Excerpted from Kathrine Dehn’s paper :Mental Symptoms And Maintaining Causes
One of the most important guidelines in homoeopathic work is Hering’s law of cure. This states in which direction the cure should take place:
1) From centre to periphery
2) From above to below
3) From more serious to less serious
4) In reverse order of appearance of symptoms
At times even in cases where the symptoms are primarily physical ones, the direction of cure can be difficult to discern if the case is very complicated. However, when dealing with very heavy mental pathology without any physical symptoms to speak of, it is also necessary to know whether or not the process is going in the right direction of cure. This can sometimes be a bit of a puzzle as there are many subtleties in the human mind and the symptoms are often intermingled. In complex cases where the disease progress has been under way for a long time some symptoms have come and gone in between each other. The homoeopath’s management of such cases is of the utmost importance. In these cases we need to know which mental/emotional symptoms are the more serious ones and we have to look for old symptoms returning on the mental level until physical symptoms gradually unfold. As mentioned above the will and the understanding form a unit, and disturbances to the will or voluntary principle show a disorder of the core of the personality. Therefore symptoms on this level have to be dealt with first.
Sometimes a particular symptom or set of symptoms may disappear and then return again if they have been in existence for a long period of time and relate to the deeper issues of the patient. On the patient’s path towards cure, going back through symptoms in the reverse order in accordance with Hering’s law of cure, the patient may suddenly choose a maintaining cause that keeps him in a certain situation so he is forced to look at and deal with the original situation. The patient may appear “as if” stuck, but on questioning the patient thoroughly it becomes apparent that he has experienced a similar situation previously and in actual fact the person is dealing with issues on a deep mental level. Trying to speed up that process or asking him to remove it may withhold the patient from dealing with an essential part of his symptoms, or existential nature, thus preventing him from personal development and growth. This is not to be confused with the maintaining causes of those people who have a tendency to always put themselves in difficult situations as that is something entirely different. They are people who seem to thrive on difficult situations like some types of Lach., who are seemingly martyrs and who cannot live without conflicts. In those patients the homoeopath needs to see that the patients break away from their vicious circles. When they have their remedies they may start choosing the easier options for themselves.
An example of the former may be the Cann-i. patient who had a delusion she was a spirit. She isolated herself in her home because she could not cope with seeing other people. She had a sensation as if she were not really present in the world. Her sensations were distorted, both in regard to herself and to others. An interesting aspect was that she had a strong aversion to smoking cannabis, but her husband smoked it frequently. As her treatment progressed she started working and doing things she had never dared do when amongst people, but gradually she took on more and more work and actually became very anxious. She developed physical pain and anxiety accompanying the physical pain. But she still did not listen to her body and took on more work, dealing with a lot of people. When she had the remedy it did not seem to have any effect, she seemed to be stuck. At that time I considered whether I gave her the wrong remedy, or whether I should tell her not to work so hard and try to listen to her body and her self, but I decided not to interfere and wait. She kept on taking on more work not listening to her own needs, her husband’s needs, or her children’s needs to see her. Physically she felt increasingly worse, but she continued working long hours and enrolled on a new course – until one day she had a terrible panic attack with a lot of physical pain, especially back pain. Suddenly that day she realised that the situation she had been putting herself through was similar to the situation her mother had put her through as a child. She had kept saying over and over in her head that she could not take anymore, she could not take anymore, and that was why she had had to become a spirit so that she did not have to sense the pain. Now the situation was reversed. She did not feel like a spirit anymore. She was back in her body and that was painful. After that experience she eased off the workload and allowed herself to take time off if she was ill. As she was sensing her own needs she became more aware of her family’s needs as well and life became easier all round.
It is not unusual when the symptoms change on the mental level from severe mental pathology with personal disturbances that a lot of fears and anxieties arise on the road to cure. After severe disturbances to the mental level have been dealt with, physical symptoms may gradually appear. Often old suppressed physical symptoms, but one should also be aware that, when dealing with mentally ill people, a healing crisis may sometimes occur. At the time when the symptom picture changes from being primarily appertaining to the mental level to the physical level, the disturbance may settle in an organ for a while and the patient may become seriously ill for a period of time.