An Adult Case of Depersonalization and Derealization Associated with Depression

“The illiterate of the 21st century will not be those who cannot read and write, but those who cannot learn, unlearn, and relearn.” – Alvin Toffler

Always in motion is the future – Master Yoda (Star Wars)

Treating Learning Disorders and Psychiatric cases:

Both these cases are part of a series of workshops conducted at the Vancouver Homeopathic Academy. They were seen as live cases as a part of the workshops under the titles- Autism and Learning Disorders as one title, and Role of Homeopathy in Psychiatric cases. The cases are being followed by local homeopaths under my long distance supervision and mentorship.

An Adult Case of Depersonalization and Derealization Associated with Depression

Case # 2

Depersonalization is a change of self-awareness such that the person feels unreal, detached from his own experience and unable to feel emotion. Derealization is a similar change in relation to the environment, such that objects appear unreal and people appear as lifeless, two-dimensional ‘cardboard’ figures. Despite the complaint of inability to feel emotion, both depersonalization and derealization are described as highly unpleasant experiences.

These central features are often accompanied by other morbid experiences. There is some disagreement as to whether these other experiences are part of depersonalization and derealization, or separate symptoms since they do not occur in every case. These accompanying features include changes in the experience of time, changes in the body image such as a feeling that a limb has altered in size or shape, and occasionally a feeling of being outside one’s own body and observing one’s own actions, often from above.

Because patients find it difficult to describe the feelings of depersonalization and derealization, they often resort to metaphor and this can lead to confusion between depersonalization and delusional ideas. For example, a patient may say that he feels ‘as if part of my brain had stopped working’, or ‘as if the people I meet are lifeless creatures’. Such statements should be explored carefully to distinguish depersonalization and derealization from delusional beliefs that the brain is no longer working or that people have really changed. Sometimes it is difficult to make the distinction.

Depersonalization and derealization are experienced quite commonly as transient phenomena by healthy adults and children, especially when tired. The symptoms have been reported after sleep deprivation and sensory deprivation, and as an effect of hallucinogenic drugs.

The symptoms occur in generalized and phobic anxiety disorders, depressive disorders, schizophrenia, and temporal lobe epilepsy, as well as in the rare depersonalization disorder.

Case: (Now that the case taking technique has been elaborated upon in great details, with regards to case1, let us approach case 2 without any interruption or comments)

D: We have a set of seminars with different topics. The topic of today’s seminar is anxiety and depression. We are here to see how homeopathy can assist you with this problem and how we come to a remedy to find a solution for your problem.

Let us start with sense of direction. I think that is why you came late. What is the thing with the sense of direction? ( He had come late for his appointment and was very apologetic for the same.)

P: My sense of direction isn’t very good. If I vigorously don’t plan, I seem to get kind of lost. Sometimes even if I do plan it. If I’m driving on some road and I remember some similar name road, I get curious to see if it connects up. But it doesn’t, since it is miles and miles away and I end up getting lost.

D: So the curiosity is also there?

P: Sure, but it gets frustrating as I run little behind. I have fairly good concentration, but when it comes to the directions, I can’t keep them (HG where he points to his head)

D: So what did you mean by this when you said you can’t keep directions and you pointed to your head. Talk about this more?

P: Just the idea that sometimes you remember things and are not sure exactly why you remember things? But I don’t know why the directions do not seem to fix in my brain? They go in through one ear and out through the other, I suppose…

D: Can you spend some more time with this when you say they go in through one ear and out the other. Tell me what you mean?

P: It is, am I able to fully concentrate on directions or do I get bored with having to listen to them and don’t pay full attention to them. It may be that I have selective hearing and I set up myself for direction misadventures!

D: Does this selective hearing come up in other areas also?

P: Not too sure. Haven’t really thought about that…

D: Has it been an issue in earlier years like in academics, relationship and things like that?

P: I did pretty well in school. Hope I do well in listening to my wife! Can’t think of anything special except for directions.

D: Since when are you married?

P: Three years

D: Do you have children?

P: No, but we have lots of animals! They are like our babies.

D: What kind of animals do you have?

P: My wife and I have three horses, two dogs and two cats.

D: Where do you keep the horses?

P: We tried keeping them with us but it didn’t suit us. As my wife is a horse trainer, she had better facilities to keep them elsewhere.

D: What kind of training does she give?

P: She teaches people how to ride horses and prepares them for athletic events like horse races and all kinds of things to do with horses.

D: I see you are a teacher. What do you teach?

P: I take ESL. It is basically an introductory teaching training course.

D: What does ESL stand for?

P: English as a second language

D: Have you both decided not to have children of your own?

P: I haven’t planned anything yet. I definitely want children.

My wife said she wants one too. When we got married, we were not in a financial position to have children and even after three years, we are not in a financial position to have them as yet. It is there, at the back of my mind, that I’m getting older and I need to have children.

D: Do you miss the presence of a child in your family?

P: Yes, I think so, but right now I’m too busy. But if we had a child, I would definitely have made the time.

D: Coming back to direction, anything more you want to say related to that?

P: Not about physical direction. But sometimes I think my life direction is not necessarily going forward. Sometimes, it feels like a lot of side tracking.

D: Can you say more about the side tracking?

P: I had plans to do many things but they never really came about. Due to lack of money and time, these kind of keep spiraling around in this (HG). When I did ESL, I did it because I needed a job immediately, but my goal was to be in the public school system. But I never had the time and money to go back to the university to finish that up. So I feel I’m kind of stuck in that ESL. I really like it. It’s not a bad thing, but it is little disappointing not to have that opportunity to go to university any more.

D: Why is that opportunity not there?

P: I don’t have funds available. If I have to do that, I will probably have to be off work for an entire year. I don’t know how to pay the bills, if I have to do that. It just doesn’t seem practical.

D: Can you focus on this gesture which you just did? You said spiraling around (HG). Just talk about it and keep doing this gesture that you just did while talking about it. What is the sensation going on within, when you do this?

P: Spiraling definitely makes me think of my head. Lot of mental anxiety. It feels spiraling and kind of pins down exactly what I’m thinking. All I know is that it is a kind of a sense of unease in my head.

D: talk about it some more?

P: I’m having this issue for the past few years and have got the realization that I’m stuck in this mental state. I had a really bad panic attack. When I think of the panic attack, I feel this separation from my body (HG). It is almost that I feel that everything is getting far, far away. And that is what the heightened sensation of the fear is like. When I had this panic attack, I never came back down. So for the past few years, I feel kind of stuck in this situation of feeling distant from myself and from reality (HG).

So I feel I’m kind of spiraling (HG)..it is spiraling.

D: Can you talk of this experience of spiraling away from you for some time?

P: I think of the Fibonacci sequence…very interesting mathematical sequence (HG). I think a spiral is an interesting shape but I think, may be its too scary (HG).

In 3D, maybe it spirals down to something …to a point that in future…..that gives negative quality to the spiral.

D: What do you mean?

P: Like if you have a spider in your house and you put it in the flush, at first the spider is going to float but eventually the water is going to suck it and that happens in a kind of a spiral motion (HG).

It is kind of stuck in the water and eventually sucked down to something.

D: What is happening to the spider…just talk about it some more?

P: The spider is trying to come up, but the water is too strong (HG). It pulls it down and you see it floating and you feel bad for that. And then water flushes it down.

D: You are doing very well. Just talk of that interesting spiral shape and how is it scary and how does it have negative qualities to it?

P: It’s kind of mysterious, like the spiral galaxy. It has a function of movement but it is movement that has no progress. I think its purpose is to drop things down and create a downward suction (HG). I think that is the purpose of the spiral. When I think of a spiral, I think of a tornado. Some kind of a pull in water….some kind of a suctioning force.

D: Talk of that suctioning force?

P: I think it is the suctioning force coming down. Whatever is up is kind of trapped by the suctioning force. What is interesting is what is causing this spiral. I think tornadoes are not well understood. I think they are meteorologically understood and can’t be predicted too well. What creates this downward suction is kind of a mystery sometimes. Seems to kind of appear and disappear.

D: What kind of a suctioning force would it be in water?

P: Whirlpool in the ocean or something like that…Metaphorically, I’m thinking it dissipates after it sucks something down.

D: Besides the word ‘sucked’, you used the word ‘trapped’. Can you visualize something which makes use of suctioning force to trap something in water

P: There are forces so strong that there is something which tries to escape but cant. The harder you fight, the longer it takes to go down but you can’t actually escape the pull (HG)

D: Is there any unique substance in nature that can create this kind of suction or trapped feeling?

P: I don’t know. I don’t think of it as organic phenomenon. Elemental may be…

D: Anything more about directionless?

P: Frustrated. It is just a little thing but it is ultimately the little things that make you angry. I think it is the thing that I know better and I know the place where I’m going, but ultimately I come into a situation where I don’t know. So it is kind of frustrating.

D: Is it directionless or that one is stuck and not going forward? What do you relate to more?

P: Maybe stuck…

D: Can you talk of this experience of ‘stuck’..little bit more?

P: I’m kind of used to that. I like to have that freedom. Even if I’m not using the car, I like to know it is there. It is frustrating because you really want to go get something but you can’t.

D: What is the experience and sensation which is beyond that frustration?

P: It causes all anxiety feelings and recently leads to headaches (forehead region) and a trapped feeling (points to sternum) and acid reflux. So if I get anxious and frustrated, I feel stuck and a tingling sensation here and some pressure over the forehead.

D: What is that pressure like? Can you talk about it some more? Is it in the forehead or does it go to the temples? ( As he was taking his hand from the forehead close to the temples)

P: It does not go to the temples. It is more in the side of the head (HG) and sometimes it goes to the jaws. I clench my teeth badly at night. Although I use a mouth guard, I bite through it n that is why it pains up here.

D: Are you conscious that you clench your teeth?

P: No, I’m not conscious but the dentist told me. It must be happening since last year that my jaw keeps popping in and out. And that gets painful too.

D: What happens exactly and when and how does it happen?

P: Right now, if I move my mouth to the left, I feel a kind of a twitch in the mandible or I feel stuck and it is almost a compulsion that I have to even it out. I just move my lower jaw to put it back in. It is kind of a compulsive habit. I have a few nervous tics.

D: Can you name some?

P: I kind of move my nose like this as this cartilage gets uncomfortable, so I sniff to move it around.

D: What is the sensation that makes you do that?

P: it is not painful, but it just feels a little strange. It feels a little out of place, so I put it back.

D: Is it the same with the jaw that you feel it is out of place and you put it back?

P: Yes

D: Is there any other anatomical part, in which you also feel it is out of place and you do the same thing to put it back?

P: My ankle and elbow. I just move it when it is not sitting right and crack it

D: In what way is it not sitting right?

P: I am not sure…

D: Do you grind your teeth in sleep?

P: Yes my wife says so.

D: Do you do it in the day also?

P: Yes, it is not so much that I’m grinding my teeth, but I feel my jaw is tight.

Like it can’t set. So sometimes I relax, and it drops down more.

D: What is the feeling in the jaw during the day?

P: It is that sometimes I recognize that I’m tensed. And what I do is I relax. When I’m tensed, I hold my jaw more and I release and drop it down. I feel it can move down little bit, here.

D: Just before, the release, what is it like?

P: Just tension.

D: Can you experience that tension as a sensation for me a bit more?

P: Little bit burning, it is suddenly painful, as much as it is kind of there.

D: When you say burning, is there any element of heat to it?

P: Yes, I want to say burning but not exactly hot. It doesn’t make any sense…

D: Explain that?

P: It may be an arthritic kind of thing. It is tight over there. I just used the sensation- burning, but it does not have the heat quality.

D: In what way is something tight there?

P: It feels that the ligament is tight, and I just want to relax it.

D: Go further with ‘tight’… it’s as if?….Visualize something away from you, which may be as tight?

P: I can remember those stress yellow balls. When some one squeezes it (HG). That is what it feels, kind of tight. There is pressure. It is not allowed to fully expand.

D: Just stay with the stress ball… it is not allowed to fully expand. Then what happens?

P: Nothing will happen to the stress ball. So you must continue to hold it. (HG)

D: And then?

D: The ball slowly releases (HG)

D: How slowly?

P: It is slowly like that foam coming up.

D: What image comes to your mind, when you talk of that?

P: It is just the material of the foam, slowly coming back to its original shape.

D: Can you imagine that squeezing a bit more? What kind of a squeeze is it?

P: It is kind of an aggressive squeeze. Like when you squeeze the stress ball.

D: When would one need to do such an aggressive squeeze?

P: Maybe it is a kind of self defense or something. Squeeze the pressure point (HG)

D: Say more?

P: When it grips over here, the squeeze is kind of painful.

D: Have you learnt any self defense?

P: Yes a little bit

D: What form?

P: It is a kind of mixed martial art form that I started a few months ago.

D: Are you enjoying that?

P: Ya sure

D: Why did you feel the need to do it?

P: I wanted some physical and mental exertion.

D: You feel it satisfies both?

P: Very well and I would like to do it some more, but I don’t have time.

D: Apart from doing it as a self defense, when else do you need to use that ‘squeeze’ as a normal function?

P: Maybe when you are standing in the bus and you have to hold on with a tight grip (HG)

D: Where else do you find yourself holding on like that?

P: Gripping…………..walking the dog, gripping the leash.

Can’t think where I’m, holding that aggressively any where else…

D: Do you want to say anything else?

P: It is a very unpleasant experience. I just feel very disconnected. I think it will take quite a while to find something that will make me feel connected. Nothing has really worked.

D: what do you mean by disconnected?

P: It seems more of a visual thing. Like my visual perception has changed.

D: So what is the perception now?

P: You seem further away than you ought to be…

D: In what way do I seem further away? Talk about it a bit more?

P: It is kind of a distance thing. I can judge you are five feet away from me. There is a kind of layer growing on (HG). That is what I can see, and then there is this back drop. In this back drop, you are further away. You are more moved away from reality.

D: What is that layer, which is there in between?

P: I don’t know. I have tried to describe it to people, but they don’t understand. It can be like a bubble as I said before…

D: You have not used that word before? What do you mean by a ‘bubble’?

P: When you try to burst a bubble, there is a kind of filmy coating. I feel I’m kind of behind that film. (HG) Kind of suddenly distorted by that bubble

D: Imagine that bubble right now… feel it, view it. What does it look like, the texture, the feel, the color?

P: I imagine it to have the quality that the bubble has, and it takes the color of the surroundings.

It is invisible. But when light comes through, I can see lot of different colors through it. It takes the color of what’s coming in. I can see that it has a double outline.

D: Talk more about this bubble?

P: That bubble is a layer. It is difficult to say more…

D: You are doing well. Describe more. Expand on the words you have already used. Elaborate some more.

P: I’m not sure if it is in my eye or it is beyond…cannot pin that down. Sometimes I feel it is in this part of my head (points to the glabella region). Sometimes, I feel my eyes can’t see or there is a problem in my eyes and brain communicating. According to the ophthalmologist, my eyes are fine. So it has to be with my eyes communicating with my brain.

D: Just imagine, what it would be like, looking at life as if through a bubble?

P: Very unsettled. I’m at a better place than what I was 1 ½ yr ago. Then I was in a very bad state for quite a while, with this constant anxiety and panic attacks along with this bubble sensation. It never goes away. I used to go to sleep, hoping that it would be gone, but it never goes away.

D: Was there any particular reason, when it was there one and a half year ago?

P: I think it was the onset, the beginning which was more overwhelming.

D: So it is important to examine that time. What was it like then?

P: It was terrible. I thought I was going crazy. I went to other doctors. My eyes were alright but I was not seeing right. The psychiatrist gave me anti-anxiety medications, but it didn’t help me with this particular thing. I didn’t feel like killing myself, but when it was so overpowering, and I felt distant from reality, I was hoping that I don’t have to wake up from sleep.

D: Did you feel this particular thing, ever before in life?

P: Ya, after I had my first panic, attack, which was 7-8 years ago. I twisted my neck, while, trying to look at something behind, while I was driving. I felt weak in my back. I had an anxiety response. I had this huge surge of trembling, I felt cold. I was in panic. My first logic was that I may have pinched something in my neck. I had to go to the hospital. I have this bubble feeling ever since.

D: In what stage of life were you eight years ago?

P: I was in my last year of university. My wife had just come to live with me. My state of life was pretty good. We were moving to our new house. I had finished school. I had lots of friends.

D: Anything more you wish to say, pertaining to yourself?

P: I have some assertiveness issues with setting boundaries, pertaining to myself.

D: Please describe that?

P: My wife always tells me that the dog doesn’t respect me and the horse doesn’t respect me, and that my dad doesn’t respect me. So I have come to the conclusion that people and creatures don’t respect me.

D: Your wife tells you this or do you feel it yourself?

P: I feel it too… my wife has just bought my attention to it. Respect to me has always been the hot bun word. It never meant anything to me. But my life philosophy has been simple. Treat everyone the same. Be nice to people. My theory was, if you want respect you have to do something so that you can get it. But the rest of the world doesn’t function that way. They say in the world, one has to earn respect. I never bought that. It seemed counter intuitive to me that, why do you have to earn respect, if it is very basic to all humans?

D: So coming back to this respect issue, what seems to be the problem?

P: The obvious weakness is an inability to assert myself.

D: Say more?

P: I can assert if I want to, but there is an inability to keep that and stick to it. I can set the boundary, but if someone knocks it over, I allow it. That is a bigger problem. It is too easy to forgive perhaps, or I have difficulty in reinforcing that boundary. Children see me as having lots of fun. I love kids. I love playing with them. But, when it comes to listening, it becomes a problem.

D: You feel they don’t listen to you?

P: They do listen. We have a more friendly relation, rather than a teacher-student relation. I don’t think, anyone will be afraid to come in to the class, if they have not done their homework. Because they know that I’m not going to yell at them or discipline them. I have tried. I have spoken to their parents. I have made them write lines. But it never seems to dissuade them. I like it. But I think the students play to my strength.

D: What do you mean when you say, play to your strength?

P: I’m not the teacher who is going to command respect, and the students are going to work hard for that. I need to play to my strength, and to make them learn.

D: Is it not a fun game to learn?

P: Ya, but sometimes it gets frustrating, to not to have the other tool kit, when you need it!

D: What is the other to tool kit?

P: More in the discipline area. People don’t listen to me. They don’t take me seriously. Maybe because I joke or laugh around? That’s why they think I’m not serious. I sometimes have to scream to get my point.

D: You said about your dad too?

P: Ya but that’s fine, because it is not his job to respect his son.

D: What kind of relation do you share with your father?

P: My relation is ok. It’s not great. He is kind of a strange guy. Very much a loner. Even during vacations, spending time with my dad wasn’t normal son-dad thing. He doesn’t, like sports. He doesn’t like to view the TV shows that I like to view. He is kind of strange. He does not have a lot of interests. Spending time with him is out of choice. We would go shopping. He would not let me push the cart. If I would hold it from behind, he would hold it from front. As if I’m going to run it into something! I’m like- ‘Dad, I’m a grown man. I can push the cart’. He doesn’t trust me. He is a strange fellow.

D: Why else do you feel that he doesn’t trust you?

P: My parents were divorced. I only got to see him in the summers. It was fun. When I went back home, I used to be upset. When I grew up, I got an opportunity to see him more. But I think he was not interested. Like he has never once came to see me on his own. I always have to go to see him. It is very frustrating.

D: How is your relation with your mom?

P: I think it is very good. She is one person whom I call and talk to, on a regular basis, about problems and personal things. She is nice to me.

D: You want to say something more about your childhood, nature, memories, interests?

P: I was an indoor child. I didn’t like getting dirty. I stayed inside. I have changed when I grew up. I liked school. I had lot of friends. I had nervous tics, that time too.

D: Any other vivid or intense memories, which you can recollect?

P: My childhood was kind of nice… I was happy then. But I’m not happy now. My memories of that time, I see more vividly than my current perception. I seemed to be much more alive then.

D: What do you mean by that?

P: The pictures and memories seem like that. Before I had this bubble thing, things seemed more real.

D: And now what do they look like?

P: They look real in a way, but it is hard to appreciate things like a beautiful sunset, a building. It is a different kind of view as before. Things aren’t as crisp as before. I feel distant from it. If I look at the building, which I used to see before, I see it as a building, but I see it like a bubble film.

D: Ok. Any fears as a child?

P: Two irrational fears. Every night, I had a fear of alien abduction. I was also scared of vampires. It stayed with me till 16.

D: Can you talk about these fears bit more?

P: Something of an alien phenomenon resonated with me and I was logically afraid of it. It is like the fear of spiders, which is extra terrifying.

D: Can you talk of the terror some more?

P: Terror is not the right word. It is like a fear, which stays with you, that you want to check your bed and cupboard, before you turn off the light. I would check the cupboard, under the bed and the windows.

D: Any other illness as a child?

P: When my parents were divorced, I got constant ear infections. I had lots of skin problems -eczema, acne, rashes. When I was in, high school, I got this psychosomatic problem. Every day at 9.30 am, I got this stomach upset, and had to go to the wash room and throw up. It lasted for half a year.

D: Would you go to school then?

P: Ya. But for the first half an hour, I was really uneasy and had to go to the washroom often.

D: What was the sensation that time?

P: I had to throw up, so in my stomach something was turning. I would also get tingling down my ears, to the throat. It was a warning signal that I had to throw up.

D: Something more about the tingling? What was the sequence? What was the first sensation?

P: I think the first sensation was in the stomach (HG) I felt uncomfortable. Sometimes after that, there was tingling from behind the ears, down to the neck. Immediately after it throwing up.

D: That kind of spiraling that you spoke about earlier, does it occur in any other situation?

P: Ya it has happened, that I see the floor moving at times. I’m just sitting and I thought it was an earthquake. It felt to me that ground was shaking. If I focus right now, I feel the ground is moving a little bit.

At that time too, it feels it’s kind of (HG) spiraling. It does not make me nauseous though.

D: Apart from this, which other activity makes this sensation even more enhanced?

P: Smell of mushrooms. Smell is worse than its taste. I smell it as very pungent.

D: What is it like?

P: very mushroomy…thick smell. The other day my wife was frying mushrooms, and the odor assaulted me. I felt a little queasy. Mushrooms are pretty offensive to me.

D: Since you are talking about odors that are offensive, are there any particular odor’s which you find very soothing?

P: I underwent a therapy last year, and they used frankincense. I think that was pretty good.

D: What was that like? Can you transfer yourself there right now and feel it?

P: Clarifying….smells like healing. Hint of that menthol smell. Minty medicine smell.

D: What other odors are soothing?

P: Odor of grandfather’s workshop. Little bit of tobacco and leather. Very reassuring smell. Every time I would walk by, I would get a hint of that smell.

D: Are you still an indoor person?

P: Half and half. I still till like being indoors but I like going outside too.

D: What kind of outdoor activity do you like?

P: I like going outside with the horses. I like to come in when I have had enough. I like the smell of horses.

D: What is that smell like?

P: It is great. It is earthy. Dirty but not in an offensive way. Wholesome smell.

D: Talk about this wholesome smell?

P: When I was first introduced to horses, I thought they stunk pretty badly. Very organic. It doesn’t have an odor like dogs have. Like an after taste that is too strong. But a horse is just perfect.

D: Tell me some more about organic smells and odors that you like?

P: Smell of making bread is great. Food in the oven smells great.

D: Any natural organic odors?

P: Sea, the ocean. It is air, water and seaweed. Smells good, lively, fresh but also a little bit gross.

D: What about it is good and what is gross?

P: In a heavy sea weed area it is gross. Just depends on my mood. Maybe someday you like it to be good. It is fresh air and freshwater mixed with a little bit of organic sea weed. Fresh and lively.

D: Can you experience that good, fresh and lively smell a little bit more?

P: Morning time would be the best for that fresh and lively smell at the beach

D: Ok. Has there been any period of extreme stress or grief in your life, which you would like to share today?

P: Stress has been in the past two years. Grief is not what I have felt a lot. It is hard to feel that.

D: What do you mean by that?

P: At times when you feel you should be more emotional than you are, like when a loved one dies, or when something tragic, happens, I find it hard to feel grief. Sometimes you are shocked by how it does not affect you, rather than how it does affect you. That is when I started equine therapy. The horses help you in getting touch with your inner emotion. And I let it out. I want to let some emotion out.

D: You want to share what came up during the equine therapy?

P: I wasn’t ready to go diving into issues. I just wanted to build my confidence. Confidence of being able to let my guard down, and cry in front of people.

D: Why do you feel that you have had to keep your guard always up?

P: I think definitely one has to keep your guard up in a public setting. You don’t want to cry in public, or make a scene like shouting in a bus.

D: The therapy helped to deal with this?

P: Yes. I have only gone for one session. It is comfortable, because horses don’t judge you. Even the kindest of people judge you. The horse gives you that opportunity to work on.

D: Can you give an instance of grief not felt?

P: My first defense is my humor. It is my safety net wherever I go. When my family moved a lot, I filled in my loneliness by cracking appreciating jokes. When something very uncomfortable comes, that is how I deal with it.

D: Can you give an example?

P: When I was18, my step father killed himself. I was the one who found him. He had hung himself in the garage. My mother had actually left him. I stayed with him for a while. He kicked me out once over some matter. I was away from home for a few days. When I returned, I found him dead and I was shocked and upset and cried a little bit. I called the police and they asked me about it. I said he was hanging around. Like it was some kind of a joke. It was so wildly inappropriate. I was upset, for saying such a stupid thing.

D: How did you deal with it?

P: My wife thinks that a lot of my anxieties may have started from that time. It is not something which haunts me or bothers me. I didn’t love him very much anyway. Not that I had a hard time grieving. A few years later, when my grandmother died, it turned to humor and again I didn’t grieve about it. It is upsetting to me. I would rather not deal with it, with this kind of pattern.

D: Is it that tears don’t come?

P: I’m too worried about what people will think.

D: How do you sleep?

P: Not too bad.

D: Any dreams

P: I get these dreams, when you are half asleep and half awake. I really feel depersonalized. I think it is worse. I have also started dreaming of being in a depersonalized or derealized state.

D: Can you give an e.g. of such a dream

P: Even in my dream I don’t feel real. It is upsetting…

D: Can you talk of such a dream?

P: My wife and myself go on a cruise. Part of my brain thinks that it is not real. It did not ever happen to me before all this happened to me. Now, the bubble is even in my dreams.

End of case

Analysis of case:

Unlike the first case where one sensation was seen very prominently in more than one location, in this case, the emphasis is on a feeling of a lack of structure. This indicates a mineral remedy. He feels inadequate to deal with certain situations. He describes it as a weakness due to an inability to assert himself.

There is a feeling of being stuck along with suffocation and a dependency on others. There is a trapped sensation too. These are themes of row 2 in the periodic table . He also talks about downward suction and spirals.

When probed further, he describes the feeling as if there is a film of bubble between him and others. He is highly sensitive to odors both offensive and pleasant. When asked about pleasant odors he talks of the barn and the horses and finally takes us to the source of his remedy while talking about walking along the seashore and inhaling the lively morning sea air.

The remedy he received was Ozone in a 1M potency.

Anne Schadde’s Ozone Proving Extracts:

Time and time again new headlines appear about the form of oxygen called ozone, which consists of three atoms to the molecule (O 3). In Greek it is actually “the fragrant”, it reminds one in weak concentration of the fragrance of hay and cloves and in stronger concentration the “fragrance” can go as far as the pungent reek of chlorine.

Around the turn of the century the irritant gas ozone was considered to be beneficial to one’s health. Spas advertised with their “ozone-rich” air. Patients with poor health were sent into the woods to take an “ozone bath”. This means that a small dose has a stimulating effect on the self-cleansing power of the lungs.

When he talks of the morning sea air and the fresh lively odor, he refers once more to the ozone that is said to be prevalent at that time of the day, and characterized by its sharp, pungent odor.

Some other facts related to ozone:

Sometimes after a thunderstorm there is a strange smell in the air. This odor comes from ozone which is created from oxygen in the atmosphere by powerful bolts of lightning. Normal oxygen occurs in molecules of two identical atoms. These double atoms in oxygen dislike to be torn apart and it is believed that a particle of ozone is composed of three identical molecules of oxygen.

The normal amount of ozone in the air, however, does no harm and may do some good. It is a great germ killer. It is also formed when large amounts of water evaporate. This is why we are told that we breathe large amounts of ozone at the seashore and on the ocean. The tangy smell we get at the beach, however, is more likely to come from seaweed and decaying fish than from ozone.

Rubrics in the case of Ozone:

Delusions, imaginations: bell over him, a transparent. {0> 1> 0} [227]

Distance: inaccurate judge of: walking, while, cannot judge distance to ground. {0> 1> 0} [227]

Confusion of mind: location, about. {3> 8> 0} [227]

Confusion of mind: loses his way in well-known streets. {6> 29> 0} [227]

Vision: blurred: milky layer, as through a. {0> 1> 0} [227]

He was given a dose of 1M

In this case, unlike case 1 where a single dose held him for a long period, and still continues to do so, the doses were required more frequently, especially during a panic attack. However the first dose was given dry, but the subsequent doses were given in water, which Hahnemann has referred to as the medicinal dose in Chronic Diseases, so as not to have a cumulative effect of several dry doses. The discovery of homeopathic potencies and the action of super dilutions in a water medium and their explanation through nano-particles is only recent! Homeopaths have been using it effectively through ages.

In the acutes, he would get the sensation of seeing everything through a bubble, and as the intensity would be very high, the 1M would be given in water every 2 hours till his symptoms would subside.

Over a period of a few months, the need for the doses gradually subsided and he has been on placebo for a few months. It has been over a year that he was first seen. He has learnt to be more assertive with his father, with his children students and with his pets. His wife too was surprised at first by his firmer decisions and by his learning to say ‘no’, but was told by us that this was an expected part of his recovery process. His bronchial asthma would also respond to the same remedy and very soon he could get rid of his inhalers. He feels very satisfied with his recovery process under homeopathic treatment, and feels confident considering bolder decisions even where his career is concerned.

This case emphasizes the need for new provings conducted the Hahanemannian way, as without this wonderful and systematic proving by Anne Schadde, it would not have been possible for me to prescribe this remedy for this patient. It also highlights the need for newer advances in understanding of our remedies and their analogues. The recent understanding of the periodic table and of row 2 in particular, has helped to understand the elements in that row and Oxygen especially. With that understanding as well as the proving of Ozone, one has been able to arrive at the remedy Ozone, which is a product of Oxygen.

Hahnemann was the first to introduce the analysis of the remedial powers of the periodic table of elements and three kingdoms using “analogy in accordance with experience.” He is also the first to combine the symptoms of two mineral elements making a synthetic prescription. Hahnemann also spoke of comparing the symptoms of remedies in the plant families. There is no denying that this is the origin of such ideas. He also cautioned against going too far by using too much speculation when studying families. He pointed out that each plant is so unique, that one cannot assume too much about lesser known remedies.

‘In science it takes at least 3 vectors to accurately locate a point in space. You cannot consistently locate a point with only one vector. That is why Hering spoke of the 3 legged stool being an absolute minimum of characteristic symptoms to be sure of a remedy.

The repertory has the potential to combine symptom segments in an inconceivable number of combinations that represent the potential of the remedy even if that exact combination is not found in the materia medica. Once a unique picture has been constructed, one reviews the materia medica to see which remedy has the potential to remove these symptoms. This is what Boenninghausen discovered when he developed the Therapeutic Pocket Book. Since that time the repertory is no longer just a simple index to the symptoms found in the materia medica. The repertory is an open tool that allows for maximum customization of an almost infinite variety of symptom segments allowing the most precise individualization. Although the repertory is not easy to learn, once it has been mastered it will provide information not found in any essence based system with their flow charts.

I would like to sum up these cases and conclude:

The success of a homeopath especially a budding one as well as recent practitioner depends on the following:

Intelligent use of repertory

Sound knowledge of the materia medica

In depth understanding of the Organon, which emphasizes the significance of accurate and detailed case taking, posology and case management and finally the need for Hahnemannnian provings.

Without these tools a student of homeopathy is too impressionable to be introduced to recent advances being introduced in homeopathy.