BM
Male, Age 28
The initial information about this patient came from his father. In 1988 BM finished technical school and then went into the army for one year. At this time his parents noticed changes in him. He didn’t want to study, became a vegetarian and joined the Krishna sect. In the spring of 1992 he was admitted to hospital with acute psychosis. In August of that year the family escaped from Bosnia to Croatia (they are Catholic). In 1995 he had another acute episode and again went to hospital. Earlier this year (1997) he was given a diagnosis of schizophrenia. He does not generally get angry but has occasional explosions of anger. He is good, willing and wants to help everybody. His main interest is anthroposophy. Until last week he was living at home with his parents but he admitted himself to hospital due to suicidal feelings.
I visited BM in the hospital psychiatric ward.
Tall, soft face, made eye contact. Communicated intelligently with me.
‘I have bad things in my mind, violence against other people. I fight in myself between good things and bad things. I pray to St Michael and Lord Christ to help me. Anthroposophy is the middle way, between the spiritual and the physical. I know that Christ is the leader of our time. There is a strong fight inside of me.
‘In the army I had a shock. It was the first time that I held a gun. I asked what is the reason or meaning of this weapon. I had a fear of being killed. I wanted to know what was the meaning of my life. I found the facts that man is not physical.
‘I want to die to be with Christ. I have fear that I will hurt someone. As a child I had a fear of vampires and the dark++, and fear to sleep alone. I get angry if people say bad things about others. I must pray to destroy the bad feelings.
‘I like light colours. I’m aware of the colours of vegetables and fruit. I want more light in my inner life. I like music and art.’
The thoughts which he was reluctant to talk about, were to do with causing violence with a knife, especially towards his mother and sister. He believed his suicidal thoughts came because it was the way to prevent him from doing this violence to others. In the hospital he asks to be tied down by his arms and legs to his bed to prevent him from committing suicide. He would commit suicide by hanging or a gun. He has the impulse to commit suicide; it is not just the thoughts of it.
Averse onion for last 3 or 4 years, also pork.
Sleeps on his back.
Medication is 100mg Lepomex morning and afternoon, 200mg evening.
Analysis
BM is presenting with a very strong mental state. In fact it is difficult to see anything else in the case and so it takes on a one sided aspect. There are a combination of factors which resulted in this final extreme state. His family background appears to be one of fixed views and doing the ‘proper thing’. He then went into the army and handled a gun for the first time. This background and exciting cause came to BM as a highly sensitive and spiritually inclined man, with the resulting breaking through of his unconscious.
Repertory
Thoughts persistent of homicide – anac, stram
Del he is in communication with God – anac, stram, verat
Del he is God, then he is devil – anac, STRAM
Thoughts separate from will – anac, anhal
Praying – STRAM, VERAT
Differentiation was between Anacardium and Stramonium.
Stramonium has a major focus on fear, often with a shocking incident as causation. In Anacardium it is more likely there will be some kind of aggressive domination as causative. In Anacardium the split is between good and bad; they really don’t know where they belong. In Stramonium the issue is more likely to be uncontrolled uprisings from the unconscious. It was a difficult decision in this case, but the essential difference for me was in the praying. After this I found the rubric ‘delusion he is god, then he is the devil’, this confirmed for me that Stramonium does cover the good/bad split.
Rx Stramonium LM1 5ml bottle, 5 succussions and 5 drops daily
First follow up two weeks later
After starting the remedy B felt worse and asked to be tied to the bed again. However, after that he began to feel some improvement and has come home for the weekend. He says ‘my soul feels clean from something bad, a fresh feeling.’ He is still praying. He has no new symptoms.
The Stramonium was finished 2 days ago.
Wait. See in 2 weeks.
Second follow up two weeks later
B had five good days, after which he felt bad again. These thoughts came after going out with his sister and her friend to a place where they watched a Baptist video. There is nothing else new to report.
Rx Stramonium LM2 5ml bottle, with 5 succussions and 5 drops to be taken as needed ie. if the thoughts last for longer than 2 or 3 hours.
Third follow up two weeks later
B is now staying in hospital during the week and coming home at weekends. He was able to spend 10 days at home over Christmas. Overall he feels 30 -40% better. He says ‘I don’t like to see knives or weapons. I get mental pictures of violence. The thoughts can come suddenly. I do feel better at night. I pray every day still and I feel I have contact with the angels. Sometimes objects can appear bigger or smaller.’
His father described B as anxious and afraid of going out and of violence. He said B has a weak will.
Rx Stramonium LM3 10ml bottle, 5 succussions, 1/2 capful daily
Fourth follow up two weeks later
B was discharged from hospital 5 days ago. ‘I feel better and the doctor thought so to’.
‘I am still getting violent images. I am watching the scene, the observer, I’m not doing it. Mostly it is guns and knives. If I commit suicide I will be free of that’. This lasts one to two hours daily.
Also in the last week B has experienced some hallucinations. He is fearful of talking about them but told me ‘peoples faces change into saints, but the same faces can change to evil. If I pray they become like saints. I see angels’.
Analysis B is much better, the main improvement being that the thoughts are less. However this is all and my instinct was that he would not get a deeper cure from the Stramonium. Looking at the general symptoms in the case there is aversion to pork and onions, sleeping on the back and after direct questioning a desire for open air. Also looking at his sensitive nature and how much he responded to my reassurance, I decided to change the remedy to Pulsatilla. In the Repertory Pulsatilla is listed under ‘delusion, sees devils’, ‘delusions, religious’, and it is also black type in ‘praying’.
Rx Pulsatilla 30c 10ml bottle, 5 succussions, 1 capful in a little water daily.
Fifth follow up after one week
There have been no hallucinations at all. ‘My thinking is good, I feel clean in my soul, mind and feelings’. He feels about 60% better. He is less frightened to go out than before. He asked me if this could be his ‘medicine for curing.’
Reduced Lepomex to 50mg morning and afternoon and 100mg evening with the approval of his doctor.
Rx Pulsatilla 30c 10ml bottle 10 succussions 1 capful in a little water daily
Sixth follow up after 10 days
B has been very well. A few days ago some hallucinations and bad thoughts came.s
Rx Pulsatilla 30c 10 ml bottle, 12 succussions and 5 drops direct
Seventh follow up after two weeks
There have been no more hallucinations. Three days ago he felt very well +++. ‘I feel free, I can breathe easily’. There are occasional unpleasant thoughts which come and last for just 15 minutes. They are not as strong as before. He spends his time watching TV, listening to music and meditating on pictures of Christ. ‘I am still praying for hope and for my health’.
He has reduced the Lepomex to 50mg before sleep.
To Do : Continue with Pulsatilla 30 as before, but in case of feeling worse, then increase the number of succussions to 15.
This patient needs considerably more treatment. He is at the point here where his life situation and environment and not helping him in his healing process. It is necessary now for him to come into some kind of activity and to take some responsibility for himself. However he needs to do this in an environment that is genuinely supportive. Unfortunately I observed that his father has very fixed ideas and a real lack of understanding and sensitivity towards his son’s situation. He only thinks that his son must work. B’s mother is extremely passive. While B lives at home it will be hard for him to take the next step in his healing.
This is not a cure but it does demonstrate what homoeopathy is capable of with very few symptoms and a fairly desperate state. He has few symptoms because his state is so far advanced. Just like you see with advanced physical pathologies, the organism has not got the vitality to produce any general or sometimes even characteristic symptoms. A good sign for him will be if he starts to get more usual mental reactions, and more strong general symptoms, or even some physical pathologies.
