Minutus

Hi all,

I am having problems with angry patients. What strategies are out there? I am a beginner so the question is quite naive.

I was thinking of a patient who I think I am losing because the remedy is bringing out anger. This is about the 8th patient who I am losing because the patient does not want to experience her/his own anger. Openly angry px don't react like this, but apparently nothing so scarry to the patient as repressed anger. This one has uterine bleeding fibroids. I gave her sabina (The Sabin [tribal name] women who were either stolen by the Romans or seduced them. Anyway the story sounds like women angry in the uterus). Next I gave her nat-m-n because she could not stand the anger that came out. Both remedies are angry uterine bleeding remedies. I have a feeling that hard, big, bleeding uterine fibroids reflect the pathology of repressed anger.

If they get angry, they also get angry with the homeopath. Then if they are taking low potencies, they quit to get back at the homeopath. Terrible logic but consistent.

I am new at this so I have been told to use low potencies (start with 6c). We are obstensibly going after a physical problem. I think in these cases, I should not use low potencies. Let them get their anger out, maybe don't warn them because they won't take the remedy if they know, and get it over with. With these low potencies, they quit after just a taste of their real suppressed anger. I am honest to a fault but I have to learn to keep a poker face. If they are physically weak, maybe tap them lightly on the shoulder with a 6c - 30c then go for a 200c or 1M if the physical aggravation is not problematic.

Also, maybe I should have given her something unrelated to her physicals and just pull out the anger before taking the remedy for the uterine bleeding. Is there such a strategy?

I had another angry quitter who got physical aggravations along with the anger. Maybe Bach flower remedies first would have been better.
That repressed anger is never described by the patient. They are so nice, so good etc. But you can feel it in their voice.

Blessings,
Ellen Madono
[Non-text portions of this message have been removed]

Hi Ellen,
I think this would be easier to talk about if you can give a couple of
specific examples of what happened--how did the problem come to your
attention, what they said, what you said?
Shannon
[Non-text portions of this message have been removed]

Thanks Rosemary and Shannon,

Shannon I will describe some of these cases.

1.) Sulphur for a middle aged man who does zazen, lives alone physically and in his head. Came in with a back problem. Sulphur 6c given and quickly it resolved it. He believes that 10 years of back aches were resolved by getting a different brand of shoes. sigh. Still had a number of sulphur related issues but stopped because he did not want to experience anger. He clearly stated this.

2.) Pro bono 25 year old woman. Gave her sulpur when the Ars and Nat-ars did not totally resolve the persistent cough. I gave her sulphur 200c to be taken once. Told her she may experience anger. She never contacted me again. When I contacted her, she said she could not emotionally afford to experience her anger.

3.) Pro bono 25 year-old. Same response to sulphur 200c. Unwilling to experience anger.

4.) Thuja 1 LM given to 25 year old woman. Very beautiful physical features but concerned with acne on her chin line. Problems with her family during teenage years. The feelings of her teenage rebellion came back. Stopped because of that and also her chin acne aggravated slightly. When the skin aggravation happened, I tried to space the taking of the LM more, but she did not communicate well with me and it was hard to figure out what was happening. History of sexual promiscuity and med would probably have helped open it up. Rosemary, would it have helped opening up the anger too?

5.) Sabina given after 6 months of Calc-carb for heavy bleeding during period due to uterine fibroids. This is very much like the other fibroid case. Very nice, avoids conflict. But according to her own report and the report of others she is very loud and critical to others. Very controlling. Always asking me what she feels to hide. On the sabina, she aggravated with severe uterine bleeding during menses and did not drink water. So she became dehydrated and went to the emergency room. Didn't contact me about this until months later when she told me. Previously, she did well with the calc-c. Her energy picked up but the PMS anger with the menses and non-painful bleeding did not change. So, I gave her Sabina 6c. We did not continue because I found that I had to chase her around to get feedback on what was happening with her. She did not answer emails or phone calls even when she was doing just fine. I decided I could not take responsiblity for the case. Thinking back, I suspect she needs something more like Platina. The case is quite complex. Her brother's family is being treated with med (as a nosode intercurrent and as the main remedy for one unrelated person) and doing very well So Rosemary, this is a case where your advice would work very well. .

6.) The uterine bleeding described in the previous email was started by antibiotic suppression of the flu. She was being treated for skin problems with sulphur by another homeopath but the treatment was not effective. Anger came out then too, but less. The case is not very complex otherwise. The uterine fibroid problem is 15 years old, but aggravated with the wide spectrum antibiotic treatment.
Redirects her anger toward political activism which in general I support. That's why she came to me. As part of her activist training, she was supposed to interview someone who has worked with her politically. I have so she interviewed me. I told her that her voiced sounded angry to me. I think she was insulted. I should never have agreed to talk to her outside the homeopath role.

7.) Sepia 6c given to a early 30's woman. Produced headache aggravation. Should have stopped Sepia there. She became increasingly angry to her husband (who I also know) and refused to talk to him. Tried to dilute and space the Sepia. Headaches went away. The anger did not go down. Then after 2 months of treatment, suddenly she got a thyroid inflamation. Told her to stop Sepia. (I am looking for a physical aggravation to stop a remedy, but I should give emotional aggravations equal weight??) She contacted 2 other homeopaths who told her that homeopathy should never aggravate. She believed them (or reinterpreted what they said) and got angry at me for her aggravations. Not so complex physically, although hormonal problems were obvious. Uses drugs to suppress them. Refuses to socialize with others, angry at her husband always, devotes her entire life to her daughter. Is forced into working for her husband's business but has no control over his business practices (he's a Tub or phos). Very angry at her parents obviously who are now dying. These are long term problems not new to her use of Sepia. I also, had the impression that being sick is a good way to avoid her other problems. Much passive-aggressive behavior too. She had sexually transmitted herpes suppressed.

Commonalities in all these cases are 1.) want to be comforted. Want hand holding but don't want to communicate This makes management very difficult. 2.) Sexual relationship are big problems or issues.

So again, I am thinking, can these cases be solved either not confronting the anger or now Rosemary is suggesting Nosodes (miasmatic treatment??). Rosemary, what do you mean by complex? Many layers of disease or just a very convoluted psychological state? Is the complexity of the case key to giving nosodes to calm down these angry cases Rosemary? Do you give nosodes even when they are not so clearly indicated? For example, med has a pretty small symptom rep.

Blessings,
Ellen Madono

HI Ellen,
My problem about starting with a 6 C always is that one can never be
sure whetner one is palliating or cureing in this low potency.
Probably its just that I[m more used to making this analysis with a
30C or 200C better.

Anger after Sulphur means the potency is too high. SUlphur may still
be indicated or a Sulphur salt instead.

The other remedies, in 6C may be partial remedies. IF there is an
aggravation, one would need to look at antoher close remedy by
reevaluating what symptoms have come up predominantly.

The focus of re-analysing the case is based on not just the change in
the cheif complaint but the whole picture. IF the predominant symtoms
that come up are not contained in the proving of the remedy, then I'd
think I need to look for another remedy. Usually the second
prescription hits the nail on the head, becasue the partial remedy
brings up the predominant characteristics more prominently. SO it
always helps to be very vigilant on the whole response within the
first couple of weeks on a remedy,

I think instead of looking at a piece meal symptom expression, one
needs to undestand the expression more deeply - as in what is causing
the anger, how is it expressed, what is the feeling behind it, how
does that feeling related to the patients childhood/past history.
OOftenthis coincides with the origin/causation of the chief compalint.
Which remedy covers this type of expression in addition to the
physical characteristics (general and pparticular) at that point.
Hope this helps,
Leela
--- In minutus@yahoogroups.com, "Kathryn Ellen Madono"
wrote:
physically and in his head. Came in with a back problem. Sulphur 6c
given and quickly it resolved it. He believes that 10 years of back
aches were resolved by getting a different brand of shoes. sigh.
Still had a number of sulphur related issues but stopped because he
did not want to experience anger. He clearly stated this.
Nat-ars did not totally resolve the persistent cough. I gave her
sulphur 200c to be taken once. Told her she may experience anger.
She never contacted me again. When I contacted her, she said she
could not emotionally afford to experience her anger.
Unwilling to experience anger.
features but concerned with acne on her chin line. Problems with her
family during teenage years. The feelings of her teenage rebellion
came back. Stopped because of that and also her chin acne aggravated
slightly. When the skin aggravation happened, I tried to space the
taking of the LM more, but she did not communicate well with me and it
was hard to figure out what was happening. History of sexual
promiscuity and med would probably have helped open it up. Rosemary,
would it have helped opening up the anger too?
during period due to uterine fibroids. This is very much like the
other fibroid case. Very nice, avoids conflict. But according to her
own report and the report of others she is very loud and critical to
others. Very controlling. Always asking me what she feels to hide.
On the sabina, she aggravated with severe uterine bleeding during
menses and did not drink water. So she became dehydrated and went to
the emergency room. Didn't contact me about this until months later
when she told me. Previously, she did well with the calc-c. Her
energy picked up but the PMS anger with the menses and non-painful
bleeding did not change. So, I gave her Sabina 6c. We did not
continue because I found that I had to chase her around to get
feedback on what was happening with her. She did not answer emails
or phone calls even when she was doing just fine. I decided I could
not take responsiblity for the case. Thinking back, I suspect she
needs something more like Platina. The case is quite complex. Her
brother's family is being treated with med (as a nosode intercurrent
and as the main remedy for one unrelated person) and doing very well
So Rosemary, this is a case where your advice would work very well. .
started by antibiotic suppression of the flu. She was being treated
for skin problems with sulphur by another homeopath but the treatment
was not effective. Anger came out then too, but less. The case is
not very complex otherwise. The uterine fibroid problem is 15 years
old, but aggravated with the wide spectrum antibiotic treatment.
support. That's why she came to me. As part of her activist
training, she was supposed to interview someone who has worked with
her politically. I have so she interviewed me. I told her that her
voiced sounded angry to me. I think she was insulted. I should never
have agreed to talk to her outside the homeopath role.
aggravation. Should have stopped Sepia there. She became
increasingly angry to her husband (who I also know) and refused to
talk to him. Tried to dilute and space the Sepia. Headaches went
away. The anger did not go down. Then after 2 months of treatment,
suddenly she got a thyroid inflamation. Told her to stop Sepia. (I
am looking for a physical aggravation to stop a remedy, but I should
give emotional aggravations equal weight??) She contacted 2 other
homeopaths who told her that homeopathy should never aggravate. She
believed them (or reinterpreted what they said) and got angry at me
for her aggravations. Not so complex physically, although hormonal
problems were obvious. Uses drugs to suppress them. Refuses to
socialize with others, angry at her husband always, devotes her entire
life to her daughter. Is forced into working for her husband's
business but has no control over his business practices (he's a Tub or
phos). Very angry at her parents obviously who are now dying. These
are long term problems not new to her use of Sepia. I also, had the
impression that being sick is a good way to avoid her other problems.
Much passive-aggressive behavior too. She had sexually transmitted
herpes suppressed.
hand holding but don't want to communicate This makes management very
difficult. 2.) Sexual relationship are big problems or issues.
confronting the anger or now Rosemary is suggesting Nosodes (miasmatic
treatment??). Rosemary, what do you mean by complex? Many layers of
disease or just a very convoluted psychological state? Is the
complexity of the case key to giving nosodes to calm down these angry
cases Rosemary? Do you give nosodes even when they are not so clearly
indicated? For example, med has a pretty small symptom rep.
couple of
I am
nothing
women
nat-m-n
hard, big,
Then if
(start with
think in
anger
they
after
fault
then go
for the
with
better.
are so
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Hi Leela,

The idea is to move up slowly to higher potencies starting with the 6c. But I see aggravations often enough that I am using them like any other potency (as little as possible). Often it is easy as a beginner to move up slowly to high potencies. The mindless beginning with 6c is what I am questioning. I try 1LM when I am not so afraid of aggravation but I am finding that excellent communication is essential to the management of LMs.

The Sulphur was a 6c, so it couldn't be too high. But the patient was taking it every other day which was probably too much. Ideally, if he is unwilling to experience his anger, he should take it infrequently enough so that he does not experience anger??

In the bleeding cases, patients are saying "I want this bleeding to stop now or I am going to have a hysterectemy. Can they not experience their anger and still keep their uterus?

Looking deeper into the aggravation is really good advice. I think I have in my mind that I am looking for a complete layer change. That's what I have been told. So when the remedy cures everything, there is no problem. There really is a layer change - Illness to health. But I think some of these cases are ones where the remedy is not going to be a cure-al until healthl. The remedy must be slightly off if it aggravates. My teacher warned me not to quickly change remedies when they aggravate. At the same time, with these experiences, I realize that there is a judgement call here. Maybe it is true that a good homeopath would never aggravate the remedy. The fibroid remedies are frankly just aimed at the specific symptom, the bleeding. Can any aggravation tell you a lot more about the case if it is within the previous case history? That is it is not a proving. Couldn't there be an overlap between an aggravation and a proving. I seem to remember cases where part of the aggravation is familiar but then there is an unfamiliar twist to it too.

Thank-you for your help,
Ellen Madono

Hi Ellen
Unfortunately for alot of individuals anger is not an easy emotion to deal with and they would rather keep their pain or find an easy way out than rather than deal with the emotion that is behind the cause. Actually most people would rather push there emotions aside and just forget they are there. Alot are taught that that is a way to survive. Bach flowers do help to cushion the emotion at times but I do not believe that there is any way around it. I am not saying that the individual has to rehash every little detail of the anger but they do have to allow it to surface, to experience, and then release it.
Good luck

Donna

Ellen,

Dealing with repressed anger is tricky. I've only had a few cases where
there's been an aggravation of anger, mostly cases of depression where the
emergence of anger turned inward is essential but potentially dangerous.

Hate to say it, but part of the problem for you may be practicing in Japan.
If your clients are largely Japanese, you're dealing with masters in the art
of repression. Telling your patients in advance that they may experience
anger is perhaps a mistake (unless the case involves depression, in which
case you'll need to do more than just advise them that their anger may come
out!). Of course they're not going to want to experience an emotion that
makes them uncomfortable and is socially disruptive! Why not tell them to
call you if they notice any changes while on the remedy?

Also, I've found it helpful to tell people that homeopathy is a process, not
just a one-shot miracle. They need to understand that it's also a
collaborative process in which they need to be involved actively. Even
folks who claim to know something about homeopathy often confuse it with
things like herbal treatment and don't really understand what it involves.
I've found that getting them truly invested in their treatment improves
compliance enormously.

Your comment that they "Want hand holding but don't want to communicate"
brings back memories of Japanese child-rearing practices. There's a
childishness in wanting consolation but being unwilling to accept
responsibility for their part.

Your Sepia case (#6) sets off alarm bells in my mind. The situation is
similar to some breast cancer cases of mine. One in particular would have
emotional meltdowns while on Sepia [I follow Dr. Ramakrishnan's protocol,
alternating Sepia with Carcinosin], and call me in tears. She was angry at
her husband, who is alcoholic, at her young son for being in her way, and at
herself for being angry. Gradually it dawned on her (along with a little
help from Al-Anon) that her reactions were childish and grounded in her
experience of having an alcoholic father. She very consciously set about
reforming her life, getting her husband into rehab, and accepting that she
could not "fix" her son's problems, only her reaction to them. I'm in awe
of how far she's come and how well she's doing.

I'm not bringing this up to suggest that you use Carc., but to illustrate
that this anger needs understanding on both your part and that of the
patient. And it needs working through. If there are counselors who can
take some of the burden off you, so much the better.

Peace,
Cinnabar

Dear Cinnabar,

Only the sepia case was Japanese. Two others were Japanese-American which may be worse. I'm Japanese-American too.

The part about anger having its own special dynamic is what I am feeling.

I was wondering if my own sensitivity to anger puts an unnecessary spin on dealing with the anger of others. I don't have so much depression etc in my personal history and it seems that depressed people don't come to me. Or maybe I don't worry about them. May be I don't feel their depression in the personal way that I feel ("Japanese") suppressed anger. Also, I don't get in my own way when I feel that the patient is depressed. It's more like their toe hurts, objective. I guess I tell suppressed angry patients that they may feel angry because I am personally anxious for them. Gotta stop that.

Thanks for your help.

Blessings,
Ellen

On Feb 9, 2006, at 11:44 PM, doctorleelah2h wrote:
I've had the same reaction. Often (at least for some people) I'll
begin with 6 or 12c--mostly so that if it *doesn't* work we don't have
to do as long a "wait and see"--but if that works well, then move on
to a high potency and see if it *still* works well.
Shannon

[Non-text portions of this message have been removed]

Thanks Donna. I fundamentally believe that we need to deal with suppressed emotions, but the trick for me is to not make a big deal out of it.

In relation to this, I have a zen riddle that I am working on now. (quit reading if you don't like getting confused) There is a phoenix that is much larger than the heavenly dragon. When the px flares up with an angry aggravation, I have a feeling in me that is like the heavenly dragon that is about to be eatten. The phoenix eats dragons. The phoenix has appeared (with the px) and the heavenly dragon is about to be eatten. So what should the zen homeopath's response be to that situation? My suppressed anger or my px's suppressed anger are the phoenix (in my mental story). The dragons are as plentiful as the curling wave crests on the ocean. So are the reasons to be angry. So anger is the heavenly dragon, in this version of the riddle. Do we run and hide because the phoenix is going to eat me (my/our/her anger). Or do we realize that the dragon and the phoenix are one in the same? That is we collapse them to nothing. Obviously that is the zen answer. So with each suppressed angry patient, I am grinding away this dualistic reaction to the situation. Probably makes no sense. But this is my grinding bowl for this dualism. These days I am grinding all my dualities with it.

Blessings,
Ellen