Introduction

Introduction – ETHOS HEALTH CARE

Homeopathy will not let you down if you conform to its principles

Homeopathic Psychotherapy : Psychiatric diseases are one sided type of diseases of the psychosomatic whole. These pose a big challenge to humanity today because of the prevailing socioeconomic and cultural conditions. To a homeopath these are unique cases for many reasons. Homeopaths can work on human mind and its all aspects bringing about changes in mental functions which no other therapy can do. But it may not be possible for every homeopath to analyze the cases with psychiatric predominance without some basic knowledge of human psychology. Patient Specific Homeopathic Psychiatry developed at Ethos Body and Mind Clinic deals with this and gives a format which is based on Classical Homeopathy and deals with such cases without going into complexities of psychiatry.

Homeopaths must be cautious about not falling into the temptation of treatment of cases by the name of sickness as followed by allopathic system of medicine. It is crucial that a homeopath remains unprejudiced and treat the case after individualizing it. This medicine is good for diabetes, that one for arthritis; this is not the way Classical Homeopathy works. Psychiatric conditions are no different. Medicines are said to be good for OCD, Schizophrenia, ADHD etc. Treating cases by names and repeating medicines TDS, is not really homeopathy, it is allopathic way of treatment in disguise. The strength of homeopathy lies in the success of its principles which are applicable irrespective of the case being psychiatric predominance, somatic predominance or both.

Types of conditions with psychiatric presentation :

1. Sudden breakout of disorder as acute condition with no apparent earlier association. This can arise because of substance abuse, toxicity, sudden environmental effects or sudden psychological cause.

2. Shift of disorder from bodily state to psychological state. This could be because of environmental conditions, conditions of life or even poor treatment including poor homeopathic treatment.

3. Disorders due to prolonged psychoemotional cause.

There is a tendency among doctors to blame every psychological disorder on the chemical changes in brain. Conditions are given a name and corresponding medicines are prescribed. So every sadness becomes ‘depression’. It is true to an extent but not in totality. And no one knows (or should know) this better than a classical homeopath. Like every other case, these cases must be examined in the entire course of sickness and that includes investigation into complete condition, both physical & psychological as –
– Onset
– Progress
– Current status

The classical homeopathic diagnosis

The classical homeopathic diagnosis requires complete information about disorder. Patient Specific Homeopathic Psychiatry uses following methodology to gather required information and reach the diagnosis.

1. Details from important contacts.
Before initiating proceedings with patient, it is important to gather as much information as possible from important contact like family members, friends, colleagues & associates. They can provide information about when and how it started. They are also important observers of patient in his / her real life situations.

2. Observation
Observation of patient gives many vital clues. Some of these are covered under Mental State Examination. But homeopathic observation goes beyond that. Objective observations can prove strong indicators of correct remedy.

3. Patient’s speak
What patient speaks is important in any case as it includes patient’s version of sickness. This must include onset, progress and current status both physical and psychological. The characteristic physical symptoms can prove deciding factors in selection of correct remedy. Sometimes what patient does not speak becomes more characteristic than what he / she speaks.

4. Psychological techniques like Counseling interview, Free Association etc.
In cases with psychological predominance, the information may not come forth simple and straight. There are many vital clues lying in subconscious mind or not told because they are considered as unrelated. Here psychological techniques like counseling interview, free association, projection techniques, hypnotherapy etc can prove immensely helpful.

5. Mental State Examination.
This is the detailed investigation of mental state. Being an unprejudiced observer is most important for a good mental state examination. This will be dealt in detail later.

Analysis of such cases requires a thorough & careful investigation. One must be careful not to jump to any conclusion on any single piece of information. Therefore separation from a romantic relationship is not necessarily ailment from love disappointed. One must include Surety to three characteristics of symptoms i.e. Intensity, Clarity & Spontaneity.

Mental State Examination
One must be careful while doing mental state examination. The information gathered is indicative of disorder. Always it is the completeness, the totality which will decide the remedy. In this examination the specific psychiatric terms have been omitted. Focus has been kept on what can be observed to identify what is characteristic of the disorder.

1. Appearance
There are certain points given by appearance.
– Apparent Age : The apparent age may differ from actual age. Condition of body structure, skin, hair etc contributes to apparent age. Older looking appearance could be because of physical illness, poor socioeconomic status or psychological distress.
– Grooming : How the patient is dressed & groomed. This can reflect disturbed mental state or ability / attitude for self care. It also reflects how patient relates to self. Note extra bright dressing or extra dull dressing. It could be both, an attempt to conceal or reveal inner self. Dressing may reveal status of gender identity.
– Physical Status : Note physical states like body built and physical handicap. How patient is dealing with his limitations?
– Gait & Posture : This reveals how the person carries himself / herself. It has psychological component along with physical component.
– Others : Altered pupil size could be possible drug abuse. Arcus senilis, palmar erythema and spider angioma indicates alcohol abuse. Skin damage may suggest compulsive washing. Tattoos & body piercing may suggest personality disorders.

2. Behavior
This includes in-clinic behavior and general behavior. In-clinic behavior starts the moment patient enters observation field and continues till departure. Observe body language. Observe how patient relates with others and with doctor. Observe activity level. Study the pattern of conscious & unconscious movements. Note the difference between desire for activity and being industrious. Look for indicators of restlessness like frequent shifting, hand wringing, leg movements etc. Look for facial expressions. Do they align with general behavior? Are there some automatic behaviors? What is the level of cooperation? How patient responds to instructions?

Note the patient’s behavior in real life situation. How he responds to responsibility and changes in life? Note the difference between lascivious, coquettish, adulterous and excessive sexual desire. Any substance abuse? See such behaviors in context with prevalent norms and cultural patterns. How is the social behavior, prefers company or aloofness? Is he timid, awkward or arrogant when in company? Is he too cautious, impulsive or reckless? Any capriciousness or fastidiousness? Is he charlatan, deceitful or liar? Is there any compulsive behavior like checking, praying, counting or washing? Is the behavior appropriate for age?

3. Speech
Two components of speech are to be observed. One is language and other is thought content. Observe the ability of patient to express self. How is the articulation? Watch for the accent & dialect. Observe the pressure, rhythm and modulation of speech. The problem could be in speech apparatus, speech centre or in psychological state. Also observe the thought content. How is the organization of thoughts? How is the direction and flow of thoughts? Is there appropriate control? If loquacity is there then about what? Are the thoughts meaningful in self and with context & surroundings? Is he abrupt?

4. Perception
Note how patient perceives self and surroundings and how is his relationship with surroundings. Is the patient in touch with reality? How he takes the impact of environmental stimuli and surroundings? How is the state of self identity? Note the distortions like delusions, illusions or hallucinations. Observe the kind of insight patient has and his ego status. Is the judgment in order? How are the judgments of time and space? Note the belief system.

5. Emotions
Note the emotional status of patient. Is it in congruence with the life situation? Is it stable or changeable? Observe the range and intensity of emotional state. How he expresses his emotions? Does he torments self in anger, curse & laments others, gets abusive, violent or taciturn? How consolation or contradiction affects him? Is he irritable or averse to be disturbed? How he responds to real life situations? Let him come up with his anxieties and anticipations. Is he fearful of anything or situation? Is he serious, in grief or sad with some reason? Note the difference between apathy, ennui, loathing life and suicidal disposition. Does he craves love, is jealous, feels forsaken or is indifferent to it? Is he affectionate or benevolent? Is he cheerful, vivacious or euphoric?

6. Cognitive Functions
Note the cognitive functions of the patient. Observe the level of consciousness, alertness & attention. Note the abilities of concentration, memory, calculation, reading, writing, learning etc. Is he absentminded or forgetful or has difficulty in concentration? Is the memory active, he dwells onto past occurrences, fancies or there is abundance of thoughts? Any tendency of theorizing? Note the state of will power and self confidence. Is there any state of confusion, dullness or delirium?

Once the information is gathered, the next task is to see what is characteristic of the disorder. A mere collection of symptoms is not helpful. Classical Homeopathy requires individualization. Remedy selection and doses including the follow-up must be in accordance with the principles of classical homeopathy. Homeopathy will not let you down if you conform to its principles.

Homeopathy brings about subtle changes in person’s psychological being. It can change the thinking pattern of a person from negative to positive. It erases past emotional trauma and enables to ‘look forward’. It improves cognitive functions and can help one to achieve a positive mental health.