AvdM: Maybe you have some last tips and tricks for us?
AV: As you know, a chair should at a minimum have three legs to stand firm! My general advice is to check everything you consider as a vital piece of information three times. When the patient says: “This event shocked me”, I will ask: “Can you tell a bit more about that?” When he repeats the word or gives a synonym, it is confirmed once. I would then ask it again but in another way in order not to give the impression I didn’t listen or didn’t understand what he said. Sometimes then the word ‘shock’ leads to some other sensation or feeling and then you can’t use ‘shock’ as a piece of vital information. The patient might go to ‘break into pieces’ or be ‘victimized’ or in fact he can go to any thinkable or unthinkable direction from there. Since we don’t know, we have to ask. When on further inquiry ‘shock’ seems to be the deepest and the last answer, we have a reliable sensation word. Now we are waiting for it to come up again on another level or in another situation. Unless we get the ‘shocked’ and ‘shattered’ feeling again in the dream, the physical, the childhood memories, the sensitivities … we are not sure. It could still be a local sensation. Anybody can have a shock in life but not everybody needs a remedy from the Loganiaceae family. In order to make that distinction we have to check three times, in three different levels or anecdotes.
AvdM: I’ve seen you asking three, four times the same question to the patient. It takes courage I must say.
AV: If you are afraid the patient will think you are a simpleton because you asked for explanations about very obvious things, then you won’t be able to do it. If you know what you are asking is necessary to help the patient, you are more confident. Even if the patient replies: “But I just told you!” you can answer that you’ve listened very attentively and noticed what he answered but that you want to make sure there is nothing underneath or something more precise he can say. Sometimes I ask the patient to use whatever alternative word or image when he feels unable to tell me more about a sensation. But you would be surprised how very often the patient doesn’t even notice I’ve repeated the question!
AvdM: I know! Sometimes you ask “What was your feeling in this situation?” and the patient answers with ten minutes of explanation and your next question is “So, what was your feeling?” We curl our toes when you do this but surprisingly the patient then gives you the information you need!
AV: And this would be my next ‘trick’: never assume you know what the patient means when he uses a word to explain his deepest feelings. When he says: “I feel lost”, I’ll ask “What do you mean by lost?” If he says: “I feel not good enough”, I‘ll ask for that. If he asks me “Don’t you know what ‘lost’ means?” I would say: “I know what it means for me but I don’t know what it means for you.”
AvdM: I see. Anything else?
AV: In the beginning of our discussion we talked about the tendency to ‘delete, distort or generalize’; hence we should be careful to avoid this. We have to take note of the exact words and expressions of the patient in the right sequence. I recommend noting down even your own questions because it’s important to know whether the information came because of a particular question or spontaneously. When you asked something and the patient answered something that is not answering your question it makes it more likely to be vital information. It means that whatever you ask the vital comes through anyway. I even had a patient once that never answered any question of mine, he disregarded them altogether as if I hadn’t asked anything. He was talking and repeating himself all of the time. Therefore I tried to encourage him to go deeper. Finally I gave up asking and just listened for two hours, then said: “That’s fine, thank you, I understand” and prescribed. Whatever he so urgently had to tell me, over and over again, must have been his vital disturbance, what else could it have been?
AvdM: Now you’re saying that we don’t have to ask anything at all?
AV: Maybe in the future we won’t, maybe it will suffice to listen with full attention to our patients and be able to prescribe.
AvdM: Then these long and strenuous intakes won’t be necessary any longer?
AV: That is possible. But for the time being I think for the patient it is already a healing experience. It takes two hours to unfold your deepest experience and for the homeopath it’s an opportunity to confirm his prescription enough to have a fair chance to find a similimum and save a lot of time afterwards. But the results of all those long intakes might help us to extract enough knowledge and evidence to make it shorter with equal or better results.
AvdM: …. anything else?
AV: A very good homeopathic question! Yes, there are a lot of things I could tell you because during a consultation many, many things happen at different levels at the same time. But something I’ve noticed often is that homeopaths miss the case because they are looking for something so very special, so very deep and so very unusual that they don’t hear the sensation words when they come. At first sight all those sensations are common; in fact most of the things the patient says are common and understandable: they belong to the human palette of experiences. The vital disturbance is one of all these possible experiences that are fixed, repetitive, determining all the other levels. For instance, everybody can experience pain or injury. How can you discern a remedy from the Compositae or Papaveraceae then? Can you tell me?
AvdM: The Compositae are prone to injuries and experience everything as an injury.
AV: Exactly! They experience everything as an injury even when not injured. If you have an accident and you feel injured, that is normal, if you fall and you feel bruised, normal again but if somebody tells you off and you feel beaten, that is SRP. Or if you are questioned about your fears and the first things that come up are: accidents, injuries, falls, being beaten up, that is the sensitivity of the remedy you belong to, at least, when you don’t have a whole history of accidents and operations.
AvdM: I see. In the lessons you said: ‘When a dog barks you don’t have to look in the rubric ‘Barking’.”
AV: But if a human does, it is a symptom, certainly! In theory everybody admits that is right, in practice though we often forget this. This is maybe part of the analysis but we can’t separate these subjects. A welltaken case doesn’t even need much analysis, since the remedy, or at least the characteristics of the remedy we are looking for, is clear. You might not know exactly which species you need but if you end up with the certainty your patient needs a drug remedy, with the capacity to anesthetize and the acute miasm, you won’t have too much of a hard time to find Morphinum, which meets all that you are looking for.
AvdM: Maybe you can finish your line of thought when you said: “While looking with too much concentration for the unusual, we miss the case….”
AV: The sensation very often is expressed in very usual and common words, often the only ‘unusual’ is the situation, an anecdote or pathology that provokes the sensation: this is what surprises us. When we start noticing that the same word comes up in no matter what level or story, we know this is the fixed disturbance which is limiting the patient’s freedom. Sometimes it is expressed directly, often it is compensated and we get the opposite feeling or action. The main thing to remember is that homeopathy is all about ‘as if’. When a baby or toddler is fearful, dependent, helpless,timid, we shouldn’t routinely give him Calcarea, because this is perfectly normal for a baby and thus not a sign of disturbance. When a businessman behaves like a businessman, it isn’t pathology. When he walks in, singing Hare Krishna or behaving like a schoolgirl, we suspect pathology there, because he does something unsuitable, inexplicable and uncommon.
AvdM: In short: Strange, Rare and Peculiar.
AV: Yes, in fact you can boil the whole of homeopathic theory down to the SRP on all levels.
AvdM: Which makes it sound simple again!