“Primal feeling, almost like a survival thing. If you cannot do things and protect yourself…I keep thinking about a cave now…it’s so primal. It’s a survival issue…”
The cave comes back and so is the primary survival instinct, which she kept referring to during the first interview.
A puzzle for us was her “nightmare” as a child of “dots getting smaller and bigger”, so now we ask her about her fears again.
“Nightmares that were frightful – little dots that would become small and large. Very scary, can’t handle it. They are so small that they disappear. Not under attack, but overwhelming. Overwhelming to follow them, endless on both sides. Smaller and smaller particles so I would get lost and disappear there. Losing the stability of the mind…(good, her logical mind is silent and she is irrational) Not flat, 3-dimensional, bubbling. Now the big ones are becoming smaller, but new ones have been produced and becoming smaller, it’s this path, and at this end is this one dot; there are not transforming, but more of them have been born or produced…(so “process” that she was telling us about before is now “born and produced”). Same with the big once. Smaller ones are there and the bigger ones are growing…growth and progression and movement into space…Follow it and they become more and more and smaller. On the other side are the larger ones – connected, observing the same process, I am sort of immersed in it, I am definitely part of it. (yes, she is completely immersed in experiencing her source). I would be surrounded by them, I am part of that process, not just observer. I was part of that process either becoming smaller or bigger. I was trapped, no way to go. (she is changing tenses – I am, I was; another sign that none of this is coming from her conscious mind). I am thinking of a caviar, but solid, but not firm, not going to bounce, not solid, but reminding me of the fish egg and caviar. That’s something that grows. Opalescent color, very pale, not distinguishable color, not solid, yet solid. There is solidity to it, because they have consistent perfect shape and they have movements, but than they are too ethereal, subtle and light. Doesn’t have a skin. Something inside…like if they are made of fog and closed in it…”
In her first interview, she described it as “tapioca” and we suspected that she was describing “fish eggs”. This time, she spontaneously arrives at caviar or fish eggs and describes this image in detail as if she is “immersed” in it. Horseshoe crabs produce “caviar” similar to the caviar of sturgeon.
We chose Limulus cyclops (horseshoe crab) for her. It fits the theme of water and the desire to move in order to escape. It explains the feeling of being pressurized and constricted. Horseshoe crabs are “creatures of the water”, but come to shore, which explains her descriptions of dust, soil, sand, etc. as well as her talk about dryness. The images of the horseshoe crab’s eggs match the detailed description of the “dots” which she sees in her dreams and the process of them being “born or produced”.
We started with 1M potency of Limulus cyclops. After the first dose, Janna had a sudden flare up of her stress induced hives and itching which was strong and lasted several hours. Then, the rash and heat subsided never to return again. During the first three months of taking the 1M dose, her energy dramatically increased and her spells of tiredness diminished. There was still no improvement in her finger’s insensitivity and muscle numbness. Her state of feeling exhausted kept coming back, though, so we increased the potency to 10M of the same remedy. (10M because she had so strongly described the experience of her source).
She has been on a 10M of Limulus cyclops for almost a year now and her recovery has been remarkable. At the beginning, she needed to take her remedy every 3 or 4 weeks. Her energy level shifted from being completely drained and exhausted to maintaining daily activities. She reports that her mind is clear and her perceptions of herself in the world changed from “danger” and “being attacked” and “primal survival” to “less resistance”, “taking it one day at a time”. Her nervousness greatly diminished and she recognizes herself as more relaxed and trustful. The insensibility in the finger and the muscle numbness took longer to change. Interestingly, the first thing that changed was her perception of the muscle atrophy – it went from being a primary concern of Janna’s to her tendency to downplay it and even forget about it. Another interesting observation was that during the first couple of months of her 10M dose, her right hand began to mirror similar sensations to the left damaged hand; sensations she had felt just before she lost sensation in the left finger. She felt a “phantom” pain followed by numbness and loss of sensation in the right thumb. Several weeks later, these sensations started to clear off in the reverse order of their appearance. Then, after some time, the sensibility in the left hand (the damaged hand) was restoring itself.
Going through this experiential process of case taking not only helped us to select an amazing remedy for her, but also enabled her to learn more about herself, as can be seen in her follow up comments below. At NYSH we are taught by Susan Sonz that homeopathy profoundly changes how we see ourselves in the world. This case perfectly demonstrates that profound change in Janna.
Her comments during the followup March 2015:
“Twice there was a return of my symptoms and after the water dose it disappeared. It’s exciting. It was just lifted. It was really instant.
And also, there’s a kind of an awareness of seeing things and myself in the world- an understanding, a shift in awareness, I’m also painting differently, more minimal, tiny little brushes but the change is big. I used to be abstract and bold and expressionistic. This homeopathy stuff makes one think differently. I saw the Cloisters differently yesterday, it wasn’t flat, I think it’s the homeopathy!”
Her comments during the follow up June 2015, when she came in complaining about her other thumb:
Can you describe the feeling in your right thumb?
“Starts as tiny little thing in the small joint and then it’s spreading- feels familiar, deja vu.
Like a fog or smoke spreading and taking over.
Starts as a constriction. Limitation.
I compare it with this left one which is now normal- oh, I don’t mean normal, but it’s normal. (The atrophy remains.)
This other thumb thing started to be just in the morning. A clicking.
Now I’m just observing how far it will go.”
What do you mean?
“The numbness in the left hand is gone, so this will go too. When you remind me of the heavy body I used to have, I realize the right thumb feels that way but my body now feels fine. And so does my left arm and thumb. Now I don’t think I’m much different from anybody else. This left arm feels completely normal!”
Currently, she continues to take the remedy occasionally in 10M when she begins to feel what she calls “heaviness” or “nervousness”. She continues to do very well, more than one year later.