Interviewed in the Student Clinic of NYSH; a Sensation System case that is confirmed by using big ideas and the repertory.
The case was initially taken by Maya Lomask as a 4th year student homeopath, and supervised by Susan Sonz.
The patient’s name has been changed.
Several short forms or punctuations might be used throughout the case. This NYSH legend below explains their usage.
E = The client
CAPITAL LETTERS= The homeopath’s questions
S CAPITALS= Susan’s questions
Writer’s comments are in [square parenthesis]
HG = Hand Gesture
SD = Spontaneous Denial
bold = Significant statements made by the client
CONF= Confluence or repeated idea
Eric is a 46 yr old white male, who goes through periods of being straight and gay. He has been married twice to women, but at the moment he identifies himself as gay.
Eric came to the NYSH clinic for a “desire to change and the ability to write”, and for a disordered digestive system. Eric stated that he has struggled with depression most of his life and has been suicidal in the past. He was looking around strangely, “I sometimes have trouble- it takes me a second to see or hear people. I’m here because I have a complete unwillingness to continue to allow my stomach to rot”.
He wants to eat right and completely give up alcohol.
E: I’m trying to improve my health and well being. It centers around my stomach. I drank a lot of beer and it caused a hot and cold thing, it shocks my system, my stomach is hot and I drink it cold. There is stress in my stomach; gas, belching, distaste. Personal transformation and mental health work helped me eliminate alcohol. I can develop a culture in my stomach rather than just a yeasty bacterial thing.
There’s an altruistic element to my being. If I get better then I can help others to be better. I want to be able to see better into people’s lives; to mature, grow, and transform. (CONF)
My physical being is affected by what I ingest; alcohol, marijuana, chocolate – I see how they change my state.
I wonder if that’s clear enough…
CHANGES MY STATE?
E: Caffeine, for example. I drink coffee in the a.m. Used to upset my stomach but not now. Used to have a latte and it was really expensive so I stopped. Switched to regular coffee and it’s o.k. It makes me more alert – makes me sense I’m no longer in a pillow head state – lethargy. When I awake in the morning I’d rather stay prone – have a tough time getting out of bed; depression; that state is something I try and avoid. Some mornings are more dramatic than others. I hope I’m not looking like the elephant man up here! [he laughs loudly]
E: I have a challenging time motivating myself to do the chores I have to do; dishes, water plants, sweep, make rice, tea, coffee. Challenging time getting myself to perform those tasks. A lethargy – I really don’t want to do this – a slacker, lazy – I resist the chores. My brain is not quite powered up. I drink coffee to jump start that process. A cup of coffee feels like jumping on my bike and riding really quickly down the street. I use caffeine in the way I use other sorts of chemicals and even French fries with lots of salt. I use food to alter my state – if I alter my state enough (CONF) then I won’t be stuck in a monolithic rut.
E: [long pause] I become inflexible – detached from my emotions – more like a character in a story that I’m writing. This guy that I would rather be. Somebody who is able to climb into my slippers and have those slippers make me feel not like the person I was feeling earlier. (CONF) Tthis is really hard [he reaches for his thermos of tea]. One of my big fears is I wind up not being able to… I have some really high expectations of myself and people and I want to be able to accomplish those. So I seek stimulants and recreational drugs and food and exercise and mild altering experiences emotional, physically or mentally that will help me to jar myself out of this sense that I’m inadequate.
E: Can’t accomplish the things I want to. As a writer I want to be able to pace myself; sit down; exercise my creative ideas and do that consistently. Finish the novel, edit the first two novels, work on my art. There’s something lacking in my – what? I guess in a way I’m hoping that there’s a remedy for what I’m lacking. Which I think is one of the reasons why I want to participate in homeopathy. It’s an old story of man wishing there was something we could take that would change our lives and make us perfect.
HOW DO YOU FEEL IN THE MORNING BEFORE YOU TAKE ANYTHING?
E: my body is sore from sleep, a heavy dead lump of wood. It takes a lot to get me going, a lot of will power to put on the slippers. (CONF)
E: What’s my state like – if I’m in my state and want to go to another state, what’s my state like? Hmmmmm, wow…beyond pillow head I’m prone and lethargic and this is the time when I want to masturbate and try to sort through the dreams I had the night before – let my mind wander and to fantasize about any number of things. So I start to think about what I see outside the window of my apartment. So I look at the light – let it play with my mood. Conscious of my wakefulness – wakingness. Conflicted about whether or not I want to be participating in the day. I shift between a rational and a poetic state. Try and sort through the days events coming up – play with ideas like light and sound. Listening for my stomach to see how long before I’m going to have to go eat some rice ’cause there might be some acid that’s settled in the night. I’m tactile – I’m awake and conscious of that – sensing that I have a body as well as my mind. In that space where I’m not ready to say to heck with this and get out of bed. Then I put on my slippers. Then, if I can, I create a psychologically induced state of anxiety. I have to be anxious in order to get things done on my list. I’m always in a rush, according to somebody else’s or my own demands. I have to be forced to, accomplish. Like Alice in Wonderland, I’m always behind, there’s too much to do, I’m way too late, there’s never any time.
S: SENSING A BODY AND MIND?
E: ..[he bites his lower lip] I don’t think I can answer that. I don’t know how to approach that question.
S: WHY DID YOU SAY THAT? …I HAVE A BODY AS WELL AS A MIND?
E: I tend to be very cerebral. I live inside of my mind and I’m not historically a physical person. I spend a good deal of time in my imagination, so I might be making this distinction because I spend so much time in my head. Secondary to my head is my body. When I wake up I feel my awakeness, then I feel my body.
[Eric stated that he was both drawn to change and anxious about it.]
E: Before the last eight years, my life was in a state of flux, a state of change. I never had money. I had uncertainty about friendships and the future. I never knew what to expect. It was a side-effect of growing up in that [his family] environment. I feel disoriented, physical change, I tend not to do research, I’m disoriented. It causes an emotional and psychological state. What am I doing here? I’m thinking I have to leave. I do it now when I go out. I’m bad socially. Why am I here?
It takes a whole lot for me to feel comfortable, without feeling agitated. I’m not performing to the norm of that establishment. I go to a ski lodge not skiing, to a bar not drinking, feeling alienated, feeling outside any place I’m at.
E: It’s remarkable I’m calm here [NYC]. I don’t feel alienated from this place. Maybe ’cause I came here when it was empty one day. I tend to have a very small number of friends and acquaintances; spend so much time in my imagination. When I go places I don’t know society and social conditions well or how people respond to things. If it doesn’t fit into my way of thinking I get agitated and decide this isn’t working out. It’s a – alienation means I don’t fit into any group or a limited number of select groups.
S: HOW DOES THAT FEEL?
E: Tightness of chest, teeth grind, hands sweat, fidgety, sense of nervousness, psychologically its fear. A near certainty that I’m being over-scrutinized by people who don’t know me. I want to loudly explain how wonderful I am so I’ll be welcomed. I’m sure if I’m loud enough and persuasive enough I will be welcomed into a place.
E: I go to Applebees on a Sunday afternoon. I want to be alone; watch T.V., talk to somebody. The only place to be alone is next to a loud table of screaming kids celebrating a birthday; the only people to make conversation with are groups of couples knee deep in their own conversations; the only thing on T.V. is the Patriots game. It’s not doing anything for me; just not my scene. Feels like there’s no place in society – becomes black and white for me – no place around for me to go and be self-expressive. But I want to get in out of the cold, be around other people; sociable but in a detached way (CONF). If I go to a place that feels good to me it’s because I’ve been there before or I know somebody who is there. I’ll feel more connected to the place. It makes me feel…helps me be relaxed. To be calm.
E: I went last night to the gay lesbian center up on 13th street to a meeting I wanted to sit in. Didn’t know anybody in this group. I showed up, took a look around, didn’t feel like I was associating with anyone who was there. All much older than me. In their late 50’s – 60’s, out of my experience and social norm. I decided not to stay. Wanting to find some association with people, places, things. (CONF)
E: I like riding the bus. The B61. People get on and off the bus that I know as fellow bus passengers. I see them and I feel like there’s a reflection of this place I live in – my neighborhood is reflected. There’s a methadone clinic around the corner – the first stop on the route was a shelter for methadonians. I’d see the same people on a regular basis, the same group coming and going from the clinic. Sharing the bus stop with those people – even though I wasn’t a member of their community – we shared in the sense of – all shared the same bus shelter and bus experience; the delays, the weather outside, the painful noise that one person is making as they complain, shout and scream. A sense of solidarity to the social experience. I also like sharing a blanket with a friend in the park on a sunny day – a bit of nature; sound around us; togetherness; music. I like to go out on my friend’s boat; I’m good on boats, get to drive sometimes. I garden; my backyard is really beautiful – been working on it since 2005. I consider it a community garden, a looking garden. Two of us who work on it and ten families who see it. A place for people to see beauty. Like to participate in the beautification of that space; makes me feel like I’m aiding in the betterment of other people’s lives.
[We all thought it was interesting that Eric liked sharing the bus with “methadonians”.]
S: WHAT ABOUT AIDING PEOPLES’ LIVES?
E: It’s about my stepfather’s abuse. Because I was the guy, I was the one who was supposed to be taking care of my sister and my mom; an element of responsibility and taking care of people. Altruistic and empathetic; do something that somebody recognizes, and I like the accolades. I like the gratification and making a change in somebody’s life. I get off on that.
Stepfather was a merchant seaman and a drunk and a sociopath. When he was home – gone for 3 months and home for 3 months – my whole cycle of change and of movement were for a long time tied to 3 and 6 month cycles in keeping with his. A cyclical thing to his presence. When he wasn’t there the family felt like it was falling apart; when he was there we wished it would fall apart. My mom was the primary person in the family that governed the way the house was kept. She was very nervous and uncertain – the opposite of calm. Spent a lot of time shaming me for every one of my little sins – really big on it. I couldn’t finish anything because the best of her love was when she said, ‘Shame on you!’ Thank you, mom.
E: Part of that destabilizing, unsettling feeling (CONF) that’s part of change, motion, agitation…feels like…now that I know that shame exists in my life – just now realizing I don’t have to always be ashamed of being me.
S: WHAT DOES SHAME FEEL LIKE?
E: The physical feeling?…Um…creates a certain anxiety…also the same sense, the anxiety I experience when I’m ashamed is a debilitating feeling; like I become immobile or…dispassionate in that, I wish.. I feel as though I am retreating all of my energy [HG fingers interlace and hands turn in towards himself] – withdrawing all of my energy into myself because I have to sort of preserve – like my tree must feel in the fall, in the winter, when all of the sap goes into it’s roots and I become immobile and completely reserved. I become sort of stuck.
E: Like the monolithic rut expression (CONF). I can explain not stuck- it means I’m doing O.K. I take chances, I do things when I’m not stuck, unstuck. Feel free to be able to experiment with ideas; name things; act on my wants and desires. When I’m stuck I keep going around and around and around or I’m up against a dead end of thinking that’s cyclical and I can’t get out of a way of thinking or I can’t get beyond that piece of thinking. I get physically – feel like I’m impotent or immobile; frustrated. Mentally I feel defeated and letting myself down. The responsibility is just too much.
My breathing stops, I don’t recognize my breath, whether or not I’m breathing. Traditionally my stomach would be tightening up… constricted, grind my teeth, caught up in a knot, pressure between head and stomach, thinking it’s futile [HG- hand on top of his head], knot, I’m panicking, knot sometimes like a stone. Pain in the front of my head, dully, pulling my scalp from within, dragging it down over my [HG – over eyes] trying to collapse myself into myself to hide…seems futile, my gaze locked up in itself, not conscious of my breathing.
E: [still has his fist to his stomach] It’s…I feel like I’m panicking. I’m really bad at that. My stomach would be tightening up. [HG – finger tips of hands together in front of him]. Everything centered in my gut. Dyspeptic. [HG – hands over his gut, fingers interlaced] Used to cough up bile. Have a sour taste in my mouth. Gas. It would drag me down – shoulders would stoop, posture would – feel like the front of my stomach and my whole torso was constricted. [HG – hands clenching in a ball in front of him and he is bending over] I’d grind my teeth. I’ve been told I have the teeth of a 70 year old man.
E: Like the knot is causing me to panic.
S: WOULD IT HELP TO CLOSE YOUR EYES?
E: I’m panicking when it happens. [won’t close his eyes – seems on verge of tears] I don’t remember clearly enough if it was like a sharp pain or a prick or a punch. It was more like a… [face gets really, really red] Sometimes like a knot or a fullness; sometimes very gaseous. Sometimes like a stone. (CONF)
E: The size of my fist. Like it could have been my – a mile of intestines knotted all up. Used to read R.B. Lang – his book KNOTS; felt like the knots he was describing in the schizophrenic communities where he worked was like the knot in my stomach as well as my own inability to think through things. I used to think I was schizophrenic because I had this knot. This bundle of tissue that was…undigested. Not quite what you’re looking for? [he smiles]
E: Yes, excessive amounts of pain. Would cause me to list – lean forward. [long pause] The irritation would make…would get me to….make me feel uncomfortable…I would want to….forsake my uprightness because I’m feeling…[HG – clutching his stomach, wrapping his arms across his stomach]
S: WHAT IS THIS?
E: Me cramping up – in this constricted state.
E: My lower back muscles aren’t working; shoulders stooped over; brow is furrowed; got this pain in the front of my head bordering on a migraine. Can’t think what to do next to get myself out of this situation.
E: Dull. Connected to my furrowing brow – like I’m pulling on my scalp from within and dragging it all down. I’m collapsing into myself to hide. [HG Fist pulling downwards from forehead]
E: When I’m in a good place I’m conscious of my posture – able to open and close my lungs. Keep my spine relatively erect. In this place that everything seems to be futile I never mind any of that – my spine, my gaze is not straight out it’s locked all up into itself looking down. I’m…[eyes close] not conscious of my breathing; not taking full breaths, my neck tends to sag. Let my head droop. [he smiles, laughs, face gets red again] Yeah. It’s – am I getting better at this? [laughs] Is this the clause that says it could take longer than two hours?
S: TELL ME ABOUT APPLEBEE’S AGAIN? HOW DO YOU FEEL THERE?
E: Shortness of breath. Agitation. [HG – fingertips together, shaking hands up and down] Nervous. Skin itchy. [up on his tiptoes] Feel my face tighten up – won’t smile or laugh. Mouth gets pasty and salivating. I might want to cry…my chest always tightens up; my stomach, my buttocks and my groin.
E: It’s like a muscular tension [HG – fists pulling away from each other] – rather than a drying out. It feels as if my jaw muscles are clenching; my stomach is bundling, my buttocks are pinching; my groin is receding.
S: TELL ME ONCE MORE ABOUT THAT MORNING FEELING?
E: I’m not in pain. It’s more like a heavy dead lump of wood. Like it’s going to be – takes a lot to get me going. A lot of will power to put on the slippers.
E: Immobile. Lethargic. Detached. Glued to the mattress. Some days I wake up and the last thing I want to do is get up – other days I’m up and in those magic slippers immediately; feels swift, light, buoyant and it doesn’t take long to become lucid. It feels different than being manic [SD]. Sometimes it would take being chased by a lion to have that radical adrenalin that would get me to roll over and put my slippers on. But some days I wake up and don’t have that feeling. There’s a certain inconsistency – part of this sense of bafflement. Never quite know what, as a human being, I’m supposed to be feeling. Is there another way I should be or could be feeling?
[he speaks in opposites throughout the interview]
S: I DON’T USUALLY ASK THIS BUT CAN YOU TELL ME HOW YOUR DEPRESSION FEELS?
E: I feel it in my head. [puts hand to top of head] Literally like a cloud has entered my head and blocked out the sun. Like a dark sheet has been closed over my head – the curtains are drawn on my head, on my mind. Totally affects me in a way like turning out the lights affects me. Makes me feel like fuck it, I don’t want anything to do with this moment, this day, this life. Depression is a world without light. Turn out the lights and nothing seems to have taste, smell, texture. I couldn’t care less about anything.
S: IS THERE A PHYSICAL SENSATION?
E: Dullness. Dullness. I feel dull. Difference for me between, ah shoot – dull, I feel dull. I was going to say something cerebral. I’m creative and have imagination but there’s also a certain amount of fantasy that I participate in because it’s a cerebral escape from the dullness of my depression or lethargy. It’s that fantasy that I use to pull myself out of this dullness. This dull state.
E: As a kid I used to have this dream about Halloween – my sister and mom and I would answer the door and there would be this gruesome, scary witch at the door but it would be way late, like the next day after Halloween.
S: HOW DID THAT FEEL?
E: Scarier than scary. I would wake up as soon as I saw that witch. Once I tried to stay with it to see…and it…it had something to do with my dad. My dad showed up. And he wasn’t always there – my real dad – and he was there to try and save the day, but this witch wasn’t having it. Got me further scared – nothing could stop this witch. There was a sense of immobility again. Not aware of the nuances of my body and my physical state – I always go back to the same sense of immobility and dull. (CONF) I keep using the same words. Makes me wish I had more of a vocabulary to describe this!
S: WE ARE GLAD YOU DON’T!
Comments from Susan:
This case was a lovely example of the plant kingdom. Eric always spoke in opposites when describing his state. He also described how sensitive he was to everything; food, places, people, morning, the dark, etc.
At first I was afraid he was so theoretical and cerebral that we would all get lost in the case, but that is part of the beauty of the Sensation System. In this system you keep the questions simple and to the point so a patient like this doesn’t get an opportunity to go way off and deep into his story. If he repeats his sensations while describing different situations as Eric did (confluences), then you know you are hearing the truth of the case.
It was particularly interesting when he described himself as “like my tree must feel when all the sap goes down in the roots and I become immobile and completely reserved”. Plants often refer to the feeling of being “stuck” for obvious reasons (stuck/unstuck).
Cannabis indica is part of the Hamamelididae family whose members share the sensations of “compressed, limited, fixed and confined, dullness, heavy and dragged down, inclination to lie down, rest and repose amel, depressed, sadness, fantasizing, and imagination”. (from SANKARAN’S SCHEMA 2005)
This case clearly seemed to be expressing the sycotic miasm, e.g. Eric’s drinking and food issues (too much of all that), his various urges, his masturbation, the fantasies, the guilt, the shame, the feeling that there was a weak spot, that there was something wrong with him that couldn’t be fixed, that this problem wouldn’t kill him but it needed to be covered up, and this left him feeling exposed. (SANKARAN’S SCHEMA 2005)
It was also very clear that this was a drug remedy case (if you look at this from a BIG IDEAS/GROUPINGS point of view). He is spacey and disconnected and likes to “alter his state”. His favorite neighbors are the methadonians! Since big ideas/groupings cases are actually repertory cases, let’s look at some of the rubrics:
Mind; Alternating states
Mind; Darkness agg.
Mind; Delusion separated, mind and body are
Mind; Fear, Insanity, losing his reason
Mind; Fear, panic attacks, overpowering
Generalities; Constricted, as if internal
Generalities; Food and drinks, alcohol, alcoholic drinks agg.
Generalities; Lie down, inclination to, daytime
Generalities; Tension, tightness
Sleep; Sleepiness, daytime
The beauty of this case is that you can analyze it any way you like and it always comes up as Cannabis indica. A case like this helps us understand that the Sensation System is based on the repertory, as is the Big Ideas/Groupings style of homeopathy. The most important thing to remember is what we have always known – if you give the patient the space and time to do so, he/she will always reveal the remedy.
First dose: 11/8/10, 1 pellet 200c .
FOLLOW UP (phone) 11/14/10.
E: OK, I’m not sure how, what to think. I’m walking to work. My body doesn’t ache. I’m getting sleep. I feel pretty good. I haven’t had any days that I’ve felt lethargic. I’m completing things, getting a lot of things done in the office.
FOLLOW UP (phone) 11/18/10
E: I’ve been walking a lot. My body doesn’t feel as sore in the morning as it did. I’m trying to figure out what’s happening. I’m trying not to drink and I’m going to AA meetings. I don’t know where I’m at. I don’t know if my body is trying to…my habits are not consistent right now.
I’m trying to understand where my body’s at, where I am mentally. I don’t recognize me. I don’t feel lethargic. I don’t feel all that dull. My concentration and focus at work is fine. I’m doing OK. I feel the need to drink, don’t know if it’s affecting my mood. Might be confusing something. I don’t know how to answer that. I have an active addiction and I have the desire to stop that addiction.