Oct 28, 2017
Hello- welcome to 1M: A Homeopath’s Podcast. I’m Kelly Callahan and this is Episode 25, Repertory with Roger: A case of Hitting the Wall
Roger Van Zandvoort and I have connected several times over the course of the year to talk repertory strategies in the form of a tutoring session for me, utilizing cases from his Clinical Case Project. They have been invaluable sessions, even though the cases are over 1/2 a century old, best practices for repertorization don’t change.
What has changed to some extent are our cases between now and then- what we talk about with patients, the issues they come to us with, and to some extent the types of complaints and treatment they have already had.
I asked Roger if he would be up for doing one of our sessions with a case from my own practice, so we could put the techniques he has to share to a modern case, and see what - if any- different issues arose and pointers that may be unique to a case of the 21st century.
The case I’m going to share is a new one to me- I wanted a case that was still in development, because it felt like that would allow for the most fresh and authentic conversation- I can’t say whether we are right or not- at least, not at the time of the call. As of this recording, I do have some preliminary results from the patient that I will share at the end of the episode.
The case is of a gentleman in his 60s, suffering from chronic headaches since his early teen years. The headaches are worse in the autumn with cold nights and warm days, come on in the wee hours of the morning, and ameliorate with motion and being upright, in addition to caffeine. The history included a move between extreme climates, and a distinct memory of getting a first headache with a blast of cold air conditioning.
I chose this case was because
So this was one point of our conversation- the extent to which character factors into case analysis and remedy choice.
This is a perennial question in homeopathy, I think, and it’s asked in different ways with different words, like personality, or trying to drill down exactly what constitutes constitution. I think it’s also one of the main points of contention between homeopaths- what do we prescribe on? what can we include, what must we leave out? what constitutes the totality? what bigger analogies to we consider or not? There are some very strong opinions on this matter, with impressive references and arguments.
Roger has his ideas- he says them here and he’s said them before. For myself, the question of whether character matters in a case has come to depend on the case. There are many pieces to consider when analyzing a case and choosing a remedy, and sometimes character- or disposition if you like- is as part of that. And sometimes it’s not.
I do think it’s an important and interesting realm of our practice to explore, however, especially because we see positive results in a range of approaches, so I don’t think that circle has been squared yet. Consider keynote prescribing- which is not always a bullseye, but can be incredibly effective in certain cases. With single sx. prescribing, character and disposition are not an aspect. And of course, it’s not just character or no character. Analysis is much more complex than that.
But anyway, I did think about this when choosing to present this case because it felt like a case where that aspect was flexible and it truly could be looked at in multiple ways.
Another point that came up for me in working this case myself and in discussing it with Roger is knowing which rubric to choose when there are multiple that fit the symptom, but you aren’t quite sure which one is the best- do you take the biggest, most inclusive and generalized?
I know this comes up again over and over in nearly every case that we discuss together, and I think that speaks to the fact that while the ‘guidelines’ if you will, are clear, each case presents a completely different opportunity to apply them, and I always feel at the need for clarification.
What if there are 5 rubrics that all say essentially the same thing in different order- take them all and combine? is there really one that is better than the others as the most characteristic?
Roger used a Christmas Tree analogy- or really, any fir tree i guess- and listen out for that because it’s a nice visual to think about.
He assured me that overlap in the rubrics and remedies is OK
We debated whether actions that *prevent* a condition from occurring are the same as amelioration? We did’t come to a consensus on that
We geek out there for a nice little bit on rubrics for amelioration standing or sitting… that was fun. i was happy to have found a couple of good ones that Roger hadn’t found- yay me! But also, this was something that was harder for me to do on the clinical project cases because i didn’t have the same grasp of the cases as i do for one of my own.
And then we talk about the ideal number of rubrics- it’s kind of like hunting down the origins of some myth or legend for me…. there is definitely a strong message that less is more that i have picked up along the way…but here’s Roger telling me the opposite and soothing my frantic mind when i’m choosing rubrics and the little voice is saying in my head- stop! you have too many! you’re being redundant!!
We also touch on using time rubrics, which i’m always hesitant to use because i often feel like i cant’ find the hour breakdown that i want, and i wonder if they are too specific anyway, to choose a rubric of a 3 hour time block.
In the end despite the revisions we did to our lists in talking to each other, we came up with different repertorizations. The remedy I picked came up in a higher place than Roger’s.
I share the remedy I prescribed at the end, and I have some follow up information to share before I close the episode-
The first three weeks on the remedy were very promising, with an aggravation of headaches and emotions in the first week, but a simultaneous relaxing of back pain- which did not come up in the rep. call nor was it something i considered other than the cervical tension- to the point that the patient found he did not need to do his standard morning stretches.
After the first week, there was a huge breakthrough in an emotional issue that he had not been able to move through, and then the headaches began to ameliorate. No headaches when he expected them and a couple that moved on without the usual interventions, which almost never happens.
This last week there was an issue that seemed to antidote the progress and set the whole improvement a step back. By repeating a lower potency- 30c- at regular intervals, he saw some quick relief and felt the positive shift again.
At this point, I can see that the remedy choice is only one part of this healing, managing the case well is going to be paramount, figuring out the potency and dosing, but also the patient is used to self medicating in various ways and so those measures will be potential obstacles to cure to contend with.
If you haven’t listened to episode E019 Taking a Case Inventory, you might listen to that. This case made me think about the Circle of Practice that I created, where I take into consideration both aspects of the patient- what’s happening in their life, their understanding of homeopathy, etc. against the realm of myself as the prescriber- ability to manage the case appropriately, and using that whole picture as reference. This is a case where I can really feel like my px. might be very good, but the patient needs some specific guidance, or I could lose him.
This is the last Rep with Roger episode for the year. Roger is happy and willing to remain a returning guest on the podcast for 2018, which I am so happy about. Ii’m thinking about changing it up a bit- the cases are great, but there are other aspects to get at the repertory, so if you have any questions or particular aspects that you struggle with ,i would LOVe to hear about them so we can plan some shows accordingly.
Next month I’ll be presenting my multi-part series on the Homeopathy One conference, which i am still processing and allowing to settle, so i’m looking forward to creating those pieces for you all. It was a really good time, I had the chance to reunite with some great friends, meet a loyal listener- Hi Irma!!- and of course revel in some high level homeopathy with some masters who I may never see again. all in all, it was a huge treat to spend the week in Bruges.
Not to mention the fact that I connected with several people who I am really excited to bring on the podcast next year- 2018 has been taking shape in my mind and dreams and if YOU have any requests for guests and topics, now is the the time to share them as I begin to pencil in the calendar. Shoot me an email at email@example.com OR message me on the Facebook page.
Thanks and until next time- stay well and be observant!