The patient in context

We have to consider a few things first before going into the topic of the ‘role of the healer’ in homeopathy.
I think we can all see the evolution in homeopathy, in the 19th century primarily concentrated on the symptoms/ pathology, shifting towards focusing on the patient in the 20th century. But again we have to broaden our perspective and I believe 21st century homeopathy should focus on the patient in his /her context. In the same way the ‘Ding an Sich’ doesn’t exist as Kant made clear in the 18th century (an idea adopted in western science by quantum physicists, cybernetics and psychologists the lasts hundred years), there is no such thing as the ‘patient an sich’. It is always ‘the patient in his/her context’.But what does that mean and does this have any practical use in our daily clinic? I think it does.
I even assume disregarding the patients context is one of the main mistakes we make in interpretation, analysis and hence in prescription.
The patient doesn’t live in a vacuum, or in a bubble all on his own (should he claim he does, keep your Ozonum ready), he lives in a family context, which is part of a bigger context, the neighborhood, again fitting in to the city context, country context, cultural context, time context, ad infinitum. It is contexts within contexts and though we don’t have to picture the whole world when our patient sits in front of us, at least we have to fill in the background.
That is one. Another one is the context of our consultation.
We create a healing setting, with many implicit and even unconscious agreements or assumptions. There is for instance the role play, in which one of the players is not acknowledged. The patients have what we could call an ‘inner child’, expressing its needs and failures throughout the consultation, asking for help. The adult part of the patient is there too, it contains all the aspects in which the patient behaves mature, able and balanced. These are not the subject of our inquiry because we don’t try to fix what works. The homeopath on the other hand only displays his capable and balanced part, ignoring the inner child with its needs and insecurities for the time being. That is the main reason why patients tend to forget that their homeopaths even have flaws, weaknesses and the like. This mean there are only three persons in the room: the adult patient, the inner child of the patient, and the adult homeopath. Number four is not there. For the time of the consultation this is fine, it provides the patient 100 % of the attention, a situation which rarely occurs in daily life, if at all. Worse is when the homeopath forgets it’s only in the healing setting his inner child is put aside for the sake of the patient, not because he ‘overcame’ it or left it behind altogether. If this is the cases, the danger is the homeopath conveys power over the patient, who will obviously only feel more miserable after the consultation.
The role of the healer becomes clearer now.
The context of the consultation yields to expectations. As most of the patients have their own version of what homeopathy is and among homeopaths there are different approaches and styles, the patient usually doesn’t know what to expect, unless they are briefed by someone else. As homeopaths we can then chose to either explain the patient what we are going to do, adapt our approach to the patients expectations or just ‘do our thing’. Only the first consultation will be a surprise for the patient, in the follow ups he will be already enough familiarized with the context the homeopath creates to anticipate the meta-messages.

Besides the way the consultation is organized and executed there is of course the context of the homeopath as well. He can silence his inner child or send it out during work, he nevertheless is as well as the patient a person in a family, a neighborhood, a social and cultural context. He can’t help but bring all this into the consultation room. The white coat of the doctor is part of the ritual: it immediately creates a world of images and associations with the patient. All uniforms do this. But homeopaths don’t wear uniforms and in last Teacher’s Meeting we discussed this lack of an archetype for the homeopath. We have archetypical nurses, policemen, psychiatrists, spiritual teachers, physiotherapists, sportsmen, wellness people, professors, and so on, but no archetype for the homeopath.
This leads to many implicit assumptions, meta-messages and interpretations on the side of the patient. Thus there is his/her context, including his interpretation of our context: the consultation (time, waiting room, decoration, style) and the impression we make on the patient. From the point of view of the homeopath, our consultation consists of decoding these from our patient, among all the other decoding we do.
Usually patients try to make a good impression on us because they want to be helped, invested money time and trust and want or hope to receive health in return. (That is why adolescents are such horrendous patients: they don’t!)

I can’t emphasize it enough, and so it in every single Master Class or Master Apprentice live case I’ve done, the first and most important question in analysis is ‘what kind of patient is in front of us’? Difficult as it might be to make an impression explicit, we should train ourselves in this art. The remedy is not in the words the patient says, it is in what patient says which words when. The context of the patients is then taken in to account. Some words are common in one patient that would be SRP in another. Some words are appropriate in one story but out of touch in another. Some expressions might be normal among friends but not with your homeopath. Some actions are expectable for a 20 year old but not for a 60 year old. Some words could express a sensation but could as well be a common expression. Only the context will decide which is what. When homeopaths ask me: ‘Ok, you say: the sensation is on ‘all levels all of the time’, but how do we know a words or feeling is from the vital level or from the emotional or physical?’ In other words how to differentiate, between a local and a vital sensation?
The answer is: only the context can tell. Without the context there is no way to know for sure.

Case after case after case, I witness this simple fact. Because I know the remedy beforehand I look for the confirmation in the case and can from my point of view discern between the reliable and the unreliable information in homeopathic teaching. Over and over again the context decides. Often the whole case boils down to one or a few rubrics that depict the most peculiar behavior of the patient, his attitude, his way of being, something Hahnemann already said is ‘impossible to hide from the homeopath’.

For example, this insurance man of almost 60 with all kinds of serious diseases, telling about his nature as if he was a teenager boasting about his quite unbelievable risky behavior. His remedy was Ignis alcoholis and to my delight I found a very small rubric ‘Deeds, as if he could do great deeds’, a perfect summary of his attitude. Or the young politician who applied for promotion and was turned down because of nepotism, suffered more from being too invisible to be granted the job than the obvious fact he had no change however capable he was. Phytolacca was his remedy and a small rubrics ‘Attended, desires to be’, describes exactly his ‘condition to be OK’. Or what to think about the Ara Macao patient, nearly 70, bringing poetry, attending theatre, dance performances, reading and writing, welcoming lots of guests for supper at her house, displaying this whole attitude that was perfectly condensed in this one rubric ‘Interesting, desires to be’.
It might be true we don’t have for each remedy this one rubric describing the sensation, but surprisingly enough, more remedies than we expect have either this one or a few rubrics depicting the very core. Wouldn’t it be great if we could produce a Materia Medica with those core symptoms to look for. I’d be certainly delighted to contribute to such useful tool!
After we discovered and explored the field, collected innumerous data, extracted systems and drew maps to navigate, we now have to boil our knowledge and experience down to workable simplicity and clarity.

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