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Totality and the Remedy
TOTALITY AND THE REMEDY - the lock and the key
By Louise Barton, February 2008
Homœopathy is a unique system of treatment because it both distinguishes and relies on the totality of symptoms. Hahnemann stressed totality in the Organon, and homœopaths from that time till now have taken up the challenge of finding totality by using different ways to determine the entirety of a case. Totality is both the strength and weakness of our system; understanding totality means the core of the problem is being observed and then treated, however discovering this central part is so often a difficult task.
There are two challenging areas that the homœopath must conquer. One is how to determine the totality of a case and the other is how to match that totality to a remedy. It is easy to go astray in either of these areas, and until the practitioner is practiced it is common to experience difficulty in not only seeing the lock but also in finding the key.
Totality can be understood by looking at our patient in a number of different ways
- Physical totality - their pathology and physical reactions to their environment
- Emotional totality - their feelings, reactions and sensations
- Mental totality - their delusion or sense of reality about their life
- Lifestyle - diet, habits and environment
Each of these is a valid way to look at a patient's totality. Conventional medicine concentrates on the physical manifestation of the patient, naturopaths on lifestyle and health, counselors on emotional presentation combined with lifestyle, and psychologists on both the emotional and mental aspects of their patients. Homœopaths, knowing that totality includes everything, take on the task of analysing as many of these areas as possible. Some homœopathic practitioners concentrate on one or two of these areas excluding the others - many combine all four to find the totality. Our task becomes a challenging one - each of these areas demands a full professional qualification and years of study - how can we understand all of them and interpret them correctly?
Objectivity and Subjectivity
When considering any of these aspects, there are two different ways we can judge the information. We can use objectivity or we can use subjectivity. In essence objectivity is what we see and know while subjectivity is what our patient feels and how we the practitioner interprets what they feel - a feeling that is reinterpreted using a practitioners experience of that feeling!
The strength and consistency of science rests in using objectivity - feelings have no place in science, only the observable is taken into account. Feelings are open to interpretation - our patient might be using a book or article written by someone else to help describe their own feelings or not even have the language skills to describe their feelings at all - the homœopath is also bound by their own judgment and life experiences.
Hahnemann warned about suspending judgment and using observation. We have no way to observe what the potential of a remedy is other than a proving. We have no way to observe our patient other than to observe them. There is no technology available that can match the two without the go-between of another persons mind. The challenge for us is to use our mind in a way that removes subjectivity yet at the same time captures the drive of the case - can this be done?
The trio of observation
All the of the following meet the criteria of objectivity and allow us to suspend any subjective thought we may have about the case
- Facial analysis
Facial analysis is the first step to using observable information when determining our patient's totality. All material beings and substances are formed from the forces or energy that lies within. This energy is what we call a miasm and the material outcome of this energy is the shape, structure and physiology of our body. The face is the most expressive and accessible part of our body and a wonderful way to observe 'what is'. Every shape and contour defines the forces that lie within us and when we understand the importance of dominance (the stronger suspends the weaker) we have an observable way of determining a patient's miasm. Whichever force is dominant within the patient is seen through their facial features.
How can we know a patients mental or emotional state without discussing their feelings? The answer is through listening to the circumstances of their life - what has actually happened rather than how they feel about it. A good example is a patient who had an alcoholic parent and now an alcoholic partner - both of these situations impact on their life. How do we assess this impact? By listening to what they tell us. If we ask them to tell us what has been significant during their lifetime both in the past and now, they will tell us. Listen to their story and not their feelings. What do we know? What is the topic that had the greatest impact? It is alcohol. So we use the rubric "mind - alcoholism".
The HFA method uses the circumstance of a person's life rather than interpretation of those circumstances. Another example is jealousy. A patient may not be jealous themselves but tell of two or more episodes where another person was so jealous it affected them greatly - we use the rubric 'Mind - jealousy'. There are numerous ways we can use mental rubrics by circumstance rather than by feeling. Using objectivity rather than subjectivity is both surprisingly easy and yields excellent results.
We have covered physical structure and life circumstance. The other area of importance is the physiology of the body - how does the person interact with their environment and how is their body functioning? Their presenting pathology is what brings them to the homœopath and if this pathology yields any repeating patterns this information is important - worse at night, better for cold, worse before menses - any of these examples is a pattern linked to the pathology - known as a general. General symptoms are objective. If we also add the generals of the patient not related directly to the pathology - for example craves meat, aversion fruit, worse cold, perspiration on exertion, right sided - we have a number of objective symptoms to make up the totality of our case.
Once we understand the difference between objectivity and subjectivity we can learn to find the lock and the key without years of experience based on feelings and interpretation.
Lifestyle deserves a special mention. Hahnemann referred to problems in this area as being 'obstacles to cure' rather than the totality upon which the choice of remedy depends. Often a patient has attempted to improve their lifestyle especially in regard to diet or exercise but still finds it isn't enough to change the core of their disturbance. Often they feel improvement for a short time but symptoms will return or their willpower isn't sufficient to maintain the lifestyle change.
We frequently see patients take up a new lifestyle after a successful remedy is given. The remedy allows their willpower to surface and if they feel inclined and know what to do they will improve the outcome even more by changing their lifestyle. As practitioners we know the remedy chosen triggered the positive outcome but without the appropriate matching lifestyle change the full effect of the remedy will not be realised.
The easiest way to successfully find a remedy that matches the totality of our patient's case is through repertorising. Every profession has its tools and to practice homœopathy effectively we need certain tools too. The following are vital to successful clinical practice
- Repertorisation software
- Digital camera
- Materia medica
Once we have the totality of the case we take this totality and choose rubrics that realistically convey the specific parts of that totality. If we choose the rubrics based on observation then the remedy will be present in our final repertorisation. Six to eight rubrics are enough to cover totality - from the final group of remedies only those that miasmatically match the facial analysis are considered. Within this group is the key to open the lock.