A perfect example of what used to be considered a deficient case was in the treatment of people suffering with autism, as they exhibited so few general symptoms. However, what can be evidenced by our writing from the early 90’s is that we have solved that issue, in fact showing that those with autism do not present as deficient cases as much as the homeopath is not understanding what and how to perceive the case. With Cycles and Segments we have a tool that allows us to categorize symptoms, those articulated as well as those observed, those diagnosed alongside those understood.
AS: Quite a few homeopathy students cross over from non-medical fields and have not studied pathology. How important is that knowledge when practicing?
AR: We should start this answer by saying we teach extensively on the importance of understanding pathology, and Paul has written expansively on this subject in the Herscu Letter (http://www.nesh.com/the-herscu-letter/). Pathology is very important and has been so since the beginning of homeopathy. Without a clear understanding of pathology, it becomes challenging to know what it is that is being treated. It also becomes nearly impossible to make an accurate and appropriate prognosis without a working diagnosis. As far back as Boenninghausen’s writing entitled, A Contribution to the Judgment Concerning the Characteristic Value of Symptoms”, we have understood the importance of this question as one of the seven attributes that make up his complete symptom, this one being the second characteristic mentioned, i.e., “quid” or what is the thing. The third attribute is ubi or the seat of the disease. In other words, what is the nature of the disease and where does it lie. The way it is played out now in our medical training, when a patient’s history is being taken, we want to know everything about the symptoms. Every practitioner must be well enough versed in the understanding of pathology, in our most developed, modern sense of the word and if that is not an area of understanding or expertise, that person should practice in a setting where they can take advantage of the knowledge of colleagues. Pathology does not belong to any one school of medicine. Anatomy, physiology and pathology along with physical and clinical diagnosis, laboratory diagnosis and diagnostic imaging are in the purview of many kinds of practitioners and ultimately all homeopaths, should have such training as well.
AS : As you teach around the world, what misconceptions or mistakes do you find most often in the way students practice?
The million dollar question. We’d like to take this from the other angle first. The positive trends we see among students inspire us. There is the openness to learning, there is the desire to be of help to those suffering in this world, there is the commitment to long hours of study, to coming along on this journey of learning, to suspending judgment and allowing grace and understanding to happen. We are energized by the students we teach and it inspires us to keep refining our craft, keep making it more palatable and doable, keeping ourselves on task, being consistent in our clinic and then teaching , being transparent in our work and of course, being encouraging. Nothing makes either of our days better than when we receive a letter or email from a current or past student, see an article written by someone we taught, or hearing from a colleague about a patient success, or perhaps an insight or a thought that reflects deep understanding. Sometimes when teaching we are struck by on-target questions students ask, and on observations and connections they make. These are moments, when strung together, that make us know our work is work of the mind and the heart, and that it matters. When we see our work magnified by others and spreading out into practices near and far, helping people from all walks of life, this elegant and effective medicine comes alive and evolves, as it should.
As to misconceptions or mistakes, there are many and we all make them, hopefully less and less, the more experience we gain. We often forget to figure out what it is that needs to be helped, what is it that is most limiting to the patient. We hyper-focus on small details instead seeing the whole person. We do not understand the pace of healing. We aim too high and have unrealistic expectations of the remedy. We fail to understand obstacles to cure in term of the stressors in our patients’ lives. We change remedies too fast & repeat remedies too often. We do not connect with the patient, and due to that are unable to get their real story. We forget about the tried and true remedies and seek obscure prescriptions. We lose hope in patients and give up.
The best antidote to these kinds of mistakes is to work with a good model. Model making is a relatively new approach being utilized across the disciplines. The Cycles and Segments model grew out of Paul’s appreciation of the essential importance of using models to help with both understanding of homeopathic philosophy as well as practical applications. A good model creates scaffolding on which to hang all knowledge, things known from life experience as well as from new didactic learning and individual reading and study. A good model supports the proper posture toward all patients and gives a map on how to take a case, analyze a case, study materia medica and take a patient over time. We have found Cycles and Segments to be helpful and elegant and internally consistent over the course of many years of both practice and teaching. (You can read what some our students say about Cycles and Segments here: http://www.nesh.com/course-seminar-offerings/course-and-seminar-reviews/what-nesh-students-and-alumni-are-saying/ A good model helps explain past understanding. It can help to explain things that seemed contradictory before and can also help to predict new phenomenon and observations. In an installment of the Herscu Letter Paul has also written this:
While reading one of my chess books, as my sons have been playing in local tournaments, I came across the following quote that reflects my feelings about why I presented these first 11 Letters (which focus on the model of Cycles and Segments) and most especially, why I wrote this and the last Letter. In 1943, International Grandmaster Reuben Fine in his book, The Ideas Behind Chess Openings wrote the following:
“In every field the man who can merely do things without knowing why is at a disadvantage to the one who can not only build, but also tell you why he is building in that way. This is especially noticeable when the prescribed cycle does not obey the laws it is supposed to: then the laborer must sit by with folded hands while the mechanic or engineer comes in and adjusts the delicate mechanism….All this holds true in chess just as it holds true in every field which is a combination of theory and action.”
So even if you never study Cycles and Segments, try to find a model around which to wrap your study and practice of homeopathy!
Colleagues also help. The best way to avoid making the same mistakes over and again is to find a mentor whose work you respect and spend time together. Don’t forget to take time off, model the essential life ingredients of both rest and reflection for your patients. This medicine is good and this medicine works. A recent patient of Amy’s who’d been chronically depressed and suffering with ulcerative colitis, took the remedy Natrum sulphuricum, and over the course of three months became symptom free and on follow-up told Amy, “I feel like I have my life back.” Keep a little folder of those kinds of comments, or other kind words you receive in thank you cards or emails. Pull them out on the tough days. Keep the faith. Keep at it and it will get easier.
AS: In recent years the concept of Kingdom has become more popular. How reliable is it as a means of narrowing down the choice of remedy? What do you consider the right way and wrong way to use it?
We do not use kingdom concepts, never have. The approach to homeopathy that we practice is based on classical tenets, refined through the Cycles and Segments approach. We use the word refined, specifically. We are not trying to replace any of the tenets of homeopathic theory, that being matching a homeopathic remedy to the pathology of the patient. Through the history of homeopathy there have been different theories proposed which supplant the symptoms of a proving with other a priori theories. We are not placing judgment or saying one way is better, but some other approaches would not be what we would consider classical homeopathy and therefore we do not use.
AS: If someone has a friend or relative in the hospital, what advice would you give for intervening with homeopathy?
AR: In many new models of health care, the patient will not be hospitalized for things they now are, so this question in the coming years will be less and less relevant. The purpose of the hospital was to concentrate expensive equipment and operating rooms. As we move toward powerful pharmaceuticals and in-office equipment and procedures, traditional uses of the overnight hospital stay will become less and less common.