This is a case of a 34-year-old male, who consulted Dr. Mahesh Gandhi, Senior Consultant and Faculty at ‘the other song’, for his depression from which he was suffering over the past 7 yrs. The patient owned a small hardware shop in Bihar which he ran along with his brother. In the midst of talking about his shop, he suddenly started weeping. When asked about this weeping, he went on to narrate that his younger brother, on his honeymoon, had visited Mumbai where the patient’s uncle kindly offered him a job in his business. The brother dutifully asked the patient for his permission to leave the hometown and come and work with the uncle in Mumbai. The patient duly consented, but only half-heartedly, because he never wanted his brother to feel that he had prohibited him from grabbing a good opportunity.
Ever since then, the patient had been feeling alone and was always wondering as to how he would manage his work alone. He felt confused and lost and often tried and wished that his family were back together. Sometime later, his mother who was chronically depressed committed suicide. The patient was shocked at his mother’s death. His brother who was working and staying in Mumbai came back to their hometown for their mother’s last rites. After gentle persuasion from him, the patient too winded up his work and personal effects and shifted to Mumbai at his brother’s and uncle’s suggestion. At this time, he said he was very depressed as only a short while ago they were all united, but now he suddenly felt that everyone had scattered.
When I asked him about his present complaints, he said that he was worried about having not much work opportunities in Mumbai. Also, he said that he was unable to work due to the sedative effects of psychotic drugs he was on. He also complained of having fear psychosis and was suspicious about many things. He could not explain this further, but then went on to say that he felt anxious when he was alone, which he largely felt especially when his brother left their home to come work in Mumbai. He does not like if someone shouts at him or contradicts him.
When asked about his dreams, he said that he had dreams where he saw himself smiling at Lord Shiva, Ganesh and Goddess Parvati (Hindu dietes). As he was not able to describe his complaints any further, I decided to interview his wife and brother who had accompanied him, so asked him to wait outside. His wife said that all his complaints started after his brother moved to Mumbai in 2002. The patient complained of headaches and became very sad and depressed gradually. He would suddenly become tearful and say that he was all alone as his brother was now far away.
The wife said that after sometime’s the patient’s mother also went to Mumbai to stay with his brother. Then, he would often bemoan that they were totally alone as now even his mother had gone away. The patient was extremely attached to his mother since childhood, so much that he would often ask permission from his mother before visiting the washroom. With these turn of events, his health started deteriorating and he would often complain of an upset stomach, sometimes having bowel movements 10-12 times a day.
After his mother passed away, the patient felt very alone and transferred all his finances from Bihar to Mumbai though he was completely unsure about his future, just to be with his brother and in order to again unite the family. His wife reported that this uncertainty about future still persisted. He was extremely suspicious of his sister-in-law, whom he always suspected of being responsible for separating both brothers. His wife went on to say that his suspicious nature extended even to her, where he suspected that she may kill his mother or would run away with another man. He was suspicious about the society at large as well, always fearing that it was dangerous and evil and that someone would easily kill him.
The patient’s wife said that somewhere along the time when he started being depressed, he was robbed after being drugged with cannabis by someone in Banaras and had to be hospitalised as he fell unconscious. The patient has no memory of this incident as he was put on heavy anti-psychotic drugs thereafter. His brother said that he was very dominating by nature and would get very angry if anyone contradicted him. He would shout in anger and his wife added that only a few days ago when he was unwell, he slapped her. After losing his temper thus, he then touched her feet for the next few days asking her to please forgive him. The patient also got anxious if anyone at home was unwell. He would often behave like this with her, even that day morning, when she wanted to use the bathroom before him, so he said, “Should I touch your feet so that you allow me to take bath before you?”
The patient was very religious. In his depressive episodes, he often visited temples and then no one could stop him from doing that. He dreamt a lot about God, she said. He was unable to sleep over the last 4-5 days, but for a fortnight before that, he slept for 20 hours at a stretch. When he was alright he thought of God like his uncle, his guardian. He revered his uncle when he was well, and would do anything he asked of him, even playing a gatekeeper or sweeping the floor. He obeyed him all the time and would leave work only when his uncle told him to. Whereas, when he was unwell, he always felt that his uncle cheated on him.
When I enquired about his childhood, his brother said that if he were to misbehave or make any mistakes in payment for purchases, the patient would immediately complain to their mother. Giving further insight into his nature and behaviour, his wife said that he had slapped her once as she had washed her hair on a Saturday, which was against his mother’s beliefs. Also, after marriage, if she wanted to eat anything, the patient insisted that she first ask his mother’s permission before he would get anything for her.
I learnt from his wife that the patient wanted to be very successful but could not achieve his dreams. He had a good business set-up in Bihar. He was extremely responsible, organized and independent and took good care of his brother and sister. He had the tendency to build air castles and often was heard telling his aunt that he will build a big bungalow in California and that they would all live together there. (On enquiring, I found that he may have chosen California as he may have come across it when reading and hence imagined going there).
The main complaint of the patient – depression, arose from being separated from the family. This point comes up again and again as a causative factor at various places in patient’s as well as in his wife’s narration. So the main theme if we are to see is being together and then being separated; family being together and then being separated, which set off all the complaints in the patient. We see a lot of sensitivity in the patient, him being affected by the separation of family and him reacting to the situation by being depressed and suspicious. This is typical of the plant kingdom. According to the Sensation Approach, the remedies are mainly classified into 3 kingdoms – Plant, Mineral and Animal. The main experience of the plants has to do with sensitivity, of being affected and reacting. The main sensation of the Mineral kingdom is all to do with structure, whether I am lacking, if I have to complete myself, or if I am losing my structure; while the main experience of the Animal kingdom is survival.1
The Sensation approach helps us understand that the patient will need a plant remedy. However, the question is, which one? In psychiatric cases, this often becomes a challenge, when the case history is limited. The few aspects of the case and the observations that are available need to be carefully analyzed in order to come to a prescription which will help the patient. Once the kingdom is available, there are parts of the case which are available to us, like his need for the family to be together, his suspicious nature, the feeling of insecurity. A successful prescription is the one where we make use of all available data. For this, we often have to look beyond and into the research and advances occurring in our field, with their bases in the fundamentals of our sciences.
In this case, once I am sure that the patient belongs to the plant kingdom, I made use of the theory of the Evolution of Plants. This idea of the Evolution of Plants is very similar to the Periodic Table in the Mineral Kingdom. These ideas are from the work of Michal Yakir, a Botanist and a homoeopath from Israel. I had an opportunity to learn from her about the evolution of plants and its application in Homoeopathy. Each mineral suggests a developmental point in an individual’s life. Similarly, these human issues reflect in the evolutionary stage of development of an individual, even in the Plant Kingdom. The Plant Kingdom can be organized in a hierarchical order, which is called the Evolutionary Tree.
Michal Yakir has developed a two-dimensional table for flowering plants that correlates the evolutionary developmental stages of plants with human developmental stages. It can be compared to the Periodic Table of minerals in which the location of every element on that Table carries homeopathic significance. In Yakir’s table, on one axis (columns) are the botanical subclasses. Subclasses represent stages of evolution of plants as they move from the most primitive to the most sophisticated ones. The evolutionary process in humans is seen to move from initial state of primordial oneness and lack of separation towards differentiation, formation of boundaries and separation. In this process one has to pass initially through the feminine principal and then through masculine principal before the final emergence of a separate, mature, individuated “I”.
In the transformative journey represented by the columns, evolving from one column to the other, the human spirit aspires to obtain awareness, uniqueness and selfhood, so that it can return to the source, this time as a conscious and evolved part, as an awakened witness to creation’s essential wonder. Each subclass was studied by Yakir as a single group to see their common attributes. Each subclass corresponds surprisingly with a particular stage of human evolution. The stages of evolution can be understood in the light of developmental stages described by Carl Jung. These stages have to do with the development of the ego, separation and individuation. The whole process is seen as progression of human development not only individually but also collectively towards becoming conscious creative beings. Within each subclass there are many Orders and each Order can have many families of plants.
The second axis (rows) comprises of Orders of plants. Within each subclass according to the evolution, the Orders are placed either above or below one another in a hierarchical way. Yakir studied each order for its common attributes. The themes of the Orders when arranged in evolutionary sequence, revealed a correspondence with another aspect of human development, namely ‘the stages of development from birth to old age.’ This sequence was observed repeatedly in every column of subclass. It is based on the understanding of the same by Erik Ericson and Rolf Moss.
The table deals with plants at the level of Orders. Orders rather than Families, as a higher hierarchy, contain more remedies and are more able to demonstrate common traits of a group. In each column, the orders are arranged according to the rising level of botanic development. Each level is botanically and evolutionarily more advanced than the one that precedes it. These levels form the rows of the Table. The first row contains the most primitive plants in each column, whereas the later ones are more developed plants. Given below is a figure of Yakir’s plant evolution table:
In this case, we will first analyse the case according to level of development. In this patient, we see almost a childlike clinging to the family, to his mother. The patient is unsecure about his future and lack of money and work opportunities. We also see that the patient has issues with trust and is very suspicious of his sister-in-law law separating the brothers, of his uncle and wife cheating on him. Also, we see that he has lack of essential confidence. He wonders whether he will be able to exist without them and hence wants all of them together. In their absence he experiences severe loneliness. All his problems started when he started feeling lonely. Also, the whole episode started after someone robbed him after overdosing him with cannabis. It echoes with his inner feeling that he is helpless, no one will help him and that they will cheat on him and take away everything he has.
All these are the features of the second stage or the oral stage. The oral stage is similar to the Natrum line. It is the phase after birth, when an individual needs mother’s milk. In the oral phase of development, the most important thing for the child is his family. Often, when family is an important theme in the case, you can directly think of the Natrum line. Money and security are also important in this stage of development as money brings provision for the family. The lack of money makes an individual insecure. In order to understand this stage better, let us consider a child just born. He cannot move at his will and cannot express if he is hungry. In this stage, he is completely dependent on the environment for his survival. He has to learn to trust the people around so that he can be well cared for. If this trust does not develop, there is mistrustfulness. So one of the main themes of this stage is basic trust versus mistrust. This mistrust is the negative experience of the oral stage of development – not being able to trust. Trust, as we all know is also an issue of the Natrum line, a strong feature of muriaticums, which have a lot of mistrust.
The patient also has no strength to do anything, which is again a feature of the oral stage of development. If the individuals belonging to this stage do not receive the security they need, they can be very violent. We see that the patient feels that the world is not safe and there is a feeling of great danger from others. We also see almost a pathological clinging to the mother. Again clinging is a very important feature of the oral stage of development. Mother is a very important figure in this stage. The patient’s wife said that he used to do everything that his mother said and would obey her blindly.
The individuals in this stage are greatly dependent on mother and then they try to be independent and separate from the mother but they are not ready for it, so they are very sad on separation. We see the patient breaking down on the death of his mother. He said that he was shocked and felt all alone. For the oral stage, it is all about the family staying united and is he very sensitive to the idea of family falling apart. Often, these are the children who when the parents quarrel, become sick and then both parents come together for the sake of the child. The bonds are weak and are falling apart. Also, in this stage, like in the Natrum line, there is fear of earthquakes, floods, thunderstorms because they can kill people and break apart the family. Losing the family is a very important theme and so they have a great anxiety if any family member comes home late.
Now, that the stage the patient belongs to is clear, we have to look at which subclass he falls into, so as to come to a clear understanding of the plant order. We see that the patient has issues with the digestion and that he had a very severe stomach upset at the beginning of depression, almost 10-12 times a day. Also, we see a lot of loss of balance and suppression of emotions. These are typical features of 5th subclass. Nutrition is an important theme of the oral stage and of the 5th subclass of plants. Gastric problems are very common in the nutrition level of development. This level has to do with digestion, nutrition, food, assimilation of food. In this subclass there are symptoms from constriction of masculine energy. There can be congestion in various parts of the body and emotions which are feminine energy are suppressed. Hence, you have remedies like Anacardium, literally meaning ‘no heart’ in the 5th subclass. The 5th subclass of plants has to do with cognition, logic, mind and emotions which are suppressed. Another important theme of this subclass is of paralysis and losing balance. It is again like an oral stage baby which cannot move.
According to Yakir, Subclass 5 is the stage of the relationship with the father and relationship with others. Within this subclass, there are families like Euphorbiaceae, Anacardiaceae, and Rutaceae families. It is very similar to the Calcarea Line, where the child is just learning to go out in the world. By evolution, individuals have become separate in this subclass; religion also develops here. Like in the Calcarea line there are issues of right and wrong, good and bad. This is the beginning of development of the Superego. The individual starts socializing and becomes conscious of him being separate from others. There are rules and guidelines one must follow. This is where development of cognition begins.
So, now when we look up in Yakir’s table, for an order under stage 2 and 5th subclass, we have the Fabales, an order of flowering plants which has many families under it. In order, to get a clear understanding of the family that the patient needs, I go back to the case and try to analyze it from the Sensation approach. The main problem for the patient was that his brother and mother went away. The patient talked about being united and then everything got scattered and fragmented. He felt lost and confused because his family was not together anymore and this affected him very much. This is his main area of sensitivity – family being together and being split and separated. According to Sensation approach the main sensation of the family Leguminosae belonging to the plant kingdom is of splitting apart, coming apart, scattered, fragmented, feeling scattered and confused, split up, not together, and bound together, feeling together and unified.2
The plants of Leguminosae also known as Fabaceae in North America belong to the order Fabales. Isn’t it just wonderful to see the two systems come together, complement and enrich each other? We start off with Sensation understanding to analyze that the patient needs a plant remedy, then to use Yakir’s understanding and classification of plant evolution, back to Sensation to complete our analysis. What is more, now we use our knowledge from materia medica and the source books in search for a remedy which belongs to Leguminosae and has the patient’s symptoms as well. Isn’t this Synergy indeed, where all approaches come together to a make a whole, complete analysis?
Melilotus officinalis belonging to the Leguminosae has a theme of mistrust. In his case, it was a feature of the schizophrenia or the paranoia in the patient. Melilotus, in my experience, is a very important remedy for bipolar disorder and schizophrenia. If I did not know much of this remedy or of the above approaches, I would have given Kali brom, whose theme is the insecurity at the level of existence and feeling of persecution. In the remedy Melilotus, there is congestion which represents constriction or masculine energy of the 5th subclass. Also, if we are to read Melilotus from Insight into Plants by Dr. Sankaran, he writes, the feeling of Melilotus offidnalis could be: Suddenly split up; acute threat from being split up. On reading Phatak’s Materia medica, we see symptoms like ‘Fear of danger, religious melancholy, weeping’.
The patient received Melilotus 30, and in his follow up after a few months he said he was much better. He had no negative thoughts and had a desire to work which was not the case earlier. He now felt sick maybe once a month in contrast to almost every day earlier. He still felt lethargic and had difficulty in waking up in the morning, which was due to the medicines he was on. I then reduced his medicines for schizophrenia. In the successive follow ups, he reported that his laziness too had reduced a lot. He said “I am feeling good from within. Now I feel I am living my life. I think I have got a new life. I am talking to everyone now. There is freshness. Only when I take stress I get fear sometimes.” I then further reduced his antipsychotic drugs and was successfully able to stop them over a few months.
Psychiatric cases demand a skilled knowledge and experience in order to help perceive the state of the suffering person. The state is such that the patient is hardly able to project much beyond his most obvious ailments. The observation of the family and the observers around comes into play here. In such cases, the symptoms though common to a disease, come together to define the overall state of suffering on which the prescription must be based. Over my years of being with Dr. Sankaran, I have found the Sensation Approach to be extremely handy in such cases. My knowledge of psychiatry, traditional approaches and Sensation together have helped me understand and build on both Sensation and the theory of Evolution of plants, the result being that a successful integration of approaches, as called for in the case, has helped me treat numerous cases successfully.
The Sensation Approach when used with finesse can lead to a definitive analysis, in the absence of obvious symptoms. The solution lies in understanding the deepest issue of the individual, that which is striking and that which runs through his mind and body and connects them, his sensation or the experience which is central to him. Dr. Rajan Sankaran, the pioneer of Sensation Approach in Homoeopathy has developed this approach with his colleagues. They have all made advancements in approaches to case analysis which are beyond the Sensation method. They will come together to present their ideas of their journey to the Sensation and beyond.
The other song has organized Sensation and Beyond: Latest Advanced in Homoeopathic Practice, a 3 day intense learning experience on 8th, 9th and 10th January, 2016 in Mumbai, where senior and international homeopaths and experts in the ‘Sensation Method’ will put these new ideas into practice. The main purpose of this event is to highlight the advances made beyond the Sensation method, which have helped treat difficult and challenging cases. Dr. Mahesh Gandhi is one of the main speakers at the seminar and he will be talking about his successful case results, especially in psychiatric cases using the above approaches.
Dr. Sneha Vyas, M.D. (Hom), Senior Editor, the other song
Dr. Ruchita Shah, B.H.M.S., Editor, the other song
1 – Rajan Sankaran, The Sensation in Homoeopathy, Vital Sensation and the Kingdoms, second Edition, 2005, Homoeopathic Medical Publishers, Mumbai.
2 – Rajan Sankaran, An Insight into Plants, Volume 1, Legumiosae, Second Revised Edition, 2005 Homoeopathic Medical Publishers, Mumbai.
About the other song:
About ‘the other song: International Academy of Advanced Homoeopathy’:
‘the other song’ is a world class premium medical centre which puts good health and well being at the core of an academic culture dedicated to complete patient care. Situated in Mumbai, this institute is one of a kind where a team of 35 doctors headed by Dr. Rajan Sankaran (the pioneer of the Sensation Approach in Homoeopathy) come together and practice Homoeopathy. At the Academy, the students and practitioners are trained in advanced Homoeopathic practices, using new methodologies in combination with the traditional approaches, all with the use of state-of-the-art technology. The Academy is also a meeting point for different schools of thought in Homoeopathy, where renowned homoeopaths – national and international are invited, to share their knowledge and experience so that there is a constant flow of ideas on a common platform.