A Case of Disruptive Behaviour Disorder

This is a case of disruptive behaviour disorder in a 10 year old girl. She was bought by her mother for the following complaints. As narrated by her mother, the patient, for the last five years, has been very aggressive and prone to violence. She fights with her friends every 2-3 days. Her fights turn very aggressive. She bites and tears clothes of the other person. She fights at school, in the school bus, the playground etc. She had been warned many times by the teacher and principal, but there was no change in her behaviour. Gradually the parents of other children did not want their children to play with her, and she was completely abandoned by her friends. Daily, one or the other parent came to her mother complaining about the child’s behaviour. All this had disturbed her mother emotionally. Her husband died five years ago and she is a single parent. Despite repeated warnings and counselling the patient’s condition had worsened which was very disturbing to the mother.

At home the child’s behaviour is very different. She is quiet and never showed any signs of aggression or tantrums. She always complained to her mother that no one wanted to play with her and she is all alone. She mostly fought with boys. On asking the patient the reason behind her aggression she said that those boys always teased her because she is of dark skin and a fat girl. She gets angry and becomes violent.

The mother said her daughter was a totally different girl a few years ago. She was very friendly and never fought with anyone. She found a sudden change in the child’s nature after the death of her father. After her father’s death she had suddenly changed mentally and emotionally. She thinks too much about little things which a girl of her age is not supposed to consider. She has become too “mature”. She keeps worrying about her mother, saying  “ My mother is doing this all alone and managing finances and other things  and nothing should happen to her”.

She has developed a lot of fears, especially fear of being left alone by friends. If she makes a mistake, she tries to hide it, as she is scared that if her mother comes to know, she will get angry. She has intense fear of her mother, who is very strict.  The girl also has a very sympathetic nature. She likes helping friends when they need her and protects them if boys are troubling them. She likes in-depth studies and is very curious to learn new things, especially scientific subjects.

My observations:

Obese

Dark complexion

Short neck

Staring look in eyes

Intelligently answers all questions.

Alert

Sharp piercing voice and sounding very serious like an adult

Analysis of the case:

The present disposition of the patient suggests a remedy which has to be aggressive and violent.  Also, I understand that the immediate cause of her aggression was being teased and feeling abused. The sudden shift in her nature was observed after the death of her father. After that she became very concerned about herself and her mother’s future. The mother said her daughter is absorbed in thoughts and keeps worrying about how the mother will manage things on her own. The girl also developed a fear of being left alone .

Aphorism 211 informs us that the disposition of the patient often chiefly determines the selection of the homoeopathic remedy.

Stram  Staph, Lyc  covered the most rubrics.

Staph and Lyc were ruled out as both are extremely timid patients and will not enter into violent fights especially with boys. Lyc is more cowardly and Staph is image conscious and selfless.

Lyc was ruled out as the patient is not very timid or cowardly. She directly faces the situation and attacks.

Staph was ruled out also as the patient is not very timid and Staph generally goes into a shell in these situations rather than attacking

I chose Stram 200, followed by placebo for a month.

The violence of Stram is defensive. Stram basically is full of life, talkative, very much cheerful. Stram is full of emotions and can be a boaster (like verat or lach) but there is a subconscious dark element of fear.

Needs lots of support (like calc) and more fearful than Calcarea.

When Stram loses support, they initially tend to becomes extremely clinging. They can also be very aggressive, violent or may become very religious.

The aggression of Stram is more of a defensive nature. In Stram, fear and aggression go hand in hand.

Follow up