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Case-Taking Methods at NYSH

Susan Sonz
Written by Susan Sonz

Susan Sonz, Director of the New York School of Homeopathy discusses the case taking methods taught at NYSH.

At the New York School of Homeopathy we run a school clinic. It is a great opportunity to offer very inexpensive or free (if need be) homeopathic care. It is also the very best way to learn homeopathy; it’s real life, real health issues (both physical and mental), and real case management.

During our monthly clinic weekends, we see follow-ups on Saturday mornings and a new patient at 2 pm. An advanced student is the “homeopath” of the day. That student will take the case with me- the director and senior homeopath at NYSH- standing by to make suggestions and if necessary, take over the case. As much as I’d like to allow the student to take the case completely on his/her own, my first obligation is to the patient. And so, if need be, I am ready to make sure we get the right remedy even if I have to take over the case.

Once the case is taken, all of the clinic students go home on Saturday evening to analyze and write up the case; they select and defend their remedy choice and they select a potency. This makes for a rather grueling Saturday night once a month, but the experience is unparalleled for a student.

On Sunday morning as a group we read the case together, and we point out the most important things the patient said. Then we all enthusiastically (!) defend our remedy choices. After we have carefully listened to one another’s explanations, we are usually open minded enough to come around to one opinion. We then decide where the remedy can be purchased and what potency to use. The student homeopath informs the patient the following day, does follow-ups by phone at least once a week, and reports back to the group via email reports. We see the patients for live follow-ups every 2 months or so, or more often if necessary.

Case-taking with the use of a Repertory

The method of case-taking is up to the student homeopath. Our students learn a range of methods. Of course, first they all learn how to take a basic case, select rubrics, and choose a remedy.

This method is often useful because some patients are only able to express themselves in a very basic way, or possibly they are too timid to loosen up and let go during the first intake. It sometimes requires an initial prescription, of a similar remedy, to help the patient feel well enough and relaxed enough to open up and reveal the true simillimum in a future retake. Other types of patients actually reveal the simillimum beautifully in a kind of rubrics language and symptomatology, as if they have studied our materia medica. Those are delightful cases because they back up all of the old information that we have learned in our foundation studies.

Unfortunately though, not all cases reveal so easily. This is why most homeopaths, including Hahnemann, have continued to improve on the old system and have sought different methods of case-taking that can facilitate the process of helping a patient reveal their remedy.

What is “Classical Homeopathy”?

However, before I discuss more progressive methods of case-taking, I feel it is important to note that there seems to be a wide spread misunderstanding in our community that there is some connection between “classical homeopathy” and the use of a repertory. At NYSH, we learn from the first lesson onwards the difference between the principles (laws) of classical homeopathy versus rules (theories) that are set forth by homeopaths. In other words, we learn to differentiate the laws of nature that govern the action of homeopathy as a medical system, from the opinions about homeopathy that are held by one homeopath or another.

The Principles of Classical Homeopathy

  1. The Law of Similars – like cures like.
  1. Totality- treating the whole person on all three levels; physical, emotional and mental.
  1. Individuality- every person is unique.
  1. Potentization- dilution and succussion.
  1. Minimal dose- the least amount of medicine required in each individual case.

As for the “classical” part of the title, these definitions below are representative of the online definitions of classic:

-Of or adhering to an established set of artistic or scientific standards or methods

-Representing an exemplary standard within a traditional and long-established form or style

Therefore, “classical homeopathy” can be defined as the practice of homeopathy as laid forth by Samuel Hahnemann, which follows the principles (laws) that govern it’s action.

Is Repertory work part of “Classical Homeopathy”?

I am making a deliberate point here on examination of the term “classical homeopathy”. Nowhere do we find the use of the repertory as a principle of homeopathy. The repertory is simply a database of symptoms and remedies, and it is very useful in some cases, but it is only a tool, and it has been mistakenly connected to the term “classical homeopathy” by many homeopaths. For years it was the most effective way to solve many cases, but nowadays it should be thought of as only one of the tools in our toolbox, NOT the only tool. We can only imagine how thrilling it was in the early days of homeopathy for practitioners to obtain a data base. Up until then, one had to memorize all of the information and keep and share copious notes. But it is important to remember that Hahnemann never used a repertory. One must conclude that the repertory has nothing to do with the principles that govern homeopathy, but instead falls under the category of a “tool”. The principles behind homeopathy are what we must follow, while the tools we use to practice homeopathy, and the rules we choose to follow, should be carefully selected in each individual case.

Therefore, NYSH students learn the use of the repertory, along with other tools. But even when one is working with the repertory, it is still best to start with big ideas, kingdoms and groupings, in my opinion- (please see the article here, Big ideas, Kingdoms and Groupings). If we begin by clearly determining what kingdom a patient is speaking from, we can effectively reduce our choices to one third of the materia medica. To explain this idea in a very simplistic way, patients who need plant remedies tend to speak of their sensitivities on every level, patients who need mineral remedies speak of the structure that they strive to achieve in their lives, and patients who need animal remedies speak of survival. Of course, kingdom differentiation is much more subtle and difficult to discern than it seems after that simple explanation, and we spend years discussing the subtle ways that a patient may reveal the kingdom. A great deal of our understanding of kingdoms in homeopathy has come from the teachings of Rajan Sankaran.

Big Ideas, Kingdom and Groupings

From kingdom selection we go to groupings and sub-groupings. By looking at the big ideas of the case, and comparing these to the big ideas of a remedy, we can often select a remedy without needing to do a repertory analysis. For instance, a patient may come in speaking quite aggressively, but also displaying a fearful demeanor and a lack of self confidence. She has a fear of snakes and all creepy crawling things, and she also has a strong anxiety about her health. She has hormonal issues; intolerable pain before the menses with swollen and painful breasts. She had a difficult childhood; her father was verbally abusive to her and to her mother which made her feel very insecure. She says that sometimes she feels disgusting and hateful and cannot imagine anyone liking her. She describes feeling disconnected and sometimes experiences dizziness or vertigo with a feeling of floating, as if her feet are not touching the ground. She vacillates between feeling powerless and victimized and feeling rage and anger. She says she gets to a point where she can only protect herself by screaming at someone.

In this kind of case there is no need to repertorize. Any 2nd or 3rd year homeopathy student at NYSH should recognize these as the big ideas of Lac caninum, dogs milk. If she also gives us the keynote of loving black pepper or spicy food it’s a bonus confirmation. But before jumping to Lac caninum we must first be certain that she is speaking from the animal kingdom if we are to consider this remedy. Her description of being victimized, attacked, and powerless along with the rage and anger that she uses to protect herself (or survive), helps us see that she needs a remedy from the animal kingdom. The sub-grouping would be mammal, and the sub-sub grouping would be domesticated mammal. (These ideas are discussed in more depth in our animal case articles. See I Just Want to Run and A Rabbit Hiding in Plain Sight)

(Again, please keep in mind that this kingdom discussion is an over-simplification of a complex idea.)

A case such as this hypothetical Lac caninum case is actually a “repertory” case even though we skipped the use of that tool by using the big ideas approach instead. The case-taking method would be similar to what we think of as a standard case-taking (ie. looking for specific symptoms that can be translated into rubrics). So, our big ideas, kingdoms and groupings approach should produce the same results as repertorization- but it is easier to find the remedy this way, if one has studied materia medica in this manner. This means that grouping remedies in a way that facilitates the recognition of the grouping, which is then followed by the differentiation of the individual members of that grouping, helps one select the specific remedy that is needed. For instance, by learning Lachesis muta we end up learning the basic characteristics of snake remedies, but snake remedy patients may need any of the various snake remedies, and these choices must be differentiated. Otherwise everyone would be receiving a bushmaster snake from Surinam while they might be needing the copperhead snake, Cenchris, or any other snake remedy. (And this is one of the reasons the repertory has limitations as a tool- Cenchris would never come up more highly than Lachesis because Lachesis is more famous.)

About the author

Susan Sonz

Susan Sonz

SUSAN SONZ, C.C.H., is the Director of the New York School of Homeopathy and principal instructor. She studied with many of the acknowledged masters in the field. Susan was awarded an H.M.C. (Homeopathic Master Clinician) diploma and is nationally certified (C.C.H.) by the Council on Homeopathic Certification. Susan publishes articles regularly for national journals, served for many years on the national board of the Council for Homeopathic Education (C.H.E.), and is the President of the New York State Homeopathic Association (NYSHA).
Susan's method of teaching includes the use of her own clinical case studies which serve to illuminate the remedy pictures, while reinforcing the homeopathic philosophy. She holds very high standards on homeopathic education, while imparting the information with humor and sensitivity. Susan lives and practices in New York City.

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