ICR Workshop, April 2000, Mumbai
NATIONAL JOURNAL OF HOMOEOPATHY 2000 May / Jun VOL II NO 3.
Reported By
Dr Deepa T. Katira
'Nat-m / Ars-alb / Psor / Mag-carb

SCR Workshop 2000
After many years, a 3-day SCR workshop was held at Vile Parle in Feb 2000. The focus was mainly on Psychodynamics and Life-space table. A novel idea was experimented with, by dividing the delegates into small groups, which brought clarity to the different approaches to Psychodynamics and made for better quality of learning. 3 cases are discussed at length.

Case 1- Chronic Migraine
A South Indian lady came in wearing jeans, T-shirt and spectacles. 43, single, 5'4", 54kgs, she had light eyes and boy-cut hair, smoked 20 cigarettes/day and took alcohol 2-3 times/week.

For the group, her community name had conjured up an image, which was quite belied by seeing her. She was an antithesis of the typical south-Indian woman. She is an MSc from IIT Bombay and is now a software Professional, having worked her way up from a Research fellow, a Senior Programmer, a Systems Manager, Senior S/W specialist, Consultant and finally a Manager. She was now ready to launch her own software business.

Daily Routine: She said, "I am a night bird, prefer to stay up till late into the night and get up late, have no breakfast, except morning tea, which with a cigarette, is an addiction. Lunch timings are irregular. I have no financial strains except for sending Rs 2000/pm to mother.

P/H: Tuberculosis in 1986 - treated.
F/H: Fa, retired Headmaster, maturity-onset Diabetes, died on 24 Aug 1996 at 88yrs.
Mo: 70yrs, own income, plus remittances from the patient and her second son
She has 2 elder brothers and 4 elder sisters. Pt is the youngest of 7.
Eldest brother: 56yrs, graduate, alcoholic, works in Bangalore, married a professional in Polymer Chemistry. H/o Migraine. 2nd brother: 45yrs, journalist, working in Singapore, married.
Sisters: 53y, 50y [2nd-marriage, after first ended in divorce], 47y, 41y [Married doing B-Ed.]

Patient As Person: No specific desire and cravings
Menstrual History: regular except twice when she had problems.

Life Space
Pt 43 yrs. Born in Kerala, living in Bombay since 20 yrs. Her agency recruits Software Professionals for USA with specific job work [Body Shoppers]. Hence, made frequent trips to USA. The American influence is very evident.

Childhood: Mother was religious and orthodox. Pt was the outcast- out-spoken and blunt. She had frequent fights with mother esp on issues of religion and family norms. Her mother's oft repeated comment "How come you got conceived in my religious womb," made the pt hurt and rejected though now she laughs it off. Father was strict, an introvert, yet well respected in society. He was her Hero, but she was never close to him. He was not the demonstrative type. Pt had special relation with the 41-yr sister, a strong love-hate relation. She Hero-worshipped her elder Br. She was quite free; in fact her first cigarette was tried in 5th. Std.!

The eternal tomboy, who did nothing to ease her relationship with her mother, even till today. . After BSc, Mo insisted she gets married. Patient refused and opted for MSc at IIT.

She stayed independently in Mumbai and worked part time. The 1st attack of Migraine appeared when her plans of going home were disrupted. She wanted to see her sister who was 'dying' to meet her. Patient too wanted to share her 'IIT-Experience'. The train was delayed and hence the plan had to be changed. Instead of Kerala, she went to Ahmedabad to her Brother. She got very frustrated.

At IIT, her friend circle grew along with smoking and drinking. Once, when she stayed overnight at her brother's, he was out late. She and her sister-in-law were sleeping when he came home after midnight, drunk and misbehaved. She was disillusioned and shocked to see him in that state. She came to know for the first time that this was his daily routine. Since then she never ever spoke to him. "A man who loses senses, loses respect." She continued to relate to her SIL but never to her Br.

During her IIT days she received a few proposals, which she refused outright. According to her, sex is a need, which can be fulfilled without marriage commitment. She had few relationships in her life. Her view was that one need not form any emotional bonds and become dependent. Relationship was a burden for her. "Why should one pass through emotions like envy, jealously and possessiveness. Once you get married, you have a child, then send your child to school and the whole gamut starts!" She did not like the current educational system. "Where so many children are already there, is there a need to have mine?"

She found it quite difficult to talk about her Fa. She regretted not relating better to him, a person whom she admired so much. Bedridden, in his last days he would have high fever, "But I never touched him, I would just sit in front of him". And ultimately when she did, he was no more "Why could I not do it?" There were tears in her eyes. She observed the strict person in him, becoming warm and affectionate. Even as a child, she never took permission from her Fa about anything, only informed him, to avoid confrontation. She feels very guilty now. She misses him after his death.

Remedy Selection: This was a clear Natrum-mur. She was better3 with infrequent doses of Nat-mur 200. The migraines reduced in intensity and frequency. In this case, the discussions were very exciting.

It was a case of extensive psoriasis: Guttate-pustular type with Reactive Depression. The patient was a graying3, short and obese, with a fair and round face, but sharp features and long eyelashes.

Craving: Sour, Garlic
Aversion: Milk² fruit.
Stool/Urine: Normal
Sweat: Now decreased. H/O profuse³, offensive² and staining yellow.
Menstrual Period: H/O Regular FMP 12yrs. 26-28 /3-4
Recent since 5 years: Weakness2 irritability2 depressed2 < during menses.
Sex: Reduced libido since illness
Abortions: Twice induced D and C as she did not want a child at that time.
Delivery: FTND
Sleep: Disturbed due to complaints and thoughts; weeps silently thinking about her illness.
Dreams: Going to old places, which she used to visit², going up and down the stairs²
Anxiety³; animals, snakes², dead²
Events; daily routine², recent²
Examination: that she is giving²
Fights²: Frightful; journey2, pursuit: someone pursuing her²
Thermal : Hot Chilly 4 In the past liked winter, fan and no covering² and cold bath till 9 yrs ago ie since illness: covering3-sometimes uses 3-4 thick covers in winter,
Summer² also a thick cover as she feels like keeping herself warm and takes a hot bath

Past History And Family History
PGF: Died of Pulmonary KOCH'S
MGF: Died of Myocardial infarction
Mo, PGM: Hypertension. MGM: Mo, Fa: IDDM
Mo: Osteo-arthritis; Fa: Osteo-dystrophies
O/E: P=70/mm, BP =130/80, T= 99.40F, R/S-CVS = NAD
Skin: Scales3, erythema2, suppuration3, yellow pus. Cracks² and cuts especially folds

Life Space: Pt hails from a middle class Hindu Brahmin family, born in Jamsedhpur. Pt is eldest of 4 and has 1 brother and 2 sisters. Father was accountant-auditor, dominating and strict. He never liked to hear criticism of elders by younger ones. "Sada Jeevan, yehi sikhsha di - good thoughts and simplicity is what he taught us" All children feared Fa. Mo was an obstinate and innocent, simple lady. There used to be frequent fights due to Fa's scolding. Though pt was the Father's favorite, she still had fear of disappointing him. Her Mo would cover up everyone's mistakes and take blame on herself, to avoid scolding and disturbed environment. Patient was good in studies, scored good marks, ahead of other girls, always overconfident. She said, "When I speak, others liked to listen". She passed SSC from Hindi medium and did BSc in Botany -in IInd division. When she was in 2nd yr B Sc, a marriage proposal came. Her fiance was in final yr Engg. He got a job where her father was in service and accommodation next to pt's house. Being concerned about him, Pt would ask her younger sister to take tea/ breakfast for him. Her sister was in 10th std and very beautiful, but the patient never had any inferiority complex on any comparison with her sister. She considered herself beautiful in her own way.

Anyway, he instantly liked her sister. After some days, when the patient met him and he came to know that she was to marry him, he could not say no to her just because she would feel hurt. But whenever she used to get time to talk to him, he would only ask for her sister, though they met everyday. Pt felt hurt by this and tasked him that if he had any affair. But he refused and pt also did not take it seriously and married him. In the first week itself, her husband told her of his love for her sister and his earlier desire to marry her. He asked to be forgiven. The patient was numb with shock - "My heart broke" in spite of his asking forgiveness. She left for her in-laws place in Bangalore for two months.

During this time her Husband had a lot of time to be with her sister and he got a bond signed by her, that she would get married to him in the next life. On patient's return, her sister narrated everything to her. He would write poems on sister's name, would leave the patient alone and sit with 'K' and her friends reciting poetry to them. Pt felt lonely and wept. Her self-confidence was threatened. She wanted to commit suicide by baygon spray; but her inner desire to live was strong. She did not tell this to anyone in the family, so as not to trouble them; did not feel angry also -took it as her fate. At that time used to feel suffocated. Now on recalling these episodes, she still feels like crying. Though sexual relations were there between her and her husband, she felt he never loved her as he should or the way she wanted. She spent restless nights, waiting in the hope that he would make love to her.

She continued her studies; then took a job as teacher in 1986 in Bihar. Husband and sister's relations continued for 5 yrs till sister finally got married in 1984. After one year of marriage pt gave birth to a baby boy followed after 7 years by a baby girl. Pt did MSc in Genetics and BEd - remained busy from early morning till late night including attending to household duties. Even though she would be late for school and dropped a needle, she would search it, lest it hurt anyone. Though she was happy with her job, she had to leave it as her husband was transferred. But she felt relaxed. 2 yrs ago, when they shifted to Mumbai, she underwent many tensions - school admissions, completion of their studies within 2 months. At home, tremendous anxiety because of her MIL's irritating nature eg she would oil her head, and then not take care, so clothes and pillows would become very dirty; after using the toilet, she would not flush. Whole day she made some peculiar sound, that irritated the pt. Pt used to tell her initially, but now has stopped. MIL has vision only in one eye and is hard of hearing. Though she has 4 sons, no other son is ready to keep her because of all these; patient has attended on her MIL for 17-18 yrs, yet MIL never said anything good for pt or gave love or affection in return only cursed and scolded her.

Pt says that she has lost interest in life, has stopped looking into mirror, does not enjoy wearing new clothes, has lost her confidence while speaking English: does not have sexual desire and simply wants to die. Seeing MIL's state she does not want to live that long and be a burden for her children. Pt appeared depressed yet expressed a need to recover. There were weeping spells during interview, with a sad look. She kept on seeking confirmation whether her illness would be permanent. It made her feel that due to it, she may be able to get back her husband's love and affection. She felt that before when her life was full of tensions, there were no complaints but when now everything is fine, all her complaints have started. "Though I have everything -there is a vacuum."

A case with good dimension of Psychodynamics and objectives achieved.
We learnt how the patient's outlook could move one. Speech, feelings, anxiety and behaviour (Caution advised). And how a sensitive Primary Physician gave much importance to it, not realizing that it is obvious in such cases. Here comes application of life-space Table. Interview with Husband needed to give full resolution (except remedy).

Treatment: Started with Ars-alb 200 QDS
1 week later: Partly > Ct all for 15 d (with regular follow ups)
3 weeks later: SQ. No change. Calc-carb 200 -1P next week 200 3P
Fluctuating response Psorinum 200 interposed followed Infrequent Calc-carb 200 3P -6 weeks later. Partly > SQ from 27-10-97 to 23-03-2000.
After discussion and review Mag-carb 200 came up as constitutional.

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