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Everyone has a unique, individual core. This core expresses itself on the physical level as an individual physical manifestation, on the mental level as individual thoughts, feelings and illusions. Above all, however, this individual human core finds expression on the holistic level in the vital sensation and energy pattern of the individual. To observe the individual expression on the holistic level authentically, we need a patient-centred, individual, integrative, scientifically based, intuitive and reproducible case-taking. To achieve this even more effectively, I have divided the case-taking into three steps: Passive, Active and Active-Active.
Passive is, for example, collecting all misplaced patient statements. We support a natural flow of the case and passively receive the verbal and non-verbal fragmented individual expressions. It helps to pay special attention to the most characteristic expressions on all levels. What repeats across all levels is the focus of the case.
- Here the physician remains outwardly passive, but is inwardly in heightened attention.
- It helps to clarify the thought-wheel and to bring the patient's unconscious spontaneously to expression.
- The passive method allows one to recognise the focus, the level of experience and the defence mechanisms the patient uses.
- The passive method also helps us anticipate which questions we must ask and how they can be incorporated into the next part of the case-taking.
Active means that the stream is directed inward, toward the altered pattern, to recognise the whole phenomenon. The reliability of the focus is established in this step. In cases where the focus has not yet been obtained in the passive method, the focus must first be found and then confirmed in the active process.
- The active phase is the transition phase between the passive and the active-active process.
- The aim here is to initiate the journey from consciousness to the patient's unconscious self and beyond.
- It is the preparation phase for the patient's final journey to their altered pattern.
- The patient is steered from their multi-dimensional way of speaking to a one-dimensional conversation. As physicians we tune from one-dimensional hearing to multi-dimensional hearing.
In the Active-Active process the whole pattern unfolds. A complete verbal and non-verbal pattern-surface emerges when the patient touches the innermost core in its entirety.
- The Active-Active process is the grand finale.
- Here the homeopath concentrates on the focus and does not let the patient drift into conscious areas.
- All the isolated, scattered, non-verbal modes of expression that stream out during the passive and active phases are connected into one phenomenon.
- The main goal is to obtain the entire altered pattern and, where possible, move it to the level of the source and direct it toward healing consciousness.
The following case example shows a case history – it has been shortened for publication.
12-year-old T.G. consults me in January 2010 for bronchial asthma, from which she has suffered since childhood.
PASSIVE CASE-TAKING:
D: Feel entirely free and tell me whatever you want.
P: Nothing, nothing, nothing ... absolutely nothing… (She shakes her head for “no” and makes a face as if she does not know what to say. Pause)
I want to talk about what I ... ... … want to become.
D: O.k.
P: I want to become a cancer specialist. (Drinks water from her bottle) And nothing else ....
D: Very good, and what else?
P: Nothing (Pause). Or I want to be a gynaecologist or a vet. (sticks finger in mouth and looks down.) Or I want to be an asthma specialist and nothing else (Pause). Or I want to be a teacher. I want to be an animal-cancer-specialist (Pause: looks at various things on the wall and then fixes a particular spot). Or I want to be a fashion designer. Or I want to be a nurse, that’s it! (she looks as if she does not know what to say, then a pause – she looks again at a point.) And nothing else, or I just want to be a doctor. (Pause) And I want to be a headteacher. That’s the right one! That’s not very much. (Pause - looks at a spot.) Or I want to be Prime Minister and nothing else. Or I want to be a photographer and nothing else, please, please, please nothing. Or I want to be an actress and nothing else. (Pause - looks at the doctor, glances up and then looks down.)
(This is the first part of the case-taking, where we listen passively and note what verbal and non-verbal information the patient gives. Here the patient speaks about different professions she wants to take up. While she speaks she drinks water and also frequently says “nothing, nothing else”. This indicates that the patient is listening inwardly, but there is a conscious defence in the form of drinking water or saying “nothing”. While we remain passive we should, however, pay attention to these subtle cues.)
P: Or I want to be the boss’s assistant and nothing else. I want to be a receptionist (Pause). Or I want to be a director and nothing, nothing, absolutely nothing else (Pause). Or I want to be a policewoman and nothing else (Pause). Nothing else, just so much. Or I want to be a dancer (nods) or a writer. Or I want to be a poet and nothing else. Or I want to be a dancer (Pause). Or I would like to work in an office and nothing else, please. Or I want to be a general practitioner and treat colds and coughs.
(We value the passive case-taking highly because of the clues it gives us. For example she says after each pause that she wants to become something else. Each time she says “And nothing else!”, but her gestures indicate that she wants to say more. The consciousness erects a defence strategy. In the passive phase of the case-taking we register these subtle hints and let her continue speaking without asking any questions or interrupting her flow.)
P: And nothing else, please. I have told you so much (nods, Pause). And nothing ...
When a child in a paediatric case history speaks only about one particular area, this may be a local problem with which they are stuck or in contact. Therefore we now change the patient’s orientation to see if what she is talking about is the focus or only a local problem.
D: Keep talking, tell me more ...
P: No, I want to be a psychiatrist or I want to be a princess. Now I don’t know anything anymore.
(Here we have a shift from psychiatrist (a word she cannot pronounce properly) to princess. There is simply no connection between the many possibilities of what she wants to be. We remain passive without analysing what the child says. She lists many more professions, everything that comes to her mind.)
In children the defence through the conscious mind is expressed in a very naive way, different from adults where it is much stronger and it takes more effort to break it. In this case we know that the conscious defence comes up but it is pure and delicate. We therefore do not bother to break it, but remain passive and see what happens.
P: Or I want to sell jewellery and nothing else and absolutely nothing any more and nothing (shakes head). Or I want to catch a big shark and a whale. Nothing else. Or I want to sell torches, pencils, books, coloured pencils, chocolate, crisps, stones and mirrors. That’s it! I have told you everything I want to be and I don’t want to be anything. (Pause). Or I want to be an ophthalmologist or an ENT doctor and nothing else. I have told you everything ... Or I want to be an ENT surgeon and nothing else. I have told you everything, now I don’t want any more; nothing, nothing, no. I have told you everything. (She looks at the things in my consulting room and talks about them.) |
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I would like to sell fish, shells, crabs, cameras, mobile phones, staplers (clears throat), stones, diamonds (coughs) statues, (clears throat), picture frames, keys and keyrings and nothing else, or Christian symbols and gods’ figures, artificial sandals, computers, artificial books, artificial chirags (a kind of toy meant to fulfil wishes), artificial mountains, laptops, watches, glasses, shoes, rings, clothes, torches, microphones, glasses, sandals, chairs, |
tables, water bottles, jugs, toys, paint boxes, glitter stuff, make-up, lenses, masks, artificial ghosts, artificial hands and legs, socks, shoes, cups, flowers, artificial flowers, bags, pouches, glass, wood, earrings, necklaces, colouring pencils, erasers, name jewellery, small mirrors, cockatoos, artificial microscopes, artificial crabs, artificial mirrors and nothing else, nothing, sandals, photos, animals, and nothing else any more, just so much. I have now told you everything, only one thing not (she raises one finger and shows the one): I want to be a giraffe keeper.
(The conscious brain is completely switched off as the patient now looks at the objects around her and talks about them. As she does this her cough reflex intensifies. The odd thing is that she now adds the word “artificial” to all the things she wants to sell.)
P: Can I call my father? And nothing, just so much, I have told you (she shows 3 fingers and says: 2). 2 pages, nothing, no, sorry 3 and a half.
(She continues to list what else she might get if she does not get the one.) |
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AT THE END OF THE PASSIVE CASE-TAKING:
Focus:
She wants to become “so many things”.
In the passive case-taking the patient lists many different professions she wants to take up. We ensure that this is not a set area by changing the subject, and yet she speaks exclusively about it. Naive defence strategies such as coughing, clearing the throat, drinking water, shaking the head, saying “nothing” or listing new things occur. These are signs that the patient is turning inward.
Level of experience:
Delusional idea
The patient determines the focus and all the information she gives. This means she experiences her everyday experiences on the level of delusional ideas.
On which level is she?
This patient experiences the focus on a general level.
How is the level of experience experienced?
The patient is in contact with the focus and recounts every detail in connection with her own self.
Potency:
The patient experiences her everyday experiences on the level of delusional ideas, so the potency is 1M.
Technique for continuing the case-taking:
We now have a focus that we can work with actively. However we remain passive with regard to everything else that arises from any other area. If that remains the case, we will confirm the focus on another, preferably unconscious, level and then move to the active-active phase to obtain the entire pattern and, if possible, also find the source.
ACTIVE CASE-TAKING (to confirm the focus):
D: You said you want to take up so many professions, hmm, I don’t understand how one can be so many different things?
P: If I can’t be one thing, I can do something else.
D: I don’t understand what that is supposed to mean ...
P: It means if I can’t become a doctor, they can make me a gynaecologist, if I can’t become a gynaecologist, I’ll be a teacher. But preferably I want to be a cancer specialist ... and nothing else.
(Since the patient is connected with the focus while she speaks, we know we are on the right track.)
D: And how can you be so many things?
P: (Smiles) I don’t know either how you can have so many professions. (Her hands move on the table, then on the chair).
(She adds that if she doesn’t become one thing, she can become something else.
D: Can you explain that to me in more detail?
P: If I don’t become a cancer specialist, they can make me a gynaecologist, and if I can’t become a gynaecologist, I’ll be a giraffe keeper, if I don’t get the giraffe keeper job, I’ll be an asthma doctor (her voice pitch rises) or I can sell many things. I can sell torches, artificial mountains, artificial stones, artificial microphones, ahhh artificial mirrors, artificial pens and artificial shoes (she looks at the things in the consulting room).
(The strange expression “artificial” also comes up. Now that the things are connected we can be certain about the focus. Actively we explore this area with open questions. But the things she speaks about all already arose in the passive phase. The case seems to stall and does not move further. This is the right moment to go to another level, especially into an unconscious area, so that we can definitely confirm the focus. The best possibility is dreams.)
D: Tell me, what do you dream about?
P: Only about cancer specialists.
D: What do you see?
P: That I am a cancer specialist.
D: What exactly do you see?
P: I play. I always play with my friend.
(Slowly the same things come up from her inner self, one side being the cancer specialist and the other side playing.)
P: I dream everything.
D: What do you mean by that?
P: How I play with my friends at one or two o’clock, I win in sport, I am a cancer specialist, I am a dentist, or I am a fashion designer, or I am a photographer, or an ophthalmologist or an asthma doctor; thus I am everything I see ahead of me.
D: Do you have other dreams?
P: How I play with my friends, how I win in sport, how I am chosen for the team, how I am captain, how I am the leader, how I am a baby, no, no, no, how I am ahh (slip of the tongue). My sister is already grown up, she is like my brother 29 years old, and nothing, only these dreams.
(For the first time a spontaneous denial of being something appears, which we will certainly explore.)
D: You said: “I am a baby”?
P: No ... (smiles); I just said that, but I didn’t mean it that way! (laughs).
(The defence comes up again now in the form of a smile. Thus we can be sure that this theme is connected to her centre. This is the patient’s way of distancing herself.)
ACTIVE CASE-TAKING (with delimitation):
D: Can you describe a baby?
P: I said it (smiles); it just came out of my mouth.
D: It just came out. What is a baby, can you describe a baby?
P: A small little person. It cannot walk when it is zero years old, cannot eat chicken ... it cannot play Coconut-coconut (smiles), cannot jump, cannot talk. That’s it.
D: What else can it not do?
P: It cannot (looks) become a cancer specialist.
(Now everything connects. We now know that she has the delusion of being a baby, which prevents her from becoming a cancer specialist, and therefore she wants to choose so many different professions. She is stuck somewhere in the process of being like a baby. This points to the mineral kingdom, left stages of the third series, the identity series. We stay with it, however, because there is one thing that is conspicuous and not yet connected, that is the “artificial”.)
D: What else can it not do?
P: It cannot become a photographer, cannot become a fashion designer, cannot go to school, has no hair, cannot maintain discipline, cannot let its hair grow long, cannot read, cannot write. It does not know how to sit, how to play or how to take a bath. (D: Hmm, hmmm). It does not know that we play with our Barbies or with friends, and nothing (looks in the mirror).
D: Do babies know who they are?
P: No ... yes ... (smiles). They know their own self. No, that’s not quite certain (laughs).
(There is no certainty from the beginning, therefore she wants so many professions. However we have already reached her centre through the unbiased passive case-taking. That is the strength of the three-part case-taking, which is at once complete and scientific; we do not lead her, but she reaches the centre on her own.)
D: What do you mean by “I am not sure”?
P: I am not sure, it can be both; they have no consciousness of themselves, but they do know who they are, there are two different sides, I am torn between them.
(At the centre there are 2 things, knowing oneself and not knowing oneself, and that is why she wants to become so many things. This is a salt theme. But we wait and remain with her on the topic.)
ACTIVE-ACTIVE CASE-TAKING:
D: I understand that and don’t understand it at the same time; I don’t know why you feel torn between these two sides?
P: Yes, sometimes they know about their self, sometimes they don’t. Some babies already have a consciousness of themselves (coughs) and some babies have no self-consciousness (clears throat constantly) or do they?
(Active-Active is the final phase on the journey to the self, and with it the defence reactions reappear. The pitch of her voice drops, she clears her throat constantly and her cough gets worse and worse. So far we are sure that this is a mineral case that has something to do with the identity series. Her problem is that she knows what she wants to become and at the same time does not know, therefore she names so many different career wishes.
The remedies that are differential-diagnostically possible for this stage are:
- Pure aluminium silicate (Alumina silicata), where on the one hand there is confusion, hence the choice between several things she wants to be, and on the other hand there is a firm career wish to be a cancer specialist. In the natural state, however, these are semi-precious stones, whose central themes have not yet come up in the case history.
- Impure aluminium silicate (Alumina), clay. This seems the most likely remedy because it consists of different proportions, which indeed is the patient’s core theme. Also the peculiar trait that she wants to sell so many “artificial” things fits Alumina.
- Sodium silicate has no own identity at all and can therefore fully absorb the identity of others, which in turn leads to a rigid identity.
This remedy probably does not fit, because the patient knows that she wants to be something and there is only confusion about what she will become, as in Alumina or clay. |
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To confirm the source there are only two ways: Either she speaks about it of her own accord, or we ask her about clay, and then we will see whether her centre is connected with Alumina or not. We can wait until she speaks about the source – in the form of homeopathic rubrics or the homeopathic |
| Materia medica, or we wait until the characteristics of the natural state come up automatically. If Alumina is her source, the naive defensive attitude will recur, either as clearing the throat, coughing or smiling, or it will be expressed in the pitch of her voice. |
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D: Tell me - do you like to play with clay?
P: Clay? Yes, great! From clay I can make anything. I can make artificial books from clay, I can make a candle from clay, I can make all sorts of heart shapes from clay, I can make a star or a star shape from clay, I can form a knife out of clay (she looks at the things in the room). I can make a cross out of clay or a doll, I can build a mountain of clay, I can make an artificial torch or a toothbrush out of clay, can I produce a folder out of clay, make a sketch, make an eraser out of clay, and I can make a shoe out of clay (coughs).
(We wait until she has connected everything verbally, but the worsening of the cough proves to us that we are on the right track.)
I can in this way also make frames, I can also make pens out of clay (coughs), I can make a bundle out of clay, I can also knead an artificial pen out of clay, I can make an artificial key out of clay, artificial earthen silk paper, artificial glass or an egg from clay. I can make an artificial dog from clay, I can model an artificial statue or form my name from clay, I can make a group of 3 knives (no more), I can also make a mobile phone out of clay - that’s it then.
(Here the patient mentions the repeatedly noted, until now unconnected “artificial” in the context of the many things she wants to make from clay, e.g. her name.)
D: What else is there to say about clay?
P: Only as much, that is the only thing that comes to my mind about it.
D: What do you like most about clay?
P: Making things; you can shape clay in many different ways, that’s why I like it. You can make anything from it.
With these words the case ends!
Case analysis:
Inappropriate and conspicuous in the passive case-taking:
I want to tell you what I want to become. (A long list of all the professions she wants to take up follows.)
Then she mentions all the things she wants to sell, including various kinds of artificial items.
Inappropriate and conspicuous in the active case-taking:
If I can’t be the one thing, they will make something else out of me. If I can’t become a doctor, they will make a gynaecologist out of me, and if I can’t be a gynaecologist, I will be a teacher. Yet preferably I want to be a cancer specialist. (She now continues to list all the professions she dreams of, or all that she wants to achieve. At this point she speaks of the “baby”, i.e. someone who is not able to do all the things mentioned.)
I am not sure that they know their own self; babies have no consciousness of themselves, but they nevertheless know who they are; there are two different sides, I feel torn between them.
Inappropriate and conspicuous in the active-active case-taking:
Yes, I mean that they know their own self; babies have no consciousness of themselves, but they do nevertheless know who they are. I can make anything out of clay. She lists all the things she can make out of clay, including her own name. I like clay!
Focus of the whole case:
If I am nothing, they can make something out of me, I am a baby - no ....
Kingdom:
Mineral kingdom. Wants so many different professions: confusion of identity. We now know that she has the delusion of being a baby, and therefore she cannot become a cancer specialist, and that is why she lists so many different professions. She lacks an identity; she is stuck at some point in the developmental process as a baby. The remedy would therefore be assigned to the left side of the third series, the series of identity.
Prescription: Alumina 1M
Follow ups:
Three months after the start of treatment the asthma attacks had reduced by 80 - 90%. However during these 3 months she developed many colds. This is a sign of the expulsion of the disease, so she was then given a placebo.
Her deficiency state, which manifested in her wanting so many things, was now no longer so extreme. Yet she still wanted to be a cancer specialist, asthma doctor, ENT doctor or gynaecologist - at least she was now sure that she wanted to be a doctor.
After 6 months the colds, cough and asthma attacks had almost completely disappeared. After initially wanting so many things, she was now quite certain that she wanted to be only a cancer specialist. |
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