This case was initially taken in 2006 by a 4th year student homeopath, supervised by Susan Sonz. It was taken in a traditional style and was analyzed using big ideas and the repertory.
Several short forms or punctuations might be used throughout the case. This NYSH legend below explains their usage.
S = The client
CAPITAL LETTERS= The homeopath’s questions
My comments are in [square parenthesis]
HG = Hand Gesture
SD = Spontaneous Denial
bold Indicates significant statements made by the client
CONF= confluence or repeated idea
Serge, 51 years old, was first seen at the New York School of Homeopathy clinic on March 11, 2006. He lives in New York and has been married 18 years. His chief complaint was suicidal depression and panic attacks. His blood pressure is elevated 150/100. He has constipation when he is not at home, and has bleeding hemorrhoids.
At the initial intake, Serge appeared to be a serious and intense man. He made an earnest appeal for homeopathic treatment and seemed to be truly suffering.
When asked about his marital status, he said, “I think I was born married.”
TELL US ABOUT YOURSELF.
S: I’m a Jew- I’m a Russian Jew, you can say that.
WHY ARE YOU HERE?
I feel depression. I can’t sleep well, I am worried and anxious. I’m different than I was before. I’m not myself. It’s worse in the morning and gets better in the evening. There is a mix of anxiety and depression. It starts in the early morning around 4am or 5am with anxiety, I can’t breathe. I can’t get back to sleep. I feel better after a cold shower.
In the morning everything seems to be a problem but by evening I ask myself, ‘what is the problem? Tomorrow it will be ok’, but then tomorrow it starts again. I have good days and bad days- lately more bad than good. One third good, two thirds bad. Before it was opposite.
[Currently, he’s taking anti-anxiety medication, as well as medication for his high blood pressure.]
S: I get anxious from work. I am responsible for everything, I feel guilty for everything. In my old country I used to feel like I wanted to cry and now that is back. I feel something here (HG-pointing to cardiac region with hand motion up to throat, a ball coming up.) When I’m driving it’s better, in the subway it’s worse. I’m losing concentration in simple things, like looking for things. I have a big job coming up. In my performance my boss says I do good, but I always feel I’ve forgotten something or I lost something. I know I have a problem. It bothers me and I HAVE to find it. Everyday, I worry about forgetting something so I always feel I am doing it wrong. I say to myself, “you made the wrong selection”. Then I blame myself. It is a feeling which prevents me from doing; it’s a contradiction forcing me to do what I don’t want. So I have to force myself to do it. Even writing a letter- I have to trick myself, I can’t get to it. So I put it off and then next day it’s easy because there is something else behind it that needs to be done. I struggle with myself so it all goes so slowly.
I feel close to crying without reason, I understand intellectually why I should not cry, but the sensation is like a rollercoaster going up. The ball in my chest is connected to my childhood. It is like a clot or lump. It feels like a spasm. I never actually cry. It usually happens in the morning, 3am.
When you are going to cry, you feel it physically- like when you are little and that ball in your throat comes up. It’s like when I was hit with a belt or had a big humiliation. That was worse. That’s why I am afraid to do things wrong.
S: One time my father hit me with a belt. It was my fault, I broke a shelf. We had no money so I deserved to be hit. I should have been more careful. But it was humiliating.
TELL ME ABOUT YOUR FAMILY?
S: That’s another story [he actually begins to cry a bit]. Now I am in spasm… Something happened- I have two major strikes in my life. One is my boss who gives me anxiety, two is my family break-up. My wife decided that my father, brother and his wife are our enemies. She tries to stop me from seeing my father. Two nice people who do not get along. It caused me a breakdown. I even got hysterical and broke a computer.
S: My family is everything to me. There was a major breakdown in our family. It makes me want to cry, gives me that same feeling. What else do you have? Job and family.
That’s it! It’s the end of the world. I was ready to jump out of a car when it was moving. There is no other solution. It’s like hysteria. I have to do something- maybe jump out of a car. It’s like the end of the world. I feel I should commit suicide.
HOW WOULD YOU DO THIS?
I would get a gun and shoot myself. That’s the most easy way.
WHAT PREVENTS YOU FROM KILLING YOURSELF?
S: 1. It wouldn’t be nice to her, 2. I still have a son, 3. It’s not that easy to get a gun (it might be different if I already had a gun), 4. I think about God and who I was in a past life. Suicide is strictly prohibited in my religion.
Because of the family split, I no longer work in the business, but my brother does. We had an agreement about money but he forgot. He took me for a slave. He said I didn’t perform enough so I left. He gives me some money little by little. I accept it, whatever. We were a good team, I helped make that company. When someone accuses you- it’s not right. I just wanted to look good and not be humiliated. It feels like I did not do my duty so I caused a disaster. It’s death, the end of the world. Maybe sometimes you can repair a disaster- maybe, but it would be better if I didn’t cause the problems and I just do my job. If I do a small accomplishment it makes me happy. I just want to do my job, it’s a big responsibility.
Serge experiences his problems as a weakness in himself. He feels that he is the problem, that he is not meeting the challenges, he is not, at critical times, making the best performance. The structure of the family and job has broken down. There is hope but it intermittently completely falls apart. Responsibility is a large theme in this case, as is the importance of family. These big ideas about the case easily led us to consider a mineral remedy. However, it was Serge’s depression with suicidal thoughts combined with the strong feeling of responsibility that led us specifically to Natrum Sulphuricum. Morrison’s keynote of “suicidal longings but restrains himself because of his duties to his family”, along with his desire to shoot himself, confirmed our decision to prescribe Natrum Sulphuricum 6c, daily.
He also suffers from hemorrhoids, is aggravated in bed, has anxiety in the morning- aggravated at 4-5am, is ameliorated by cold bathing, has the delusion he is disgraced, the delusion he is not worthy to live, all of these are symptoms of Natrum Sulfuricum.
[Two weeks after Serge took the remedy he had this to report.]
S: I felt nausea before, but now no more, I’m feeling better. I also have no blood from hemorrhoids. In the morning I feel first a little worse, then a little better. The feeling still exists but less. Later, I have more energy. I had a “touchy” discussion with my wife but I recovered quickly.
[One month later]
S: I am 60 – 70% better. There are problems at work and that worries me. I’ve dealt with them before but the (bad) thoughts are still there. I think, “Maybe it’s better to be dead than face these problems.” The hemorrhoid bleeding has gone. I still have problems with the family but I recover better.”
[Although Serge still had some suicidal thoughts, they were less and lasted for shorter periods of time. It was concluded that Serge should continue his remedy of Nat-Sulph, 6C, daily. Serge was monitored regularly and in April he came to see us for his follow-up clinic visit.]
Follow up April 10, 2006
HOW ARE YOU DOING?
S: I don’t want to cry. I don’t feel the ball in my throat anymore. There is nausea when something bad happens, bad news. I rise early now. I like getting up at 4:30. I have to be at work at 8:00 a.m. When I come home. I sit in the chair at 7:00 PM and I listen to the radio. It’s nice. I wouldn’t feel good without it. When I sit there I feel I’m really resting in that hour. Nobody bothers me.
The family didn’t change but now I am used to it, no more fights. It used to bother me a lot. Fear is much less.
My legs are heavy. The blood pressure is 140/90. At work, I feel I have to do everything myself because my coworker is incompetent.
[The prescription was raised to 7C, once a day – to start when the 6C is finished.]
[Over the following weeks and months, we checked in on Serge. He was continually improving, eating better, walking daily and following up with his doctor. He is still taking high blood pressure medication but his blood pressure has improved. His remedy was raised to 8C, once a day.]
Follow up 8 months later- 11/18/07
HOW DO YOU FEEL?
S: (smiling) Yes, I feel a better. I have recovered 99%, no one is 100%. No more bleeding, I am still on blood pressure meds and Lipator. Before, I had a mental depression, now I have no longer.
A student homeopath from the clinic stays in touch with Serge. We see him once or twice a year. Over the years, Serge has continued to improve. We have moved from daily doses to monthly doses and he does well on Natrum Sulphuricum 200c, even in acute situations. It also cleared up his fungal feet and fungal rashes.
When we speak with Serge, his focus is still mainly on work and family. “It’s just my nature.” he says. However, his general disposition has also improved. He smiles more often, is more relaxed and he recognizes how extreme his feelings used to be.
“I understand now, I was just overreacting.”
We always enjoy seeing Serge in clinic. One’s love of homeopathy is reinforced by successful cases like Serge’s. He has changed from an anxious and depressed person with suicidal tendencies to a happy and successful man; in fact he has just bought a new house for his family. A long term case like this one provides a wonderful opportunity to learn about case management. When we hold the high intention to “cure, as it is termed”, management is as important as finding the correct remedy.