Minutus

Re the Delusions case you said there are NO delusions of superiority???? are you sure because psychologically that is not logical - what I sent you was an extract from my new book (educational module) on Homoeopathic Psychiatry which is a teaching module I am preparing for Radar. Delusions of persecution are the underlying issue to 'delusions of grandeur' or 'delusions of superiority'. There are not many remedies which have no 'delusions of superiority'? Read below and go back to the patient and relook at the dilemma. Because to have SO many persecutory delusional views means they have to be proceeded by psychological delusions of superiority which become the precursor to persecution and paranoia.

I group the Delusion rubrics according to these stages. The rubric-categories match the psychological delusions and the psychological stages which all patients manifest in an illness. The developmental order of the groups follows the psychological processing of delusional states within patients as they deny rather than acknowledge their loss of well-being. In all homoeopathic consultations the patient will move through one or all of these five states as they struggle to acknowledge that they are suffering an illness. A patient will often start their story from the arrogant assumption, or misapprehension of immortality; we all assume that we are entitled to health and long life.
1. Denial: hubristic denial of disease - "I am not sick", or "I will be cured", or "I will cure myself", or "I should not have got sick", or "This should not have happened to me".

2. Forsaken: disproportionate feelings of abandonment - "My body has let me down", or persecutory delusional beliefs, - "My illness has been caused by others", or "I have been cheated of my life", or "I have been singled out for punishment".

3. Causation: disproportionate guilt - "I have caused my disease", or "This is my fault".

4. Depression: predictions of failure - "I will never become well".

5. Resignation: overblown resignation to disease and death - "I am dying".
In the Psychology Module I take the most commonly used Delusion rubrics that I have found in my practice, group them according to the five rubric headings and explain their delusional use.
They encompass respectively, the psychological 'delusions of grandeur', 'delusions of abandonment', 'delusions of persecution', 'delusions of original sin', 'delusions of impending doom' and the 'delusions of hypochondria'. The purpose of understanding these five psychological stages is to match the simillimum to the psychological presentation of your patient's delusional state, whether it be 'delusions of persecution' or 'delusions of hypochondria', etc. If you learn how to recognize these five psychological stages in the consultation within your patient, it will help you in the rubric-repertorisation and in finding the simillimum. The additional advantage in identifying and understanding the psychological processing that your patient is moving through is that it allows you to narrow the remedies being considered to the remedies listed in those particular rubric-categories.
1. I have allocated all the Delusion rubrics which pertain to 'delusions of grandeur' into Denial. If the patient's trauma starts with denial of/and disbelief in their illness/sickness then the simillimum is listed in Denial. If the trauma inside your patient starts with religious martyrdom and/or delusional belief in cure then the simillimum is listed in Denial. If your patient unrealistically believes they are so great or superior that they will not die then the simillimum is listed in all the Delusion rubrics: immortality, in communication with God, under an all powerful influence, or being divine.

2. I have allocated all the Delusion rubrics which pertain to psychological 'delusions of abandonment' or 'delusions of persecution' into Forsaken. If the trauma inside your patient starts with them feeling alone and abandoned, or singled out for punishment by their illness then the simillimum is listed in all the Delusion rubrics: forsaken or persecution.

3. I have allocated all the Delusion rubrics which pertain to psychological 'delusions of original sin' or self-blame into Causation. If the trauma inside your patient starts with them feeling guilty and unrealistically responsible for their illness then the simillimum is listed in the all the Delusion rubrics: he is sinful, he has committed a crime or he has done wrong, and is allocated to the section Causation.

4. I have allocated all the Delusion rubrics which pertain to psychological 'delusions of impending doom' into Depression. If the trauma inside your patient starts with them feeling hopeless doom about being sick or them feeling like they will never succeed in becoming well in life, then the simillimum is listed in the Delusion rubrics: failure and he will not succeed and is allocated to the section Depression.

5. I have allocated all the Delusion rubrics which pertain to psychological 'delusions of hypochondria' into Resignation. If the patient's trauma starts with hypochondria or delusional doom about being sick, or you feel that your patient is exaggerating their weakness or sickness then the simillimum is listed in the Delusion rubrics: death, and disease and is allocated to the section Resignation.

I did not read the original delusion case that preceded this so cannot comment on it...

This classification while interesting, does it follow any preexisting classification or something you came up with? If you did, does it cover the possibilities comprehensively? Moreover what is the purpose of the classification?

Items 2-5 all of them are part of depression family.

Delusions of grandeur and of persecution are mixed in manic presentations... " I must be really important and that is why these people are against me" is a very common presentation in mania.

Of course Mania is but a compensation for depression.

I would prefer another classification based on Ego defense mechanisms -

Instead of the infantile "Denial" mechanisms if the patient is using much more mature mechanisms for handling things...

Are we talking about delusion in the way psychiatrists use it or the way homeopathic delusionists use it?
--- In minutus@yahoogroups.com, "Liz Lalor" wrote:

Are we talking about delusion in the way psychiatrists use it or the way homeopathic delusionists use it? IS THERE A DIFFERENCE? - WHERE DO YOU THINK DELUSION RUBRICS ORIGINATED?

What I call as homeopathic delusionists are the ones coined by Rajan Sankaran et al...they are not the same as delusions from a psychiatric point of view-

I think most of even the regular, classical "delusions" in our materia medica and repertory rubrics are mostly hallucinations....
--- In minutus@yahoogroups.com, "Liz Lalor" wrote:

Well looks like we are both looking at different books and use different definitions for delusions and hallucinations

but my primary assertion remains true - our materia medica and repertory have mixed delusions and hallucinations ( and illusions) and that is how they are

Hering mentions "Delusion, sees spiders ( in diphtheria) - Lac. c

This is a hallucination , not delusion - lots of symtoms of delirium are in delusions rubric

Most of the "delusions" under various poisons are mainly hallucinations

Still go ahead, good luck with your work - anything that throws clarity on this is good
--- In minutus@yahoogroups.com, "Liz Lalor" wrote:

A further explanation for you.
Homoeopathic psychiatry is the psychoanalytical study of the meaning and application of the Delusion rubric in homoeopathic case-taking and case-analysis.
A delusion is an illusion which misrepresents the truth. Psychology is the science that deals with emotional and mental processes and behaviors. A psychological delusion is a perception or opinion which is exaggerated or disproportionate to reality. In psychiatry, a 'delusion of grandeur' is viewed as a symptom of mental illness and is applied to the patient who is displaying hallucinatory exaggeration of their personality or status. For example: he suffers from the delusion he is a great singer. In psychiatry, the patient's psychological delusion is treated because it indicates an abnormality or illness in the affected person's thought processes. In both modalities - psychiatry and homoeopathy - the psychological delusion exists, and is diagnosed (in the case-analysis) because the patient needs to avoid reality.
In homoeopathy the psychological delusion is also viewed as an exaggeration of personality status which indicates a symptom of abnormality or an illness. In the Mind section of the repertory there is one section which is called the Delusion rubrics. These are the rubrics which are applicable in the case-analysis if the patient displays psychological delusions. The rubrics in the repertory which resonate with a conflict matching the psychological delusions can only be the Delusion rubrics because these rubrics indicate an abnormality or illness in the affected person's thought processes. The use of a Delusion rubric applies to the case-analysis when a patient misrepresents and misinterprets reality in a disproportionate way consistent with the psychiatric definition of a psychological delusion.
In the application of a Delusion rubric (in case-taking) the homoeopath seeks to understand why the patient has set up the delusional state and why they need to maintain the misrepresentation of reality. This understanding in homoeopathic case-analysis is an integral part of case-taking which will indicate the simillimum in the case. In a psychiatric consultation, the psychoanalyst also seeks to understand the need behind why the patient has created the psychological delusion to avoid reality. In both modalities - psychiatry and homoeopathy - the psychological delusion is recognized as being injurious to health and recognized as the first indicator of potential illness across all levels - the emotional, mental and physical. That is where the similarity between the two modalities end.
The treatment of the patient in homoeopathy is based on the cure from the simillimum in the case. The psychotherapeutic understanding of the patient's need for the psychological delusion is the indicator and explanation of the simillimum in case-taking. For example, to continue with the above example of the delusion of being a great singer - the patient will say, I am a great singer, I have the most spectacularly beautiful baritone voice of all time, but it has not been recognized by the world. I have not been able to sing for the last ten years that is why I need you to treat me with homoeopathic remedies. The reason why I am not able to sing so well at the moment is that I am suffering from an allergy to the tree outside my flat, in fact this tree is causing me such weakness that it has made me feel incredibly vulnerable. I have suffered terribly from these allergies. This tree has caused me to be rejected by all the music academies, they have deliberately not recognized how beauty in my voice. In homoeopathic case-analysis this case would be analysed by using the following Delusion rubrics.
· Delusion rubric: beautiful: Sulph.

· Delusion rubric: persecuted; he is persecuted: Sulph.

· Delusion rubric: poisoned; he; has been: sulph.
In both modalities - psychiatry and homoeopathy - this patient would be seen to be suffering 'delusions of grandeur'. The psychological delusion has been maintained and created to avoid the reality that his voice is not as incredible as he thinks it is. The psychological delusion is also seen to be the causation behind his need to create or manifest his allergy to the tree outside his flat. This case-analysis is a typical rubric-repertorisation which would be applicable to the remedy picture of Sulphur. His 'delusions of grandeur' have led to him exaggerating his allergy reaction or potentially manifesting his allergy in the first place. His physical weakness is needed to explain why he has been unable to move out of his flat. If he becomes physically well he will have to face the reality that his voice is not good enough to be recognized by the opera houses of the world. It is to his advantage to maintain the psychological delusion that the tree is the cause of his failure to be recognized. His psychological 'delusions of persecution' are to his advantage because they help maintain and protect his 'delusions of grandeur'. Homoeopathic psychiatry is also the study of the psychotherapeutic application of the need for the psychological delusions within each of the constitutional remedy profiles. Sulphur has a psychotherapeutic need to avoid personal responsibility for failure which manifests itself in an intense psychological need to delude themselves into believing they are great. This Sulphur patient has developed and stayed in the mental and physical disability of the allergy to avoid the emotional reality that his voice is not as beautiful as he thinks.
My purpose in writing this teaching module is to use my twenty-nine years of experience counselling patients to offer insights into the literal meaning of the Delusion rubrics and into the psychodynamic illusions of the mind that each patient reveals within their disease state and their psyche. This teaching module explores the application and meaning of the Delusion rubrics in case-repertorisation.
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I have never read your work before including the piece down below in full. This approach you have down below is not the diagnostic classification of delusion / depression. It was my mistake to think that you were trying to use these words in their allopathic DSM IV classification way

Instead, this is just how you perceive a patient's reaction to his / her illness...

Any patient worth his / her salt ( or saltless diet) will be primarily depressed - ( it is rather difficult to find a patient who says he is happy that he has diabetes or hypertension) and the reaction as you say goes from disbelief ( denial ) to varying shades of depression...

So what you have as the 5 item classification is only varying shades / symptoms of depression and that is why I commented on items 2-5 being part of depression..
- In depression guilt, loneliness, forebodings, feeling of failure are common... denial is a compensation to the perceived loss -

So the way you are using these terms - delusion / depression - are not the "allopathic", diagnostic ways these terms are used - this is the homeopathic way of looking at patient's reaction to disease

Interesting

But you know what - this is exactly why I got confused - we homeopaths have the habit of taking a well defined, precise word and converting it into something with special connotations in our own loosy goosy ways

When you have a system that takes delusion, delirium, hallucination, illusion, sensations as if, dreams and equates them what do you get? I am not saying it is bad, it is our approach and that is ok; but we should not say that hallucinations are delusions and we got it right

We even mangled what homeopathy is - what more is there to say?
--- In minutus@yahoogroups.com, "Liz Lalor" wrote:

Liz - The way "delusions" is used in psychiatry is very different from the way "delusions" rubric is used in homeopathy Even the Sulph examples you have given below are creative extensions of the Delusions rubric but would not be considered delusions by any psychiatrist in the strict sense of the word

BTW I am a psychiatrist who for at least a few years was actively engaged in diagnosing cases using DSM 3 and 4 and ICD 9 and 10 classifications

And then was doing a PhD in Professional Psychology before I quit even that - so there my trumpet

What you explain below is homeopathic delusion not psychiatric delusion - all of this confusion is because of the overused term of delusion

Well now that we know who we are and where we stand - let us leave the illusory, delusional world


-- In minutus@yahoogroups.com, "Liz Lalor" wrote:

Is the analysis or defining of the meaning of a delusion rubric and the application in case-analysis a mangling of the meaning of homoeopathy??? Either this is a psychological delusion of persecution on your part or delusions of superiority that you understand all there is to the analysis of homoeopathy.

--- In minutus@yahoogroups.com, "Liz Lalor" wrote:
Wow - Liz- I did not mean you - I was referring to the constant discussions that go on in the group about defining homeopathy -

Just take my comments and look at them objectively-

I certainly do not have delusions of persecution from a psychiatric point of view... - perhaps sometimes delusions of superiority

If you look at me from your Homeopathic psychoanalysis point of view I might look like a worm that is squirming to be crushed

You can put me in your Denial category for now before I slide into the other ones