MB – Welcome to the Hpathy Hot Seat Dr. Dinesh. It is a pleasure to have you with us. I was recently reading your new book – The Scientifically Intuitive Case Witnessing Process – The Journey of Three Steps. I must say it is a wonderful work that you have done and I really enjoyed reading your book.
Let me begin with a basic question. From the very early college days we used to hear about ‘case taking’. Then a few years ago, a new term, ‘case receiving,’ was introduced. And now you have introduced another term – ‘case witnessing’. What is the difference between case-taking, case-receiving and case-witnessing?
DC:When I started doing case taking, during that time I was reading Buddhism. I came across this term ‘witnessing’ where they use this word for their meditation.
A witness is someone who has a firsthand experience of something; he neither adds anything, nor receives anything. Most of the time when we take a case, we either ‘take’ or ‘receive’; we do not witness as is. Often we receive the case according to our perception or ‘take’ the case according to our pre-existing knowledge of case taking. I wanted a technique where we are witnessing the whole pattern as it is. And the whole aim of ‘witnessing as it is’ is according to that patient. That is why ‘case witnessing’, where you witness the cases without adding or subtracting any data. And you keep witnessing till the remedy arises by itself.
MB: So how does that differ from case-taking and case-receiving in practice?
DC: Earlier a question in my mind was –why are two homeopaths unable to come to the same remedy? Why are two homeopaths unable to come to the same understanding of a human being? And the reason I found was that most of the time case taking is done mostly according to our pre-existing knowledge of case taking, which we have learned in the books or which has been taught by our teachers. But it was never done according to human individuality. If we believe in individualization, then the whole method of bringing out individualistic features of a patient has to be individualistic. And that would only happen if we “witness” the case in a passively alert way, rather than taking the case according to our knowledge of homeopathy. For me it was subtracting all the knowledge of homeopathy that we have, and witnessing the case as is. Like in court we have a witness, the person who gives you a firsthand account of what he has seen, without adding or subtracting anything from it.
MB: But when Dr. Sankaran introduced the term ‘case receiving’, wasn’t it a very similar concept – that you don’t interfere and let the patient flow to his natural conclusion, that you let the patient move in the direction that she wants without interfering and without interpreting the data? So how does the technique of case witnessing differ from case receiving?
DC: I was with that technique for almost five years. What I found was that despite using that technique, most of the time we were not able to come to the real center of the patient, according to the patient. Most of the time I felt that the case taking we were doing was according to the existing knowledge of the system that we had created. A method that was according to the center of that human being was required. I wanted a case receiving process which is scientific, simple, according to the center of the human being and easily reproducible. So what I asked was – can I, in each and every case, reach the center of the patient and use an individualised approach according to the need of an individual patient?
MB: So the question is, can you?
DC: It is a good question. This is what I was trying to do since the last ten years. I will tell how I came to this method. I was watching the universal phenomenon and I came to the conclusion that everything in the Universe happens in a three-step process. Initially we are putting together information scientifically, but the things are not connected and coordinated. Then gradually things start connecting. Then a time comes when things connect and coordinate to come together in a single pattern. Let me give you an example. Let us say you are learning to drive a car. Initially you know everything, where is clutch, where is brake, where is accelerator. But when you start driving, your mind and hands and legs are not coordinated. Then a time comes when things start connecting and you can drive with effort. Finally comes a time when everything is so coordinated that you can drive effortlessly.
So I wanted a system where the PQRS symptoms, which are not connected, gradually start connecting in a single pattern. We initially put in scientific effort, but gradually the whole process becomes intuitive, effortless. So if you look at my case witnessing process, which is in three steps, these three steps are actually that. Initially you give free-floating attention to your patient where, with all your knowledge of case taking, you are just listening to the patient. And you are getting PQRS symptoms, maybe at the local level or mental level or general level or holistic level. But they are not connected. Then you keep giving them space till you see that out of these, there is one thing that is coming up again and again at the local, general and holistic levels. Now that becomes the center for me. It becomes the key to open the door of the subconscious and beyond (subconscious).
Then I start the second step, that is active case taking. Now I know that this is the right key, this is the PQRS symptom that will open the door of the subconscious and beyond. Then the other PQRS symptoms start getting connected to it. I know I am at the right path, when the verbal and non-verbal language starts becoming connected. And the moment it starts connecting, I know it is time to begin the Active-Active case witnessing process. You keep on doing the case taking till every PQRS symptom gets connected as a whole.
I wanted a method where everything in a case happened according to the patient and not according to my knowledge. Where I give him space, then I understand what is the real center of him that is a appearing in many areas. Then you make sure that this is it. Once you are sure of it, then go on till all PQRS get connected in a single pattern. Then you give a remedy where everything is connected like this.
MB: So, can you elaborate these three steps for the homeopaths who have not read your book or who are not initiated into the case receiving and case witnessing process?
DC: I would like to tell you the whole story. The question that was bothering me was – why couldn’t two homeopaths come to the same remedy and same understanding of a human being? Why two homeopaths belonging to classical homeopathy and modern classical homeopathy, never come to the same understanding of a human being. If we believe in laws that are simple, then naturally each and every homeopath should come to the same conclusion.
The first thing that I did in 2003-2004 was to understand this problem. Then when I read Hahnemann’s books again, I found that Hahnemann speaks about the PQRS symptoms at the local level, PQRS symptoms at the general level, and PQRS symptoms at the mental level. Then definitely there must be a PQRS symptom which is coming up at the local level, physical general level and mental general level. Naturally, then this is the PQRS symptom at the holistic level.
So in order to do a successful classical homeopathy I need to find out the PQRS symptoms or the individualised symptoms at the holistic level. Those expressions that are there in each and every area that the patient talks about – is what I call individualization at the holistic level. I feel that individualization at the holistic level is most important.
And what is a simillimum? I believe that a simillimum is where the PQRS symptoms of the patient at the holistic level, match the PQRS symptoms of the remedy at a holistic level.
Once I understood this, then I thought, let us understand the Sensation method again. What we call the ‘sensation’ is where the mind and body come together, where the PQRS symptoms come at the holistic level. Once I understood this, I realised what Dr. Vithoulkas calls ‘the essence’, Dr. Dhawle called ‘the core’, what Dr. Sankaran called in the early 90’s – the core delusion, and what he now calls the sensation -all these are nothing but the PQRS or the individualization found at the holistic level!
So now the scene is, we have many stalwarts who help us to understand patients at deeper level, holistic level; we have stalwarts who are doing successful case taking themselves as per their understanding of (or as per their system) “Holistic” patient. But the problem was, many of us (sometimes) including me could not reproduce the case taking that our stalwarts could follow – in various of our cases. The stalwarts could do a successful case taking most of the time but we often failed (whichever system we followed!)
So, the next question for me was – Can we have a method that is ageless, timeless and beyond any personality? A case taking method, which is also simple, scientific and reproducible? Can we develop a method of case-taking which is Human-centric – where we do not do case taking according to any system, but we do case taking according to the center of that human being? (And that’s the reason why my second step was to find the PQRS at the holistic level.)
Now the question was, how to develop this method – where you (as a homeopath) are out of the picture and you do case taking according to the center of the patient. So I understood that the PQRS symptom at the holistic level is most important. So the aim of the case taking is to bring out the PQRS symptom at the holistic level. Different people call it differently – some call it the sensation, some call it the core, some call it the essence, some call it the core delusion and some are calling it the genetic core.
So I felt the need of such a case-taking method, which was simple, scientific, intuitive and reproducible and according to the patient’s center so that I don’t bring out what I know, but actually it (the core/essence/ etc.,) comes on the surface the way it is. And that is the reason I use the term witnessing.
So that answers the question “why was there need to bring in Case Witnessing Method?”
Now, let me share why this method is the way it is (having three steps).
I wanted to know what kind of case witnessing should be there, to really make it simple and scientific, which everybody could do, from old classical homeopaths to modern classical homeopaths, or belonging to any school.
I told you I was observing all phenomenon of the universe. From Bushmen to car driving to the philosopher who gave the law of three – he said that everything in this universe happens in three steps. The way I understood it, is that initially when you put in any activity, you put in scientific effort, but still the end result is not connected, not coordinated and not in tune with the effort you put. Then a time comes when the results start coming according to the effort put out. The thing starts getting coordinated and connected. And then a time comes where everything starts coming together in a beautiful pattern, where you put little effort in, but the outcome is much more. And it is almost intuitive.
Let me give you an example. Newton was sitting under the tree, an apple fell down and he discovered the law of gravitation. It was intuitive. Buddha was sitting under a tree and he got enlightened. It looks as if it happened suddenly, but actually both of them had put several years into this effort. Newton put in several years and Buddha also put in six years. And one day the result was intuitive.
I gave you an example of car driving. That initially in spite of all my scientific effort the outcome is not coordinated. But later on everything is coordinated. I can drive at the speed of 150kmph without thinking of my eye and hand coordination. It’s the same way I wanted my case taking to be. Initially I put in scientific effort and later on, according to the center of that human being, the whole journey becomes effortless and intuitive, going towards the center of this patient – And that’s why the case witnessing has been divided in these three steps – Passive, Active and Active-Active.
The passive is universal to all the patients – from the age when a child can speak to old age, and for all pathologies – every patient goes through the passive case taking, where you give just free floating attention to the patient, and space where the patient can say whatever he wants to. This is passive case taking, where you are not altering the flow of the case. But why am I doing it? I want to see what PQRS symptoms he is giving and at what level. Some patients will give me local symptoms only, some will give generals, some will give mentals, and some would give feelings, delusions or dreams. I will note down everything as it is. This is my first aim in passive case taking.
Then while noting down, I’ll try to find out which is that symptom which is holistic – which is coming in general, particular and mental general and all the areas that patient is talking about. That which is coming in two or three different areas, not related to each other, I would call it the “focus” of the case, the key of the case or what Dr. Sankaran now-a-days calls as ‘the anchor of the case’…because I know this is the key towards this holistic remedy, or this is the key to his subconscious. Till then I’ll allow the patient to go in any area he wants to. And all the questions I’ll design will be open-ended. The aim of those questions would be to make the patient move in the direction he wants to. Some would go in the chief complaint, some in generalities, some in emotions – allow them to go and see what is coming up again and again. This is passive case taking.
Once I know I have got the key, I move on to the second step. But the second or the third step is according to the center of that human being. Because now I have got the theme or symptom which is coming up again and again, I have got this key and I ask – could there be chances that this key is wrong? So how do I make sure that this key is right? I told you earlier that as the case taking advances, the symptoms and themes start appearing coordinated. The moment I see that the other PQRS symptoms start connecting with this key, I know I am on the right track.
The moment the verbal and non-verbal language starts getting connected, I know this is definitely coming from the holistic level. And there are many other things that we won’t mention in the beginning. But these two things will give me the surety that this is the key. The moment I am sure of the key, I start the third step, Active-Active case taking. Now I know this is the key to open his complete subconscious. This is the key where every part of his remedy would come in front of me. This is the key where every PQRS symptom would get connected beautifully. And I keep asking about it till every PQRS symptom gets connected, till I get the whole holistic expression of that patient. The remedy should have that pattern in that fashion.
So these three steps help me in case taking. Initially you wait till the right action comes, make sure that this is the right key and once you make sure, go till the remedy. And once I start the third step, I know I have to go towards the remedy. There are patients, who will connect all the PQRS symptoms, then there are patients who will slowly start going towards the source or the remedy itself and there are some patients who would directly go the healing level, which we will talk about later.
MB: Dinesh, the last time I saw Dr. Sankaran in a seminar was in November 2010. The cases that I saw then were also very similar to those that I read in your book. All the cases were such that in the end, the verbal language of the patient and the gestures all come into alignment and start pointing towards the source. So my question to you again is – how is your case-taking, or case-receiving, or case-witnessing different from what other practitioners of the sensation method are doing? Because I do feel that there is a novelty in your approach in that you have divided the process into three clear steps, but the broad pattern in practice is similar to what I see Dr. Sanakaran doing, or other sensation method practitioners doing. You start from some key aspects of the case at the general or particular level, let the patient speak, move to a core area of the patient, what you label as PQRS, and then take the patient to the core where the physical language and verbal language and the cues, all come into alignment and start pointing towards a definite source. So how does your approach differ or innovate over the existing method?
DC: initially when I started teaching, the students used to say that the sensation method is too good. Students appreciate it till date, however they find it is very difficult to reach there. Second, if you see in sensation method, all my teachers including Dr. Sankaran, Dr. Jayesh, Dr. Sujeet, Dr. Divya, D. Sudheer – each one of us has a method to reach to the center of the patient. Now the question was that, definitely all of us are right, but if we do the case taking according to the center of the case, then in application each patient would need a different technique to go to his center or sensation.
I’ll give you an example. A patient is suffering from constipation and I, as a sensation method practitioner, ask him ‘what is the sensation?’ But that patient is at the physical level and there is a paucity of symptoms. So you are talking in a language, which is right according to you, but you are asking it to the wrong person at the wrong time. So all which was existing – the passive, active and active-active parts were already there. What I did was, I made a system which can be reproduced by any practitioner in any case, and depending upon the case, you use a different technique. The case witnessing method is not a method belonging to any one school of thought. Traditional and new homeopaths can identify with this method. This is a system which is reproducible.
Now the feedback I get from the countries where I give seminars, is that ‘now, we are able to practice sensation method’. The review of my pediatric book (Wander with a Little Wonder), which was published by Narayana Publishers, says that this is the method which can be practiced by anyone. It’s not that you need to be part of the Sensation school in order to do this kind of case taking.
MB: How will you address the difference in our understanding of what constitutes the PQRS? Different schools consider different types of symptoms as PQRS. A conventional classical homeopath will take anything that is rare, unusual or intense – at any level- as the PQRS symptom. In your method, it is the unusual expression or gesture which is out of place or intense or occurring at two or more different levels, that is taken as the PQRS. Your PQRS at that point of time becomes different from the one used by a classical practitioner. What is characteristic to the patient does not differ in reality, but the information that a classical practitioner and a sensation method practitioner take, does differ at the outset. So how will those two practitioners reach the same remedy, when the information being used is different?
DC: Again you are talking about a system which varies from practitioner to practitioner. Now see what I mean by PQRS symptom – when you are listening to the patient, take any expression that is out of place, out of order or out of proportion – whether at the local level, general level or mental general level. Whatever is coming up (a local symptom or fear or delusion or dream, or a physical general) you just make a note of it. In that I am just doing what a classical practitioner would do, whether belonging to Sehgal school, Dhawle school, Vijayakar school, Vithoulkas school and Sanakaran school. I am paying attention to all PQRS symptoms, which can be a modality, a word, a concomitant or anything. Now out of these PQRS symptoms, I’ll see which one is coming from the holistic level – what we call the grand generalization of Boenninghausen. But here the patient gives you a sensation that is present in his local symptom, in his modalities, in his fears, delusions, dreams also. Now I would take that as the PQRS symptom at the holistic level.
MB: SO what you are saying is that instead of just focusing on PQRS symptoms within individual symptoms, you find a symptom that is reflecting at all levels.
MB: And you take that as the general PQRS. And with that PQRS you move to the Active-Active case taking?
DC: No. First I make sure that this is it, because if it is wrong, then my whole journey is wrong. So first I make sure.
MB: So how do you make sure?
DC: Suppose I get ten terms (PQRS or out of place, out of order expressions). Out of this, one was appearing at the local level, physical general level and mental general level. Now I take that symptom and start asking about it. When I ask about it, the patient starts connecting three more symptoms from the remaining nine with this particular PQRS symptom. This will only happen if you are moving towards the holistic PQRS. I know that we are on the right track as these symptoms are all connected and not separate. The moment I ask about that, the verbal and non-verbal language starts getting in tune with it.
There are many other things, like the patients often start throwing defences at this point. Like if you ask about something from your deeper conscious, then automatically a defence comes up. Like the chief complaint gets aggravated. Suddenly the patient will ask to go to pass urine or would start perspiring or would become restless or body language starts coming up. I know this is coming from the whole. That’s where everything starts getting connected.
So active case taking is the part where I make sure that this symptom which has come up is actually the PQRS symptom at the holistic level. Once the other symptoms start connecting, once the verbal and non-verbal language start getting connected, I know I am on a right track. These will definitely lead me to the full expression of this PQRS symptom where the whole is connected.
MB: You talked about defences coming up when the core is touched. I was reading some of your cases and saw that in many of them the defence that came up was that patient would either ask for a glass of water or the patient would cough. If you are taking an hour long case, or a two hour long case, wouldn’t it be physiologically normal for a patient who has talked for half an hour to have a dry throat and ask for a glass of water?
DC: Naturally if the AC is not working then obviously the patient might ask me to start the AC or may ask for a glass of water. But what I am trying to tell you here is – the moment you touch the core, at that particular time only the defences are thrown. Every time you touch the core, the periphery is aggravated. It actually happens according to the concept of homeopathic aggravation, where you touch the center and the periphery gets aggravated. So I am not talking about random acts where the patient asks for a glass of water, or wants a break to pass urine. I watch closely that every time I touch the core, either the chief complaint gets aggravated or a reaction comes up again and again. For eg. I touch the core and yawning comes. I can miss it once and feel it could be a coincidence. But every time I touch the core the same reaction comes up and gets deeper.
MB: So that is how you confirm the PQRS in the active process.
DC: Yes. When the defense starts coming, the moment he goes in, the chief complaint gets aggravated – till the whole remedy is out. The moment the remedy is out, automatically the chief complaint becomes complacent and nothing happens. So you are watching again and again, if it is happening two three times, then you know that this is it.
This case taking is like if you are watching a castle from outside. So the first step is watching the castle from outside, where you see the domes, the pillars, the walls – everything. There are multiple keys lying there. Now you need that one key which is for the main door, which goes directly to the king’s room. If you pick the wrong key, inside the castle the defenses are already ready. The more wrong you pick up, the more aware they will be. So once you get the key, make sure that key is right and you try to open the door. If it is the master key then the door will open and you will have way to go to the king’s room. But the defenses are already ready, and if you touch the main door, the defenses will attack. And now for the first time you see inside what is in there. Same way when the subconscious is touched, it throws a defense.
MB: so you are saying that we need a key to open the door. But I have seen many sensation practitioners taking a log of wood and hammer at the door with it.
DC: That’s why we say we are ‘therapists’. You divide that word in two and we become ‘the rapist’. And the rapist is one who does everything without consent. So naturally there would be a problem. You are penetrating into the patient’s core without consent. I am talking about a case taking were the patient subconsciously gives you his consent. You wait, wait and wait till the patient is ready to go to his subconscious level. That’s the time you use the master key and smoothly open it. Then there is least resistance.
That is the reason why we need three steps. Many people ask me, “Why not do the active-active directly?” It is like waiting for the golden egg. You wait and wait till the golden egg comes out. You are ready to witness and then respond.
MB: So we have seen what happens in passive case witnessing and also in active case witnessing process. So how do you move into the Active-Active case witnessing process? And what is the objective of that process?