I am presenting this case as illustration of how a Sensation-based approach, combined with mapping as developed by Bhawisha and Shachindra Joshi, can take us to a clear understanding of the patient’s deepest vital pattern, and thereby to the simillimum, even when the remedy is unknown in our materia medica. Although this remedy is, as far as I know, so far unproven, it is available from Remedia. The mapping concepts referred to in the case may be unfamiliar to some, but can be explored further on the Joshis website or in any of their books.
The first case-taking was in May 2016. The patient is a woman of 46 years, divorced, with a teenage daughter. She works as a child-minder. The presenting complaint is a sudden onset of alopecia aerata, with one large patch of hair loss and several smaller ones, which are still appearing. There was no apparent aetiology for the hair loss, but she says in this context “I’m always kind of uptight and angsty”. She also describes “massive headaches” around menses, and low energy.
After taking the symptoms and modalities of the hair loss and headaches, the patient’s heavy, exhausted appearance prompts me to ask about her energy, as a good starting point to go deeper into the case.
How is your general energy? I don’t have any. It’s all a struggle…no zest. I wake up and feel it’s another day, same old, same old. (Her shoulders hunch up.) I get up and then the day doesn’t stop, it’s do, do, do. I do it because I have to, but feel it’s all an effort.
Describe that a bit more, it’s all a struggle, same old, same old?
I feel something is taking my time, everybody wants a piece of me, everybody wants something from me. The resentment builds up. I’m very much a “yes” person. I feel guilty if I say no, so I say yes. Then somebody else wants a piece of me: the dog, my daughter, mum, people at work. Whatever they ask, I feel guilty if I say no, so I say yes.
It is early in the case, but already the patient’s words “everybody wants a piece of me”, give a clue to the first element of the map, suggesting that the situation is perceived as “me versus you”, that others are the problem because of their demands, so this could be an animal remedy. The phrase is repeated three times, and as a possible kingdom indicator, it’s a good place to delve further and understand more about her individual pattern.
How does this feel for you, that everybody wants a piece of you? It’s draining, overwhelming. People know I say yes, so they ask. Five people can ask me to do something, I say yes, then I think, everybody wants a piece of me. Sometimes I feel fine with it, sometimes it’s NO! How dare you! I can go off on one.
Describe that? Sometimes I can just go off on one like that (clicks fingers). How dare you! I’ve done all this for you, and that’s how you react. I don’t know when it’s going to happen, it just comes out.
What is the feeling in that for you? I’ve done all this for you, and that’s how you react?
I’d like someone to do something for me. I never ask anyone for anything. They never ask about me, no one asks “How are you?”
So far, the story and emotions are not untypical of a busy, working mum, and we might think of remedies such as Sepia, for example. However, by pushing past the story and emotions, and understanding her perceptions of her situation, we can grasp more elements of the map, and individualise further. Importantly, I need to understand her Level of Human Development, i.e where is her focus, what is her issue? The issues of Level of Human Development, as described by the Joshis, correspond to the issues of the rows of the periodic table, but apply to patients needing animal or plant remedies, as well as mineral.
How does it feel that no-one ever asks “how are you”?
It makes me feel that I’m in it on my own, and I feel that every day. I’m not especially sad about it, it’s just what it is, so I get on with it.
What is the feeling to be on your own?
It doesn’t feel scary. I’m capable and reliable, so it makes me feel safe. I can only rely on me, then I know it’s done right, I know it’ll get done. In one way, I don’t want to do it on my own, in one way, it’s my comfort. At the end of the day, it’s all done, I can go to bed content, then I wake and it starts all over again.
Describe the comfort feeling?
It’s like a big blanket, it draws me in, I feel strong in it, I can stand in it, hold it, own it, it doesn’t unnerve me, it’s a warm feeling. It’s never let me down, it’s an old friend, a solid, reliable one.
What would happen if you say no to somebody?
You’re letting them down. If you say yes, people will like you, appreciate you. I always want to give, trying to make myself be seen. It’s a validation.
What is it like to be let down?
It zaps you, takes a little bit of you, your energy or positivity, your feel like this (her shoulders go up) and your back aches. Then I feel very fiery, and I could snap. Then I feel I’ve let it win, it’s got me.
She talks about getting angry with her daughter for answering back.
How can you be so rude when I’ve just done all these things for you? It’s the not seeing me and what I do, not appreciating. Can’t you see me, these things that I do?
How does that feel?
I feel unloved, unwanted, unthought of. Can’t you see me? It feels like somebody can’t see the person you are, the things you give, the love. Then you question yourself. Is something wrong with me, what am I not doing? What more can I give?
What do you get from giving?
You get compassion, love, somebody seeing you, wanting to do things for you, warmth, nurturing, safe, like a mother and child.
How does it feel to get that?
I don’t know, I’ve never had it!
Just imagine how it would feel?
Nice, going back to that comfort place, knowing I can rely on me, all those things I get from standing strong by myself, I assume it feels like that. A warm, nurturing feeling, safe and comfortable.
What is the feeling in the safe place?
Energetic, everything is OK, I can deal with it, I can do it. I’m all right how I am as a person, I know I’m a good person. I’m a good mum, I’m good at my job and can get up and face the day. I know I’m kind, loving to my child, helpful, I’ll do anything for anybody. I’m sinking in quicksand, but it’s not going to drag me down. I’m good and solid in it.
Here we understand more about her need to say yes. She wants people to like her, appreciate her, see the person she is, and to feel compassion, warmth and nurturing. She talks about how she is as a person. These are the issues of Level 3 of Human Development. Further expressions of the Animal kingdom include the perception that others do not give her validation; if she snaps in anger she has “let it win, it’s got me”. According to the Joshis’ mapping system, the issues of Level 3 in the animal kingdom indicate a mammal (or a bird) remedy, as they correspond to the dependence on the group for nurturing and safety. In the mammal remedies we also see expressions of both dependence and independence, which she expresses clearly. On her own, she is capable, reliable, strong, giving her the comfort she does not get from others. However, we can also see issues of another level. Who she is as a person ties in closely with being a good mum, being good at her job, with “do, do, do”, only going to bed when everything is done. The lack of appreciation for “what I do” gives her the feeling of “same old, same old”. This is an issue of her “task”, corresponding to Level 4. Additionally, her sense of her own capacity and strength, indicate that she has a stronger sense of self than seen in Level 3. So far I can map this patient as Animal, Mammal, because of the Level 3 issues, with a Level 4 focus. I need to understand a few more characteristics, including the extent of her strength and the nature of her anger, which she has mentioned several times, to help pinpoint the exact mammal remedy she needs from those the Joshis have identified as corresponding to Level 4 of Human Development.
Describe I’m sinking in quicksand?
It’s pulling down (Hand Gesture). It’s weighty, it wants you, you can feel the pull, it makes you stronger. The more you pull the more I’m going to rise up. It’s like the weight of a herd of elephants, tugging constantly. The more I resist, the stronger the pull gets, but I always win. I’m mentally very strong in it, but physically weak.
What might happen?
What would I be? Would I be less strong, would I be weak? It’s a feeling of weakness, I let it get me.
Tell me more about your anger?
If something is said to me in an angry way, I respond with anger. I’m back in the quicksand, I’m going to fight back, I will go on and on. They have to say “ok, I get it” or I’m not backing down.
If you back down? I’m weak and vulnerable.
So we see a tremendous sense of her own strength, withstanding a herd of elephants! But there is also a sense of vulnerability, a fear of weakness. Her anger is defensive, rather than aggressive. The sense of weakness and vulnerability, and the defensive anger point to a prey mammal rather than a predator. The strength and capacity to withstand indicate a large mammal.
In the Joshis’ map of the mammals, the large prey mammals of Level 4 are the bovids. An excerpt from the Joshis’ book Homeopathy and Patterns in Mammals describes characteristics of the patient needing a bovid remedy:
(Cattle-like bovids) are the ones who slog away, day in, day out, without recognition. Their feeing is that they follow the same old routine for no reward or appreciation. They have the feeling that they are (strong), yet emotionally weak…and so dependent that they are open to abuse.They devote themselves to others 24/7, yet they are neither valued nor respected.
…They want to give and receive love and provide for the family. Because of this uncomplicated, giving nature, they can get taken for granted. Yet they carry on, albeit with resentment, because of the need to be part of the group.
…These feelings are accompanied by relatively high self-esteem in regard to their capacity to do things.
…They have a sense of inner strength, courage and security. The are also very duty-conscious and work hard to provide for, and be part of their group.
(Joshi, 2016, pp. 198-199)
A differentiation between the large bovids led me to African Buffalo, rather than Lac Defloratum from the domesticated cow, or Bison. A Lac Defloratum patient would be more dependent on the group, with fear of being alone. A Bison patient would be very easily moved to anger by relatively minor triggers, (Joshi, 2016, pp. 193, 201) whereas this patient, while her anger can be unpredictable, is generally reacting to specific triggers, in relation to her perception of not being appreciated.
Rx African Buffalo 200 once daily for 3 days.
At the first follow up she reported that her daughter had noticed she was less snappy and reactive. In the car that evening, she’d got stuck behind a car, but waited patiently. Her daughter was astonished, “Mum, you have really changed!” She had felt calmer, and not as if she had “lost her mojo”. She was still aware of the alopecia, but not stressing about it. The “same old, same old” feeling was gone. “I get up happy and get on with it.” The “everybody wants a piece of me” feeling was largely gone, and she had said no to somebody without feeling guilty. The feeling of being dragged down by a herd of elephants was gone. “I do feel I’m floating on a happy equilibrium and nothing can burst my bubble”.
The alopecia took some months to resolve completely, but the headaches stopped after the first dose until January 2107, when one repetition was needed. She has taken a repeat single dose occasionally over the last 18 months, when she has felt “flat” or “angsty” and she is still doing very well.
I hope this case has illustrated for you how this systematic approach of mapping kingdoms, subkingdoms, and Levels of Human Development can lead to a confident prescription of highly individualised, deep-acting and long-lasting remedies, our goal for all our patients.
Reference: Joshi, Dr B. and Dr S., Homeopathy and Patterns in Mammals, 2016, Dr Shachindra Joshi (HUF), Mumbai
A review of this book is available on this website at http://facekom.info/book-reviews/homeopathy-patterns-mammals-dr-bhawish-joshi-m-d-dr-sachindra-joshi-m-d-reviewed-vatsala-sperling/