“The Advanced Clinical Guide to the Homeopathic Practice”
The Birth of Delusions and the Core Delusion
The highest value among Aphorism 153 symptoms is accorded to delusions (see Chap. 9, Hahnemann Revisited). According to Carl Jung, delusions or fixed ideas are created by unresolved, long-lasting, painful events. Delusions always contain a kernel of truth. In the case of males, delusions often have to do with performance, work, achievements, and standing in society. In women, delusions are most often linked to affairs of the heart: loss of love, perceived or real; unrequited love; deception; betrayal, etc. For example, the woman is usually the one who tells her husband, “You forgot my birthday today,” not a very important event for him, and one he is likely to forget. Many of our delusions stem from unrealistic and exaggerated expectations. Delusions are created by aiming for things that are out of our reach, by underestimating difficulties, by having unjustified optimism, or by being overly anxious, jealous, greedy, egotistical, etc.
Among all the delusions patients present, there is one that started the whole process: the core delusion (CD): what Jung also called, the primal, archaic, or original delusion. The CD is the source of all subsequent delusions or fixed ideas, which are created along the road because the patient received inadequate support or therapy. The CD is the center point or nucleus, the beginning of the story of our patient–and it indicates the remedy he needs! Therefore, discovering the CD will be an important step, not only in formulating and understanding the crux of the patient’s suffering, but also in finding the similar remedy that will free him from the chains of his central, fixed idea. In addition, the CD will be the homeopath’s tool when differentiating between two or three remedies at the end of the consultation. The correct interpretation of the CD must match the secondary delusions and their compensations through provings of the remedy, the only standard we apply in homeopathy to separate truth from fiction. (I typically refer to the provings of Hahnemann, Hering, and T. F. Allen.) When looking at the totality of symptoms, the CD cannot be taken out of the context (see Aphorisms 5 and 7). The CD expresses the most important characteristic of the patient’s totality. This has prompted me to formulate another definition of the CD. The CD is the emotional or spiritual center, surrounded by a cluster of images or ideas which are the patient’s compensations.
How shall we further define the CD? How can we identify it?
The CD is the expression of the dominant, ruling emotion. It will be the driving force behind the actions, thoughts, and plans of the patient, creating, along the way, secondary delusions. For example, Lachesis has the CD that he is injured by his surroundings; that he is wronged. When this situation is persistent (as it is by definition in the case of a delusion), it will lead inevitably to secondary delusions such as: He will be sent to an asylum and his medicine is poison. These are expressions of a paranoid delusional state, proof of further evolving pathology often ending in schizophrenia. Thus, all compensations and secondary delusions have their origin in the CD. For example, a patient needing Lachesis might be loquacious, have religious fixations, meditate, and have increased sexual activity. It is imperative for everyone (as we all have a CD) to effect compensations, which can be regarded as defense mechanisms aimed at fleeing from a negative CD or reinforcing a positive CD. The patient may create lots of compensations to avoid his fate, yet ultimately, he will have to face this CD at some point in his life. Even a “good” delusion such as, humility of others while he is great (Platina, Staphysagria), is obviously bad for the person as it reflects a delusion of grandeur and impedes self-growth. If “positive” psoric compensations persist, over time their intensity will grow excessive (sycosis) and ultimately become destructive (syphilitic or luetic) to others and the self.
The Five Why’s: Confirming the Core Delusion
We must try to answer the question: How do we find the expression or compensation closest to the CD or better still, one that directly expresses the CD? How do we avoid prescribing based on compensations (Persona or mask) far removed from the CD? Once we have found, or think we have found, the CD or a compensation close to the CD, it is important to make sure that it is the basic or primary delusion by asking one more WHY, if at all possible.
At a conference, one of my students heard the speaker suggesting that in any behavioral situation one should ask oneself “why” five times, each time working from the previous answer. By the fifth “why,” a hint of the emotional state of affairs that underlies the feeling or situation will become evident. While it might be arbitrary to ask “why” five times, at least by concentrating on five, the homeopath will not stop questioning too early when assessing his patient. If the patient decided to go back to an ex-boyfriend, for example, this might at first sound like reconciliation, a positive step, which would not be taken into account in finding the simillimum. Upon further questioning, however, the homeopath finds out that the patient did not return because she thought breaking up was a mistake or because she still loved the old boyfriend; instead, the homeopath finds that the patient wants to go back because she felt lonely and craves attention (possibly indicating the remedy Pulsatilla). Or maybe the motivation was to exact revenge: to make up simply in order to break up the relationship herself, to “have the last word,” so to speak (a classic response in the case of Aurum). Or suppose someone wants to go to graduate school, not because he wants to get ahead in life through education but simply to earn the respect and love of his family, which he so much desires. Here, after one more “why,” the delusion, I am not loved, may become the delusion, I am worthless, and thus transform itself into the delusion, I never succeed in anything (Aurum muriaticum natronatum, Argentum nitricum, Anacardium, Baryta carbonica). If the answer to the next “why” is: “Because everyone criticizes me,” then we have the delusion criticized, which is a fixed idea that is not at all typical of the above-mentioned remedies. If you then asked the question, “How do you feel about this?” in order to elicit the ruling emotion and thus the CD, the patient might answer, “I feel like a cripple and cannot make any decisions.” This statement can be translated into the delusions: he walks on his knees; his legs are cut off. And that answer would confirm a prescription of Baryta carbonica. If, at this point, no further “why” can be asked, we can safely assume that we have arrived at the patient’s CD, one belonging to Baryta carbonica.
Although this person thinks getting a degree will be the road to self worth, he does not know that he has simply relegated his delusion that he is not loved to the unconscious where it awaits its next opportunity to return.
If we don’t ask a sufficient number of “why’s,” the patient will show us compensations far removed from the CD. We will then be prescribing for the mask rather than the shadow side–the mask formed by all these compensations. This will lead to the selection of a simile, for:
The mask is the simile; the shadow side is the simillimum!
An ancient Chinese proverb expresses the same:
Confucius says: To return to the root (CD!) is to find the meaning, but to pursue appearance (compensations!) is to miss the source!
Take for example a patient who says to the homeopath, “I am worthless.” On first consideration, this is an Aphorism 153 symptom and can be used to find the simillimum. At this point, the homeopath might consider remedies like Anacardium, Aurum, Lac caninum, and Thuja. In fact, however, we need to ask “Why do you feel this way?” in order to find an Aphorism 153 symptom that more closely describes the shadow side or CD. That will help us make a differential diagnosis among the previously mentioned remedies. The patient might answer, “Because I do everything wrong” (delusions: he does everything wrong; he can not succeed–see Anacardium, Argentum nitricum, Aurum, Baryta carbonica). If we stop here, it appears that Aurum and Anacardium are in the running, being present in both rubrics. On the next “why” the patient might reply, “Because I am confused, since there are two opposite forces at work, and I can’t make up my mind. Sometimes I get into trouble because of my decisions. It is as if there are two persons in me with two different opinions. One voice seems to tell me to do my business fast, even in a dishonest way, since it will bring me more profit. At the same time, the other voice, I guess my conscience, tells me to be honest and serve people rather than taking advantage of them. And I never really know who is going to win: my conscience or the dishonest voice.”
Finally we have come to the CD–the crux of this patient’s suffering. He suffers from the delusion that a devil is speaking in one ear prompting to murder, and an angel in the other ear, prompting to acts of benevolence. This symptom belongs to Anacardium and is often caused by ailments from domination during childhood.
To show Jung’s influence in our homeopathic practice, I put Lachesis’ story as it is expressed according to our best provings (Hering’s Guiding Symptoms).
Under-prescribed in the practice
Lachesis, a polychrest, is one of the most under-prescribed remedies. How can that be? Because of its resemblance to other remedies like Phos, Sulph, Staph and of course its twin brother, Lyc (the acute of Lachesis). When Lach lacks some very characteristic physical symptoms (esp. on the cardiovascular plane, throat problems, the intolerance of constrictive clothing, and relief of symptoms through discharges), it is difficult to recognize on the mental/emotional plane.
Essence and CD
The essence of Lachesis is the caveat or warning about an unlived life or as the late Edward C. Whitmont called it in his book Psyche and Substance, “the penalty of unlived life.” (E. Whitmont, 1991, p. 151). This should warn us immediately about the possibility of such a situation causing cancer: the ‘Carcinosin state’ reflects precisely the same theme: letting others live her life, having no boundaries to prevent this. The appearance of cancer is the last warning to finally start living your own life. In the case of Lachesis, we are not surprised to see cancer appearing in the ovaries and sexual organs as they are the center of repressed libido and sexual urges. Besides physical pathology, the penalty of the unlived life is often a series of neurosis, embitterment and mental decay. With the presence in Lachesis of an over-stimulation on every plane, which requires an outlet, we should not be surprised to find restlessness, anticipation anxiety, and hypersensitivity (offended easily; sensitive to criticism in its primary phase. Often it is followed by secondary melancholy and depression. Lachesis seems to be unable to cultivate peace in the garden of his heart by removing the weeds of egotism and jealousy. Not surprisingly, peace is not manifested externally neither.
What is Lachesis‘ core delusion? She is about to receive an injury from her surroundings and she is being injured and wronged. As a result, we find suspicion (full of mistrust), and the trio of symptoms (anticipation anxiety, restlessness, and melancholy) mentioned above. Another delusion expressing the same thought as the CD is, del., he is persecuted, he is pursued by enemies and he has been poisoned. In the provings it says word for word, “imagines he is followed by enemies who are trying to harm him, and there are robbers in the house and he wants to jump out of the window.” The latter delusions often come after the primary delusion has been allowed to run its course and thus will be part of an advanced mental-emotional pathology, making Lachesis one of the most frequently needed remedies for all kinds of schizophrenia.
When it comes to Jung’s conscious types, Lachesis is most frequently the extraverted, thinking, intuitive type. According to the circumstances and under the influence of triggers (especially from ailments from disappointed love), this extravert can easily become introverted as she can switch from loquacity to being taciturn. Now we are getting ahead of our story, as Lachesis has enough positive tools to try to protect herself, at least initially, from this core delusion. The question is, are these tools or compensations psoric or mainly sycotic? First, let’s answer one question: How did Lachesis end up in this ‘tormented’ situation in the first place?
Lachesis Ailments From (A/F)
There is no doubt that ailments from grief and disappointed love play a big role in the pathology of Lachesis (chronic complaints after long lasting grief or sorrow). Lachesis IS a ‘superior,’ thinking human being, as are Aurum, Carcinosin, Sulphur, China, and Lycopodium, but of course her reactions to grief are essentially different from those of other remedies. The above-mentioned, ‘superior’ remedies also have a big ego and great ambition, along with plenty of delusions of grandeur, but Lachesis is a very passionate person who gets vexed about ‘competition’ with other women, whether in love matters or professionally. This jealousy gets worse on approaching menopause (confirming Lachesis’ amelioration through discharges). This is a very dangerous time period if the Lachesis layer has not been corrected. Lachesis, belonging in TCM to the Fire/Heart element, cannot live without passion and demands a form of loyalty from her partner that often borders on foolishness. Anger is never far away where grief and disappointed love occur. The Lachesis person will find examples among friends who are ‘spoiled’ by their husbands (“he cut my nails for me;” “he always says, can I do something else for you”, etc.), and use those as markers to determine how much she is loved and cared for by her own husband (delusions of reference according to Jung-Foot note).”
We see the intensity of Lachesis in the emotions: there is no middle ground, only the high road, like an Olympic flame that burns with desire forever! Indeed, the flames of this fire need very little impetus to get out of hand and, driven by foolish and irresistible jealousy they can lead to hysteria and compulsion and thus to all kinds of unexpected, impetuous actions which, to her mind, are totally justified. Lachesis is often an example of a person who is partially overcome by her unconscious. The condition at first can be temporary when it is a matter of emotional upset. In such state of violent emotion (foolish jealousy), she says or does things out of proportion, things she regrets afterwards when reason is somewhat restored. Even the most normal individual is not proof against this danger but Lachesis can bring this outburst to unsuspected heights. And not much is needed: disappointed love, grief, jealousy, or hatred for her rivals is often strong enough to reverse the relation between the ego losing control and the unconsciousness, temporarily gaining the upper hand. Lachesis is a ‘well-spoken’ lawyer at heart: you cannot win an argument with a Lachesis! To everyone else, she is suffocating (as a boa constrictor can) and appears utterly ridiculous since there is often no real basis for this jealousy, except in her imagination.
Footnote: It is interesting that Hyoscyamus and Lachesis, two of the most jealous characters, have many delusions of reference. Jealousy is a great cause of delusions for these two remedies. When they are driven by it, any small circumstance, gesture, or word can produce the grossest misjudgment. Under suitable conditions, these characters will “jump out of their skin” and temporarily imitate the insane. Often Lachesis or Hyoscyamus will jump to the conclusion, during their first moment of anger, that they have been deliberately injured or insulted, (del, has suffered wrong; del, is injured by his environment). The danger is of course that Hyosc and Lachesis transgress the danger line from neurosis to psychosis and many cases can be found in the homeopathic history under these two remedies of frank insanity.
A perfect example of such foolish jealousy is as follows:
“I am constantly accusing my boyfriend of looking at other women and thinking of other women while we make love. Recently I gave my boyfriend a gift certificate for a massage, but I wanted to be in the room, watching everything that happened. When I found out we could not be in the same room, I cancelled the appointment. After hearing him complain about his bad back, I rescheduled the massage. Then after the massage, I yelled at him for having some other woman’s hands all over him. I am thinking of leaving him because he has been ‘tainted’ by someone else.” (This is example drawn from The New Mexican, Annie’s Mailbox Aug 30, 2005).
Of course ‘counseling’ was the advice given to the person who wrote in to that newspaper column. Indeed, allopathy does not have one single drug to allay jealousy whereas homeopathy has at least 50!
How to compensate for all these events (grief, disappointed love, anger and horrible things affect her greatly) leading to her core delusion? As a reaction/compensation and also as part of the origin of her core delusion, Lachesis possesses a strong ego. In haughtiness and pride, she is not much behind Platina and Lyc, the most outspokenly arrogant people. Interesting also that the triggers of the latter two remedies are vexation, mortification, and disappointment, something they have in common with Lach, though their reaction to this assault on their ego is quite different. Platina, depending in what stage she is in, eventually chooses one of her extreme outlets (sex, religion) and pursues her path in that way. Lycopodium often maintains his quest for power, attempting to remain at the top of the social ladder through defiance, cynicism, hard work (del, neglects his duty), and false arrogance as he exhibits an almost dictatorial behavior (dictatorial, speaks with a voice of command) with want of amativeness in men (3). Lachesis and Lycopodium are both ‘thinking’ remedies, but Lachesis belongs more to women. A Lachesis wants to be successful above all in relationships and her careerâ€”in that order. Lycopodium, more often a man, sees success as being at the apex of his career just like Nux-v and Sulphur. Lachesis places the greatest importance on her career only by default, i.e., when she is frustrated sexually and her husband cannot match her intensity of possessive love. So for Lachesis it is more a perception than reality of not being loved but her jealousy makes it incapable to maintain her mask in the relationship.
Thus, the delusions of these remedies will take different forms. Lachesis, belonging to the Fire element, is prone to more hysterical ‘heart-love’ delusions, expressions of the strong anima, the snake being a symbol of the human anima, e.g., del, she is beautiful and del, she is going to have a heart attack. Lycopodium, belonging to the Wood-Liver element, will have more delusions about his place in society, his image, and his success at work–the animus or sword at work, e.g., del, he neglected his duty; del, he is presumptuous; del, he is unfortunate; and core del, everything will vanish.
Platina and Lycopodium end up being queen and ‘false’ guru respectively (a real guru serves people, does not insist on being served by others). Lachesis is a tormented soul in the sense that she does not understand why her often foolish and out-of-control passion is not returned with an equal show of ‘love’. Lachesis and Platina are both ‘spiritual’ remedies and thus act and talk as though they were under super human control[. Platina is a little harder, yes, even a little more crude in her actions than Lachesis, who is much more easily influenced by ‘being mesmerized’: thinks she is somebody else and in the hands of a stronger power; she acts like she is charmed and she cannot break the spell. Thus, Lachesis will more likely be part of a cult or group rather than a leader like Lyc and Platina.
To bolster her ego, Lachesis possesses something else that makes her superior to Platina and Lyc: her loquacity! Lycopodium‘s speech is more dictatorial towards his inferiors (even abusive and insulting towards subordinates, often with anger from any contradiction). This brings to mind Nux-v, who like Lyc, employs every possible means for his ambition (also Platina!). At the same time, Lycopodium‘s speaks differently in the presence of his boss: he is a flatterer because he knows he needs to be on good terms with his boss in order to reach that coveted position of power. Platina‘s loquacity can be equally abusive and insulting, especially a child toward its parents (Lyc). She can be a braggart and boaster and squanders her money through ostentation (Verat-a). This is part of her ‘beauty’ which takes the form of an ice maiden rather than a warm sympathetic figure. In her deeper pathology (luetic phase), Platina ‘desires to be silent and is indisposed to talk’.
Lachesis‘ speaks in differing ways depending on her state of pathology. When in balance, Lachesis is a witty and brilliant conversationalist. There is quick comprehension and mental activity with almost prophetic perception. Lachesis stops you in the middle of your sentence as she knows the rest already, even worse for you, she knows the question before you have asked it. His ideas are abundant and no sooner does one idea occur to Lachesis than a number of others follow in quick succession. She is active, lively, and vivacious. Usually her speech reflects all this: Wants to talk all of the time; inclination to be communicative; vivid imagination and extremely impatient at tedious and dry things (they don’t go well with her small talk!). She has the most extraordinary loquacity, making speeches in very select phrases, but jumping off to the most heterogenous subjects. One word leads into the midst of another story. This exceptional loquacity is marked by a rapid change of subject; she jumps abruptly from one idea to another (whereas Platina ‘has a wandering speech; repeats the same things’). Lachesis ‘talks, sings, or whistles constantly’. True to her snake nature, her tongue will be used to hurt in a very refined but cynical and critical way. They hurt you with a word while having a smile on the face. For Lachesis, talking is therapy that soothes her core delusion.
This loquacity is of an imminently sycotic nature, indicating clearly to the homeopath that Lachesis is a very sycotic remedy, rather than a psoric one–very different from Calc-c, a strong psoric remedy, someone who likes to ramble about all the little things he suffers from, but never speaks eloquently. (If he ever waxes loquatious, Calc-c always wants to mull things over before he becomes a nuisance, talking about his little issues and ailments.) Any compensation of Lachesis will be an exaggerated one with an intensity to it that matches the remedy’s sanguine nature. At least initially for the more stable Lachesis, the loquacity is an outlet of a rather positive nature as they can use it to be a good lawyer, politician, teacher, or preacher!
“Loquacity” also comes in letter or email form! If you as a homeopath always get a lengthy answer to your follow-up questions, all about “small” complaints but very detailed and always urgent, pleading, and self absorbed, you can call that loquacity! Their messages are blow by blow accounts hurled at the homeopath (making you think of an Arsenicum personality) as they are consumed with anticipation anxiety and restlessness! An out-of-balance Lachesis really suffers from the del, she is doomed, and in her panic reason goes quickly out of the door.
How else can Lachesis get away from her core delusion? In accordance with her haughty and proud character (Lachesis is a 2 here; Lycopodium and Platina are a 4), Lachesis believes she is in with powerful people (Del, is under powerful influence). Furthermore, she may be of the opinion that she has a special relationship with God: Religion becomes another outlet for this tormented soul. She seeks safety by communicating with people in high positions, e.g., writing letters to the President of the United States. This makes me think of Veratrum album who thinks he should be received by the most famous people in order to advance his own social status. As usual, we often see a religious compensation when the sexual outlet is either suppressed or impossible as for example in puberty (Kali-br, Platina, Lil-t, Lyc, Verat-a). Lachesis’ religious compensation also matches the intensity of the sexual outlet and is equally of sycotic (exaggerated) nature. There is religious monomania and even fear of being damned. It is especially the female teenager who will invoke religious compensation when sexuality awakens, if she has been brought up in a strict religious milieu where the topic of sex is taboo. They might go into the streets to preach to people about the end of the world (Verat-a). Male teenagers are more likely to engage in thrill-seeking and dangerous behavior. As usual, the extreme can turn into its opposite: we can find rabid atheists among Lachesis people, i.e., Lachesis patients are fanatical. Lachesis has always this compelling quality in their beliefs: they are totally convinced and reject any dissenting opinion.
A ‘positive’ compensation for Lachesis is the sexual outlet. If the sexual outlet is available, i.e., not suppressed by family mores (there is a big difference between growing up in a 60s’ pot-smoking environment and a strict religious family!), it also takes an extreme form. The male either becomes a Don Juan (great excitement of sexual desire) or more commonly is so fixated on his partner that he becomes as demanding sexually as a Lycopodium male, easily transforming his wife into a Staphysagria or Sepia female. This quickly leads to the negative cycle: to foolish jealousy which transforms this passionate person into a man who normally is in firm command of all his actions, but now loses it at the slightest emotional event. Here again is a perfect example of the thinking Lachesis who gets into trouble when the situation calls for the intervention of his inferior, more primitive feeling side. This superior, thinking individual is now confronted with situations he cannot handle and it manifests itself in very foolish behavior and all kinds of jealous reactions: jealousy with rage; jealousy with saying and doing things he normally would not do; gentle husband becoming brutal from jealousy. To dull those very painful feelings, Lachesis, once on this negative pathway, does not shy away from alcohol which he can tolerate very well, even a debauched life, which then fuels his jealousy and suspicion even more. We must not forget that Lachesis is THE remedy for hereditary familial alcoholism!