The Invisible Wound: A Clinical and Homoeopathic Perspective on Post-Traumatic Stress Disorder

Dr Janki R Vank

Abstract
Post-Traumatic Stress Disorder (PTSD) represents a profound disruption of the human psyche following exposure to overwhelming terror. While modern psychiatry focuses on neurotransmitter stabilization, Homoeopathy perceives PTSD as a “frozen” state of the Vital Force. This article provides an exhaustive review of PTSD, blending the diagnostic rigor of DSM-5 and ICD-11 with the deep-acting philosophy of miasmatic prescribing. By navigating through epidemiology, clinical scales, and repertorial rubrics, we outline a holistic roadmap for rehabilitating the traumatized soul.

Keywords: PTSD, Homoeopathy, Miasmatic Prescribing, PCL-5, CAPS-5, Trauma.

Introduction: The Nature of Trauma
Post-Traumatic Stress Disorder is not merely a “memory” of a bad event; it is a physiological and psychological “stuckness.” In clinical terms, it is a failure of the nervous system to return to homeostasis. In homoeopathic terms, it is a “Never Well Since” (NWS) state where the initial fright has created a morbid susceptibility, leaving the patient perpetually reacting to a ghost of the past.¹

Diagnostic Framework

DSM-5 Criteria

According to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.), a diagnosis requires:

• Exposure: Direct or indirect exposure to actual or threatened death, serious injury, or sexual violence.
• Intrusion: Distressing dreams, flashbacks, or intense psychological distress.
• Avoidance: Persistent efforts to avoid feelings or external reminders of the event.
• Negative Cognitions: Persistent distorted blame of self or others, and an inability to experience positive emotions.
• Hyperarousal: Sleep disturbances, hypervigilance, and exaggerated startle response.²

ICD-11 Coding

The World Health Organization (2022) classifies PTSD under 6B40. A significant addition in ICD-11 is 6B41: Complex PTSD, which identifies trauma arising from prolonged, repeated events (like childhood abuse) from which escape is difficult.³

Clinical Evaluation Scales
To move beyond subjective observation, modern clinicians use validated scales to quantify symptom severity and monitor progress. These are equally useful in a homoeopathic setup to track the action of a remedy:

1. CAPS-5 (Clinician-Administered PTSD Scale): Considered the “gold standard.” It is a 30-item structured interview used by healthcare professionals to make a definitive diagnosis.⁴
2. PCL-5 (PTSD Checklist for DSM-5): A 20-item self-report scale. A score of 31–33 or higher typically indicates probable PTSD. This is excellent for “waiting room” assessments.⁵
3. DASS-21: Often used in homoeopathic case studies to measure the triad of Depression, Anxiety, and Stress alongside PTSD-specific tools.⁶

The Indian Context: Epidemiology

In India, the prevalence of PTSD is deeply tied to socio-economic stressors and natural calamities.

• Prevalence: General population estimates hover between 4% and 7%.⁷
• Disaster Impact: Following events like the 2004 Tsunami or the 2001 Gujarat earthquake, regional PTSD rates have been recorded as high as 30%.
• Barriers: Stigma and the “somatization” of mental distress—where patients present with body aches rather than “fear”—often lead to underdiagnosis in rural Indian clinics.⁸

Management Strategies

Allopathic Management

Current conventional protocols prioritize:

1. Pharmacotherapy: SSRIs (Sertraline, Paroxetine) for mood stabilization and Prazosin for nightmares.⁹
2. Psychotherapy: Eye Movement Desensitization and Reprocessing (EMDR) and Trauma-focused CBT.²

The Homoeopathic Approach & Miasmatic Expression

Homoeopathy treats the person in the trauma, not just the trauma in the person. The miasmatic lens helps us understand the “depth” of the wound:

• Psora (The Struggle): Anxiety, palpitations, and “what if” thinking.
• Sycosis (The Secret): Suppression of the event, leading to fixations or obsessive behaviors.
• Syphilis (The Destruction): Suicidal despair, total memory loss of the event, or violent outbursts.¹⁰

Comparative Materia Medica for PTSD

The following table summarizes the unique indications for our most effective “trauma” remedies:

Remedy	Key Mental Trigger	Unique Clinical Features
Aconite	Immediate life-threat	Predicts time of death; intense, cold sweat; acute panic.
Ignatia	Emotional shock/Grief	Paradoxical symptoms; sighing; “lump” in the throat.
Staphysagria	Humiliation/Violation	Suppressed indignation; trembling after anger or abuse.
Natrum Mur	Long-standing grief	Dwells on past insults; craves solitude; < consolation.
Opium	Terror/Fright	Dazed, “spacey” look; painless state; heavy sleepiness.
Arnica	Physical/Mental shock	Says “I am fine” while in shock; fears being touched.

Repertorial Rubrics

Key rubrics from Kent’s and Murphy’s Repertories:

• MIND – AILMENTS FROM – fright: *Acon., Op., Ign., Gels.*¹¹
• MIND – FLASHBACKS – post-traumatic stress disorder in: *Arn., Staph., Nat-m.*¹²
• MIND – DREAMS – accidents, of: Arn., Bell., Sul-ac.
• MIND – FEAR – happen, something will: Acon., Calc., Phos.

Conclusion
PTSD is a multifaceted disorder that requires a compassionate, multi-dimensional response. By integrating the diagnostic precision of scales like the PCL-5 with the individualized depth of Homoeopathy, we can help patients move from “surviving” to “thriving.” As clinicians, our mission is to restore the peace of mind that trauma has stolen.

References

1. Hahnemann, S. (1921). Organon of Medicine (6th ed.). (W. Boericke, Trans.).
2. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.).
3. World Health Organization. (2022). International Classification of Diseases (11th Revision).
4. Weathers, F. W., et al. (2018). The Clinician-Administered PTSD Scale for DSM-5 (CAPS-5). Psychological Assessment.
5. Bovin, M. J., et al. (2016). Psychometric properties of the PTSD Checklist for DSM-5 (PCL-5). Psychological Assessment.
6. Lovibond, S.H. & Lovibond, P.F. (1995). Manual for the Depression Anxiety Stress Scales.
7. Murthy, J. K. (2010). Mental Health in the Indian Context. Indian Journal of Psychiatry.
8. Kar, N. (2010). Post-traumatic stress disorder in children and adolescents in India. Indian Journal of Psychiatry.
9. Bisson, J. I., et al. (2015). Post-traumatic stress disorder. BMJ.
10. Banerjea, S. K. (2006). Miasmatic Prescribing. B. Jain Publishers.
11. Kent, J. T. (1900). Repertory of the Homoeopathic Materia Medica.
12. Murphy, R. (2010). Homoeopathic Medical Repertory (3rd ed.).

Dr. Janki R. Vank
Email : vankjanki22@gmail.com
PG Scholar , CDPCHM – Surat