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- The homeopathic treatment of eating disorders and the case of a starving child (A. Maslan)
Female, 21 years
Observation: Emaciated, child-like, long blonde hair, veins showing under her eyes. Weeps heavily while talking. Expressive. Discharge dripping from nose. Childish giggle in between tears. Loses train of thought.
Main Complaint: Anorexia and bulimia (5'4", 75 lbs.).
I am not emotionally grown up, pretending in a world of make believe. I try to be normal and feel crazy inside. I think too much. I have a hard time differentiating between thoughts and emotions. I feel frustrated. I have had the eating disorder for a long time. When I was a really little girl, I was fearful of everything. My aunt had cancer. I thought: Will I get cancer and die? I was hypochondriac as a little girl and a perfectionist.
My parents divorced when I was 10. My dad took me away from mom. Traumatic. I didn't want to go away from mom all my life. I have to grow up. It makes me crazy. I wish I could get rid of my perfectionism and self-hatred. I need to grow up. I am self-destructive. I want to take care of myself. I destroy myself. We have been with our soul for infinity. I want to feel comfortable with my own soul. I never give up. I wish I could reveal my true self. If I let go, I am afraid of abandonment, of people disliking me. I had to be pleasant and beautiful to be accepted and loved.
I was graduating from high school and I was deathly afraid to leave my mom. I used to say, "Please let me live with my mom." I was 18 and I had to be an adult. What do I want to do as an adult? I had no idea. I was scared. My intellect and brain stopped working and, in the middle of a test, I could not think. I balled (cried) like a nervous breakdown. I did not have money for college. Hopeless feeling. I would really like to be responsible for myself and independent. My mom had four kids by the age of 20. I was the oldest. She had no ideas of the ropes. I had no resources. At the same time, my mom was getting her nutrition degree. I wanted to be accepted and loved by mom. If your mom doesn't love you, who the hell will?
I had D-sized boobs and weighed 130 lbs. I thought: I can diet, I can do enemas, I can eat good. It got out of hand. Turned into anorexia and then bulimia. I try to eat, then get ravaging hunger. Everything I eat I have to regurgitate five to six times with each meal. I can't get rid of this perfectionism. You are destroying your teeth and body. I am afraid my fucking food won't digest. It is utter hell. I fucking can't sit to have a meal. Fear it won't be properly masticated. I have to masticate my food. I have to chew really good, and regurgitate to masticate again.
I want a lobotomy in my brain, to turn it off and crawl in someone's lap. There is a really responsible adult inside. I can't find her. I think: You can't do it, you are a bad person, you are not honest with people. I have built a lot of shame. Everyone else is normal. I can't live with myself. I think that food is not good, you have to regurgitate. I do it to shut off my feelings and shut out the world. I am an animal, I am no longer a human. I am an animal starving to death, gorging and trying to eat, like a ravenous animal inside. A soul angel and a devil inside me that are fighting. I want to surrender. The angel says, "You can do it, you can heal yourself. God loves you." She cries all the time. The devil says, "Yeah right, you know what you're doing, you can't make it as an adult, you can't even do artwork, you suck." It is deep-rooted craziness.
As a young girl, I thought, "Please don't let my grandma die." Most kids are out playing, yelling and screaming. I have a history of craziness. I could not sleep unless I asked guardian angels, "Please protect me." I was the older sister, a loner and outcast. No one related to me. I want to feel, "You are my mom and family." Loved and accepted.
I don't want to be dependent with a man. Hard to be close with a guy. I have a boyfriend. I won't have sex with him. I am a freak of nature. I am skin and bones. I wish I did not have to eat. That would be awesome. I would not have to be afraid to have to regurgitate. Death would be a lot better. I have a feeling my food will sit there and won't digest. Crazy belief system. I get stomach aches. Food sits there like a rock, regurgitates and turns to liquid, then the body accepts. I cook brown rice, millet, parsley, garlic, onions, and garbanzo beans. I am a fricking-prisoner in my own body. We are living to learn to love. So scary. Get to the afterlife and God won't love me. I am so bad. I am destroying the body he gave me.
Divorce? I loved my mom and dad. I needed my mom though. I felt like I failed. I needed to help my mom. I was lost. My roots were severed. Where do I go? I was confused. I needed to take care of her. During school, I remember that I cried during the pledge of allegiance. I just wanted to be with my mom. Dad spanked me. I had an aching feeling in my heart. Always aware that there was something mom could not give to me. Could not be 100% with my mom. It reminded her of her own pain too much.
Dreams? I was led by these guards to a dungeon and jail cells. Women and men were having sex and peeing on themselves. People were in pain, groaning. Little girl was walking with these guards. It was a crazy dungeon. A queen was on a throne in the court. People were lying on the court, men pooping in women's mouths, then vice versa. I felt helpless. I was just a little kid watching it all, hopeless.
Fears? Not doing the job right. Fear of failure. What if I mess up? Fear of getting cancer and getting sick and dying. Nothing is certain in this life. I was introduced to mortality at a young age. Fear for my boyfriend to see me without makeup or clothes. I am ugly. I am my own destroyer.
Anger? I want to blow up inside. I destroy myself and feel guilty for feeling angry, a bad person. I will hurt other's feelings. I put it on myself.
My boyfriend, he wants to be around me. He calls me all the time. I am not able to give love. We have fun together as friends. If he needs me emotionally, I feel drained. I get mad if people invade my space. I love to be around people, but my eating disorder forces me to seclude. I love to laugh and have fun. Who wants to see someone regurgitate their food? I fear people and love them. I am an introvert and an extrovert. People remind me of God. When I am alone, I get lost in my own world, my own head. If I am not pet-sitting, I wake up and say, "God, please protect me." I am afraid to live. Really hungry and afraid to eat. I have to be perfect and only eat certain combinations of food. I want to be a counselor of some sort. My brain is not smart enough. This disorder keeps me from living. I have to regurgitate. It is killing me. As a child, I did not like when people teased me. Makes me feel like shit. I am not goo. I am worthless. This life is to develop confidence and self-love.
Sleep? I can't allow myself to sleep. Tell myself: You can't sleep, you have to keep yourself up. I go to bed and regurgitate food. Vomit out and eat-then I vomit again, again and again. Muscles? Sore.
Menses? I have not had a period in three years. They used to be heavy.
Heart palpitations? Sometimes.
Body temperature? I get hot. Hot sensation in my heart.
Food cravings? Mayonnaise. I won't let it in myself. I crave fats and sweets. I wish I had a big cake and salmon. I want to eat the whole fish, but I would have to regurgitate it. I used to love food; it was my comfort.
When the eating disorder started, I thought: I can get close to my mom if I do this. Change myself to be accepted. I tried psychotherapy, Prozac. I have an Overeaters' Anonymous sponsor. Clinics are way too expensive. I was hospitalized one time.
I would like to see myself living in a community with people. A commune, a spiritual environment. Community connectedness and service. If I had confidence, I would get myself a car and explore and go to school. Get involved with people. Be a therapist, some sort of healer. I am all messed up. I want to do everything at once. I get tired. Like a tornado in my brain and my body. Like having a baby through a pinhole.
In puberty, I hated my body. I knew I loved myself, but I hated it. I felt I was unacceptable and going to be unloved. Not just the weight; it was trying to receive the love. Eating was an avenue that I had control over. I wanted to be me. If I was me, it did not mean love or acceptance-it meant being alone. Mom would shut off and get mad. That was hell.
As an infant I had projectile vomiting. I cried a lot. Nothing digested. If I eat, my stomach will hurt. I did not know how to nurse. I could not suck. Mom had an aneurysm and did not see me for a month right after I was born. I was in an incubator for a month.
What is this case about? Before I began to look at rubrics I wanted to have a deep understanding of the case. She was a premature infant who was separated from her mother for the first month of her life. Her entry into the world was rough. Now she is literally starving for the motherly bonding that she did not experience.
Then you have her mother who has four children by the age of 20. Even in the best of circumstances, this mother would not have been able to give her eldest daughter the attention that she so desired. The theme repeats throughout the case. Her parents divorce at age 10 and she is once again separated from her mother. At age 17, when it is about time to leave the nest, she begins a path of obsessive dieting to once again gain approval from her mother. She grows up never leaving the child-like state of an infant needing love and nourishment from her mother. She carries a constant feeling of failure and self-reproach. So the young girl spends her entire life trying to be the perfect daughter, to receive acceptance from her mother-even to the point of deprivation of nourishment.
This case can lead you in many directions. There is the reference to the internal angel and devil. She also mentions feeling like an animal. These descriptions can easily pull you astray. To heal this patient, you need to get to the essence of the case, which is the relentless desire for symbiosis with her mother.
In analyzing the totality, we look at the etiology, pathology, traumas, dreams, delusions, generals, etc. I think that the patient's exact language and keywords are an outer expression of the inner state of the vital force. This patient uses some very clear words to describe her symptoms, such as "regurgitation" and "mastication." I wanted to find a rubric using her exact words. I needed rubrics that covered mother, separation, digestion and self-reproach. I chose the following rubrics that covered the essence of the case:
• Stomach: Eructations; food, of, regurgitation
• Mentals: Succeeds, never
• Generals: Emaciation
• Clinging to mother (ReferenceWorks)
I had a few ideas for remedies, but before I made my decision, I wanted to look at the case from a different angle. Her first words were, "I am not emotionally grown up, pretending in a world of make-believe." I thought of the Hydrogen series from Jan Scholten's use of the periodic table. This series is about the development of life and the period of the unborn child-the very beginning of life and the decision to be or not to be in this world. The Hydrogen remedies express a profound love for and connection with the entire universe and all inhabitants. This is their nirvana. However, once the unity is severed, they experience a deep sense of isolation from the rest of the world. It is as if they have fallen into hell. Scholten states, "their paradise becomes a world of good and evil." (22) They try desperately to rekindle that connection, but it is not possible.
The connection was severed for this patient with her premature birth and being separated from mom for the first month of her life. Because of this traumatic isolation, she spends her life trying to recreate this connection and it is never enough to recover what is missing. It is as if she was cast out of the womb too soon.
When we look at the period table, on the left side we see the Alkali remedies which consist of the Carbons and Magnesiums. These remedies tend to be more round and robust and have a feeling of being with mother. On the right side of the periodic table, we have the Halogens (salt-forming). They tend to be thinner, as they are heading towards death. These remedies reflect the feeling of without mother.
The third horizontal row of the periodic table is the Silica series which represents relationships and family. Moving to the right along this row we come to vertical row 17 where we find Chlorum (chlorine). This remedy is about the splitting up of relationships or the desperate need to hold onto relationships, especially the relationship of mother and child.
When chlorine is combined with hydrogen, it forms the basis of hydrochloric acid (muriatic acid). This basic ingredient of muriatic acid is a colorless gas produced by the action of concentrated sulphuric acid on common salt. When mixed with water it becomes hydrochloric acid, which of course is produced in the stomach to help break down proteins.
By analyzing this case through both the repertory and the periodic table, I came up with the same remedy, Muriaticum acidum. I needed a remedy that included longing for mother and digestion problems. This patient came into the world with an inability to digest her food as she had projectile vomiting in infancy. Her constitution already had the tendency for bulimia. She just needed the right circumstances to trigger this deep wound. Muriaticum acidum gave her the nourishment she lacked from mother and from food.
Muriaticum acidum represents the desire to be one with the mother. These people demand constant and total attention from mom. So if you are thinking of the clinging of Pulsatilla, Baryta carbonica, or Bismuth, look also at Muriaticum acidum. They need to have their mother completely to themselves. To prove their love, they want to be mother's helper. When this patient describes her parents' divorce, she does not grieve the loss of her father, which is common amongst young girls. She wants to help take care of her mother, which Muriaticum acidum patients want to do. I believe her mother must have been very frustrated because, most probably, no amount of attention would have been enough to fill the void in this child's heart. Her non-acceptance was her delusion. Muriaticum acidum has a tremendous fear of failure and anxiety about death or disease of mother or family.
Prescription: Muriaticum acidum 200c.
Anorexia cases tend to be high maintenance due to the patients' frail state. In this case I kept in touch with her daily for the first few weeks. In the beginning, she experienced a great deal of emotional highs and lows. Also, she felt ravaging hunger for everything in sight. This can be frightening for an eating disorder patient, so she needed a lot of support and encouragement.
Follow-up at 2 months
I went to the doctor and gained more weight than ever. I gained 10 lbs. over a two-week period. [They weighed her twice because they could not believe it.] Something is kicking in my brain. I am making peace with it. I feel a slow shift. It is very gradual. The depression and utter sadness, I am able to say no. Stop myself and rest and put something back in my body after regurgitating. I don't want to deprive myself. It is progress. There is still the craziness, but I am able to get in touch with reality. Last night I spent a full day with my boyfriend. I actually sat and ate with him. I have never been able to do it. I actually enjoyed myself.
Follow-up at 6 months
I am learning how to do things all over again. I drove to my appointment yesterday. I would be too worried or nervous before. I am excited about school. I am taking a theatre class. I feel good. I am hard on myself and I worry. I am feeling peaceful and have an urge to create. My mom said she was going to call me back and she forgot. I have a lot of anger and I realized I have been putting it on myself. That is why I abused myself. Now I tell her and it is ok.
Plan: Wait. Sniff remedy as needed (olfaction).
Follow-up at 1 year
It feels good to be away from home. I am learning to live my life separate from my mother. I don't feel angry anymore. I feel whole for the first time in my life. I was having some reflux after eating. I sniffed the remedy and my food began to digest. I go all day without thinking of regurgitating. That is a miracle. Weight: 109 lbs.
Plan: Muriaticum acidum 200c.
My patient moved away to enter art school. She sent me a beautiful illustration of a flower coming out of the universe with the following poem from Dante's
This mountain of release is such that the ascent's most painful at the start, below, the more you rise, the milder it will be. And when the slope feels gentle to the point that climbing up sheer rock is effortless as though you we re gliding downstream in a boat, then you will have arrived where this path ends.
This was one of the most rewarding cases I have been involved with. Her childlike presence automatically brought out the mother in me. I was happy to see her spread her wings and fly.
Gross, Michael. Model: the Ugly Business of Being Beautiful. New York: Morrow, 1995.
Scholten, Jan. Homeopathy and the Elements. Utrecht: Stichting Alonnissos, 2000.
Yasgur, Jay. A Dictionary of Homeopathic Medical Terminology. 3rd ed. Tempe, AZ: Van Hoy Publishers, 1994.
Allison Maslan, RSHom (NA), is Director of The Homeopathic Wellness Center in Cardiff by the Sea, California (San Diego) and Co-director of The Homeopathic Academy of Southern California. She also chairs the Marketing committee for NASH.