Due to the so-called renaissance of the 1970s and 1980s, homeopathy experienced a major resurgence. Classical homeopathy, which had spread rapidly in the 19th century because of its remarkable successes, was effectively sidelined at the beginning of the 20th century, together with all other “natural” methods, to make way for chemical pharmaceuticals (the Flexner Report). After several decades of continuing its work in relative silence, the time was ripe for a revival.
What was special about this revival was that the Materia Medica and the Repertories of the classical authors were supplemented with countless provings and additions. With the advent of the computer, homeopathy made another quantum leap, because rapid search capabilities enabled homeopaths to see relationships and similarities between remedies that until then had been studied and memorized individually. These relationships led to the development of systems that, on the one hand, introduced “all remedies in the world” as potential candidates, and on the other hand structured the search process.
As head of the CKH (Centre for Classical Homeopathy), I observed how students initially became lost. The transition from the classical foundation laid in the first two years—based on the classical masters and the polychrests—to the classification of remedies into large “kingdoms” and miasms was confusing. Because many were unable to bridge this gap, various homeopaths began offering methods and tools. The Vital Approach is one of these, although I continue to maintain that it is not a new method, but rather a common-sense approach that preserves the best of all methods while simplifying the working process.
Perhaps unnecessarily, but I wish to emphasize this clearly: what is outlined here applies only to constitutional treatment, that is, to determining the patient’s similimum. In the majority of our patients, this allows us to witness a total transformation, which is the promise and potential of homeopathy.
That there are many complaints and problems that are not constitutional—in other words, that do not originate from the fifth level (vital/sensation)—goes without saying. These may possibly be addressed with other remedies, though always with the question in mind of whether removing the symptoms is, in that case, the best solution. In acute clinical cases, this doubt is often absent; the situation is different, however, when physical symptoms are chronic or systemic. When toxicity and artificial diseases are involved—an increasing problem—appropriate treatment modalities are required.
For nearly twenty years now, I have worked primarily on simplifying homeopathy, based on the observation that the situation had become unmanageable. How can a homeopath, with thousands of remedies available from homeopathic manufacturers, choose the correct one? How can one, knowing that all phenomena on earth and in the heavens may constitute a possible remedy, have any certainty about a prescription, even with the best computer search methods? On what should one base oneself during a consultation that already lasts two hours and demands marathon-like concentration? Which elements in pages of notes are important, and which can be ignored?
I have attempted to formulate an answer to these questions with the Vital Approach (VA). In essence, it comes down to the following:
The general issue must be separated from the details.
In our training, we learned keynotes that were meant to serve as tools to guide us toward a remedy. Everyone liked these keynotes; it made you feel clever if you could recite a few from memory. Burning soles of the feet? Sulphur! Sleep aggravates? Lachesis! Desire for salt and fat? Nitricum acidum!
These tools were useful when we worked with some thirty polychrests, or—among more ambitious homeopaths—perhaps a hundred that one wanted to memorize.
Today, however, these keynotes stand in our way. They usually concern details and are often unreliable, or they appear in rubrics of the expanded repertory among hundreds of other remedies, thereby losing their “keynote” status.
It can happen that a very particular detail opens the door to the correct remedy, but this is extremely rare. In most cases, an emphasis on the main issues offers the best guarantee of meaningful prescriptions.
What, then, are the main issues?
Repeatedly, in the analysis of every live case I have conducted in various settings, I have begun by asking the participating homeopaths the following questions: What kind of patient is sitting in front of you? What kind of case is this?
Many homeopaths find these questions difficult to answer because, during the two-hour consultation, they were already busy searching for hints and peculiarities that might lead them to a remedy—a panic reaction. During the consultation, we do not need to be concerned with that, as it distracts our attention from what the patient is trying to communicate. Toward the end of the consultation, most of the puzzle pieces usually fall into place.
The question “What kind of patient?” is intended to prompt the homeopath to make explicit observations. These should not sound homeopathic and should be free of interpretation. A woman who enters carrying an expensive handbag is simply a woman carrying an expensive handbag. A young man with seven earrings and a nose piercing is a young man with seven earrings and a nose piercing. An obese middle-aged man wearing overalls is an obese middle-aged man wearing overalls. I have written several articles on what I summarize as “context” and gladly refer to them.
Can one prescribe on that basis? Obviously not. What it tells the homeopath is how this person sees and presents themselves to the outside world. One may then use labels that are verified during the consultation. A first impression, however, captures the most striking features (even if the most striking feature is being “unremarkable”), and that is what is “strange, rare, and peculiar.”
All of homeopathy can be summarized as “strange, rare, and peculiar” on all levels.
What other main issues are there, besides appearance and behavior?
A further extension of the concept of “context” concerns the course of the consultation itself. This reveals how the patient relates to the outside world—in this case, to the homeopath. From this, one can usually readily conclude in which kingdom a remedy should be sought, and often also in which row. For this, I refer to the Vital Approach Map of Homeopathic Families.
The chief complaint is also important. Is it an emotional problem, a relationship problem, an existential problem? This too points to a kingdom. The way the problem is handled and the treatments that have been attempted tell us which row to search in. Because I sometimes describe the Map as a world map with two continents (2D and 3D), by identifying these main issues we can already search on the correct continent (the dimension) and in the correct country (the row) for the right city.
This again requires from the homeopath the ability to distinguish main issues from the details. After two hours of listening with full attention, the question is: what are the conditions to be OK for this patient? What is at stake? The answers to these questions—without all the details—lead to the subgroups, twenty of which can be found on the Map, each described in a few words by their main characteristics. If the homeopath working in this way arrives at a fearful, trembling mammal, it no longer matters whether the patient has warm or cold feet or likes fatty food.
Only once the analysis of the main issues leads to the conclusion that a mammal remedy is needed can the specific remedy be determined, based on hints noted during the consultation as SRP or through targeted repertory research.
I would describe this approach as a new model.
It is based on the premise that uniqueness, even though it expresses itself in countless details, is primarily recognizable through general characteristics. We recognize a friend from afar in a crowd at a train station; we can identify who is speaking to us by voice alone; we recognize someone we know by their manner of walking, even from behind on the other side of the street. Broad outlines are sufficient to recognize a pattern. A circle with a vertical line beneath it and four diagonal lines suffices to depict the pattern of a human being. A circle with two dots and a curved line beneath it is perceived as a human face.
When we apply this to homeopathy, we arrive at the simplification I strive for—while preserving all possibilities, all potential remedies, and all the latest developments.
