Introduction:
Human mind is the
most fascinating and most illusionary subject to understand in
its entirety. All homoeopathic physicians know the importance of
mental state and its appreciation in the avenue of selection of
a proper homoeopathic remedy and the management of a patient. In
the homoeopathic clinical practice, exploring and understanding
the mental state is the most difficult and exasperating aspect
for a homoeopathic physician because the mental state is a
vibrant and free flowing. It is not a concrete and material like
a physical body and it needs to be precisely fathomed in its
depth and extent.
The human being and
the society:
The human being is
born and develops in a social setup. For a child, the family –
parents and other relatives is the primary unit and this unit is
the part of a larger social unit.
The family unit
influences, moulds and shapes up the personality in the initial
development of a child. The child learns the basic processes
like thinking, feeling, judging and acting through models,
imitation etc... Through the progressive learning, child becomes
gradually socialized. This socialization does not take place
through isolation, but through continuous and intimate
inter-personal relationship (I.P.R). With the dominance of
genetic milieu, the child’s overall evolution marches ahead
under the influence of family set-up, school set-up followed by
the continuous process of socialization.
Growth and
development are the inseparable phenomena leading towards
maturity involving both evolution and involution. An individual
makes-up the society. The society shapes the individual and the
society is also shaped by the individuals.
Inter-personal
relationship:
I.P.R. is the substratum of
society. It begins soon after birth, when the child arrives in
the world. Progressive socialization results when the child
comes in contact with different persons, thus spawning the
inter-personal relationships. The personal desires, aptitudes,
attitudes, pleasures, ethics, beliefs, faiths, id, ego,
circumstances etc. contribute towards origin, development,
maintenance or destruction of I.P.R. Harmony is essential for
the sustenance of sound I.P.R. We find many persons in the
society having different emotional and intellectual set-ups. The
areas of work are quite different, rather antagonistic, but
still I.P.R. of a healthy type exists for a long time even
though it may have a trifling basis or only one common
harmonious basis like art, music, sports or ethics. In contrast
to this, one may encounter the disturbed I.P.R. between the
persons having several identical views.
Change is the
characteristic of universal phenomena. Circumstance(s) is the
reflection of time and space, the integral part of universe.
Under the time-space continuum, the circumstance(s) may give the
opportunity to form or strengthen the I.P.R. or it may give
negative feedback for I.P.R. which may become unpropitious or be
irreparably spoiled.
Inter-personal
relationship and dis-ease :
Dis-ease implies ill-at-ease : at
the physical level, the mental level and at both the levels. The
human mind gets developed, vitalized / devitalized, rejuvenated
/ cracked down through inter-personal relationship. Disturbed
I.P.R. causes stress and strain on the mind and if the mind is
not capable of mobilizing its resources to effectively cope
with; critical threshold value is achieved leading to the
development of disease process which is manifested in acute or
chronic phases depending on the stressors, genetic
predisposition, reservoir of energy and the timing when
stressors are operative. To illustrate: Elevation of blood
pressure after an acute emotional upset is a known phenomenon
observed in clinical practice. D. U., Migraine, Irritable Bowel
Syndrome, anxiety neurosis, ulcerative colitis, chronic
somatization disorder and many psycho-somatic illnesses can be
linked to prolonged disturbed I.P.R.
The disturbed I.P.R.
acts as a maintaining / precipitating cause of the dis-ease
which gets manifested in the intra-psychic conflict
à
somatization mechanism, which again may act as a stressor. Thus
the cause becomes an effect and effect again becomes the cause:
vicious cycle is thus set-up and continued.
The consideration of
inter-personal relationship may give a new dimension to our
thinking of disease phenomenon. ‘Stressors’ which deviate the
immune response as well as related change in hormonal balance
can be better identified.
As heredity has a
significant role in the area of individual resistance, the
constitutional predisposition on the part of a sick individual
is of paramount importance.
Homoeopathy and
inter-personal relationship:
Hahnemann demanded
understanding of the individual, the total human being, the MAN
behind sickness. The motto in Homoeopathy is: ‘Treat the patient
as a WHOLE and not merely a disease’.
Homoeopathy deals
with MAN. We understand Homoeopathy as a HOLISTIC medicine.
Do we conceive of
these fundamental ideas in their entirety and perspectivity and
implement them effectively into our practice when we claim
ourselves as homoeopathic physicians?
We claim to treat
the sick PATIENT and we do not know the I.P.R. of the patient;
we don’t know the significance of I.P.R.; we don’t know what is
going on in the life of the patient and yet we claim as
physicians of HOLISTIC medicine! What we travesty!
Can the
understanding of a sick individual be adequate and possible
without knowing the IPR in detail?
The concept of
totality: need for an integrated view:
Totality
: of what?
: only signs and
symptoms of a disease?
: only the symptoms
narrated by the patient of a somatic type?
: of Psychic
manifestations only?
: only past and
family history?
: Why not totality
of ‘Human Experiences’?
: Why not in-depth
study of I.P.R. since childhood?
: What happened to
Hahnemann’s concept of treating the patient as a WHOLE?
: Are we able to
understand the patient as a PERSON with the present totality we
elicit?
And yet we feel
ourselves contented: because: ‘Habits die hard’.
Inclusion of I.P.R.
in detail should become the necessary part of the interview, of
totality of sickness: for it will replace clarity, in place of
confusion.
The understanding of
the patient as a PERSON will be severely hampered if a
homoeopathic physician doesn’t know the impact, depth and
consequence of I.P.R. over the sick individual. The
understanding of psycho-dynamic and psycho-somatic mental state,
somatization mechanism, cause --- effect relationship,
intra-psychic conflict-all will be adversely affected as far as
erecting the proper, integrated totality is concerned and the
entire management of a case..
Unfortunately many
homoeopathic physicians are entirely oblivious of this concept
or very little is known about this type of approach of eliciting
the totality through I.P.R.
The proper analysis
of I.P.R. will not only give the mental characteristics (which
are difficult to derive or infer otherwise) but also help select
the proper homoeopathic Rx.
One sided diseases’
or diseases where data is inadequate, homoeopathic physician is
stumbled to the extent of losing the case. I.P.R. elicited
skillfully in such cases will bring forth the personality traits
and will help fish out an accurate homoeopathic remedy.
Interview of a patient through IPR is a very interesting aspect
and a physician gets the inner state of the mind through deeper
relations. Experience reveals that ‘Key-note prescribing’ has
many pitfalls and demerits. There are more problems in the
follow-up of a case as key-note prescribing involves multiple,
changeable, zigzag and jumping method resulting in utter
confusion.
The entire
management of a case that also includes psychotherapy and
counseling can be sorted out; individual strategy can be planned
out if we have adequate information about I.P.R. of the patient.
Logical Application
of the Law of Similars:
The homoeopathic
remedy has an immense potential to affect the personality of the
patient. Intelligence and emotions are the two basic qualities
of human mind and the human pharmacology – as explored through
provings yield disturbances in both of these fields; in
addition, the somatic semeiology is also recorded. By using the
methods of inductive and deductive reasoning, Jungian
Psychology, Freud’s psycho-analysis, Behaviorism concept,
Transactional psycho-analysis, Piaget’s cognitive theory,
Eriksson’s psycho-social theory etc. one can structuralize the
personality: the individual characteristics, behavioral
responses as per circumstance(s), dispositions and expressions
etc. out of vast proving data available to us in the
homoeopathic materia medica. Each homoeopathic polycrest drug is
a PERSON having its own characteristic individual features. The
semblance between the natural person existing in the society and
the artificial person grasped through homoeopathic provings will
yield an accurate homoeopathic constitutional drug, as it will
cover the ‘essence’ of the personality.
Inter-personal
relationship and interview:
We want to explore:
WHAT?
The patient as a PERSON
The person as a WHOLE
What made the person
PATIENT?
His life-style,
his characteristics,
personality traits
His totality of life
experiences,
Approach to life
How he copes up with
the conflicts,
His thought
processes:
Their logic,
sequence, coherence, relevance.
His level of
consciousness:
Attention, awareness, orientation.
His sensory
perceptions:
Tone,
facial expressions, demeanor, posture, how he sits,
stands, sleeps, looks, communicates.
His Transition:
As a child
As an adolescent
As an adult
We want to explore:
How?
Through PROPER
interview Techniques:
Through
Skill
Greeting
Facilitation
Reflection
Empathy
Confrontation
Silence
Interpretation
To probe I.P.R. is
an interesting experiment
But a difficult task:
For: it demands:
extensive knowledge of:
: Human mind
: of collective / individual
Psychology
: of Psychiatry
: of Psycho-physiology
: of Psycho-pathology
: of Psycho-neuro-immunology
: of life and living and
: a lot more.
It demands:
Sensitivity and Sensibility
at every step of interview.
It demands:
Multiple
requisites
human and humane approach
And the condition
must be fulfilled:
‘The patient must
feel satisfied after the interview’
For: there should
be
free association
discharging of emotions
Without letting the
patient
hurt
insecured
suspicious
confused
guilty
‘Rapport’ is
essential
Physician------ Patient relationship
Should be
intimate
harmonious
healthy
frank
trustful
active.
Alliance should be
shared by
both patient and physician.
Both should recruit
their
own resources
If the aim of
cure
is to be achieved.
One stalwart wrote:
‘A well taken case is almost half cured.’
Do we pay our
attention to interrogation?
A primary step of
understanding the case?
Opening of an
interview
Continuity-break
during interview,
The influence of
physician’s all-round knowledge
The ‘dominance’ by
the physician
The perfectionism,
neatness,
accuracy of the physician,
Physician’s
personality,
All these affect theBOND
between physician and
patient.
INTER-PERSONAL
RELATIONSHIP OF SOME POLYCREST REMEDIES:
As the subject is
vast, we will consider here I.P.R. of some frequently used and
well-proved homoeopathic remedies in a succinct way.
THE NATRUMS :
There are two
definite Natrums- introverted and extroverted. The introverted
are the silent sufferers who go on burning themselves. In both
of them, getting hurt deeply and not able to come out of the
hurt feeling is common. The extroverted Natrums are the
aggressive, irritable, and domineering fellows having ‘fighting’
spirit. In addition to these, they have an anti-authority
element due to which Natrums find themselves in conflict
with many persons. The typical Natrum personality doesn’t
like the domination of authoritatives like father, mother, GF,
GM, at home or of boss / colleagues at work area. Provided that
the circumstances are favorable, he will fight outrageously and
exhibit his grievances in an agitational and aggressive way; or
he will exhibit his impulsive and impatient character to the
stimuli of circumstance(s), by hurting the concerned person
irrespective of the respect, caliber, age or prestige possessed
by that person.
Another response
shown by the Natrum personality is the feeling of
hostility, resentment, indignation or suppressed anger, being
expressed by seeking the solitude. The Natrum person will
go alone and will weep outside. Many Natrum personalities
are characterized by outward serenity but inward turmoil and
‘brooding’ is quite characteristic. The Natrum person is
highly sentimental and is governed more by emotions than by
intelligence – hence attachment is strong as far as I.P.R. is
concerned and breaking up the bond often causes a hostile
response and the domineering, egoistic behavior of Natrum may
end up the inter-national relationship.
If the circumstances
are such that expressions are not possible, Natrum person
will exhibit his irascibility over other persons, other than the
one to whom there is a hostile response e.g. domination at the
work area by a boss will get discharged in the form of anger, or
domination etc. over the wife or children.
I.P.R. in Natrum
personality is usually disturbed and relatives of the Natrum
person usually complaint a lot about the negative aspect of
Natrum mind. Natrum makes his own life miserable and that of
others too. He adds salt in IPR and make everything bitter.
THE MAGNESIUM
PERSON:
The Mag.
behavioral response is characterized by an inward response.
Instead of ‘fighting’ spirit which is observed in extroverted
Natrum (other drugs are Staphysagria, Tarentula, Lachesis
etc.), we come across the withdrawal phenomenon. The genesis
of withdrawal in Magnesium lies in childhood repression,
suppression, vexation etc. that results in strong feeling of
being neglected and rejected. Magnesium person prefers
isolation, remains segregated, and becomes asocial and reserved.
Magnesium
should be
projected when we come across the history of death of mother or
father at an early age and there is h/o deprivation of love.
Characteristically though there is over-crowding of emotions,
desires, aspirations and anxieties coming out of insecurity,
outward expressions are poor. The person becomes introvert and
gets himself entrapped into the capsule of his own and the
feeling of being neglected is augmented by the insult or
misbehavior committed by other persons. Hence sensitivity to
insult is quite marked.
Mixing is a problem
to the magnesium personality: to children as well as to adults.
Shyness is marked in children and they fear a lot about
strangers. Temperamental incompetence to protest and
communication difficulty make mixing difficult. He doesn’t
express his sentiments, thoughts, agonies, anxieties and
grievances and rather becomes more introvert.
Another strong
characteristic of magnesium is that thought there is a lack of
expression at the conscious level. At the sub-conscious field,
we come across expressions in the form of dreams. Variable forms
of dreams are covered in magnesium.
Mag.
Is full with
anxieties, fears, and a host of negative emotions but they are
kept inside. Others, hence, are unable to sense Mag. Sufferings
and emotions are not shared and the problems are continued.
THE KALIS:
Kalis
make the acquaintance very readily. As they are characterized by
inherent / spontaneous attachment of a strong type, at the
outset, they appear to be extrovert and quite easily mixing with
friends, relatives, neighbors etc. However this attachment
itself is a source of many conflicts resulting in pathological
I.P.R. that produces various manifestations at the somatic and
psychic level.
The bonds of love
and affection soon get established in Kali I.P.R. It is
difficult for a Kali person to remain segregated in the
society. A Kali woman will try to develop an amicable
relationship with other persons. For maintaining the I.P.R.
sound, she will even sacrifice to some extent but in return will
expect the same from others. If she doesn’t get any positive
response, she soon gets depressed and sad. Irritability,
agitation occurs out of retaliation.
Instead of ‘fight’
response observed in Natrum, Lycopodium, Lachesis etc.,
we find ‘flight’ response in Kali. The Kali person
is overwhelmed by anxiety and anticipation. He / she is so
encased into the capsule of ‘fear, fright, anxiety state.’ It
will not be wrong to write that Kali runs and walks out
the anxiety. If the husband / children are late in coming home,
the Kali woman will become anxious, depressed and will
wonder to and fro in the veranda, will telephone many times and
will heave a sign of relief when they come home. The elderly
Kali woman whose sons are away in other city for education
will enquire a lot about them, will write letters often and make
plenty of suggestions about their health and behavior.
Underneath the
disposition of attachment lies the irritability that comes as a
counter response to threats (to the attachment) that make her
sad, depressed and lachrymose. Brooding is quite marked over the
incidences that have insulted her. This mental portrait added
with anxiety represents the ‘anxiety neurosis’ with depression.
As far as I.P.R. is
concerned, Kalis are attached to people. They do not want to cut
off relations on there own. They are rigid, moralistic and
refrain themselves from doing wrong deeds. They are ego-centric,
family oriented and cocoons.
INTER-PERSONAL
RELATIONSHIP ‘BREAK’:
Some prominent
remedies are discussed in succinct.
i)
Pulsatilla:
Will try to prevent a rapture as I.P.R. is like and O2
Puls is like a leech.
ii) Lycopodium:
Will employ wit for conciliation and will try to keep his
dignity through non-rupture. Rupture, according to Lyco. amounts
to defeat. However, Lyco. lacks the sweetness of Puls.
iii)
Ars-alb:
A continuous, critical and censorious harping leads to severing
relations with those not performing of his standards.
iv)
Nat-mur:
Although there is an internal need for unconditional love,
Nat-m. will cut off relations out of hurt feeling; to forget or
to forgive is difficult; she will add more salt and will make
the I.P.R. complex of irreversible.
v) Sulphur:
Quick to quarrel but equally quick to forgive and make up and
hence there is no real falling out. The quarrel is more
intellectual.
vi)
Calcarea:
Wants a home; is generous; but if offended, will withdraw in its
own shell. Will protect its security and will see that it is not
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