Treatment of Schizophrenia
Posted: Fri May 07, 2004 4:11 am
Okay, here's the article. My "editing" would have consisted only of leaving
out extraneous material; I didn't change anything else.
Because this is so long but so rich, I've excerpted what *I* think are some
main points, which I'd love to hear thoughts on or experiences regarding:
- Schizophrenia is not "a disease", but rather a syndrome: a large number
of disorders all with similar symptoms and gathered together under one
title.
- "Most of the schizophrenias can be cured so long as the practitioner
treats the patient at all levels: psychologically, physiologically, and
spiritually. ... [Homeopathic treatment of schizophrenia] must include a
prescription for diet, environment, and mind management."
- Schizophrenia is different from the Dissociative disorder called Multiple
Personality disorder. In schizophrenia the split is between mood and
thought - emotions and intellect.
- Further definition of schizophrenia: "There is a temporal criteria of
onset before the age of 45, the symptoms lasting for at least six months
where there is a marked deterioration from the individual's previous level
of functioning. The substantive criteria for diagnosis are: (i) there must
be a gross impairment of reality testing, (the patient must make grossly
incorrect inferences about reality), and; (ii) the disturbance must affect
several psychological processes including -thought, emotion, perception,
communication, and psychomotor behaviour. However... this ... fits many
disorders and still does not define, nor does it accurately diagnose
schizophrenia."
- The nutritional requirements are as important a part of the prescription
as the specific remedy itself. The body cannot ... effect repair if the
necessary tools [nutrients] are absent. ... Organon ... states in
aphorisms 226 and 261 that the nutritional requirements are a part of the
homoeopathic prescription.
- He describes typical dietary habits: "The average schizophrenic living
on their own or in a community house with other schizophrenics will
participate in a diet that consists of massive quantities of bread, jam
(jelly, to our US friends), and ice-cream; all with numerous cups of coffee
daily. ... Remember that the bread is certainly a problem for the
schizophrenic patient: it is a refined carbohydrate that will be of no
nutritional value; a potential allergic or sensitivity problem; and is
better replaced with other foods." (I would be curious about whether some
of these people might not get *huge* improvement just from eliminating all
wheat?)
- Posology: "The Homoeopathic remedy will - especially in the early stages
of treatment - need quite frequent repetition (in most cases) of very high
potencies. I have had patients that have needed a dose every second day of
10M long acting remedies for quite protracted durations. Then, suddenly,
the remedy takes hold and the patient may go for months without another
hdose. ALWAYS ADMINISTER THE DOSE YOURSELF - DON'T LET THE PATIENT DO IT.
DON'T TRUST YOUR SCHIZOPHRENIC PATIENT TO DO IT CORRECTLY (or at all).
- Analysis: "The QRS symptoms are usually of limited help in the treatment
of the schizophrenias because QRS symptoms are the order of the day in this
disorder. Secondly, the QRS symptoms may only be perceived, not actual, to
the patient; and furthermore these symptoms may be quite transient. Take
care with QRS (queer, rare, strange) symptoms, they may be quite
unreliable." [Ouch...]
SCHIZOPHRENIA
Posted to Homeonet, Sep 5, 1993 by peg:wrussell in cdp:hn.topics (#50)
[edited...] I have had extensive experience in the treatment of the
schizophrenias (and some other psychological disorders). I had a practice
in Melbourne (Australia) where I specialized in their treatment (approx. 33%
of my patients were schizophrenic). When I left that practice and came up
into the country, the numbers of schizophrenic patients only dropped to
about 16%. I must confess that my long term success rate is probably just
over half - but I am improving. I wish I had all the answers. If you know
any please let me know. But I have developed a few theories and to that end
I have been labouring at writing a book on the subject now for about the
past 8 or more years.
Treating schizophrenia is considerably more complicated than repertorization
followed by prescription. I stress again that my success rate is nothing to
be proud about - but I might point out that all of theschizophrenic patients
gained some ground.
I must again stress that I have had extensive experience but not as much
success as I would like in the treatment of this disorder. But I am well
aware that every little bit of experience passed on to others prevents the
constant repetition of the same mistakes.
Treatment of the Schizophrenias with Homoeopathy
"Schizophrenia" is a term used for a group of psychoses. Generally, the
schizophrenias are disorders of thinking from which flows troubled behaviour
and troubled mood. There may be delusions, hallucinations, general
lassitude, attention deficits, and sometimes paranoia.
Schizophrenia need not be a life sentence; nor should it mean long
periods on psychoactive drugs. Most of the schizophrenias can be cured so
long as the practitioner treats the patient at all levels: psychologically,
physiologically, and spiritually.
The first and most important point for the practitioner to remember is
Homoeopathic medicine is not simply the prescription of pilules or drops of
a similimum to the patient; but must include a prescription for diet,
environment, and mind management.
So, what actually is Schizophrenia? Can it occur at anytime in one's life
and can it be cured? There is a common misconception that schizophrenia is a
disorder where the schizophrenic individual has two distinct personalities.
This is not schizophrenia but in fact a Dissociative disorder called
Multiple Personality disorder. In schizophrenia the split is between mood
and thought - emotions and intellect. Schizophrenia is not simply A
disease, but in fact a syndrome: a large number of disorders all with
similar symptoms and gathered together under one title. A Schizophrenic
patient of mine once said to me: "There are as many schizophrenias asthere
are schizophrenics. " This, I believe, sums up the complexity and the
variability of schizophrenia neatly, but unfortunately it does not help or
resolve the problem of the disorder's definition or its correct diagnosis.
There is a temporal criteria of onset before the age of 45, the symptoms
lasting for at least six months where there is a marked deterioration from
the individual's previous level of functioning. The substantive criteria
for diagnosis are: (i) there must be a gross impairment of reality testing,
(the patient must make grossly incorrect inferences about reality), and;
(ii) the disturbance must affect several psychological processes including
-thought, emotion, perception, communication, and psychomotor behaviour.
However, as one can well imagine, this criteria thus far fits many disorders
and still does not define, nor does it accurately diagnose schizophrenia.
Let us go back to the statement made by my schizophrenic patient: There are
as many schizophrenias as there are schizophrenics. This statement is of
extreme importance if one is to understand the disorder, if one is to define
it, if one is to diagnose it, and if one is to treat it. As can be seen, an
accurate single definition of the schizophrenias is impossible because there
is no one single schizophrenia; therefore, diagnosis is as grey as defining
the disorder.
It is said, by many homoeopaths, that diagnosis is but of scientific
interest from a homoeopathic point of view, but is of little value in
reality. It is not good enough to prescribe a single homoeopathic simplex
on the symptoms alone without diagnosis. This is especially the case in the
treatment of the schizophrenias. Unless there is a diagnosis, the
practitioner will be less likely to meet the nutritional requirements of the
patient. The nutritional requirements are as important a part of the
prescription as the specific remedy itself. The body cannot be expected to
affect repair if the necessary tools, in the form of nutrients, are absent.
Hahnemann in his Organon of Medicine states in aphorisms 226 and 261 that
the nutritional requirements are a part of the homoeopathic prescription.
Grey as the task of diagnosis may be, diagnosis is possible and of vital
importance.
Another important reason the Homoeopath cannot afford not to diagnose is the
elimination of the possibility of brain tumour. Schizophrenia is a disorder
where the boundaries of the mind simply disintegrate. Think about it; no
matter how "out of sorts" you feel, no matter how crazy or off-beam you may
be when at your worst, there is always a sense of "self". For most
schizophrenics there is no boundary to self, no "I". Some sufferers of the
schizophrenias will experience hallucinations, some won't; some will have
disturbed thoughts, others won't; and, some will experience paranoia and/or
grandiosity, others will simply feel lethargic and deeply depressed. Some
will experience being invaded by the world's stimuli, crowding them; all
will experience the world differently from the experiences of the so called
"normal" population.
Perhaps the greatest problem in the diagnosis of schizophrenia is that it
has been too often diagnosed, including people with drug induced psychoses,
affective psychoses (clear cut), nutrient deficiency induced dysperception
or psychoses, through to individuals who, for social/political/family
reasons just simply "opt out". Care must be taken by the diagnostician not
to impose his/her social/religious/political/ethnic values on the patient
as this is a path to over diagnosis of the schizophrenias.
Kurt Schneider (1971) provided a list of symptoms "of the first rank" which,
in the absence of epilepsy, intoxication, or other evidence of gross
cerebral damage, he regarded aslikely to indicate a diagnosis of
schizophrenia. Schneider's first rank symptoms of Schizophrenia include:
thought insertion, i.e. experience of thoughts being put into one's mind;
thought withdrawal, i.e. experience ofthought being removed from one's mind;
thought broadcasting, i.e. experience of one's thoughts being known to
others; feelings of passivity, i.e. experience of sensations, emotions or
body movements being under external control; primary delusion, i.e.
delusions arising inexplicably from normal perceptions; third-person
auditory hallucinations including voices discussing or arguing about one,
voices commenting on thoughts or behavior, voices repeating one's thoughts
(echo de la pense), voices anticipating one's thoughts.
Added important diagnostic symptoms include: affective change, eg.
blunting of affect, incongruity of affect, mood lability; formal thought
disorder, i.e. lack of causal link between thoughts (asyndetic "Knight's
move" thinking), interpenetration of themes, use of imprecise approximations
(metonyms), overinclusiveness, i.e. no boundaries to concept, inability to
think abstractly including "concretism", creation of new words (neologisms).
Occasionally one may find the following: catatonic states, i.e. mutism and
immobility with no impairment of consciousness; Folie deux shared paranoid
disorder), i.e. identical manifestations of the same mental disorder in two
closely associated persons; Capgras syndrome, i.e. the delusional negation
of identity of a familiar person; time disorientation, time dysperception;
echolalia (echophrasia),i.e. the automatic meaningless repetition of
another's words or phrases, delayed echolalia (it occurs hours, days, or
even weeks after the original stimulus).
Points to look for in the early diagnosis of the schizophrenias include:
loss of weight; poor posture; loss of concentration; dramatic deterioration
of handwriting; small handwriting; increased irritability; uncommunicative;
reply in monosyllables; reply in rage and storm; fear; paranoia; increased
skin pigmentation, or, conversely, fair "china doll" skin; a characteristic
and unusual smell; clammy hands; poor circulation; digestive problems;
exhaustion; poor body temperature control; abnormal strength; bed wetting;
obsessive and/or compulsive behaviour; and allergies.
Other early signs of schizophrenia include: failure to make friends;
unnatural fears, timidity, grandiosity; profound insomnia; announced sudden
belief in a great truth: "God is love" or "I'm taking off to find the real
me".
Another highly discriminatory symptom for schizophrenia, if organic
conditions are excluded, is the primary or autochthonous delusion. This
delusion appears, fully formed, without any known experience to explain it.
It is the spontaneous realization: "I saw that piece of paper on the
footpath and knew that God had chosen me to be his son", or another, to all
intents and purposes healthy person says "The instant I pricked my finger, I
knew that God wanted me to . . . "
Thought insertion is the belief that thoughts of another person are being
inserted into their own mind. To say that the Devil is causing them to
think evil thought is NOT thought insertion. Neither is the belief that
their thoughts can be read. Manic patients may say that their thoughts are
as powerful as the thoughts of the sun: this, too, is not thought insertion.
Thought insertion is where thoughts are "transmitted" into the individual's
mind by another person: i.e. by telepathy, a radio receiver in their head,
or directed there by rays from a powerful being - perhaps from another
planet. Thought insertion may lead to delusions of influence and/or
control. Here the patient believes he is told what to do or say by the
thoughts that are inserted into his brain. The individual will insist that
his words, or his writing, or his actions are controlled by some alien power
(alien in the sense that it is not his own control - not necessarily from
another country or planet).
Care must be taken here not to too easily diagnose thought insertion. The
average Christian may believe that God guides, even controls, his life or
actions; and this is done (so some believe) through insertion of thoughts.
And, one should be very careful about telepathy, especially when dealing
with peoples that consider telepathic abilities to be a natural and normal
faculty: i.e. the Aboriginal people of Australia.
As intelligent schizophrenics are very good at hiding their symptoms, and
because schizophrenic symptoms tend to change in presentation and/or
intensity, a careful patient history must be taken. Note that responses to
a specific question posed at the beginning of questioning may bring a vastly
different response if asked again latter on the same day. The reasons for
this anomaly are vast, but include paranoia/fear that you are possibly
trying to trick them with trick questions; the patient has lost interest in
your questions and is no longer paying attention; the patient's attention
span prevents interest in your questions; the patient perceives the question
differently each time he hears it, and; so on the list may go.
Let us briefly recap delusions: they are a tenacious, erroneous belief or
perception held inviolable by a person even in the face of evidence that
normally would be sufficient to destroy that belief. So, what is the
difference between a delusion and a hallucination? An hallucination is a
sensory perception that does not result from external stimulus. It is a
false sensory perception that has a compelling sense of reality. Understand
that the hallucination is usually transitory and the delusion is often well
entrenched. This is not always the case and the two words have been used to
mean the same thing. Kent's Repertory, in fact, places the two words
together. There is a subtle difference, however, which, to my mind, points
to two different origins in the brain. A delusion is a part of the belief
system that creates its own reality, whereas the hallucination is usually a
faulty perception that develops belief system or delusion: in short, the
location and nature of the fault in the brain determines whether the
hallucination or the delusion comes first. Incidentally, in schizophrenia
hallucinations are commonly auditory - but they can implicate the other
senses.
The patient may have Delusional mood, in which he feels that there is
something going on around him but he is not quite sure what: something is
not quite right and he is unable to elaborate. The patient may present with
Delusional ideas; these are fully formed delusions that may suddenly enter
the patient's mind, as in the person who - for no reason - suddenly believes
that his food is being poisoned. And, I believe, the patient may have an
hallucination which may or may not lead to a delusion.
In Delusional perceptions, the object is perceived correctly but is
interpreted in a delusional way, i.e. the patient sees and recognises the
vase for what it actually is but believes it is there to tell him of a
specific message from the Martians.
There are Delusions of Grandeur where the patient believes she is on a
special mission or that he is Christ, or Napoleon- they are outrageous
exaggerations of one's own importance, power, wealth or talents; Delusions
of Poverty where the patient sees himself as destitute, here we also find
self-depreciation and guilt where - perhaps - the patient believes he is
worthless or he should be sent to jail because he has committed a crime; in
deeply depressed individuals there may be a delusion of a serious life
threatening illness; Nihilistic Delusions are where the patient believes
that either he, or a part of himself is dead; there are (rarely) Delusions
of Infestation where the patient believes that certain places are infested
by insects or some other living thing; Delusions of Stupor where there is a
state of lethargy and unresponsiveness as seen in catatonic states; Paranoid
Delusions (the word paranoid originally meant deluded) where the patient
believes that someone or something is persecuting or "watching," observing,
him; there is Erotomania or Delusions of Love where the patient believes
that a certain individual is deeply in love with him despite the fact that
there is no evidence to suggest this; Delusions of Infidelity is when there
is extreme jealousy - I have found this delusion very common; Delusions of
Influence is where the patient believes his mind or body is under direct
control by an outside influence, and; Delusions of Reference are where the
patient believes that the television, radio or perhaps the newspaper
contains special messages for him.
Abnormal perceptions may occur with any of the sensory modalities and may be
slight - a distortion of taste, smell, hearing, vision or touch - or severe
where the patient experiences an hallucination. A perceptual distortion is
where there is the sensation of, for example, the colours of an object
changing in intensity, or where the object seems closer or further away.
Illusions occur when the object is real but the perception is disturbed, for
example, it is night and you are afraid as you walk home, you see a tree in
front of you but interpret it as a man who may attack you. Hallucinations
occur in the absence of an appropriate object yet the patient still insists
that he has perceived something. In certain instances hallucinations may be
non-pathological phenomena, as in hypnagogis and hypnopompic hallucinations
experienced by a person going to sleep or waking up. Hallucinations also
occur in organic and functional psychoses. Auditory hallucinations are
where the patient may complain of music, words, voices, identifiable or
unidentifiable; Visual hallucinations may vary in intensity from simple
flashes of light to sophisticated visions of people, animals or places;
Olfactory hallucinations are hallucinations of the sense of smell; they,
too, may vary in intensity; Gustatory hallucinations are rare but
characteristically occur in temporal lobe epilepsy; Tactile and Somatic
hallucinations - in cocaine psychosis patients may complain that they feel
insect scrawling over them, formication, other patients may experience the
sensation of having sexual intercourse, and; Vestibular hallucinations may
cause the sensations of flying through the air.
Deja-vu may occur in normal people but is usually associated with temporal
lobe epilepsy and is characterized by the patient feeling that he has been
in this current situation before. Capgras' syndrome is where the patient
asserts that people are not who they claim to be, but perhaps are their
double (or an android).
It is estimated that there are about 150,000 schizophrenic patients in
Australia, and that 10% will suicide in the first 5 years from diagnosis.
So what is medicine doing about such a horrific loss. Little to nothing.
A skeptic may postulate that since the disorder costs the taxpayers such an
exorbitant amount in Medicare and pension, it is seen as something of a
relief to the social welfare system if they do suicide. The medical
profession can only palliate the disorder, not cure it: the patient is the
contents of a smelly rubbish bin, and the medical profession will only put a
lid on the bin. This is not to say that research is not being carried out
in this area.
Schizophrenia cannot be cured without taking into account: (a) the
nutritional needs of the patient; (b) the gustatory and olfactory competence
of the patient; (c) the sensory incompetence of the patient; (d) counseling
the day to day trials of the patient; (e) the physical, psychological and
spiritual oneness of the patient; (f) the environment in which the patient
exists; (g) the drugs that the patient is currently taking; (h) the drugs
that the patient has taken in the past; (i) the miasm of the patient, and;
(j) the constitution/essence of the patient. (I'm sure I've missed a few
here - as I remember any I'll weave them into the general information.)
Let us look at each of these in turn.
(a) the nutritional needs of the patient. You cannot build a body
towards health without the necessary building materials. Schizophreniform
symptoms can be found in people with vitamin deficiencies, and/or with blood
sugar problems,and/or with thyroid problems, and/or with mineral
deficiencies and/or excesses, and in individuals that exhibit food
sensitivities and/or allergies.
(b) the gustatory and olfactory competence (digestion???) of the
patient. It has been shown that where there is gustatory incompetence,
there is an inability to absorb the nutrients in the diet (this is despite
the fact that the food eaten may have high levels of the nutrients). On
this point then, one needs to look at remedies that will cover this problem
when repertorizing. Remedies for want of taste (in order of rank): Puls.;
Nat-m.; Bry.; Cycl.; Ant-c.; Mag-m.; Merc.;Sulph.; Ant-t.; Aur.; Bell.;
Calc.; Sil.; Verat.; Bor.;Kali-bi.; Lyc.; Anac.; and others. As the sense
of smell plays a part in the action of "tasting", consideration must also be
given to the olfactory sense for the reasonmentioned above. Remedies for
want of sense of smell (in order of rank): Hyos.; Kali-bi.; Mag-m.; Plb.;
and others. Remedies for want of taste and smell (in order of rank):
Puls.; Nat-m.; Sil.; Cycl.; Alum.; Bell.; Calc.; Anac.;Hep.; Mag-m.; Sep.;
Sulph. ; Aur.; Bry.; Kali-bi.; and others.
(c) the sensory incompetence of the patient. It stands to reason that
if the patient doesn't perceive as does the practitioner, there may develop
confusion and misunderstanding as to the meaning of things in communication.
I have found, through bitter experience, that A isn't necessarily A to a
schizophrenic; and when he or she talks of B, that B may be anything from an
A through to a Z.
(d) counseling the day to day trials of the patient. All too often
schizophrenic patient's day to day problems go unaided by the physician who
seems only interested in the larger problem - whilst the patient is all
consumed by how to make it through the next day, or who he has to see in
order to pay the rent. Thus, in order to make the physician pay attention
to his or her needs, the schizophrenic patient distorts the symptoms.
(e) the physical, psychological and spiritual oneness of the patient.
This is what Homoeopathy is about: treating the whole patient.
(f) the environment in which the patient exists. The environment of the
patient is important for so very many reasons. The environment may harbour
allergens, stressors(psychological, physiological, or spiritual), a negative
environment where family, friends or others feed his/her beliefs, or create
new ones.
(g) the drugs that the patient is currently taking. This is quite a
problematic area: seeing the true individual under the cover of the drug is
somewhat difficult - be it prescribed drug or street drug. How much effect
on the Homoeopathic treatment does the drug have / how much effect on the
action of the drug or on the drugged individual does the Homoeopathic remedy
have? Care must be taken to take into account all drugs used in the past -
these are layers that must be addressed: (h) the drugs that the patient has
taken in the past.
(i) the miasm of the patient. It is absolutely without question that
cure cannot be effected without correctly taking into account the patient's
miasm. A schizophrenic may be any of the miasms, do not be told that they
can only be this or that. Determining the miasm of the schizophrenic
patient may be rather difficult (see k) and care must betaken to remove each
miasmatic layer.
(j) the constitution/essence of the patient. It is the constitution of
the patient - not the constitution of the disorder - that you seek. All too
often the Homoeopath projects a constitution onto a patient that has been
derived from current symptomatology and that symptomatology alone. Finding
the constitutional remedy of a patient who is constantly schizophreniform is
quite a challenge, for the visible patient is just a mass of scizophreniform
symptoms. If the picture is unclear - if you cannot get a glimpse of the
true patient under the symptoms, repertorize on the symptoms, find a remedy
and treat the disorder as an acute problem to remove the symptoms enough to
get a brief look at the patient.
(k) Determining the miasm of the schizophrenic patient can be rather
difficult simply because seeing the patient underneath all of those rather
extreme symptoms can be, in itself, rather difficult. However, remember
that the upper layer - that visible layer - is, in fact, the current
miasmatic layer and this must be removed first. So, when you have
determined the constitution of the patient, be sure that the constitutional
remedy is a miasmatic remedy for the current miasmatic layer. The history
elicited from the patient and his/her relatives of what the patient was like
before the disorder, will give you an idea of what the miasmatic layer was
well before the disorder and this too must fit with the remedy you intend
prescribing as a constitutional remedy (if it doesn't fit, then the
suspected miasm pre-illness is wrong, or the constitutional remedy is
wrong). I believe that the vast majority of Homoeopaths do not understood
miasmatic theory. They understand some of the basics of the application of
miasmatic medicine, enough to- on the whole - make the prescription work,
but they really don't know what they are doing. (Time has come to radically
review miasmatic theory - but this is another issue to be approached on
another occasion.) Understand that you will never "cure" if you don't get
the miasm right, and; your patient WILL have a number of miasmatic layers
that will need to be dealt with.
(l) It is essential to correctly interpret your patient's delusion, and to
differentiate between delusion or illusion -and more importantly between
Hallucination and Illusion. In fact, be careful with all of your rubrics: I
had a patient 2 days ago who was exhibiting schizophreniform problems (she
was in her sixties) and she insisted that "I feel I am being poisoned!" and
all attempts to get herto elaborate on that statement were initially futile.
But on her second visit I elicited that it was accumulated toxins from
everyday life that she was getting at. There was no paranoia with this
patient: no fear that another individual was poisoning her.
(m) Patient compliance with you prescription is horrific! Particularly the
dietary part of your prescription. The average schizophrenic living on
their own or in a community house with other schizophrenics will participate
in a diet that consists of massive quantities of bread, jam (jelly, to our
US friends), and ice-cream; all with numerous cups of coffee daily. On top
of this frightening diet, they will almost certainly smoke cigarettes and
possibly use street drugs. A very important part of the prescription for
those patients who either live on their own or who live with other
schizophrenic or psychiatric patients, is how to prepare quick and
nutritious foods. Remember that the bread is certainly a problem for the
schizophrenic patient: it is a refined carbohydrate that will be of no
nutritional value; a potential allergic or sensitivity problem; and is
better replaced with other foods.
Other dietary obsessions I have found with schizophrenics include pasta,
cakes, sweets, alcohol, tinned (canned)foods and chocolate. The
practitioner may have to be patient with the patient on the matter of drugs.
However a firm but realistic stand is often appreciated. Don't make too
many, or too great, your demands on diet or street drugs. Follow through to
make sure that your patient complies.
(n) Prescribed drugs are a pain in the neck to all Homoeopaths treating
these problems. Firstly make sure that you are seeing the patient and
his/her schizophrenic symptoms and not the symptoms elicited by the drug.
Find out what schizophrenic symptoms were there before the drug as they MAY
be your current symptoms (but not necessarily). And don't assume that the
patient is as they were pre-schizophrenia now that they are taking the drug
(the drug has its own picture). The Homoeopathic prescription to treat the
allopathic drug picture firstly to ignore it as you probably won't be taking
the patient off the drug just yet; secondly, when you do consider taking
them off, consider that you may need to either "dump" the drug from the
patient's system by prescribing a high Homoeopathic potency of the drug,
and/or antidote the drug. I have used Chlorpromazine 30c and 200c to great
effect in the treatment of several patients. One, in particular, had been
on Largactil for many years in her early twenties and some 12 years later I
gave Chlorpromazine; the improvement in this patient was incredible and it
cleared the way for further treatment: removal of a layer.
(o) Don't treat the schizophrenias superficially. Don't let your patient
think that it is cured when the problem needs to be treated right back to
childhood and beyond.
(p) Remember that not all schizophrenias can be cured. If there is an
inherited physiological problem, a defect, then you will not eradicate that
problem. But you will almost surely find away around the problem.
(q) The Homoeopathic remedy will - especially in the early stages of
treatment - need quite frequent repetition (inmost cases) of very high
potencies. I have had patients that have needed a dose every second day of
10M long acting remedies for quite protracted durations. Then, suddenly,
the remedy takes hold and the patient may go for months without another
hdose. ALWAYS ADMINISTER THE DOSE YOURSELF - DON'T LET THE PATIENT DO IT.
DON'T TRUST YOUR SCHIZOPHRENIC PATIENT TO DO IT CORRECTLY (or at all).
(r) The QRS symptoms are usually of limited help in the treatment of the
schizophrenias because QRS symptoms are the order of the day in this
disorder. Secondly, the QRS symptoms may only be perceived, not actual, to
the patient; and furthermore these symptoms may be quite transient. Take
care with QRS (queer, rare, strange) symptoms, they may be quite unreliable.
The prevalence of psychiatric disorder in the community is of such magnitude
that every practitioner must be able to carry out a psychological assessment
and from that assessment be able to diagnose any illness that may bepresent.
Diagnosis, as elucidated in the Introduction, is rather difficult, but
necessary. Because Schizophrenia is a syndrome, it is wise to be methodical
in your approach to diagnosis.
As stated earlier, it is imperative to diagnose your patient's problem. If
the disorder is schizophreniform, it may be anything from a nutritional
deficiency to cancer. To treat the disorder with a single homoeopathic
simplex without taking into account the nutritional needs of problem would
not be Homoeopathic prescribing.
The treatment of the schizophrenias is a daunting task: exceedingly
difficult. But the rewards in affecting cure in a schizophrenic patient are
as great as any reward you are ever likely to achieve as a Homoeopathic
Physician.
There is very much more to be written on this subject, but I have already
rambled on for too long. Please await my book (if I ever finish it). On
winding up this article I can think of a dozen or more major points I have
not touched on here, but there is no time, nor is this theright forum for
such a comprehensive tome. Please, if you have questions or criticism, fire
them at me - until then: have fun. Les
** End of text from cdp:hn. topics **
==== ==== ==== ==== ==== ==== ====
Response 2 of 2
** Written 12:38 PM Sep 9, 1993 by peg:hera in cdp:hn. topics **Les.
Great information regarding schizophrenia. It's this type of report that
can help us make inroads to such a problem illness. One point regarding
diagnostic criteria. Referral to current standards such as the Diagnostic
and Statistical Manual of Mental Disorders by the American Psychiatric
Association or the WHO's International Classification of Disease gives
current acceptable criteria. I have found Comprehensive Textbook of
Psychiatry by Kaplan and Sadock ( pub :Williams and Wilkins) to be an
invaluable source in understanding the natural disease in mental illnesses.
I was especially interested in your comment about the PQRS symptoms being of
limited help, as the PQRS symptoms are the order of the day and thus
unreliable. I tend to agree, just as we lastly refer to common symptoms of
physical illness when arriving at the similimum, the same should apply to
mental disorders. Even though the bizarre forms that come up in mental
cases appear to be juicy repertorial stuff.
One thing that comes to mind in the treatment of mental illnesses is the use
of Physical Concomitants. I think it was Frank Bodman who said that in
Physical cases the mental symptoms help decide the remedy and in Mental
cases the Physical symptoms help decide. What is your experience of this.
Also do you find Hahnemann's observations on the management of mental
diseases in the Organon vindicated in such cases.
And yes, miasmatic appreciation is fundamental; please let us know your
understanding of the concept of chronic diseases at some time. I know some
homoeopaths feel it has merely amusing historical value; I wonder how they
approach such cases.
Thank you for all the work.
Jim Veljanovski** End of text from cdp:hn. topics **
out extraneous material; I didn't change anything else.
Because this is so long but so rich, I've excerpted what *I* think are some
main points, which I'd love to hear thoughts on or experiences regarding:
- Schizophrenia is not "a disease", but rather a syndrome: a large number
of disorders all with similar symptoms and gathered together under one
title.
- "Most of the schizophrenias can be cured so long as the practitioner
treats the patient at all levels: psychologically, physiologically, and
spiritually. ... [Homeopathic treatment of schizophrenia] must include a
prescription for diet, environment, and mind management."
- Schizophrenia is different from the Dissociative disorder called Multiple
Personality disorder. In schizophrenia the split is between mood and
thought - emotions and intellect.
- Further definition of schizophrenia: "There is a temporal criteria of
onset before the age of 45, the symptoms lasting for at least six months
where there is a marked deterioration from the individual's previous level
of functioning. The substantive criteria for diagnosis are: (i) there must
be a gross impairment of reality testing, (the patient must make grossly
incorrect inferences about reality), and; (ii) the disturbance must affect
several psychological processes including -thought, emotion, perception,
communication, and psychomotor behaviour. However... this ... fits many
disorders and still does not define, nor does it accurately diagnose
schizophrenia."
- The nutritional requirements are as important a part of the prescription
as the specific remedy itself. The body cannot ... effect repair if the
necessary tools [nutrients] are absent. ... Organon ... states in
aphorisms 226 and 261 that the nutritional requirements are a part of the
homoeopathic prescription.
- He describes typical dietary habits: "The average schizophrenic living
on their own or in a community house with other schizophrenics will
participate in a diet that consists of massive quantities of bread, jam
(jelly, to our US friends), and ice-cream; all with numerous cups of coffee
daily. ... Remember that the bread is certainly a problem for the
schizophrenic patient: it is a refined carbohydrate that will be of no
nutritional value; a potential allergic or sensitivity problem; and is
better replaced with other foods." (I would be curious about whether some
of these people might not get *huge* improvement just from eliminating all
wheat?)
- Posology: "The Homoeopathic remedy will - especially in the early stages
of treatment - need quite frequent repetition (in most cases) of very high
potencies. I have had patients that have needed a dose every second day of
10M long acting remedies for quite protracted durations. Then, suddenly,
the remedy takes hold and the patient may go for months without another
hdose. ALWAYS ADMINISTER THE DOSE YOURSELF - DON'T LET THE PATIENT DO IT.
DON'T TRUST YOUR SCHIZOPHRENIC PATIENT TO DO IT CORRECTLY (or at all).
- Analysis: "The QRS symptoms are usually of limited help in the treatment
of the schizophrenias because QRS symptoms are the order of the day in this
disorder. Secondly, the QRS symptoms may only be perceived, not actual, to
the patient; and furthermore these symptoms may be quite transient. Take
care with QRS (queer, rare, strange) symptoms, they may be quite
unreliable." [Ouch...]
SCHIZOPHRENIA
Posted to Homeonet, Sep 5, 1993 by peg:wrussell in cdp:hn.topics (#50)
[edited...] I have had extensive experience in the treatment of the
schizophrenias (and some other psychological disorders). I had a practice
in Melbourne (Australia) where I specialized in their treatment (approx. 33%
of my patients were schizophrenic). When I left that practice and came up
into the country, the numbers of schizophrenic patients only dropped to
about 16%. I must confess that my long term success rate is probably just
over half - but I am improving. I wish I had all the answers. If you know
any please let me know. But I have developed a few theories and to that end
I have been labouring at writing a book on the subject now for about the
past 8 or more years.
Treating schizophrenia is considerably more complicated than repertorization
followed by prescription. I stress again that my success rate is nothing to
be proud about - but I might point out that all of theschizophrenic patients
gained some ground.
I must again stress that I have had extensive experience but not as much
success as I would like in the treatment of this disorder. But I am well
aware that every little bit of experience passed on to others prevents the
constant repetition of the same mistakes.
Treatment of the Schizophrenias with Homoeopathy
"Schizophrenia" is a term used for a group of psychoses. Generally, the
schizophrenias are disorders of thinking from which flows troubled behaviour
and troubled mood. There may be delusions, hallucinations, general
lassitude, attention deficits, and sometimes paranoia.
Schizophrenia need not be a life sentence; nor should it mean long
periods on psychoactive drugs. Most of the schizophrenias can be cured so
long as the practitioner treats the patient at all levels: psychologically,
physiologically, and spiritually.
The first and most important point for the practitioner to remember is
Homoeopathic medicine is not simply the prescription of pilules or drops of
a similimum to the patient; but must include a prescription for diet,
environment, and mind management.
So, what actually is Schizophrenia? Can it occur at anytime in one's life
and can it be cured? There is a common misconception that schizophrenia is a
disorder where the schizophrenic individual has two distinct personalities.
This is not schizophrenia but in fact a Dissociative disorder called
Multiple Personality disorder. In schizophrenia the split is between mood
and thought - emotions and intellect. Schizophrenia is not simply A
disease, but in fact a syndrome: a large number of disorders all with
similar symptoms and gathered together under one title. A Schizophrenic
patient of mine once said to me: "There are as many schizophrenias asthere
are schizophrenics. " This, I believe, sums up the complexity and the
variability of schizophrenia neatly, but unfortunately it does not help or
resolve the problem of the disorder's definition or its correct diagnosis.
There is a temporal criteria of onset before the age of 45, the symptoms
lasting for at least six months where there is a marked deterioration from
the individual's previous level of functioning. The substantive criteria
for diagnosis are: (i) there must be a gross impairment of reality testing,
(the patient must make grossly incorrect inferences about reality), and;
(ii) the disturbance must affect several psychological processes including
-thought, emotion, perception, communication, and psychomotor behaviour.
However, as one can well imagine, this criteria thus far fits many disorders
and still does not define, nor does it accurately diagnose schizophrenia.
Let us go back to the statement made by my schizophrenic patient: There are
as many schizophrenias as there are schizophrenics. This statement is of
extreme importance if one is to understand the disorder, if one is to define
it, if one is to diagnose it, and if one is to treat it. As can be seen, an
accurate single definition of the schizophrenias is impossible because there
is no one single schizophrenia; therefore, diagnosis is as grey as defining
the disorder.
It is said, by many homoeopaths, that diagnosis is but of scientific
interest from a homoeopathic point of view, but is of little value in
reality. It is not good enough to prescribe a single homoeopathic simplex
on the symptoms alone without diagnosis. This is especially the case in the
treatment of the schizophrenias. Unless there is a diagnosis, the
practitioner will be less likely to meet the nutritional requirements of the
patient. The nutritional requirements are as important a part of the
prescription as the specific remedy itself. The body cannot be expected to
affect repair if the necessary tools, in the form of nutrients, are absent.
Hahnemann in his Organon of Medicine states in aphorisms 226 and 261 that
the nutritional requirements are a part of the homoeopathic prescription.
Grey as the task of diagnosis may be, diagnosis is possible and of vital
importance.
Another important reason the Homoeopath cannot afford not to diagnose is the
elimination of the possibility of brain tumour. Schizophrenia is a disorder
where the boundaries of the mind simply disintegrate. Think about it; no
matter how "out of sorts" you feel, no matter how crazy or off-beam you may
be when at your worst, there is always a sense of "self". For most
schizophrenics there is no boundary to self, no "I". Some sufferers of the
schizophrenias will experience hallucinations, some won't; some will have
disturbed thoughts, others won't; and, some will experience paranoia and/or
grandiosity, others will simply feel lethargic and deeply depressed. Some
will experience being invaded by the world's stimuli, crowding them; all
will experience the world differently from the experiences of the so called
"normal" population.
Perhaps the greatest problem in the diagnosis of schizophrenia is that it
has been too often diagnosed, including people with drug induced psychoses,
affective psychoses (clear cut), nutrient deficiency induced dysperception
or psychoses, through to individuals who, for social/political/family
reasons just simply "opt out". Care must be taken by the diagnostician not
to impose his/her social/religious/political/ethnic values on the patient
as this is a path to over diagnosis of the schizophrenias.
Kurt Schneider (1971) provided a list of symptoms "of the first rank" which,
in the absence of epilepsy, intoxication, or other evidence of gross
cerebral damage, he regarded aslikely to indicate a diagnosis of
schizophrenia. Schneider's first rank symptoms of Schizophrenia include:
thought insertion, i.e. experience of thoughts being put into one's mind;
thought withdrawal, i.e. experience ofthought being removed from one's mind;
thought broadcasting, i.e. experience of one's thoughts being known to
others; feelings of passivity, i.e. experience of sensations, emotions or
body movements being under external control; primary delusion, i.e.
delusions arising inexplicably from normal perceptions; third-person
auditory hallucinations including voices discussing or arguing about one,
voices commenting on thoughts or behavior, voices repeating one's thoughts
(echo de la pense), voices anticipating one's thoughts.
Added important diagnostic symptoms include: affective change, eg.
blunting of affect, incongruity of affect, mood lability; formal thought
disorder, i.e. lack of causal link between thoughts (asyndetic "Knight's
move" thinking), interpenetration of themes, use of imprecise approximations
(metonyms), overinclusiveness, i.e. no boundaries to concept, inability to
think abstractly including "concretism", creation of new words (neologisms).
Occasionally one may find the following: catatonic states, i.e. mutism and
immobility with no impairment of consciousness; Folie deux shared paranoid
disorder), i.e. identical manifestations of the same mental disorder in two
closely associated persons; Capgras syndrome, i.e. the delusional negation
of identity of a familiar person; time disorientation, time dysperception;
echolalia (echophrasia),i.e. the automatic meaningless repetition of
another's words or phrases, delayed echolalia (it occurs hours, days, or
even weeks after the original stimulus).
Points to look for in the early diagnosis of the schizophrenias include:
loss of weight; poor posture; loss of concentration; dramatic deterioration
of handwriting; small handwriting; increased irritability; uncommunicative;
reply in monosyllables; reply in rage and storm; fear; paranoia; increased
skin pigmentation, or, conversely, fair "china doll" skin; a characteristic
and unusual smell; clammy hands; poor circulation; digestive problems;
exhaustion; poor body temperature control; abnormal strength; bed wetting;
obsessive and/or compulsive behaviour; and allergies.
Other early signs of schizophrenia include: failure to make friends;
unnatural fears, timidity, grandiosity; profound insomnia; announced sudden
belief in a great truth: "God is love" or "I'm taking off to find the real
me".
Another highly discriminatory symptom for schizophrenia, if organic
conditions are excluded, is the primary or autochthonous delusion. This
delusion appears, fully formed, without any known experience to explain it.
It is the spontaneous realization: "I saw that piece of paper on the
footpath and knew that God had chosen me to be his son", or another, to all
intents and purposes healthy person says "The instant I pricked my finger, I
knew that God wanted me to . . . "
Thought insertion is the belief that thoughts of another person are being
inserted into their own mind. To say that the Devil is causing them to
think evil thought is NOT thought insertion. Neither is the belief that
their thoughts can be read. Manic patients may say that their thoughts are
as powerful as the thoughts of the sun: this, too, is not thought insertion.
Thought insertion is where thoughts are "transmitted" into the individual's
mind by another person: i.e. by telepathy, a radio receiver in their head,
or directed there by rays from a powerful being - perhaps from another
planet. Thought insertion may lead to delusions of influence and/or
control. Here the patient believes he is told what to do or say by the
thoughts that are inserted into his brain. The individual will insist that
his words, or his writing, or his actions are controlled by some alien power
(alien in the sense that it is not his own control - not necessarily from
another country or planet).
Care must be taken here not to too easily diagnose thought insertion. The
average Christian may believe that God guides, even controls, his life or
actions; and this is done (so some believe) through insertion of thoughts.
And, one should be very careful about telepathy, especially when dealing
with peoples that consider telepathic abilities to be a natural and normal
faculty: i.e. the Aboriginal people of Australia.
As intelligent schizophrenics are very good at hiding their symptoms, and
because schizophrenic symptoms tend to change in presentation and/or
intensity, a careful patient history must be taken. Note that responses to
a specific question posed at the beginning of questioning may bring a vastly
different response if asked again latter on the same day. The reasons for
this anomaly are vast, but include paranoia/fear that you are possibly
trying to trick them with trick questions; the patient has lost interest in
your questions and is no longer paying attention; the patient's attention
span prevents interest in your questions; the patient perceives the question
differently each time he hears it, and; so on the list may go.
Let us briefly recap delusions: they are a tenacious, erroneous belief or
perception held inviolable by a person even in the face of evidence that
normally would be sufficient to destroy that belief. So, what is the
difference between a delusion and a hallucination? An hallucination is a
sensory perception that does not result from external stimulus. It is a
false sensory perception that has a compelling sense of reality. Understand
that the hallucination is usually transitory and the delusion is often well
entrenched. This is not always the case and the two words have been used to
mean the same thing. Kent's Repertory, in fact, places the two words
together. There is a subtle difference, however, which, to my mind, points
to two different origins in the brain. A delusion is a part of the belief
system that creates its own reality, whereas the hallucination is usually a
faulty perception that develops belief system or delusion: in short, the
location and nature of the fault in the brain determines whether the
hallucination or the delusion comes first. Incidentally, in schizophrenia
hallucinations are commonly auditory - but they can implicate the other
senses.
The patient may have Delusional mood, in which he feels that there is
something going on around him but he is not quite sure what: something is
not quite right and he is unable to elaborate. The patient may present with
Delusional ideas; these are fully formed delusions that may suddenly enter
the patient's mind, as in the person who - for no reason - suddenly believes
that his food is being poisoned. And, I believe, the patient may have an
hallucination which may or may not lead to a delusion.
In Delusional perceptions, the object is perceived correctly but is
interpreted in a delusional way, i.e. the patient sees and recognises the
vase for what it actually is but believes it is there to tell him of a
specific message from the Martians.
There are Delusions of Grandeur where the patient believes she is on a
special mission or that he is Christ, or Napoleon- they are outrageous
exaggerations of one's own importance, power, wealth or talents; Delusions
of Poverty where the patient sees himself as destitute, here we also find
self-depreciation and guilt where - perhaps - the patient believes he is
worthless or he should be sent to jail because he has committed a crime; in
deeply depressed individuals there may be a delusion of a serious life
threatening illness; Nihilistic Delusions are where the patient believes
that either he, or a part of himself is dead; there are (rarely) Delusions
of Infestation where the patient believes that certain places are infested
by insects or some other living thing; Delusions of Stupor where there is a
state of lethargy and unresponsiveness as seen in catatonic states; Paranoid
Delusions (the word paranoid originally meant deluded) where the patient
believes that someone or something is persecuting or "watching," observing,
him; there is Erotomania or Delusions of Love where the patient believes
that a certain individual is deeply in love with him despite the fact that
there is no evidence to suggest this; Delusions of Infidelity is when there
is extreme jealousy - I have found this delusion very common; Delusions of
Influence is where the patient believes his mind or body is under direct
control by an outside influence, and; Delusions of Reference are where the
patient believes that the television, radio or perhaps the newspaper
contains special messages for him.
Abnormal perceptions may occur with any of the sensory modalities and may be
slight - a distortion of taste, smell, hearing, vision or touch - or severe
where the patient experiences an hallucination. A perceptual distortion is
where there is the sensation of, for example, the colours of an object
changing in intensity, or where the object seems closer or further away.
Illusions occur when the object is real but the perception is disturbed, for
example, it is night and you are afraid as you walk home, you see a tree in
front of you but interpret it as a man who may attack you. Hallucinations
occur in the absence of an appropriate object yet the patient still insists
that he has perceived something. In certain instances hallucinations may be
non-pathological phenomena, as in hypnagogis and hypnopompic hallucinations
experienced by a person going to sleep or waking up. Hallucinations also
occur in organic and functional psychoses. Auditory hallucinations are
where the patient may complain of music, words, voices, identifiable or
unidentifiable; Visual hallucinations may vary in intensity from simple
flashes of light to sophisticated visions of people, animals or places;
Olfactory hallucinations are hallucinations of the sense of smell; they,
too, may vary in intensity; Gustatory hallucinations are rare but
characteristically occur in temporal lobe epilepsy; Tactile and Somatic
hallucinations - in cocaine psychosis patients may complain that they feel
insect scrawling over them, formication, other patients may experience the
sensation of having sexual intercourse, and; Vestibular hallucinations may
cause the sensations of flying through the air.
Deja-vu may occur in normal people but is usually associated with temporal
lobe epilepsy and is characterized by the patient feeling that he has been
in this current situation before. Capgras' syndrome is where the patient
asserts that people are not who they claim to be, but perhaps are their
double (or an android).
It is estimated that there are about 150,000 schizophrenic patients in
Australia, and that 10% will suicide in the first 5 years from diagnosis.
So what is medicine doing about such a horrific loss. Little to nothing.
A skeptic may postulate that since the disorder costs the taxpayers such an
exorbitant amount in Medicare and pension, it is seen as something of a
relief to the social welfare system if they do suicide. The medical
profession can only palliate the disorder, not cure it: the patient is the
contents of a smelly rubbish bin, and the medical profession will only put a
lid on the bin. This is not to say that research is not being carried out
in this area.
Schizophrenia cannot be cured without taking into account: (a) the
nutritional needs of the patient; (b) the gustatory and olfactory competence
of the patient; (c) the sensory incompetence of the patient; (d) counseling
the day to day trials of the patient; (e) the physical, psychological and
spiritual oneness of the patient; (f) the environment in which the patient
exists; (g) the drugs that the patient is currently taking; (h) the drugs
that the patient has taken in the past; (i) the miasm of the patient, and;
(j) the constitution/essence of the patient. (I'm sure I've missed a few
here - as I remember any I'll weave them into the general information.)
Let us look at each of these in turn.
(a) the nutritional needs of the patient. You cannot build a body
towards health without the necessary building materials. Schizophreniform
symptoms can be found in people with vitamin deficiencies, and/or with blood
sugar problems,and/or with thyroid problems, and/or with mineral
deficiencies and/or excesses, and in individuals that exhibit food
sensitivities and/or allergies.
(b) the gustatory and olfactory competence (digestion???) of the
patient. It has been shown that where there is gustatory incompetence,
there is an inability to absorb the nutrients in the diet (this is despite
the fact that the food eaten may have high levels of the nutrients). On
this point then, one needs to look at remedies that will cover this problem
when repertorizing. Remedies for want of taste (in order of rank): Puls.;
Nat-m.; Bry.; Cycl.; Ant-c.; Mag-m.; Merc.;Sulph.; Ant-t.; Aur.; Bell.;
Calc.; Sil.; Verat.; Bor.;Kali-bi.; Lyc.; Anac.; and others. As the sense
of smell plays a part in the action of "tasting", consideration must also be
given to the olfactory sense for the reasonmentioned above. Remedies for
want of sense of smell (in order of rank): Hyos.; Kali-bi.; Mag-m.; Plb.;
and others. Remedies for want of taste and smell (in order of rank):
Puls.; Nat-m.; Sil.; Cycl.; Alum.; Bell.; Calc.; Anac.;Hep.; Mag-m.; Sep.;
Sulph. ; Aur.; Bry.; Kali-bi.; and others.
(c) the sensory incompetence of the patient. It stands to reason that
if the patient doesn't perceive as does the practitioner, there may develop
confusion and misunderstanding as to the meaning of things in communication.
I have found, through bitter experience, that A isn't necessarily A to a
schizophrenic; and when he or she talks of B, that B may be anything from an
A through to a Z.
(d) counseling the day to day trials of the patient. All too often
schizophrenic patient's day to day problems go unaided by the physician who
seems only interested in the larger problem - whilst the patient is all
consumed by how to make it through the next day, or who he has to see in
order to pay the rent. Thus, in order to make the physician pay attention
to his or her needs, the schizophrenic patient distorts the symptoms.
(e) the physical, psychological and spiritual oneness of the patient.
This is what Homoeopathy is about: treating the whole patient.
(f) the environment in which the patient exists. The environment of the
patient is important for so very many reasons. The environment may harbour
allergens, stressors(psychological, physiological, or spiritual), a negative
environment where family, friends or others feed his/her beliefs, or create
new ones.
(g) the drugs that the patient is currently taking. This is quite a
problematic area: seeing the true individual under the cover of the drug is
somewhat difficult - be it prescribed drug or street drug. How much effect
on the Homoeopathic treatment does the drug have / how much effect on the
action of the drug or on the drugged individual does the Homoeopathic remedy
have? Care must be taken to take into account all drugs used in the past -
these are layers that must be addressed: (h) the drugs that the patient has
taken in the past.
(i) the miasm of the patient. It is absolutely without question that
cure cannot be effected without correctly taking into account the patient's
miasm. A schizophrenic may be any of the miasms, do not be told that they
can only be this or that. Determining the miasm of the schizophrenic
patient may be rather difficult (see k) and care must betaken to remove each
miasmatic layer.
(j) the constitution/essence of the patient. It is the constitution of
the patient - not the constitution of the disorder - that you seek. All too
often the Homoeopath projects a constitution onto a patient that has been
derived from current symptomatology and that symptomatology alone. Finding
the constitutional remedy of a patient who is constantly schizophreniform is
quite a challenge, for the visible patient is just a mass of scizophreniform
symptoms. If the picture is unclear - if you cannot get a glimpse of the
true patient under the symptoms, repertorize on the symptoms, find a remedy
and treat the disorder as an acute problem to remove the symptoms enough to
get a brief look at the patient.
(k) Determining the miasm of the schizophrenic patient can be rather
difficult simply because seeing the patient underneath all of those rather
extreme symptoms can be, in itself, rather difficult. However, remember
that the upper layer - that visible layer - is, in fact, the current
miasmatic layer and this must be removed first. So, when you have
determined the constitution of the patient, be sure that the constitutional
remedy is a miasmatic remedy for the current miasmatic layer. The history
elicited from the patient and his/her relatives of what the patient was like
before the disorder, will give you an idea of what the miasmatic layer was
well before the disorder and this too must fit with the remedy you intend
prescribing as a constitutional remedy (if it doesn't fit, then the
suspected miasm pre-illness is wrong, or the constitutional remedy is
wrong). I believe that the vast majority of Homoeopaths do not understood
miasmatic theory. They understand some of the basics of the application of
miasmatic medicine, enough to- on the whole - make the prescription work,
but they really don't know what they are doing. (Time has come to radically
review miasmatic theory - but this is another issue to be approached on
another occasion.) Understand that you will never "cure" if you don't get
the miasm right, and; your patient WILL have a number of miasmatic layers
that will need to be dealt with.
(l) It is essential to correctly interpret your patient's delusion, and to
differentiate between delusion or illusion -and more importantly between
Hallucination and Illusion. In fact, be careful with all of your rubrics: I
had a patient 2 days ago who was exhibiting schizophreniform problems (she
was in her sixties) and she insisted that "I feel I am being poisoned!" and
all attempts to get herto elaborate on that statement were initially futile.
But on her second visit I elicited that it was accumulated toxins from
everyday life that she was getting at. There was no paranoia with this
patient: no fear that another individual was poisoning her.
(m) Patient compliance with you prescription is horrific! Particularly the
dietary part of your prescription. The average schizophrenic living on
their own or in a community house with other schizophrenics will participate
in a diet that consists of massive quantities of bread, jam (jelly, to our
US friends), and ice-cream; all with numerous cups of coffee daily. On top
of this frightening diet, they will almost certainly smoke cigarettes and
possibly use street drugs. A very important part of the prescription for
those patients who either live on their own or who live with other
schizophrenic or psychiatric patients, is how to prepare quick and
nutritious foods. Remember that the bread is certainly a problem for the
schizophrenic patient: it is a refined carbohydrate that will be of no
nutritional value; a potential allergic or sensitivity problem; and is
better replaced with other foods.
Other dietary obsessions I have found with schizophrenics include pasta,
cakes, sweets, alcohol, tinned (canned)foods and chocolate. The
practitioner may have to be patient with the patient on the matter of drugs.
However a firm but realistic stand is often appreciated. Don't make too
many, or too great, your demands on diet or street drugs. Follow through to
make sure that your patient complies.
(n) Prescribed drugs are a pain in the neck to all Homoeopaths treating
these problems. Firstly make sure that you are seeing the patient and
his/her schizophrenic symptoms and not the symptoms elicited by the drug.
Find out what schizophrenic symptoms were there before the drug as they MAY
be your current symptoms (but not necessarily). And don't assume that the
patient is as they were pre-schizophrenia now that they are taking the drug
(the drug has its own picture). The Homoeopathic prescription to treat the
allopathic drug picture firstly to ignore it as you probably won't be taking
the patient off the drug just yet; secondly, when you do consider taking
them off, consider that you may need to either "dump" the drug from the
patient's system by prescribing a high Homoeopathic potency of the drug,
and/or antidote the drug. I have used Chlorpromazine 30c and 200c to great
effect in the treatment of several patients. One, in particular, had been
on Largactil for many years in her early twenties and some 12 years later I
gave Chlorpromazine; the improvement in this patient was incredible and it
cleared the way for further treatment: removal of a layer.
(o) Don't treat the schizophrenias superficially. Don't let your patient
think that it is cured when the problem needs to be treated right back to
childhood and beyond.
(p) Remember that not all schizophrenias can be cured. If there is an
inherited physiological problem, a defect, then you will not eradicate that
problem. But you will almost surely find away around the problem.
(q) The Homoeopathic remedy will - especially in the early stages of
treatment - need quite frequent repetition (inmost cases) of very high
potencies. I have had patients that have needed a dose every second day of
10M long acting remedies for quite protracted durations. Then, suddenly,
the remedy takes hold and the patient may go for months without another
hdose. ALWAYS ADMINISTER THE DOSE YOURSELF - DON'T LET THE PATIENT DO IT.
DON'T TRUST YOUR SCHIZOPHRENIC PATIENT TO DO IT CORRECTLY (or at all).
(r) The QRS symptoms are usually of limited help in the treatment of the
schizophrenias because QRS symptoms are the order of the day in this
disorder. Secondly, the QRS symptoms may only be perceived, not actual, to
the patient; and furthermore these symptoms may be quite transient. Take
care with QRS (queer, rare, strange) symptoms, they may be quite unreliable.
The prevalence of psychiatric disorder in the community is of such magnitude
that every practitioner must be able to carry out a psychological assessment
and from that assessment be able to diagnose any illness that may bepresent.
Diagnosis, as elucidated in the Introduction, is rather difficult, but
necessary. Because Schizophrenia is a syndrome, it is wise to be methodical
in your approach to diagnosis.
As stated earlier, it is imperative to diagnose your patient's problem. If
the disorder is schizophreniform, it may be anything from a nutritional
deficiency to cancer. To treat the disorder with a single homoeopathic
simplex without taking into account the nutritional needs of problem would
not be Homoeopathic prescribing.
The treatment of the schizophrenias is a daunting task: exceedingly
difficult. But the rewards in affecting cure in a schizophrenic patient are
as great as any reward you are ever likely to achieve as a Homoeopathic
Physician.
There is very much more to be written on this subject, but I have already
rambled on for too long. Please await my book (if I ever finish it). On
winding up this article I can think of a dozen or more major points I have
not touched on here, but there is no time, nor is this theright forum for
such a comprehensive tome. Please, if you have questions or criticism, fire
them at me - until then: have fun. Les
** End of text from cdp:hn. topics **
==== ==== ==== ==== ==== ==== ====
Response 2 of 2
** Written 12:38 PM Sep 9, 1993 by peg:hera in cdp:hn. topics **Les.
Great information regarding schizophrenia. It's this type of report that
can help us make inroads to such a problem illness. One point regarding
diagnostic criteria. Referral to current standards such as the Diagnostic
and Statistical Manual of Mental Disorders by the American Psychiatric
Association or the WHO's International Classification of Disease gives
current acceptable criteria. I have found Comprehensive Textbook of
Psychiatry by Kaplan and Sadock ( pub :Williams and Wilkins) to be an
invaluable source in understanding the natural disease in mental illnesses.
I was especially interested in your comment about the PQRS symptoms being of
limited help, as the PQRS symptoms are the order of the day and thus
unreliable. I tend to agree, just as we lastly refer to common symptoms of
physical illness when arriving at the similimum, the same should apply to
mental disorders. Even though the bizarre forms that come up in mental
cases appear to be juicy repertorial stuff.
One thing that comes to mind in the treatment of mental illnesses is the use
of Physical Concomitants. I think it was Frank Bodman who said that in
Physical cases the mental symptoms help decide the remedy and in Mental
cases the Physical symptoms help decide. What is your experience of this.
Also do you find Hahnemann's observations on the management of mental
diseases in the Organon vindicated in such cases.
And yes, miasmatic appreciation is fundamental; please let us know your
understanding of the concept of chronic diseases at some time. I know some
homoeopaths feel it has merely amusing historical value; I wonder how they
approach such cases.
Thank you for all the work.
Jim Veljanovski** End of text from cdp:hn. topics **