AvdM: Back to the crucial question: how do you know if the information you get is vital and not local?
AV: I guess you remember the hints on the scheme and the explanation in ‘The Vital Approach’? On the physical level everything that doesn’t belong to the pathology must belong to the patient. Let’s take the example of a patient with eczema who says: “I’m afraid nobody will be able to help me.”
This information is extra, it’s free and it gives you an idea how the problem is experienced. “Nobody can/will help” means: “I’m all alone with this problem”, which points to the Leprosy miasm. Even in the case of problems, even when asking for help, paying people whose profession it is to help, the patient doubts if he can get any help. This is the most important statement in the information the patient gives. If he had a fatal disease in an advanced stage, this remark could have been appropriate but it is not common nor in proportion with and to eczema.
AvdM: This also means that a lot of information the patient gives about his pathology is of no value to us?
AV: Yes, everything common, in proportion, explicable, appropriate is healthy and not an expression of a disturbance. If an asthma patient feels oppressed, obstructed and panicky, this is all common to his complaint. Then we would rather focus on what provokes the attacks, when it started, what he did so far to manage it, what is the impact on his life. All these could give more specific information.
How to differentiate the local from the vital?
AvdM: And this is part of step two?
AV: In general, yes. After the patient has told you everything spontaneously, we can ask more about the topics he mentioned and the words he used. When he said he had a problem with his stomach we shouldn’t ask him about the pain but about the problem. If the patient talked exclusively about these physical complaints and we want to know more about him as a person, then those questions will help. In fact we already are asking how he dealt with his problem and this will reveal how he deals with problems in general. Almost always he will generalize at a certain moment in the case. This is a special and precious moment because then we know for sure that we are on the right track. He connects the problem to himself, unconsciously of course, and thereby telling us: “This is vital, this is how I am.”
AvdM: But maybe he will only tell us how he is in a psychological way and you repeat over and again we shouldn’t prescribe on a psychological portrait?
AV: We don’t prescribe on it but in order to be able to do that, we have to discern what is common from what is SR and P. In the same way we don’t prescribe on the physical pathology as such. We have to study physiology and pathology in order to know what we are not prescribing on. We should understand the psychology of the patient in order to see how the vital disturbance shapes and limits it. In his report of his psychology there will be the same anomalies as there are in the physical: things that are not explained by the situation. Although the majority of patients will explain their symptoms away in irrelevant psychological analyses, we should stay focused on what doesn’t fit, what doesn’t make sense, what is out of proportion, out of sequence even.
AvdM: I find this second part of the consultation very tiring.
I see you writing down every word of the patient, pages and pages, but I can’t contain all this information. On top of that I start to lose my concentration.
AV: It sure helps when your attention span is long and you can focus well. I consider it an exciting journey into the inner world of the patient and this can’t be done quickly. There is no shortcut to the vital disturbance, I’m afraid. But don’t you think it is exciting when you feel you are approaching the treasure? It’s like unveiling it, little by little unwrapping it. I always thought this was a most exciting thing to do. Leaving me exhausted afterwards, I admit, but it is very rewarding to have understood and to be able to give a similimum.
AvdM: To recapitulate what we said so far: the homeopath should be in a state of inner silence, love his patients, be unprejudiced and have full attention throughout the case. On top of that he should ideally know at every moment of the case where he is heading.
AV: That summarizes it perfectly!
AvdM: The casetaking itself is structured. Most important in the first part is to let the patient tell whatever he has to tell spontaneously without interrupting and only in the second part we question him about those topics.
AV: In his own words, yes. By that time the kingdom and miasm are probably clear and we only have to confirm.
AvdM: In almost all your live and paper cases, this happens already in the first part and surely gets confirmed in the second. I recommend my colleagues to read your cases and see what you mean.
AV: The last seven years I have been teaching the Master Classes in several countries where I do almost exclusively live cases and where I explain my approach with those examples at hand. I can theorize until the end of my days but the proof of the pudding is in the eating after all! At this moment more than 75 of my cases have been published in English and maybe an equal number in Dutch. A series of 50 cases called ‘Rare Remedies for Difficult Cases’ are available on RADAR/OPUS. In this way I hope to demonstrate in practice what I teach in seminars and books.
AvdM: Can you repeat again how we know a symptom is vital and not just local?
AV: A local symptom is only on one level, one example, one occasion but doesn’t hold throughout the case. It is like an obvious piece of a puzzle… but there is nowhere to attach it. Then you know for sure it is local, no matter how special or how clear the sensation there might be. People will tell us about a fight with their motherinlaw and use words like ‘territory’, ‘domineering’, ‘fight for my rights’, ‘stronger and weaker’, ‘victim’ but as long as there is no other hint for an animal, it might be the report of a local event and only a Level three common expression. It is normal to describe a fight as a fight, isn’t it? It only becomes vital when the same underlying sensitivity or issue is coming up in all situations, all stories, all examples, all levels.
AvdM: Which leads to the conclusion: “The vital is on all levels all of the time!”