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Apr 10, 2017

This is Episode 17, and today in our journey of learning through failure, I’m diving into case-taking.

If you think about it, what we do as homeopaths when taking a case is different than any other holistic or medical practice.

 

Like doctors, we want to know about the body- was ails it, what makes it better or worse, the quality of the pain, when it started, what started it, the medical history, effects of medications and so on.

Unlike a doctor, we care about *all* the physical symptoms, not just the ones that ail them.  We want to know their general physical disposition, and details about symptoms in addition to the chief complaint. Boy- do we want detail. And we listen.

 

Like a therapist, we want to know how the patient feels, emotionally. How do they respond to challenging situations in their life? what traumas and upsets have they weathered in life? How are their relationships? Do they get angry? about what? what does that anger look like? and so on.

 

Unlike a therapist, we do not counsel. We don’t interpret the trauma and subsequent behaviors and reactions. And *really * unlike a therapist, we may never re-visit some of those issues again.

Like a life coach, we might wonder about their aspirations and goals- and where are they in that journey? what holds them back?

 

But we do not give suggestions or exercises to improve themselves.

 

Like a spiritual guide, we ask about their dreams and fears and say more… say more… and what does that mean?

 

But we do not interpret for them.

 

Some homeopaths are all business, and some wander and weave and indeed the session can feel and *be* incredibly therapeutic. Some who have the knowledge and credentials may recommend supplements and include other therapies, many refer.

 

For the patient who comes in for some relief for their arthritis, and finds themselves recounting the pain of their parents divorce some 30 years prior, the experience is not often what they expected. Some patients feel they’ve divulged their entire life story and then some. Others might be suspicious and closed, uncertain of why dreams have anything to do with arthritis.

 

Homeopathic case taking is it’s own unique experience, for the homeopath and for the patient. But it’s ultimately where the healing begins. What we perceive in the hour or two hours that we initially meet or speak with a patient sets the trajectory, and while we can course correct along the way, providing the patient stays with us, we can never get back that initial meeting.

Is it possible to fail at case taking?

When i look back over my old cases, I can easily find holes where now I would gather more information. Places where I pushed for detail, that did not end up making a difference in my understanding of the case. Glossed over physical details that were important, in favor of the story.

 

In my students’ cases, I see the same types of things- no detail where there needs be, holes in physical symptoms, tangents that don’t add to the coherent whole.

 

I have no doubt that in a couple years, I will review the cases I am taking now, and find another group of what I will later consider to be mistakes and mis-steps.

 

How, then, do we become good, skilled case-takers?

 

How do we develop the capacity to be in the interview, making connections and picking up clues that guide us to where we need to go *in the moment*?

 

And what are we even looking for, anyway?

 

We are meant to take the case without prejudice. We are instructed to receive and perceive the case, thus it is important to remain open and not really *be* looking for anything. Once we start looking, we narrow our field of perception, and do a disservice to our patient and ourselves.

If you’ve been listening to the Repertory with Roger episodes, you’ll know that we’re looking at old cases from the Homeopathic Recorder. One of the most interesting aspects of this to me, is long-term successful prescribing in cases that are short compared to our modern cases, and also more heavily weighted on physical symptoms. Often even one mental symptom is not mentioned. These homeopaths used small remedies, as well as large ones.

 

How did our colleagues of 60 years ago know when they ‘had’ the case?

How did they advise new homeopaths and students?

 

— in the beginning, the learning curve for case taking is steep, and if you are under supervision, you may be getting good direct feedback.

 

but what about when you’re no longer a new homeopath? what about when you have 10, 15 years under your belt? Do you still need to pay attention to your case taking? How can you continue to improve and refine your case taking when you are no longer technically a beginner?

 

As I like to do, I plunged into the journals of my RadarOpus software to find some good writing. There’s a lot of good stuff in there.  I head to the material that was written before our contemporary methods, because in those writings is wisdom that can be applied across the spectrum.

 

I settled on an article by C.M Boger from British Homeopathic Journal- No 6

entitled ‘The Whole Case’

A quick bit of background on Boger, as either a first introduction or a refresh-

Dr. Cyrus Maxwell Boger was an American homeopath, a graduate of the Philadelphia College of Medicine, as well as the Hahnemann Homeopathic Medical College. He wrote several textbooks, journals, and translations. You likely have one his books on your shelf or in your software- most likely the Synoptic Key of Materia Medica or Boenninghausen’s Characteristics Materia Medica and Repertory.

 

I’m going to read the article and break it up with some discussion and my own applicable analysis. Essentially, it’s like studying out loud- taking in information from highly experienced predecessors, and then making connections to what I already know, and trying to take it up a notch.

 

You may hear Boger’s words and come to an entirely different conclusion, make a different connection, apply it to your own style and method of case taking in a different way- and that’s fantastic. As always, I encourage you to comment on the website or the Facebook page with your own thoughts about the topics in the show.

 

Before we dive into the article; please stick around at the end of the discussion for a few announcements- I’ll be posting an interview with Rajan Sankaran and Frederick Schroyens- together in an interview for the first time- in just ONE week; also, I’m planning something fun for the summer- here in the Northern Hemisphere-  a homeopathy book club! Let's get a whole crowd of us to read Lectures on Homeopathic Philosophy by Kent! There will be a private Facebook group, and I'll be facilitating discussion. You can also choose to talk to people- live! in bi-weekly discussion groups via webinar. Whether you are reading it for the first time, or the 5th... join me! 

Another Repertory with Roger is on tap before the end of the month. 

Lots of good stuff happening around the 1M podcast you won’t want to miss!