Method Explained

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Components of the Case

Underlying Constitution

A person's constitution is who they are as a person. Their personality, their quirks, their traits, essentially what makes them, them. It is how they are structured as a person. It is how they respond to life. It is how they respond to stresses and challenges. It is their perspective on life and things. It is the definition of their uniqueness. Thus, it defines them in a way that is categorizable, understandable and discussable. And this uniqueness, we find, corresponds to a particular remedy. We call this remedy their constitutional remedy. And when we give them this remedy, we call that constitutional treatment. Understanding when and how constitutional treatment is appropriate is a subject that each homeopath must understand. 

Miasmatic Burden

This is a burden upon our vital force that is generally inherited from our parents or even further back. Or, sometimes, it can be something that was acquired early in one's own life and was suppressed and thus caused dysfunction in the vital force. This can be separate from the constitutional remedy or can be the same as the constitutional remedy. For instance, a person can have a constitutional remedy that is also a miasmatic remedy. In fact, most remedies can be categorized within one of the 10 accepted miasmatic categories. Whether everyone has a miasmatic burden or not is debated. But it is probably extremely common to the point that most people are dealing with such a burden in their vital force. However, since essentially all remedies fit somewhere within the miasmatic framework, the debate may be moot. But it is important to understand the miasms because this is an important factor in choosing a constitutional remedy. Sometimes, the constitutional remedy that we select will also cover the miasmatic burden but sometimes the burden must be treated separately. Understanding this is very important for success. 

Prominent Presentation 

The dysfunction of the vital force will present itself prominently as a remedy state. This may or may not be a state different from that of the constitutional remedy state. This presentation can be seen in an acute situation or it may be so prominent that it appears to be a constitutional state in itself. If the vital force is presenting itself very prominently as a remedy state other than that of a constitutional remedy state, then, giving that prominent remedy may well correct the underlying constitutional dysfunction as well. The vital force asks for what it needs in order to correct its dysfunction. If it is presenting a very prominent remedy state, then that is the remedy that it feels it needs to correct itself. We must then reevaluate after giving the prominent state remedy and see if further constitutional treatment is still required.

Intercurrent State

As we are proceeding with constitutional treatment or treatmen rednt of the prominent presentation, it is common for an "acute" state to present itself and require treatment with an acute remedy. This is what we call an intercurrent state. It is a state in which the vital force had frequently presented itself in its attempts to correct the underlying imbalances. You may find that your client has a history of frequently needing a particular remedy for a recurrent acute state. That would be their intercurrent state remedy.

Causative Factors

It is very important, especially at the beginning of treatment, to investigate any causative factors that may have led to the current state of the patient. Frequently, these causative factors need to be addressed prior to constitutional treatment or treatment of the prominent presentation. (For example, if someone is having chronic urinary issues and has, in the recent past or even the far past, had a major pelvic surgery, this may be a significant contributing factor to their current urinary issues. The trauma from the pelvic surgery needs to be addressed first and then reevaluate and see what is left over so that we can decide what needs to be treated from there). Other situations that must be considered as causative may include, but not limited to; vaccinations, emotional traumas, physical traumas, etc. Attempting constitutional treatment or treatment of a prominent presentation without first addressing causative factors, if present, will greatly complicate the situation and probably lead to frustrations and failures in treatment

Obstacles to Cure

Obstacles to cure are those things present in the patient's environment which are actively contributing to their current state. If these things are not removed prior to treatment, they will continue to aggravate the patient's state and thus treatment will likely be ineffective. (For example, if the patient is complaining of chronic respiratory infections and you treat them appropriately but the problem continues, you will likely assume that you are not treating them correctly. But then you find out that they live in a house with a very serious mold problem, which, had you address that problem in the beginning, the patient would have been quickly cured or may not even have needed treatment in the first place). There are so many other examples, too many to name, but obstacles to cure are essential to address from the beginning of treatment otherwise proper treatment will not be effective despite being the proper course of action.

Guiding Idea

Ultimately, the point is to be able to see the dysfunction of the vital force and then understand how to gently nudge it in the direction that it needs to go at the various points along its journey to wellness. The better that we are able to do this, the more successful the treatment will be. Ideally, we should be able to clearly see and understand the dysfunction that needs to be corrected and clearly see and understand the proper course of action. Anything less than this will make the treatment inefficient and perhaps even ineffective. It is our responsibility to the patient to provide the most efficient and effective treatment. It is the responsibility of the homeopath to develop the skills necessary to do that.

Guiding Principles

There are four stages of treatment.

1 ) Case Taking (understand the case)

2 ) Remedy Selection 

3 ) Potency and Dosing (treatment plan)

4 ) Case Management 

Below, I will attempt to address these issues in a concise way.

CASE TAKING and REMEDY SELECTION

1 ) You must have an intuitive understanding of the client/case. You must be able to feel, inside yourself, what is the fundamental nature of the case and its various components.

If one relies solely on repertorization in order to find the remedy, it is likely to only be effective a small percentage of the time. This is because the repertory or the computer program is not able to understand the nature of the patient and the nature of the dysfunction in the patient's vital force. It is only as good as the information that is entered by the person entering the information. If the person entering information is very intuitive and has a good understanding of the state of the patient and the state of the dysfunction and they are also very familiar with the repertory or computer program, then they are able to enter good information and will likely get a good recommendation from this process. (However, if the person entering information is already good at understanding the state of the person or the state of dysfunction and if they also understand the remedies very well, then they will have much less need for repertorization). Finding the proper remedy depends on the ability to understand what is happening inside the patient. 

2 ) You must be able to take a perfect case in a short period of time.

Many homeopaths waste a lot of time aimlessly wandering around a case without direction. This not only wastes the time of the homeopath but also the time of the patient and is likely to yield a great deal of useless information that will just distract the homeopath from selecting the proper remedy. It is important to be able to get to the heart of the case in an efficient manner in order to find the information that is crucial for proper remedy selection. Don't hinder the patient from describing their state, you may miss an important clue, but rather, help the patient stay on track and have the skill to discover the important clues fairly quickly while avoiding the waste of time in unhelpful information. 

3 ) You must know the remedies so well that you recognize them when you see them in the case.

Understanding the nature of the remedies is just as important as understanding the nature of the case. If we are able to take a very good and very accurate case but don't know and understand the remedies, how are we to select the proper remedy. One must understand the nature of the remedies as well as one understands the nature of the patient state. Only then can you match a remedy to a patient's state. 

4 ) You must understand which component to start with and how to proceed at each step along the way.

When we see the case in its entirety, and understands the case and all of its facets, then we must understand how to most appropriately proceed with treatment. There must be a starting place and, in order to find that starting place, we must understand how the case is constructed. Then we start at the beginning. But, understanding exactly where is the beginning is crucially important. Starting in the wrong place may simply suppress symptoms and drive them deeper thus damaging the health of the patient. If the homeopath only recognizes the surface of the case and misses what is underneath, they run the risk of driving superficial symptoms deeper into the vital force. For example, it may, sometimes, be appropriate to begin at the prominent presentation, but not always. Finding the proper beginning place is a crucial skill to develop. Once we have appropriately started the case, then we must closely observe and monitor the progression of the case so that we know when changes need to be made, and, know exactly which change needs to be made at what point in the case. We call this case management.

5 ) Constant follow up is necessary to evaluate the effectiveness of the remedy and whether a different remedy or approach may be needed at that time.

If the case is not progressing in the way that you were expecting, reevaluation is necessary. It is important to follow Hering's law of cure. You must be able to look at the way the case is progressing and understand if it is moving in the right direction. The goal is to restore the vital force to health. If what we are doing is not accomplishing that goal, we need to reevaluate our treatment plan right away. Do not continue a plan that is moving the case in the wrong direction. But, don't stop a treatment plan prematurely. Having the skill to understand if the case is moving in the right way is of the utmost importance. It is imperative that you never move a case in the wrong direction. Sometimes the treatment plan must include modalities other than just homeopathic remedies (i.e. nutrition, autopathy, isopathy, detoxification, energy channel manipulation, physical manipulation, etc). The homeopath must be skilled in all necessary modalities in order to achieve the goal of restoring health to the vital force, or, at least, know when to refer a patient to an appropriate practitioner. Many homeopaths, when faced with a difficult case and don't know what else to do, conclude that the patient is incurable. A patient is only incurable when they are so close to death that there is not enough time to repair the vital force. If the homeopath finds themself in a situation where they are unable to repair the vital force of a patient, instead of concluding that this patient is incurable, it is better concluded that; the homeopath doesn't currently have the skills necessary to restore this patient to health. At this point, the homeopath can either acquire the skills needed or refer the patient to someone who does have the necessary skills. It is lazy and unethical to simply conclude that the patient cannot be restored to health just because you don't know how to do it.

POTENCY and DOSING

1 ) Start high enough to effect change but without overwhelming, thus damaging, the vital force/organism. Adjust as needed. 

Starting too low will not bring about a deep enough change but starting higher than the vital force can tolerate may cause serious damage. It is incumbent upon the homeopath to understand what is too low and what is too high.

2 ) There must, at some point, be a "purge" or series of "purges". No purge, no cure.

The healing process starts from the inside and works its way out. The purpose of appropriately and judiciously applied remedies is to assist in that healing process as necessary. As the healing begins, the vital force will heal the deepest aspects first and proceed toward the more superficial aspects. The vital force will begin with the most crucial systems and work its way toward the least crucial systems. In this process, as the vital force works from the deepest most crucial aspect outward, it will push dysfunction toward the surface. This process, especially if there is a good deal of dysfunction, will present as a return of old complaints. In cases of severe dysfunction, this process can be somewhat intense. This has been referred to as a "healing crisis" but may be more appropriately referred to as a purging process. In cases where there is very little or very superficial dysfunction, the purging process may go unnoticed by the patient because it is relatively mild. But the more severe the dysfunction in the case, the more difficult the purging process is likely to be. Thus, during the treatment process, if there is no noticeable "purging", we must ask, was the dysfunction very mild and superficial or was the treatment incorrect and thus did not produce the appropriate healing process. This is a very important part of the case management process.

3 ) Use whatever potency, dosing schedule and delivery method that is appropriate at the time.

Evaluating the case includes, in addition to all of the previous information, the evaluation of what potency is appropriate and what dosing schedule and delivery method is most appropriate at the time of treatment. The selection of potency, dosing schedule and delivery method is a subject in which the homeopath must become proficient. Some have said that potency is a myth and it doesn't matter what potency one uses as long as it is the correct remedy. This is demonstrably incorrect. Potency does, in fact, make a great deal of difference. Wrong potency use will prove, in the least, to be ineffective, and at the most, to be harmful. In addition to the selection of the appropriate potency, we must also understand how often that selected potency should be repeated. The repetition of the dose will depend upon, in great deal, the selection of the potency, but also there are a number of other factors that must be considered. Also, there are many different methods for delivering the remedy. Well it be taken dry, in liquid, will it be succussed, will it be diluted, how many times will it be diluted, will it be taken by mouth or by olfaction or transdermally. All of these factors must be considered at the time of treatment and are based upon the needs of the patient.

4 ) Constant follow up is necessary to evaluate needed adjustments.

It is a very important part of the case management process to very closely monitor the dosing schedule in order to ensure that you are optimally dosing the patient and not overdosing them. This, along with all of the other factors previously discussed, are a part of the art of homeopathy. In order to properly apply the science of homeopathy, one must become an artist, an artist in the facilitation of healing.

5 ) Know when to stop dosing.

As Hahnemann, and many others have stated, many cases have been ruined by too soon repeating the dose. We must artfully employ our skills in the selection of the proper remedy at the proper time and also the selection of the proper potency and dosing schedule at the proper time, but, we must also know when to stop dosing the patient. It is a very fine balance and, as homeopaths, we are walking the razors edge of potency and dosing. If done properly, the results are astounding, by the grace of God. But if done improperly, the results can be troublesome or even devastating. So, choose well, choose artfully.

CASE MANAGEMENT

This has been addressed in the above information and there's very little that needs to be added. Case management is one of the most important aspects of proper treatment. Even if we select the right remedy, potency and dosing but fail to manage the case properly, we will likely not get good results.