The inspiration for this article is drawn from a ‘journey to healing.’ not initially a progressive one, experienced by one of my own patients, which took her from initial consultation with her GP, to a psychotherapist, back to the GP and ultimately to me as the homeopath. During the course of this journey she had varying consultations, a combination of pharmaceutical drugs, psychotherapy, and homeopathy. In the light of this case, which will, for the sake of brevity and clarity be briefly discussed only, the purpose being not to analyse the remedy choice or prescription, rather to explore the ‘medical’ journey that lead to the homeopathic consultation, I will demonstrate why homeopathy should be seen as a first line of treatment in many conditions, and why treating symptoms in isolation, ignoring the totality, is problematic and unsatisfactory, whatever the medical discipline.
Given that the focus of this article is very much on the ‘totality of symptoms’ it is significant in this context to clarify that the homeopathic approach is strongly representative of ‘holism’ where the inference is that the totality, i.e. the person in her entirety, is considered as opposed to part of her body. This is particularly true of classical, constitutional homeopathy where the simillimum is given to cover the ‘whole’ person. Holism does not imply isolation. ‘Holism acknowledges that the person’s spirit, mind and body interact together to produce an individuality which goes beyond any one single aspect of the self. Thus holism requires a transcendence of the mind-body split which is implicit in reductionist scientific method.’ (Stone and Matthews, 1996.) Conversely, the allopathic approach is to see each symptom in isolation and treat separately, potentially leading to a chaotic state induced by pharmaceutical drugs, the combined interaction of which has invariably never been tested.
To an extent, the same could apply to polypharmacy in homeopathy; Dr Luc de Schepper states: ‘Polypharmacy, giving many prescriptions at once, is harmful in homeopathy as well as in allopathy. Remember that the remedies bear a powerful force. If they can consistently cure the so-called “incurable diseases,” they must be highly active agents. Each remedy delivers an energetic “punch” to the Vital Force, and it is the secondary response of the Vital Force which acts against the illness and heals the patient. Giving too many remedies at once can leave the Vital Force punched down like a boxer staggering to his knees. (De Schepper, L: 1999) However, the purpose of this article is not to dispute the method. The potential drawbacks of polypharmacy in every field have been alluded to and should be taken seriously. Rather it is to demonstrate that the following illustrative case was ultimately treated, resulting in healing, with a single remedy, covering all the patients’ symptoms, mind body and spirit, associated modalities and concomitants.
Evidence of mental and emotional symptoms often being the cause of pathological physical issues is relatively well known but invariably not addressed. Less well known are physical symptoms causing mental problems which will be highlighted and cited appropriately. Whitmont (2002:202) states ‘Is the body the deepest level of the unconscious or the psyche the highest level of biological differentiation? One may go on splitting hairs indefinitely, failing to realise that the whole question rests on a priori dualistic splitting into mind and body of which it a functional unit manifesting to our sensory experience as though dualistically separated.’
Similarities between homeopathy and other psychotherapeutic disciplines will be exemplified drawing clear and undeniable parallels particularly in the approach to case taking. Additionally, homeopathy is often unfairly criticized and reduced to the idea that our treatments are nothing but placebo, discouraging referrals from every source. For this reason, the term placebo will clarified and discussed. Whilst accepting that all medical disciplines are subject to some degree of healing through the therapeutic consultation, homeopathy has, on many occasions, both in ‘scientific’ RCT’s and observational studies been proved to be significantly more powerful than placebo. 
The following case deals with ‘depression’ and ‘gynaecological complaints.’ Each person manifests a ‘disease’ in a unique way, and this is abundantly clear to physicians of every discipline Labelling with an allopathic diagnosis, although admittedly possibly helpful in giving an outline of a condition and possible disease progression, is not treating the person, it is treating the disease. ‘The disease is not to be named but perceived; not to be classified but to be viewed, that the very nature of it may be discovered.’ (Kent, JT 2003: 646.) We are human beings, with complex mind/body interactions occurring all the time, not robots where if you fix one part all is in perfect working order again. This has been recognised for thousands of years as is evidenced here: ‘The cure of the part should not be attempted without treatment of the whole, and also no attempt should be made to cure the body without the soul, and therefore if the head or body are to be well, you must begin by curing the mind: that is the first thing … For this is the error of our day in the treatment of the human body, that physicians separate the soul from the body.’ (Plato, Chronicles)
The Case, As Discussed, Symptoms In Brief
Details given to the GP; same symptoms, reported to me, laterally as the homeopath, although clearly expanded on exponentially during homeopathic consultation.
GP Visit 1: consultation approximately 10 minutes.
42 year old female, married, 2 children 10 and 12.
She did not feel like herself. She was tearful and upset a lot of the time. Normally sociable she had started to distance herself from friends. Always tired and felt unmotivated. She was having difficulty in sleeping, and was not interested in eating. She wanted to be back to her old, fun loving self. She resented other people trying to encourage her to be sociable and simply wanted to be left alone. She was finding the relationship with her husband tedious and uninspiring and her libido was low. Friends were worried that she had lost her sparkle and energy in life. She felt she had become dull and that she had no energy left, to give to anyone, or even herself.
Adjunctive advice, given by the doctor
‘Try to get out more, you will feel better.’
Referred by GP to a psychotherapist, who was also a counsellor. Objective: trying to avoid the need for medication, at this stage, which could be seen as commendable.
Outcome after 6 months
The patient attended weekly psychotherapy sessions. In short, although the talking and listening skills of the therapist were helpful initially, it was not enough and the patient, after 6 months returned to the GP with similar emotional symptoms as those outlined above, with added despair of recovery and a worsening of the physical symptoms, which still at this stage had not been solicited by either the GP or the psychotherapist, although clearly not the remit of the latter, under normal circumstances.
GP Visit 2, 6 months after first GP consultation
The patient re-iterated the emotional symptoms and at the end of what was a 20 minute consultation as she had booked a double appointment, was prescribed Prozac. She also mentioned, in desperation and hurriedly due to time constraints the physical symptoms, which now had increased and could not be ignored, such as anxiety; palpitations, weakness and sudden fainting, worse before periods. Periods becoming irregular with exceptionally heavy flow. Total loss of sexual libido. Worried about her mental health as often irrational and unusually irritable whilst having to deal with the family when all she wanted to do was be alone.
To help with the ‘physical’ and hormonal, menstrual symptoms, the GP recommended the Mirena coil to the patient to regulate and control her menstrual symptoms. She left the surgery with hope that both medications would help, emotionally ‘lifted’ with a glimmer of joy that finally she was finally getting the treatment she needed
Outcome one year later; her account, first homeopathic consultation.
I encouraged her to just talk freely, before any interjection from me.
Totally disillusioned and now desperate, a friend recommended the patient to me for homeopathic treatment.
Pale and tired looking, almost sallow skin, demeanour exhausted, no light in her eyes, deep set wrinkles which made her look older than her years. No makeup, or apparent care in her appearance, an almost dishevelled look. Hair not brushed, long, unkempt; looks like she could be attractive but had given up. She slumped in the chair and noticeably avoided direct eye contact.
Throughout the previous year, the patient, without questioning and trusting in the proposed ‘cure’, had the coil inserted and took the Prozac. In retrospect, she was at the mercy of a system that knew no better and which did not intend to cause harm. To add insult to injury the combined medications were a disaster, with the initial problems now being compounded, with the addition of new symptoms. It is of course possible that some people would not have reacted in the following way; we are all unique in our responses to treatment. In short, she, in her own words, became restless and found it difficult to sleep, often experiencing bad dreams and almost hallucinatory type symptoms. Her libido was now non-existent and she gained 7 kg’s in weight over this period of time, making her already fragile self-esteem suffer. Some of the anxiety had diminished and she felt quite ‘laid back’ at times, however there were occasions where she would experience frightening attacks of palpitations far worse than before, one of which resulted in a visit to A&E. The menstrual symptoms resolved only in that the monthly heavy bleeding stopped; instead, she was bleeding lightly, most of the time, often accompanied by cramping which she previously had not experienced. In her reporting much of this to me, there was an element of disbelief, tears, and black humour, which was a welcome in what could potentially have been a long, dark, consultation. Humour, as long as it is not misplaced, I have found is a wonderful way to lighten a consultation and gain trust; it is mutually beneficial to both the homeopath and the patient, often breaks the ice and is confirmatory of our shared joy and recognition in humanity. It was the beginning of a wonderful rapport, the basis of which lay in empathy and understanding and a feeling of trust, enforced by the innate knowledge of confidence in the next steps: ‘A key element in the development and maintenance of rapport is the display by the doctor of empathy, or emotional sensitivity towards the patient.’ (Usherwood, T: 1999:27)
Analysis and why the totality of symptoms is so important and why sometimes the psychological, psychotherapeutic route is inadequate in isolation.
What is specifically demonstrated in this case is that any approach to healing, particularly in chronic conditions which does not take in the symptoms in their totality, is misguided and unsatisfactory, resulting in physical and mental confusion, with primary and secondary symptoms from the medication often causing iatrogenic disease and complicating and compounding the pathology. This also applies to the homeopathic approach where a constitutional homeopathic remedy cannot just concentrate on the mental and emotional symptoms. This is why the psychological/psychotherapy route is also, often inadequate, in isolation. A detailed anamnesis should be conducted and the whole picture taken into account; i.e. the entire history of a patient’s physical, mental/emotional health including that appertaining to miasms. Catherine Coulter (2008:100) states that ‘the strongest, deepest current in classical homeopathy – the tug that pulls the stream to the river and the river to the sea- is to address the multiple manifestations of the single disordered life-force with a single remedy; in a phrase, to shape unity from multiplicity.’
To consolidate, throughout the consultation, we are looking for that which has altered in every sphere. Obviously, the emotional aspect is of importance, but is not enough on its own, as is demonstrated in my illustrative case. My patient’s emotional state was influenced by physical factors; a web of emotional and physical ailments that could not begin to be untangled until the underlying elements were exposed and brought into the equation. With reference to the use of the word ‘web’, which I see as illustrative and almost symbolic of the homeopathic consultation) Kent states: ‘All true diseases of the economy flow from the centre to circumference (Kent, 2003: xxi) The simillimum is just that, totality; not partial, but a complete reflection of a state that is mentally, physically and spiritually in alignment with its subject. ‘The constitutional remedy is found by a series of symptoms absolutely new to that patient’. (Boger, CM, cited by Seror, R: 2002)
Significantly, Hahnemann, in the Organon discusses the use of mental and emotional symptoms in aphorisms 210-230. He makes it clear that a remedy should only be given for an altered state, not that which has remained unchanged: ‘Therefore, one will never cure according to nature- that is, homeopathically- unless one considers the mental and emotional changes along with the other symptoms, in all cases of disease, even acute ones and unless for treatment one chooses from among the remedies a disease agent that can produce an emotional or mental state of its own similar to that of the disease as well as any other symptoms similar to the disease. (Hahnemann, 152, Aphorism 213)
The same clearly applies to the physical sphere. We should only be concentrating on pathological symptoms, altered states, and see them in their totality and not fall into a trap of prescribing on keynotes, viewed merely from our perspective. A classic example is, she is slow, fair and fat, and therefore she is Calcarea. Potentially wrong; lesson here, take the case; she may just have become this due to physical and emotional changes, which have become pathological and need treatment. As ever, look for that which presents as strange, rare and peculiar and unique concomitants.
Having accumulated all the case details, I prescribed, constitutionally, Sepia, 200c, split dose. Constitutional treatment: ‘simply stated, it involves taking the whole person into account as far as possible, and treating the person simultaneously on all levels – physical, mental and emotional’. (Watson, 2004:12). My greatest concern here was not to treat the patient as ‘a selection of parts’ like her previous allopathic doctors had, the results being little relief and undeniable evidence of iatrogenic disease. ‘In no case being treated is it necessary to give a patient more than a single simple medicinal substance at one time and for this reason by itself it is inadmissible to do so. It is inconceivable that there could be the slightest doubt about whether it is more natural and rational to prescribe a single simple well known medicinal substance or a mixture of many different ones for a patient at any one time. In homeopathy, the only true and simple natural therapy, it is absolutely forbidden to give the patient two different medicinal substances at any one time.’ (Hahnemann, S: 2005 189, Aphorism 273.)
In my opinion, the single remedy approach should be advocated, wherever possible, in line with the fundamental tenets of classical homeopathy and to avoid the same problems that could occur, as discussed in the introduction by Dr Luc de Schepper with the allopathic approach, by treating symptoms separately, and not seeing the ‘whole.’ There are occasions where one has to be flexible however, with the possible use of intercurrent remedies, alternating remedies, tissue salts and other possible approaches: ‘On the other hand, the “single drug” principle doesn’t mean that he did not sometimes use remedies in alternation or in short succession. The change in the aspect of Vital Force—the image of the sickness—demands a change of remedy. On the other hand, as he stated in the 4th Organon, the remedy must be left for enough time to act.’ (Morrell, P: 2005)
Suffice to say, however, less continues to be more in terms of healing, obviating the potentially harmful, suppressive action of many ‘stimuli’ at once; I strongly believe through simplicity comes clarity. Julian Winston opposes any type of polypharmacy stating: ‘To have a truly scientific art, one needs to clearly understand the interaction between the patient and the remedy. When more than a single substance is given at the same time it is impossible to know, from the reaction of the patient, which of the substances caused the observed changes. The use of polypharmacy is contrary to the ideals that Hahnemann set forth. (Winston, J. 2000)
Follow Up 6 weeks later
For the first time with reference to her ‘condition’, she had felt truly ‘heard.’ During the consultation additional advice was given regarding any ‘maintaining causes’ hindering her recovery specifically an inadequate diet and lack of sleep, which she had taken on board. She had a sense of calm, was desperately tired and had slept for 2 days after receiving the remedy, now not tearful, at peace, in control. Not full of energy but not overwhelmed. She was able to cope and smile. She had experienced a ‘return of old symptoms’ in the form of a urinary tract infection, which was something she had been plagued with pre-children but it was fleeting. In addition, acne she had experienced as a teenager reappeared, but did not linger more than a few days. Physical aspect of menses still to be fully addressed, early days as coil recently removed.
6 months later
As above, with menstrual cycle regulating with lessening of pathological symptoms. She had been gently weaned off the Prozac, working with her GP as she was feeling significantly brighter. In general, she felt so much stronger and had started to look forward to her future with her family and friends. In treating her homeopathically, the totality of symptoms was considered: ‘The physician must perceive in the disease that which is to be cured and the curative indication in each particular case of disease is the totality of symptoms’ (Kent, 2004:7). There is clearly no doubt that the homeopathic prescription given was appropriate to this case. As hoped, the remedy had brought a sluggish Vital Force into balance. ‘It is only this vital force thus unturned which brings about in the organism disagreeable sensations and abnormal functions that we call disease. Being invisible and recognisable solely by its effects on the organism, it can express itself and reveal its untunement only in pathological manifestations in feeling and function…’ (Hahnemann, 2003: 15), Aphorism 11.
Professional Psychiatrist recommends homeopathy
Given the above, it is not surprising that there is a definite shift amongst more enlightened conventional medics who have the ability to see outside of the box and consider different approaches and less damaging solutions, even if it means integrating systems of medicine; again, with due care and as minimal a medication approach as possible. As stated many times in this article, physical symptoms are often the cause of emotional imbalance and vice versa, hence a need to look at the totality. This is without doubt, illustrated here: ‘A study by Anderson et al. (1989) described the “necessary fallibility” and worrisome variations in accuracy of clinical diagnosis. To complicate it even further, a large percent of psychiatric patients receiving medications for their ‘mental health’ troubles were later diagnosed as having ‘medical’ disorders causing their psychiatric symptoms (Flaherty et. al. 1989; Schenkenberg, 1999; and Koranyi, 1979).
This view has been recently taken a step further with an eminent psychiatrist, Dr Vengalis Zafeiriou highlighting the benefits of integrating homoeopathy in psychiatric health care at an integrative Medicine Conference organised by Dubai Healthcare City Authority’s Centre for Healthcare Planning and Quality (CPQ.) He said: ‘homoeopathy can reduce the duration of hospitalisation, quantity of the medicine needed, number of laboratory examinations, frequency of relapses, and the individual and state health care costs. This form of alternative medicine also improves overall health and helps all chronic diseases, excluding irreversible tissue damage; it has no side effects and can be successfully combined with any other kind of treatment.’
“In psychiatry there aren’t any medicines designed to be curative, rather these relieve symptoms. Homeopathy can treat all kinds of disorders from anxiety and phobias to depression and schizophrenia. In mental hospitals, homoeopathy can treat patients with severe mental disorders, contributing considerably to the therapeutic outcome of conventional psychiatric treatment.”(D’Souza, C: 2012)
Homeopathy should be considered as a first line of treatment and this is why.
As a result of this case, with philosophical and management approaches considered, several factors have come to light, prompting other issues which need to be discussed to help build our credibility, integrity and professionalism. Firstly, the importance of seeing ‘the person’ as a whole and viewing the symptoms collectively. Secondly, many conventional GP’s/medics are under the illusion that in the absence of prescription medications, particularly for mental and emotional conditions, the counselling/psychotherapy route are the only routes to be taken. Admirable of course, in that the prescription of potentially dangerous drugs are avoided, albeit, often, temporarily; but I would also like to see homeopathy be considered and recommended. Very few allopathic practitioners are aware that homeopathy contains within its historic and current practice an interviewing style and therapeutic stance that would immediately be recognisable to those formally trained in psychological approaches and congruent with many of their practices (Bohn, 1970. ) Also, it is evident from reading literature focussing on counselling and psychotherapy that there are 4 common features that overlap with the homeopathic approach to treatment:
- A relationship between therapist and patient in which the therapist is seen by the patient as competent and caring,
- A socially and culturally defined practice setting where this relationship intended for healing occurs,
- The exploration / encouragement / witnessing of a “story” or explanation accounting for the patient’s suffering and how it may be resolved, and
- A “method” or set of procedures that both therapist and patient place confidence in and agree to participate in for the intent of restoring the patient’s health and wellbeing. (Frank, 1973; Frank & Frank, (1991)
The benefits of the above consultation mode, coupled with the administration of the correct remedy prescribed on the totality of symptoms often results in healing and a sense of empowerment in the patient who feels in control of their health, thanks to this collaborative rapport.
Thirdly, the reason many Medical doctors would not immediately refer a patient to a homeopath often lies in their belief that homeopathy is simply placebo. For this reason it is necessary to discuss further and explain why this is not the case in the simplest possible terms available, given the complexities involved. One, as a homeopath, has the right to feel offended by sweeping, ill thought out statements such as those that classify homeopathy as ‘simply therapeutic placebo within the context of a medicinal ritual space’ (Bornhoft & Matthiessen, 2011.) As homeopaths we are aware of the highly complex mechanism of action of a homeopathic remedy and have the depth of knowledge acquired from intensive study of homeopathic philosophy. Those that criticize or demean the practice to merely ‘placebo’ are not educated in or aware of the fundamental tenets of homeopathic philosophy, such as ‘direction of cure’ and ‘return of old symptoms’ which are all too evident when the correct simillimum is prescribed. This case, illustrates that healing was gradual and all encompassing. She manifested many of the signs of ‘direction of cure on a physical level and mentally, her state was strengthened. It is difficult to imagine almost complete healing could be attributed to merely placebo. In addition, it is difficult to deny that healing occurs in those who couldn’t begin to understand the meaning of placebo; babies, children, animals, with the same evidence of healing being reflected in homeopathic philosophy.
David Little (2007) clarifies what happens once a homeopathic remedy (the simillimum) has been prescribed:
There are 8 observations of the direction of cure found in Hahnemann and Hering’s writings.
- Pains are removed from above to below
- Diseases are removed from within to without
- Symptoms are removed from the most important to the less important areas
- Symptoms are reversed from the newest to the oldest
- During the process of cure old resolved symptoms may arise
- An amelioration takes place in the mental condition of the patient
- The strength and vitality of the patient increases during treatment
- The opposite of these progressions are signs of disease getting worse or being suppressed. That is, that pains travel from below to above; from within to without, from the less important to the most important; the symptoms increase; complaints the patient never had appear, the mental state gets worse; the patient gets weaker. These are signs that the disease is getting worse or is suppressed.
In fairness it is understandable why so many people fail to understand and appreciate the above given the highly complex system of medicine that homeopathy is. When presented with the above scenario following administration of a remedy, it is clear to the critical homeopathic eye that the remedy effect is way above merely placebo. All protestations to the contrary are a sad attempt at denial of a therapy that has proved to work in many cases.
Conclusion and recommendations
The following words reflect the intention, tone and purpose of this article: ‘Whilst present day medicine has at its disposal a wider spectrum of therapeutically effective drugs and much more advanced surgical techniques, it still operates in terms of isolated functions of an assumed physiochemical human machine, all protestations of holism notwithstanding. The malfunctioning of the machine’s parts have to be identified in order to be fixed….Even though the targeted disturbance or discomfort may temporarily or even permanently be relieved, this remediation often occurs at the price of the unbalancing and damaging the overall health of the organism.’ (Whitmont, E: 1993: ix)
The evidence that it is frequently impossible to separate the pathologies of the mind and body can be seen in the outcome to this case and in many others that both I and my colleagues have personally witnessed. In addition, the testimonies of eminent psychiatrists have been presented to support this observation. Inadequacies in the current, non-holistic approach to treatment have been glaringly exposed, particularly with reference to iatrogenic disease; the intention of the article being to advocate and integrate safer treatment methods, through individualisation and respect for the entire organism of a thinking, feeling, human being.
What has also been demonstrated is the need to prescribe not only on the totality of symptoms, but also as minimally as possible, whatever the medical discipline. Clearly there is often evidence of iatrogenic disease when pharmaceutical drugs are used but in keeping with fundamental homeopathic philosophy there is still, in my opinion, a need to avoid what Catherine Coulter (2008) refers to as ‘conflicting stimuli’ i.e.: polypharmacy in homeopathy, as much as possible. Given the power and potential life changing force of a homeopathic remedy, I would have thought this would be simple, common sense. On this note is worth remembering the words of one of the great masters of homeopathy, Constantine Hering: ‘If our School ever gives up the strict inductive method of Hahnemann we are lost, and deserve to be mentioned only as a caricature in the history of medicine.’ (Cited by Saine A: 2002)
In the case above, the simillimum had been found, in one remedy, Sepia, treating the emotional and physical pathology. Healing, in this case was empirically and philosophically beyond the placebo effect. Clarity was achieved by viewing the symptoms of a person in their totality, the simplicity and purity of a constitutional prescription gently facilitating the body’s innate healing abilities.
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Another thought provoking piece from Gill, I agree entirely with her approach here, so often our patients come with such a “history”. Well done.
Thank you Gwynne. Yes, it is really important to delve into all aspects of a patients health, particularly for chronic conditions. This should be applicable to all medical disciplines, as discussed.
Beautifully written, Gill. I hope the medical community will dance for joy when learning the benefits of homeopathy. It may mean they will need to hit the books, take a course, learn more about the depth of homeopathic remedies and how to take in the “totality” of each case. We are social beings. Building a relationship between patient and physician will produce a wholistic outcome for all. Blessings, Debby
Thank you Debby! I think if the medical community danced for joy on learning the benefits of homeopathy and started to understand and recommend/refer to us more, I would join them!! I wait for that day with great anticipation, in the knowledge that seeing a patients symptoms in their totality is clearly the way to go.