Dr. Ajit Kulkarni M.D.(Hom.)
Email : [email protected]
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.
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?
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 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.
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 jeopartized.
vii) Kali-carb: Attachment a source of troubles; rigidity, conservatism, and weak will lead to cold war; Kali-c. On her own will not cut off; she is more practical and well-grounded and will keep it hanging.
viii) Sepia: Continuous ragging and detached attitude (sell imposed, in Kali-c it is imposed upon by others) results in seyering the relationships, however, Sep. doesn’t have to break the relations with others, as others break with her first.
ix) Staphysagria: Jorial, conciliatory until his sensitive mind, rather sensitive pride is maintained; once offended, pent-up emotions will explode resulting in severing the relations.
x) Kali-iod: Its crude, rude and harsh behaviour expressed through abusiveness raptures the relations.
INTER-PERSONAL RELATIONSHIP AND MIASMS:-
Exploration of the dispositional characters and the behavioural responses yield the miasmatic dominance.
- The emotive responses of high order expressed in I.P.R. but with base-line of I.P.R. being maintained indicate PSORIC miasm. Healthy attitude towards I.P.R. is kept up thought with emotional overtone on many occasions.
- The sycotic stigma demonstrates pathological I.P.R. The negative attitudes and characters viz. suspiciousness, vindictiveness etc. make I.P.R. disturbed. The states in ineldncholy, gloominess etc. develop as a consequence to chronic disturbed I.P.R.
- Unpredictable, erratic behaviour in tandem with emotional overtone complicate I.P.R. in Tubercular Miasmatic subjects.
- The syphilitics reflect the irreversible