AV: These levels are much easier because we are all familiar with them. We all have the common emotions like grief, fear, anger, guilt, shame, anxiety, worry and combinations of those. Almost all our patient will tell us spontaneously about situations in their lives and the emotions they bring. In former times we used to prescribe on this but now we know emotions are quite superficial and are merely an expression of the vital disturbance.
AvdM: But if you question a person and probe more deeply, very often more emotions come up. Maybe they are deeper emotions but still emotions?
AV: It depends on the way you question the patient. We’ll go into that when we talk about case taking. The patient doesn’t know what we are looking for, nobody ever talks about his vital sensation, this is homeopathic jargon. In popular books and articles the impression is given that homeopathy prescribes on ‘types’ and your patient might have read this. It is always good to check what the patient is looking for, what he is expecting, in the first consultation in order to avoid misunderstandings.
AvdM: Well, some homeopaths do prescribe on types, don’t they?
AV: And there is nothing wrong with that as long….
AvdM: … as they know what they are doing! I knew you were going to say that. But I see the problem: they are prescribing on expressions of the disturbance rather than on the source of the problem.
AV: And the expressions are by definition individual and consequently endless. It depends on the personality of the patient in which way he will or can give expression to his particular individual sensation.
AvdM: When you have interrogated your patient carefully and he or she goes deep inside and feels the emotions, often they come to the conclusion they were not loved by their mother, not accepted, not good enough, not supported, of no value and the like.
AV: This is not vital, it is common. All humans have deep inside the emotion they are no good, don’t deserve love, weren’t loved or cuddled enough, feel insecure about themselves and the like. This is common ego stuff and we react to that with ‘conditions to be OK’. Remember? But we shouldn’t prescribe, according to aphorism 153, to what is common but to what is strange, rare and peculiar. We are looking for what doesn’t belong to the normal psychological makeup of a person of this age in that setting but for what is, regardless of the emotions, individual and belongs to the patient.
AvdM: This means we don’t use the emotions at all!
AV: We do, but not directly. The patient will tell us anecdotes of situations where he suffers from one emotion or another but instead of prescribing on the emotion, we listen very carefully for the message in that story. We listen to see if we can hear something specific, something that nobody else would say or do or feel in that situation. In other words, something that is not explained by the situation.
AvdM: Because otherwise it would be ‘common’ and not Strange, Rare and Peculiar?
AV: Exactly. You could actually summarize my whole approach as: what is strange, rare and peculiar on every level. It’s as simple as that.
AvdM: It sounds simple but it looks quite sophisticated when you take a case. What should we understand by “the message in the story”?
AV: The patient never gives an anecdote or a situation at random, it always contains the vital information. Why would he pick this particular situation out of an innumerable number of potential situations if it were not typical for his vital sensation? This means that he knows it is there on an unconscious level! The only difficulty now is to find out what this ‘it’ is. And of course any emotion that is unexpected, unusual, out of proportion, inappropriate is a SRP symptom on the emotional level and thus a pointer to the vital.
AvdM: But what is an inappropriate or unusual emotion? Isn’t that hard to define? Isn’t there a danger we take ourselves as the standard?
AV: Homeopaths should have a good insight into human nature, Hahnemann already mentioned this in his Organon. What are the attributes of a good homeopath? Do you remember?
AvdM: How could I forget? § 98 says: “The investigation of the true, complete picture and its peculiarities demands especial circumspection, tact, knowledge of the human nature, caution in conducting the inquiry and patience in an utmost degree.”
AV: And this text dates from before Freud! My point is that in the same way the homeopath has to have a good idea of the physiology and pathology of the body, he should have a good knowledge of psychology in order to discern between what is normal and what is disturbed.
AvdM: So we need to study even more in order to know what we will never use as an indication for prescription!
AV: Indeed. This allows us to easily move to the fourth level. I talked about the conscious aspect of it. This comes into the consultation whenever the patient starts his sentence with: ‘I think’…. or whenever he analyses his feelings or explains his symptoms. This information is useless for us as homeopaths. We should never explain a symptom because by doing this with our conscious mind, we explain the symptom away. A symptom can’t be explained, it is an expression of the vital sensation, which in itself just ‘is’. There is no ‘why’ and ‘because’ on the vital level because that would equal the question: “Why are you the way you are?” That is a meaningless question, isn’t it? The unconscious mind where all the unwanted, intolerable, taboo feelings and thoughts reside is our focus of interest. It is as close as we can get to the vital level regarding expressions. If the patient is unable to verbalize his vital sensation directly, he will give us delusions, convictions, impressions and images from the unconscious mind. The difficulty here is not to confuse products from the mind and expressions of the vital.
AvdM: I think that is the most difficult part of case taking: to be aware of this distinction while taking the anamnesis from the patient.
AV: It’s a matter of practice. As in any method, one gets better by repetition. I can give an example to make it clearer. The patient can have a delusion he is being watched. That is a Level 4 symptom but still not enough to prescribe on. When we look in our repertories we see there are still many remedies listed and they are from different kingdoms. If we can now elicit the experience of the patient who imagines being watched, we have the vital. He can feel it as a threat to his very existence or something that makes him breakable and transparent, or an attack to his person, which would resonate with a mineral, plant or animal remedy experience. This doesn’t come from the mind, this comes from ‘beyond’. His mind is part of his personality and this will determine how he gives expression to it. But it originates from a level ‘beyond’.
AvdM: And you write and demonstrate in every case that the unconscious mind is easiest to elicit in the areas of least control: fears, dreams, major stressful events, hobbies and fascinations. It is always beautiful to see how the inner world of the patient is brought to the surface in that way, but with the unconscious mind I have more difficulty.
AV: Let’s put it this way: since it is unconscious, it very seldom comes up in the consultation at all. It is the aspect of the individual, which is part of humankind. It is where we take part in experiences that are bigger than our individual live, like the big transitions: birth, childhood, puberty, marriage, parenthood, grandparenthood; the hero, the quest, the wounded healer; where we have the archetypes, expressed in the pandemonium in every culture, the demons, the inbetweentwoworld creatures, who connect us with other dimensions, the realm of the myths, the fairy tales, the allegories, the legends, the parables. It’s the collective memory, which is passed on over time through innumerable numbers of generations.
AvdM: Those things that might come up as symbols in a patient’s life or in his dreams: can we use them as symptoms?
AV: So far we have little knowledge about them but that’s a whole domain waiting to be explored. My only experience with the mythical level so far is that I believe it cures severe pathology. If you can work with myths or symbols, I have witnessed pathology to disappear like snow in the sun. But still I believe it touches the symptoms, not the patient.
AvdM: Still, it is amazing!