CHAPTER 1 : Disease, Cure and Health
What is there to be cured ?
The first thing every homeopath should ask himself when confronted with a patient, is: What is there to be cured in this patient?
The answer seems obvious: the complaints of the patient of course!
But there is more to it, the complaints are only the tip of the iceberg. I remember I had this dilemma in the beginning of my practice when a patient came to me with loss of hair; it was a man in his twenties, still single and he had loss of hair indeed, not dramatic but he was very worried about it, he was obsessed about not being attractive anymore for a woman. What is there to be treated in this case?
For the patient it was obvious - if the hairloss was cured also all worrying would stop. But for me it was obvious that if then something else would come up like a wart in his face the same worrying would immediately come up again. Of course one can say you have to treat both things but you have to decide on the center of gravity in the case, what is your criterion of remedy-evaluation when the patient comes back next time.
In paragraph 3 of the Organon Hahnemann refers to this topic when he says: If the physician clearly perceives what is to be cured in every individual case of disease and if he perceives what is curative in each individual medicine ..............then he is a true practitioner of the healing art.
H. uses the word "perceives" which means "to get an understanding " (or to get an insight) of what has to be cured - it is not just "observing" what has to be cured or what the patient wants to be cured.
Health, Disease and Cure
Cure is the road, the way from disease-state towards health. But first we have to agree on our definitions or concepts of health, disease and cure. How do we measure health? In his Science of Homeopathy Vithoulkas uses creativity as the measure or parameter in health. Vithoulkas says (p.41): "By creativity I mean all those acts and functions which promote for the individual himself, and for others, their main goal in life: continuous and unconditional happiness". About health on a mental level Vithoulkas states (p.28): "If it were possible to have an absolutely healthy mind, we would see people who live continually in spiritual bliss, daily revealing new creative ideas expressed in a very clear way, always of service to others". An example of health on an emotional level (p.30): "The most healthy and emotionally evolved people experience some of the most profound states known to mankind: mystical experiences, ecstacy, pure love, religious devotion and a wide range of sublime feelings, difficult to describe".
For me a lot of those symptoms of health remind me of the hallucinogenic drugs, they are more an escape from than a healthy grounding into reality.
Vithoulkas also mentions freedom on the three levels as a parameter of health, in my view a much more relevant parameter than creativity.
The WHO definition of health
The WHO defines health as: a state of psychological, physical and social well-being. This well-being is dependent on two factors: the outside circumstances (social, economical, political, personal) and the inner-state of the person himself. Politics is mainly concerned with the first, and homeopathy gives priority to the inner-state.
Consciousness as parameter in health and disease
Rajan Sankaran in his book The Spirit of Homeopathy is linking the measure of health to the degree of consciousness/awareness of the here and now (like many psychotherapeutic schools do). Being healthy then means to be a 100% conscious or aware of the here and now, on a mental level, the emotional level and the physical level.
In this healthy state you will think, feel and act in proportion and appropriately to the situation you are in (the here and now). That means you will not be in continuous, unconditional happiness but you will grief and weep when you lose a dear one, you enjoy life when the sun is shining and you have a day off, you feel pain on a physical level when someone gives you a punch on the nose, at the same time you feel anger on the emotional level and you act adequately according to the circumstances at that moment. This is everyday grounded health.
Disease then is a state in which you are not totally conscious or aware of the here and now on the three levels. This results in thinking, feeling and acting not in proportion and not fully adequate to the present situation. The responses to the present are influenced in a negative way by unresolved, unconscious conflicts from the past ("unfinished business" ). If you lose a dear one and you cannot weep, then this is disease and homeopathically we might think of Natrium muriaticum or Ignatia.
Cure being the road from disease state towards health is the awakening into the present by means of a resolution or a release of repressed traumatic conflictual energy, that was bottled up in the unconscious. Cure, the awakening into the present, is often accompanied by painful remembrances rising into consciousness. It is exactly this feeling of repressed and never before felt pain which constitutes the letting go of the past and enables a threedimensional (mental, emotional and physical) full awareness of the present.
On the origin and purpose of symptoms
In our normal, every day life we receive many stimuli from the outside, which will be processed and followed by a response. Life could be defined as the ability to react to external influences, following the natural law of “action=reaction”. One could however imagine an extreme situation, in which the external stimulus is so strong, that the natural stimulus-integration capacity of the organism can’t cope. This may result in death: a mosquito is usually unable to integrate and survive a well aimed hit by a fly swatter.
Repression to survive
There are other situations wherein the external stimulus may not be as strong as to cause the death of the organism, but is nevertheless too strong to be able to be integrated fully and instantly. For instance: the blow of a hammer (stimulus) on the head of an unsuspecting victim (organism with stimulus-integration centre) results in a period of unconsciousness (response of the organism). This situation could be compared to a short circuit in an electrical system whereby all the fuses are blown and total darkness follows. If the fuses did not blow, the whole network would be destroyed and burnt out. Similarly, the loss of consciousness in our example is the result of too high a load on the fuses of the stimulus-integration centre. It is a safety mechanism of the organism to protect the nervous system from ruin by too high a voltage.
The main part of the blow cannot be processed and, without being felt or integrated, is consequently stored in the subconscious (=repression). When you regain consciousness you will probably have a bad headache (this is the part of the blow that you were/are able to integrate).
Repressed loads urging towards consciousness
Every energetic load that has been stored in the subconscious has a fundamental urge to rise to the surface, to work its way up towards consciousness in order to be felt, to be expressed and to be integrated after all. It actually takes a lot of energy and effort on the part of the organism to keep all this unfelt and unconscious pain down in the subconscious. You can compare this with a big beachballoon that you try to keep under the watersurface, the balloon being the repressed traumatic energetic load, held down under water (the unconscious) and trying to rise to the surface (consciousness).
In order to take the pressure off, the organism occasionally allows a little part of the unresolved load to trickle up to the surface of the conscious mind, for it to be felt and integrated (pricking a needle into the balloon). In the example of the above mentioned blow from a hammer, this could for instance take the form of regularly returning headaches (which were not present before the blow).
But the organism also has to take care that it doesn’t let too great a load escape from the subconscious to the conscious mind (like pulling the plug out of the balloon), in that case the stimulus-integration centre gets overwhelmed again and blows a fuse (fainting or ”black-outs”) or in the beachballoon metaphor: pulling the plug creates such a turmoil, wave at the surface where the ego (the integrationcenter) is floating that it will be flooded.
One of the measures of the organism to prevent this from happening is, for instance, to bring about a loss of memory of the traumatic event itself. A conscious recollection of the trauma might trigger the whole load to come to the surface with all the dangers of flooding the organism or the recollection of the trauma is only on a mental level and the emotional level is split off (to prevent flooding= retraumatisation).
Insensitivity (numbness) and hypersensitivity (allergy)
In the wake of a trauma which was too overwhelming, we find both certain insensitivities and certain (hyper)sensitivities.
Insensitivity is the defence of the organism to prevent a massive triggering of an unconscious trauma.
Hypersensitivity is a (symbolic) form of processing an unfelt trauma little by little, more to blow off steam than to realise a full integration. The symbolic form is to prevent a conscious link with the original trauma which also could induce massive triggering.
Mental, emotional, physical
These in- and hypersensitivities may be present on three levels. On the mental level an insensitivity or blind spot may take the form of loss of memory or a dullness and an oversensitivity the form of a delusion or a very compelling belief. On the emotional level we may find respectively an inability to feel certain emotions (indifference, detachment) or an exaggerated emotional response (hysteria, fears). On the physical level an insensitivity is for instance numbness in a certain area, or an inability to feel when your feet are cold , while the sensation of pain or allergic reactions might be seen as hypersensitivities.
A girl who has been sexually abused at a young age might have forgotten the whole incident (mental insensitivity), or she may remember the incident without any of the feelings which would normally accompany such a trauma (emotional insensitivity). In the latter case she might be able to talk about the incident in a very reasonable and detached manner, as if she had “integrated “ it all.
She does however have a very strong aversion to men in general (emotional oversensitivity) and she thinks that all men are the same and all are after one thing (mental hypersensitivity). She has sexual problems in the form of frigidity (physical insensitivity). She also suffers from recurring inflammations of the bladder and vagina (physical hypersensitivity). What we see in all these in- and hypersensitivities is a (succesful) attempt of the organism to deal with and to survive the original trauma (by repressing the trauma into the subconscious and preventing a massive triggering into consciousness). And although the girl may, in her rational mind, suspect a relationship between the original trauma and the present events, she is neither able nor allowed to experience this on the level of feeling ("protected" by an emotional insensitivity) to prevent triggering of the whole load of the original trauma which would too much for her to integrate.
Paragraph 7 of the Organon
The totality of the in- and hypersensitivities are described by Hahnemann in par.7 as “ this outwardly reflected picture of the internal essence of the disease”. In the same paragraph he also says that this totality of symptoms is the sole means whereby the disease can make known what remedy it requires. When, after the correct remedy, all symptoms have been removed, then the disease, the affliction of the vital force, has been cured.
All in- and hypersensitivities are to be found in the MM and Repertory as "homeopathic" symptoms.
Consciousness in relation to in-and hypersensitivities
What is the relation between these (patterns of) insensitivities and hypersensitivities and consciousness? Let us first have a look at the term consciousness, or rather “being conscious”. “Being” means existing, here and now. “Conscious” means aware. So “being conscious” means being present in the here and now with full awareness, and therefore being able to react appropriately to all the stimuli of the here and now.
An insensitivity means a blocking of the consciousness of the here and now, because a stimulus of the here and now is not allowed to be felt and an appropriate response cannot be given.
A hypersensitivity means an exaggerated response to a stimulus in the here and now (a reaction which is out of proportion to the strength of the stimulus) and means a narrowing of consciousness because too much energy is focussed on one issue (compulsary) at the expense of others.
In both cases the input of here and now is not experienced in its right proportion.
Confusion of past and present
The hyper- and insensitivities are an appropriate reaction to a past (traumatic) situation and this reaction still persists in the present. In this way past and present are confused.
Insensitivities as silent witnesses
In a homeopathic interview the insensitivities are far more difficult to spot than the hypersensitivities. Patients usually complain about their hypersensitivities, because these are troubling them the most (pains, inflammations, allergies, sadness, phobias, feeling insulted etc.). The insensitivities are the parts that you don’t feel.
That is why we have to be extremely alert to notice the disappearance of the insensitivities during the healing process.
For instance: A patient has come with stomach complaints and he has no psychological problems at all. You give a remedy and on the next visit he says: “Doctor, that remedy was very good for my stomach pains, but I am now feeling terribly depressed”. Your first thought may be: wrong remedy, complaints are going deeper into the organism from a physical level to an emotional level. But on closer questioning you discover that all sorts of “depressing things” from the past are coming up, things which had never troubled the patient because he had “worked all that out long ago”. It is making him very sad, he cries a lot, he is not interested in his hobbies anymore and he is off work, while he could at least still carry on working when he had his stomach problems.
Now it is most important to evaluate this development correctly: An existing mental and emotional insensitivity (the inability to remember and to feel some painful events of the past) has been removed. The, at that time unintegrated and unfelt, pain is now being felt and expressed. This may appear to be an emotional oversensitivity, but it is not. A hypersensitivity is a symbolic process of integration (one might say: in order to soothe the unconscious), while in this case we have a direct and proportionally correct processing of the trauma. Now the symbolic stomach complaints on the physical level are no longer necessary. What is important is that we realise that a cure on the mental and emotional level is taking place (namely the disappearance of the mental / emotional insensitivity) as well as a cure on the physical level (the disappearance of the stomach complaints).
Not changing the remedy, but carefully explaining the process and offering guidance and support in such a difficult time of integration, is of vital importance to the success of the (homeopathic) treatment.
Opium and insensitivity
Opium and Morphinum are homeopathic remedies which are well-known for their patterns of insensitivities on three levels:
mental: unconsciousness, dullness, sleepiness
emotional: indifference, detached, content, asks for nothing
physical: painlessness of complaints usually painful
In a posttraumatic stress situation the body can make a lot of endorphines as a survival mechanism (insensitivities). When the endorphine system of the body is lacking and hypersensitivities (pains, anxieties, delusions, sleeplessness, allergies) dominate then artificial endorphines from outside are needed (drugs, anxiolytics, antipsychotics, antidepressants, sleeping pills, corticosteroids, cigarettes and food).
Cure is becoming conscious
Cure means a complete recovery of the here and now consciousness on mental, emotional and physical level; resulting in the ability to respond appropriately to all stimuli in the here and now. Our in- and hypersensitivities (being an appropriate response to a past unintegrated traumatic event) prevent us from living fully in the here and now, and keep us tied to the past.
The role of the constitutional remedy in the process of becoming conscious (cure)
By giving the right remedy we strengthen the constitution (that is the physical and emotional integration capacity). When the strength is increased the load can also be increased without the organism collapsing or being flooded. So the capacity to process the unintegrated pain residing in the subconscious has been increased, and the organism gratefully takes advantage of this opportunity: its starts on overdue maintenance work and a thorough “spring cleaning”.
How does this manifest itself in practice? Let us go back for a moment to our example of the sexually abused girl. Initially after the homeopathic remedy the existing hypersensitivities might increase (blowing off more steam), made possible by the increase in the loadbearing capacity. The irritability towards men may get stronger and the vaginal complaints worse (homeopathic aggravation). She may even temporarily develop some new physical hypersensitivities in the form of f.e. boils or diarrhoea. These cleansing reactions could be regarded as being the physical counterpart of releasing the burden of old, unfelt, unintegrated pains and energies.
In this way a major part of the old unconscious trauma can be released and processed. Now the organism could permit to bring the memory of the trauma itself back to the conscious mind ( in the beginning most often in dreamform), without the danger of being overwhelmed. This process will bring with it some very painful and violent emotions; that which has been locked away for years is now at last being felt, expressed and thereby integrated. The in- and hypersensitivities are no longer necessary because they were only there prevent rising of the trauma into consciousness, to prevent flooding of the integration center (ego) and prevent blowing fuses. The real reason for her aversion to men will be realised and the irritability will disappear. The vaginal- and bladder complaints, the symbolic expression of the pain which was once inflicted to that area, will now be permanently cured. The sexual insensitivity (frigidity), which was really a withdrawal of the consciousness from an area which had been badly hurt, will now make way for a new awareness of that area and the possibility of natural sexual feelings. Finally, the energy that the organism had been using for years to keep the trauma in the subconscious, will now be available for other things, so that the tiredness that she had felt for years will also disappear.
The here and now consciousness on mental, emotional and physical level has been significantly increased and therefore also the ability to think, feel and act in proportion and appropriately to the present (= health)
When we look at symptoms in this way, it makes sense; a symptom has a reason and a purpose. And a symptom is not on his own, it is related to the other symptoms in a dynamic and meaningful way. The picture of disease becomes understandable for homeopath as well as patient.
Disease is delusion, Awareness is cure
This is the final conclusion of Rajan Sankaran in his Spirit of Homeopathy. Delusion in this sense means: having a distorted view of a situation. And the awareness of this distorted view (on a mental, emotional and physical level) is cure and enables you to see and feel the situation as it is and act in proportion and appropriately to that situation.
Disease is in this case the way we look at the present with eyes that still see the past, which is a delusion. Feeling the unfelt pain from the past (integration) makes the insensitivities and hypersensitivities superfluous (were only there to keep the unfelt pain repressed), so we can take it to become aware of the delusion and see the present as it is.
CHAPTER 2: Post - Traumatic Stress Syndrom
Symptoms (sensitivities and in-sensitivities) are not just at random or unconnected to each-other, on the contrary they are dynamically interrelated and serve a purpose.
They can be seen as a (kind of) posttraumatic stress syndrom and this ptss has a threefold purpose. First of all it is a survival mechanism: the symptoms are the most appropriate ones to survive in the original traumatic situation. Secondly the ptss is there to prevent a massive triggering of the repressed load into consciousness which would again overwhelm the organism resulting in unconsciousness/death or insanity. And thirdly the ptss should pave the way for possible full integration of the unconscious traumatic load in a way that is in proportion to and respecting the integration capacity of the organism. Let us look at this more closely.
1 Survival - Dissociation
Normally stimuli/stresses that do not exceed the integration capacity are fully felt, processed and assimilated. Traumatic stresses that do exceed the integration capacity have to be split off and dissociated from that part of the traumatic stress that can be integrated. This dissociated part is "introjected" without being digested or assimilated (becoming repressed in the unconscious), you can not make it your own (yet). It is a foreighn destructive energy you cannot get rid of it. It is like swallowing down an indigestible lump lying in the stomach like a heavy stone. Insensitivities are commonly the "expressions" of this dissociation.
2 Prevention of traumatriggering - Avoidance
By means of insensitivities the organism survives and also prevents triggering. Certain hypersensitivities (mental, emotional and physical) giving rise to a hyper-alertness or fears concerning any (symbolically) traumarelated issues also prevent triggering cause of strong avoidance reactions (f.e. claustrofobia).
3 Striving for integration
Other hypersensitivities are there to blow off steam and are of a (symbolic) integrative value; f.e. nightmares, chronic headaches after a blow on the head.
Hypersensitivities also involve a lot of trauma-projection on the environment and seeing the (unintegrated) trauma everywhere (mental hypersensitivity: delusion), they are a constant reminder of what still has to be integrated and they will not leave till integration is completed. This is the phase where homeopathy comes in.
Trauma and recovery - the PTSS story
Judith Herman, american psychiatrist, gives in her book: Trauma and Recovery a thorough survey of the history, social, political and psychological implications of the posttraumatic stress disorder. In 1980 PTSD has been added to the psychiatric diagnostic manuals as a separate diagnostic entity.
Common symptoms in an acute PTSS are an intense fear or terror, feeling of helplessness, loss of control and a threat of annihilation/destruction. (Homeopathically immediately Stramonium comes to mind).
In ptss there are three kind of symptoms:
This is the most prominent symptomgroup, it involves a constant overreaction of the sympatetic nervous system which brings the organism in a hyperalertness as if the trauma can return any moment. Easy startling (from noise), poor sleep, fears, high bloodpressure, palpitations, an overall irritability, agressive outbursts.
(These hyperarousal symptoms belong to the hypersensitivities that can give rise to strong avoidance reactions f.e. because of the intense fears concerning traumarelated issues).
Now and then parts of the trauma intrude from the subconscious into consciousness in the form of flashbacks (in wake time) or nightmares (during sleep). Sometimes in disguised form (symbolically) f.e. in repetitive play of traumatised children. This kind of play has a compulsive character and is "unconscious" - not really realising what they are doing.
The intrusion will again cause hyperarousal symptoms (but this time appropriate to the intrusion). The intrusion symptoms can be seen as a spontaneous and unconscious attempt to integrate the traumatic event.
By constriction is meant constriction of the field of consciousness. Dissociation, repression, numbing are the mechanisms of constriction and the guarantees for survival. The insensitivities are the constriction symptoms: amnesia, paralysis, numbness, detachment, all forms of lowered consciousness, depersonalisation, out of body experiences. The body endorphines play an important role in these constriction symptoms (homeopathically Opium and all other drug remedies can evoke and therefore cure constriction symptoms). Traumatised people with a weaker endorphine system will kill the pain from the outside with tranquillizers, alcohol, drugs.
Of course there is a dynamic interrelationship between arousal, intrusion and constriction-symptoms. Intrusionsymptoms are accompanied by arousal but they can also stimulate the endorphine mechanism for painkilling. Every individual ptss has its own specific pattern of arousal, intrusion and constriction symptoms. Quite often alternations between constriction and arousal is seen.
Traumatic events causing ptss
Events like rape, incest, war, disaster (earthquack, flood), hostage taking, concentration camp, domestic violence, assaults, all can give rise to ptss. Especially when the expression of the mindbody-responses to the threat had to be suppressed (as survival) a pttss will follow. It will make a big difference in ptss if the traumatic event was a onetime event (earthquack) or a continued traumatic episode (f.e. incest over a longer period of time). Also will the ptss more severe if the perpetrator is someone within the family (father, husband) on whom the victim is dependent for safety, consolation, social and economic reasons.
On longterm follow up after traumatic events leading to ptss the intrusive symptoms diminish and numbing and constrictive symptoms come to predominate. Also the general anxiety symptoms (arousal symptoms) tend to diminish but the psychosomatic symptoms actually got worse (p. 48 Trauma and Recovery).
"Constrictive symptoms are not readily recognised and their origins in a traumatic event are often lost. With the passage of time, as these negative symptoms become the most prominent feature of the post-traumatic disorder, the diagnosis becomes increasingly easy to overlook. Because post-traumatic symptoms are so persistent and so wide-ranging, they may be mistaken for enduring characteristics of the victims personality. This is a costly error, for the person with unrecognised ptss is condemned to a diminished life, tormented by memory and bounded by helplessness and fear. Long after the event, many traumatised people feel that a part of themselves has died". (p.49)
"No two people have identical reactions, even to the same event. The traumatic syndrome, despite its many constant features, is not the same for everyone. In a study of combat veterans with ptss, for example, each man his predominant symptom pattern was related to his individual childhood history, emotional conflicts, and adaptive style." (p. 58)
This can be all evidence that a traumatic event later in life triggers an earlier ptss. Otto Rank, one of Freuds disciples already stated in the thirties of the last century that birth was the most traumatic experience in life. This can be a basic ptss where the intrusive symptoms have vanished or are there in quite symbolical form (fe claustrofobia), where anxietysymptoms have been converted in psychosomatics. Later traumas will trigger this basic ptss survival responses (reason why no two persons have identical reactions to the same trauma).
The intensity and destructivity of a traumatic event can be determined by three factors:
1 The violence of the outside traumatic stress (easily exceeding the integration capacity of the organism)
2 The inability to express adequat responsing to the threat (for survival reasons or because of situational settings)
3 The vulnerability of the (integrating capacity of the) organism concerned (f.e. when not yet fully developed or already overloaded by previous traumatic events)
The younger (and more dependent) the organism the more vulnerable. In several psychotherapeutic schools it is acknowledged that pre- and perinatal traumatic events (in pregnancy, around birth and the first few months after) are the most deep with lifelong consequences.