OCN: Plight of the Hapless Bird
NATIONAL JOURNAL OF HOMOEOPATHY 2000 Mar / Apr VOL II NO 2.
Dr Praful Barvalia
Dr Yamini Bhagat
'Calc-sil / Carc
The rising sun sparkled across the ripples of the large river. Simultaneously the vacuum filled by the melodious songs of the birds, rustling of leaves and humming of the initiation of human activities. Birds leave their nest and fly. A few even go up and up to explore new horizons. There is one bird that just makes rounds around the nest. He holds his breath and forces himself to go beyond the point but alas! His feathers ruffle, he stalls and falls.
This bird is not Jonathan Living Stone seagull! This is the portrait of Obsessive-Compulsive Neurosis. He is gifted with a desire to fly, but psychic disability prevents any flight. His wings are clipped by a rigid conscience and morbid anxiety.
In Freud's view, all neuroses originate in childhood from conflicts between parents and child. Along with loving parental care, the child is at the same time, subject to parental discipline. Though the conflicts and consequences become repressed, they may nonetheless disturb patient's development. This failure to cope sows the seeds now and gets integrated in adaptational psychodynamics.
The origin of OCN is believed to rest in the early struggles of the growing child between his drives for omnipotent self-assertion and the necessity to conform to parental demand, in order to earn their love. The early period of toilet training initiates the conflict, compounded later by the obsessive-compulsive mother, who insistently demands compliance and threatens both loss of love and punishment for failure to behave. The growing child experiences repeated arousal of rage but must repress them in order to retain his relationship with the parent. Very early in life he learns to regard his underlying thoughts of hostile reprisal to be taboo, and therefore subject to punishment and requiring penance.
This attitude has impact on the development of a rigid conscience, sense of right and wrong and consequent development of guilt.
Insistent obsessive thoughts are defensive in purpose. The persistent idea is not to be taken at face value, but it is a substitute for another idea and thereby serves an anxiety preventing function. Hidden feeling of guilt is the common source.
Let us examine the following case.
Case.1
Name: Mr BRM, 66 - Retired commercial inspector at Central Railways
| Father: expired 4½ years back Brother: 59, 56, 53, 49, 45 Son - 26 years, Engineer. |
Mother: 83 years. Sister: 62 years. Consultation date: 22/12/98. |
Chief Complaints:
- Obsessive thoughts & compulsive acts. Intense since 15 years.
"Aversion to touch previous clothes, bed sheets etc after a bath."
"Collecting unnecessary things (plastic-papers)"
"Accumulation of clothes and dresses (using seldom to prevent wear and tear)."
Dread of taking bath, drowsy in day and sleepless at night. - Depression - Anticipatory fears ++ < Cloudy Weather
- Imaginary Fear < Cold Weather (T<20°C); Grief - Sorrow
- Boredom - no purpose of the life < Lack of Sun
- Dullness < Lack of Sleep
Guilt, terror of conscience - Insomnia - persistent.
- Disorientation - No sense of direction-East/West, North/South. Gets lost in maze of streets.
- Skin h/o Eczema - nape of neck, forearms "dry itch, thick scaly skin" discoloration - still hyper-pigmented. At the age of 21 years.
Rx: Psorinum, Sulphur, Petroleum, Graphites, Merc-sol, Nux-vom & Allopathic medications & ointments. Mental disturbances got aggravated after treatment of skin ailment. - Recurrent URTI and Sinusitis - difficult expectoration - Allopathic medications.
- H/o - Frozen shoulder 7 years back, since tonsillectomy at 17 years of age.
- Constant twitching of facial muscles. muscles and blinking of eyes.
- Generals: craving for sweets2 Aversion meat2.
Perspiration - h/o- offensive -rank , fishy odour. Deafness < draft of air
Thirst App-good.
Since last 15 years : Skin & respiratory complaints reduced.
Offensiveness of perspiration disappeared. Mental disturbances worse. - Dreams: Big snakes, Death of mother - twice when 7 years old.
- Thermal State: Sun à easy exhaustion & perspiration; Cloudy weather < depression
Fan - slow in Summer; Covering - 2 bed sheets upto neck in winter.
Bath: Aversion3; cannot tolerate cold bath, feels chilly. Takes hot water bath.
Life Space:
Mr MRB is a 66 yrs old man. Bespectacled, short, stout person, round faced with gray hair. Marked nasolabial folds with thick lips and cheeks. Continuous involuntary blinking of eyes and twitching of facial muscles especially cheeks, more marked when answering some qs.
Patient comes from an orthodox Muslim community. He is eldest of 5 brothers and 1 sister, sister next to him. Studied till Inter Arts and retired as Inspector in Central Railway.
Father, a lawyer, died 4½ years ago at the age of 91. Mild by nature, but a workaholic, always in a hurry. Patient admired him for his fast life style. Patient's mother is 84 yrs and stays with him.
Patient described her as an "over dominating and very strict regarding etiquette, discipline, manners and tidiness". She is schizophrenic, at times having manic spells- shouting and taking the whole house on her head. Patient's father being mild, he used to avoid her by being involved in work and staying out. Mother often threatened suicide by jumping from balcony.
Belonging to an orthodox Muslim background, she would make the patient go inside the house whenever any female visitors came. She also instilled an impression in the patient that men are bad. All this resulted in the patient becoming a timid, introvert person always dependent on his mother. In school he used to be shy, mix less with other classmates, as he had a fear of other people.
He had a strong, suppressed (due to fear of strict mother, inhibited family and religion) sexual drive since 15, which was never fulfilled, nor indulged.
His sister being of fairer complexion and the only girl in family, was given more affection-giving rise to a neglected feeling in the patient's mind, but held no grudges. Academically he was a good student, very particular about his studies. He passed his 10th standard with 67% marks. Patient had high dreams: to become a VIP (Scientist) or do something great in life; the aim remains even now. He joined Diploma Course in Mechanical Engineering at VJTI, but could not cope up with the excessive load of studies. After trying for 1 year he switched over to Arts, but did only till Inter Arts. Then joined Western Railways on a clerical post but later shifted to Central Railways. He worked there for almost 35 years and retired as a Railway Inspector earning a pension of Rs 3000/ Being an introvert, he avoided all parties and social functions. Constant anxiety and nervousness with respect to completion of work on time or in all smaller incidences. He had 2 relationships:
- at 26 with a nurse which lasted for 1½ years: patient broke off due to fear of mother and society.
- with a neighborhood girl, which continued for a short period & broke off because patient once saw her blowing her nose. He found this very dirty and developed repulsion towards her. There was no sexual experience with either of them.
Patient married at the age of 39. Patient described his wife as a "hot-tempered, dominating lady, repulsive, loner, non-sympathetic and non-adjusting; doesn't care about me, somewhat frigid and living in her maternal house. She never dressed or carried herself well. She was physically thin and repulsive." Patient's relations with wife were never good, there were constant conflicts. After 21 years of living together, she shifted to her mother's place in Jabalpur because her son had taken admission in a computer engineering college. Patient visits her regularly for 10 days every month.
Patient's son is 26 years old and an IT Professional, working at Nasik. Patient is proud of him, describes him as of a "noble and of good character". He is very attached to him and worries about how he will adapt to the new environment after having been the centre of attraction for mother and .brought up in a over-protective home.
Patient's relation with his brothers is quite superficial; they are busy in their own work. 2 brothers are abroad and rest in India. One is a schizophrenic and other, a depressive.
He has a "love-hate relationship" with his mother; wants to leave her and go away because of her domination but again has a large sense of responsibility (other children have deserted her). In fact he always wanted her in the childhood.
Patient has voracious appetite for reading; having read various philosophical books like Plato, Sufi literature, also likes reading books of physics, maths, mysticism and Homoeopathy. He picks up a lot of things from the textbooks of Materia Medica & Philosophy & makes correlations which leads to a lot of anticipatory. He constantly think about the future, frustration and guilt with respect to actions taken in past. This leads to depression.
Theorising++ patient's whole history consists of various examples where he keeps on corelating all his symptoms to one thing or other.
Patient described himself as a "religious, God fearing, philosopher, theoriser, simple, ignorant". "Fear of sin (even minor) dreads me". Along with this, a dominating mother led him to become fearful of other men and women; coward and fastidious as a person. Thus the arose the "terror of conscience."
Lately to avoid depressive thoughts he tries to get in to conversation with others and mix with other people, sit in busy market etc.
Patient's ambition of being a VIP (Scientist) could not be realized which led to frustration and depression, "thus from introvert (drowned into a world of fantasy and imagination and inferiority complex) I became half-extrovert and talkative (counter reaction)". Thus boosting up his inferiority complex.
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