I would like to take you along with me through this journey during my case taking process using the sensation method.
As I went from the most superficial to the deepest levels of her state confirming her miasm and kingdom along the way, I surprisingly discovered the deepest sensation and energy of one of our well known remedies!
Patient -
38 year old woman, married with two children referred to me by a Naturopath. She had completed my questionnaire, which had the following important points, before the interview.
Chief complaint -
The anxiety attacks and irritable bowel have ruled my life for over 15 years.
Every time I travel, I have these chest pains, tightness of chest, palpitations associated with an irritable bowel.
It is more intense when I am in a hurry, if running late or going to an appointment and haven’t met the person. I get very nervous and feel ‘churned up’ in the stomach, like really bad butterflies in the stomach.
Past history – Tonsillectomy (recurrent tonsillitis as a child) and small moles.
Family history - Mother has suffered a stroke and has taken Warfarin on a daily basis for the past 30 years. She had a cardiac valve replacement six years ago.
Generals -
Hot patient
Sleeps on right side.
Mental state - Bad childhood with mum and dad having violent episodes. I have blocked most of my past out especially my girlfriend’s death which took over six months of grieving. Saw a counsellor, then a hypnotherapist which all helped a lot. I have problems getting along with my family. My dad is very strong and so is my sister, but I am a strong person also, so we all have times when we don’t talk, which is happening now.
The consultation was as follows. My thought process is given in italics in brackets.
Tell me about the panic attacks?
I get it from my mom. Phobias in confined places. I don’t go on buses, trains. Feel I can’t get out.
My best friend died in a horrific car accident 13 years ago. She was crushed by a garbage truck.
I have a sister who doesn’t accept me for who I am.
During panic attack I have to empty my bowels. I am very particular about cleanliness. OCD. Washing hands.
(She immediately goes from one subject to another, so I bring her back to my initial question.)
Can you please describe what happens during the attack?
For example when going by train to the city, I feel I am trapped. I feel ‘just get me out of here, somewhere to a toilet.’ Its been more so after the kids were born and while coping with them when they were so dependant. My ten year old daughter is full on. I am very anxious. I take Bach flower drops to settle me down during the attack. But they still come back.
During the attack I need to have nobody around me. When in a car I feel I can open the door and just jump. I need to get out. Feel tight and very trapped.
(She mentions a sensation here – tight and trapped. So I enter the case from here.)
Describe this a bit more please?
It goes straight to my stomach and I have this urge to go to the toilet. When I get the urge nothing can stop me. I have to go especially when I am in a train/bus or car with no toilets around. The feeling is ‘what if there are no toilets around?’ I feel trapped as in a cage.
I need to drive and only then feel I am in control. If I am not driving I am not in control. It’s not normal. We are confined at home. I need to plan ahead for trips. I drive my husband insane. I hate spontaneous things. If I have to rush somewhere it churns up things inside. My mum is the same.
What is the experience of being trapped?
It’s a sensation over my entire body. Confined inside, can’t get out. Agitation and anger as if I could hit someone. Get me out. I am possessed. Get me out of here now, just drive over or kill someone but get me there.
(This must be the deepest she can go from her chief complaint. She goes from a local complaint to a general sensation. Trapped, confined and can’t get out. The way she reacts to this is with anger and violence to the extent of killing someone and losing control. This is the miasm i.e. syphilitic.
Now I need to explore other areas and confirm whether the same sensation is recurring with similar coping mechanism and reaction.)
I had a similar panicky feeling when I visited Jenolan caves. I was spaced out and dazed, couldn’t comprehend. I felt if I go deeper and deeper in the narrow cave I will die.
(She spontaneously mentions another situation with a similar reaction. I realise she is too fast and quickly jumping to another thing before I catch her to explain further.)
I have fear of crocodiles, spiders; I have had dreams covered with tarantula spiders.
I can be so angry. I wouldn’t hurt anyone, but I get a bunch of plates and crash them. Then I laugh. It’s my release.
Push me and I snap.
Tight in the chest and not in control.
Don’t come near me two days before menses.
My dad would niggle and torment mum. She would snap, scream and would pass out. Felt confined. No way in the world I am going to put up with that.
(She takes me to her child hood with a similar sensation – being confined. So this is another entry point.)
Niggle?
Cleverly doing things to annoy you. We would be sitting there feeling sick. Chew fingers, pick skin, nervous and edgy, too frightened to open mouth. They do it so quietly.
He locked the TV, whipped us with a lash.
I have anger which I cannot control. I was a good girl in life. Did not touch drugs.
I remember all the traumas. First day at school, I was screaming; it was traumatic. Dad was bashing mum, yelling at her.
I have the most vicious tongue in the world. Stay away from me. Its a lead up. My life is just edgy. I am a perfectionist.
I hate being told what to do. I so hated school. My husband says it has to be your way and on your terms. I have always been rebellious when teachers made me do something. Left school at year 10.
At home it was dad. If you did the wrong thing he never bashed us, but you had to do what was told. He was a control freak. There was no room to move. He never let me go anywhere. He ruled us. No sleepovers. He was a strong personality. Dragged us to the beach. It was doing what he wanted to do. Dad hated my boyfriends. I sneaked out. Deceived him and lied; went to night clubs at 16. Didn’t tell dad as he would be cranky and take it out on mum.
(She describes situations of being controlled, ruled, abused and dominated by her father and teachers. There was no room to move. She reacted in anger, being a rebel, using deceit and lies.
This is the delusional level. I need to go deeper to the sensation here.)
What was the experience of being in that situation with your father and no room to move?
He was so strong it was frightening. When he bashed mum she had a fit and we even laughed with him as we had to be good kids!
But when I was a bit older I gave it to dad. I said you are not going to rule me anymore. You push me and I snap. It was push- push- push and I snapped. I can only take so much. I am nice, so nice and then go nasty nasty and it’s your fault. It just irritates me. In the past I had a lot of guilt as he was my dad after all. But now I have dropped that. I have this fiery temper but I don’t bash people. Dad is licking his wound back home now.
I was trapped in his house. It was dad’s way or no way. Couldn’t get out.
(Again she came to the same sensation of being trapped in his house. She reacts with violent anger.
We are at the sensation level and hence the kingdom is getting clearer with some key words. It is she versus someone ~ the situation of a victim and an aggressor. Strong and weak. Competition and survival of the fittest. This is the animal kingdom.
There is an animal side and a human side. Also there is a conflict between the two. The animal side is concerned with fighting back while the human side has the guilt for the animal within.)
At work, I have been picked on and looked down on. I don’t work well with people. I have high expectations and am running the job but I don’t treat my colleagues as if they are down there. I am the organiser. If someone tells me to do it I go gr…gr….( Hand gestures of opening fists and growling noise). I am multi-skilled and perfect but I get tired.
My sister is the ruler. She’s a lot stronger than me. Doesn’t like to be told.
(Again at the sensation level she is a lot more animated.)
Dreams?
Attacked by a shark. I wake up and my heart is going fast. Something horrible happening to the kids.
Dreams of spiders, big ones, tarantula, huntsmen. Once a spider entered our lounge and I was very scared. I was twitching and climbed a stool on the dining table. I twitched all night.
It was extreme panic and fear.
I don’t remember what I felt as my mind was going too fast.
(I couldn’t reach any deeper here. So went to another entry point.)
Hobbies?
I am very creative. I am also very quick with answers and figures. Extrovert. I dart around the room and I can go from one conversation to another.
I like walking. River walks with my dog. I am not happy with myself. I need to lose at least five kgs weight but I can’t walk in a gym! Its too closed!
(Another expression of the same sensation, No closed places. Need to walk in open places.)
I have a nice family. We love each other and our family is bonded. We talk non-stop. We are soul mates and people are jealous. We have a dog but he is human-like. Very intelligent. It is like another child in the family. I am not very keen on cats. Once a cat attacked me. I hated cats even as a child and was cruel to them. They are selfish. Dogs can be taught tricks and can be good companions. Our dog doesn’t realise he is a dog. He is a bit of a boss; he looks after the girls.
(She anthropomorphizes the animal kingdom with different examples of behaviour, of domination and being dominated.)
I had a huge panic attack during my last holiday. We were in a confined area. I wanted to get out. I felt it come up here. (Points to throat.) Zoned out, stomach turned.
(She again takes me to another situation where she had a huge panic attack in a confined area.)
Now having confirmed the same sensation i.e. trapped and confined, in multiple ways and different areas I wanted to qualify the sensation and possibly get the complete animal story. Her survival story.)
What is the worst type of confinement possible?
Buried alive in a coffin and dying. Suffocating and dying. Drowning is also a horrible way to die. Trapped and not being in control.
Or being caged and cannot unlock the door and walk off. Eaten by shark or crocodile. (This is the sensation in her dreams). Mum has episodes of TIA.
I need ventilation. Lots of air. Trapped and not being able to breathe. Dying a death of suffocation. No one can help. Horrific the way my girl friend was trapped, squashed and killed.
A quick reaction would be to drive off but she froze. She was not in control to make a decision and do something. She just froze. Nobody can help. You can do nothing.
Once I read a horrible story of man being trapped in water. Angry how that poor man couldn’t do anything. Its unfair. He didn’t deserve it. Screaming for help and no one hears you. Somebody put him in and he died by being trapped. The pressure of water pinned him against the railing: he was trapped. No time to get up.
I hate hearing such horrible stories. I don’t like violence.
However I love the program ‘Underbelly’. That type of violence doesn’t worry me.
Police couldn’t pin them and they managed to kill 30 people. It’s interesting how the other side lives. How did police not pin them? How were they so clever to get away? They were cunning and clever. It’s real.
Pinning someone?
Just like my dad. Niggling and making me bite. I can pick people and see through them.
My daughter has been called a bully. A girl pinned her and called her a bully.
I react and bite.
However if someone is stronger I back down. They rule over me but I can fight it. If somebody is on top I can be furious if they won.
I am very quick to react. I can think things like that. I do dramatize things. I juice it up, my sister says.
When my stomach turns it feels as a tight knot in my abdomen and then it goes up in my chest. I don’t like tight clothes.
(By this time the subkingdom was getting a bit clearer. It is the story of being trapped, suffocated, pinned, squashed and killed. Push Push Push, Niggle niggle niggle and then the reaction is to bite, snap back in anger, desire to kill or escape by a quick reaction, being cunning, clever and deceitful.
This is the survival mechanism of snakes.)
How do you react to snakes?
My grandfather breeds them. No fear at all. No fear of them choking me. But I hate spiders!!
Case Analysis -
It is interesting that she experiences the whole survival mechanism of snakes at sensation level but did not mention any snakes. She did mention a lot of animals at a delusion level but the sensation was always trapped and suffocated to death. This is where it is vital not be prejudiced by these metaphors which are symbols at the delusion level.
Having understood the sensation and the reactions well, I went to the source books and the proving data to check if the remedy was a proved one.
I did not want to break the understanding of her deepest sensation into rubrics for repertorization but I wanted to find which animal remedies cover these deepest sensation and themes.
I used the Quest feature of the program HomeoQuest and entered her key words. This gives me a thematic analysis from all our proving data. (In short a thematic repertorization from the repertories and also the materia medica.)
I used the following key words at the sensation level.
- Trapped
- Suffocation/death by suffocation
- Constriction/tightness.
The only animal which came up strongly was the well-known snake Lachesis.
Understanding lachesis at various levels as related to her case
Sensation Level -
The rubrics/symptomsii in Lachesis which come closest to the sensation are
- Fear of narrow places
- Fear of Suffocation.
- Asphyxia death suffocation from, drowned person in.
- Constriction external.
- Tight clothes agg.
- Violent anger, desire to kill.
- Quick to act.
- Biting
- Loquacity, jumping from one subject to another.
- Jealousy
- Deceitful, Sly
- Cruelty
- Del powerless, is
- Del persecuted, of being
- Del injured of being, by surroundings.
- Del wrong, suffered, has
- Anticipation, ailments from
- Authority, refusal to accept, other, person of another
- Dictatorial, control others, wants to.
- Death of loved ones, beloved agg.
- Disputatious
- Dreams animals of, danger of
- Anxiety, palpitation with, cramps in precordial region
- Anxiety, riding aggravates.
- Anxiety, abdomen in
- Pain abdomen, riding in a carriage agg.
- Panic disorder and irritable bowel syndrome.
Prescription -
She was given the Lachesis 200C, one dose. She was also advised to take doses whenever she had a panic attack. She was booked for a follow-up a month later but had to cancel it.
Follow up -
I didn’t hear from the patient until she called me after about a year later to book in again.
21/5/09
I was very well for an entire year. Didn’t have another panic attack since the first dose. The medicine was wonderful. I even got on that plane ok for my husband’s birthday.
Things are fine with my family. Dad has just accepted things. Sister keeps a distance from him.
Work is the same; no stress with that.
However just the last month I have been very anxious and having a stressful time. I thought I would check with you whether the drops are still ok as I still have that bottle you gave me last year!
Bit of a political problem at daughter’s school. I have no anxiety attacks now but just walking to her school I get anxious and then five minutes into the walk I am fine.
Can you talk about this incident?
I was one of the organisers of the fete at school. I put my heart and soul into it and it was a huge success. After that five children were selected for leadership including my daughter. But someone changed the rules and she wasn’t picked. It was very unfair on her. After what we had done for the school, they disregarded us and let us down. That silly woman (assistant principle) changed the rules. I was boiling inside and confronted her. She then drew daggers at my daughter. Once at a speech, I had my daughter put a hat on. She had it taken off. So my daughter wasn’t visually evident. It was a war between her and me. I changed her school finally.
It was unfair, she was discriminated against; I hate deceit and lying. It became personal. They were playing with fire (which is me). So I completely cut it and they felt it. I was depressed, drinking and crying. My daughter felt hurt and crushed. I know they feel wrong was done to us. Everyone deserves fairness.
My second daughter is still in the same school but I have documented everything so if they give her trouble they have had it. I threatened the principal that if you put my younger daughter in the previous teacher’s class I will take her out of the school and he has agreed to that.
I still get angry when I see that teacher. I felt as if in a hole and couldn’t get out.
Apart from that the entire year had been fine. I was taking drops as and when required when we travelled in September last year. I felt fantastic straight away and they have been good.
Didn’t remember to take them during this stress at school.
I have had no panic attack episodes which were out of control since starting them. If they do come the intensity is very low. The feeling does come as I walk my second daughter to school but I keep walking through and then I am fine. Nothing like the extreme way I used to run for a toilet before.
Even when I have this urge to go to the toilet on long trips in a car, I simply think I want to go at the next service station and it is fine.
Maybe things are starting to creep back in and I may require more drops.
I don’t have phobias as much.
People, especially my dad thinks this (homœopathy) is mumbo jumbo but I don’t know why this calmness has come over me since I have started the drops. That anxiety had ruled over me for 15 years before!
Prescription -
She received a fresh dose of Lachesis 200C as her sensation was still the same and the chief complaint was coming back.
I last called her in August 2009 to request her permission for this article and she wrote to me regarding her present state in an email.
‘I feel great at the moment, no episodes whatsoever. I have been a bit stressed with work as it has been very busy with tight deadlines to meet, but this hasn’t affected me at all. I must admit I do feel comfort in just having the remedy in my bag as it gives me a sense of safety and security and I would like to continue to get this medicine refreshed from you every six months or whenever you recommend. I do take it if I feel that I may become a little anxious e.g. before appointments etc. Thanks for asking about the article and I am so happy to have met you.’
Conclusion -
Today we are privileged to have more tools and methods to work on our cases than a century back. So depending on how deep a patient wants to go, I normally vary my case taking and analysis to suit them. Like everything else in homoeopathy I prefer my approach to be individualistic.
In my experience the best thing about working with the Sankaran method is that I require minimal effort during the follow ups! All that work is basically done during the first consultation. It’s as if you uncover all layers and all levels at one go instead of uncovering layers each time. So the follow-ups are just a process of reconfirming the state and determining when to repeat.
- HomeoQuest Software www.homeoquest.com
- Zandvoort Roger Van (2008) Complete Repertory www.morphologica.com
This article was published in Similia – The AHA homeopathic magazine Dec 2009.
