The Vital Approach, Anamnesis - Step 3: Confirmation

- Anne Vervarcke, www.thewhiteroom.be ,http://walkforhomeopathy.wordpress.com/,
http://annevervarcke.com/blog/
By the time the territory is defined by the patient and the topics in it fully explored by the homeopath, stuffed with all the patient’s anecdotes and examples, the homeopath usually has a good idea where the treasure is hidden. He doesn't know what he is going to find but he knows where he needs to dig.

The third step of the consultation is mainly for confirmation. The homeopath can begin to ask more direct questions, for example: ‘There are a few words I'd like you to clarify, in the beginning if the interview you said…’, or: ‘I noticed you used the word ‘pressurized’ a few times, can you talk a bit more about pressurized?’, or: ‘Your pains in the legs are unbearable, you said, can you say a bit more about unbearable pains?’.

Now is also the moment to ask about the patient’s fears and anxieties, even if the patient has already talked about them, it is important to check. The homeopath can ask: ‘Is there anything you are afraid of?’. If during the consultation the patient has already talked about his fears, he will come back to it and that provides a good confirmation. If the patient has not already been specific about his fears, he might link them to the Chief complaint anyway.

Psychoanalysts describe dreams as the highway to the subconscious, but the homeopath uses them in a completely different way. The homeopath doesn't try to interpret the dream at all, but takes the facts and the feelings in the dream as important features. For instance: somebody may dream of being in a boat on the water. When asked what the feeling is, the patient may say: ‘very calm and pleasant’, or ‘extremely scary, it was like a threat came from the deep water’ etc. The image alone is not enough to understand the patient’s experience. On the other hand, many dreams seem to belong to daily human activity: dreams of coming unprepared for exams; having to hurry to catch a train or plane'; going out into the street half dressed; being persecuted; trying to escape but the legs won't move; teeth falling out; dreams of flying and so on. Although these dreams are common, we must still ask for the individual patient’s feeling in the dream and how often they have had it.

Whether we take the dreams into account depends somewhat on the intensity and the frequency of the dreams. The same applies to children's dreams. It is quite common for children to dream about a ghost or a monster, but if the child has frequent nightmares about them and the child wakes up terrified, then it becomes a problem. Very often an attitude or a feeling in itself is not strange, rare and peculiar, but rather the fact that it is recurrent, or inappropriate, or out of proportion.

If at this point in the interview we do not already have a good idea of the delusions in the case, we can often discover them by exploring the fears and dreams. Also the things that the patient can’t stand are discussed. It is up to the patient to give meaning to ‘can’t stand’. This may be anything, from the smell of eggs to people who abuse animals. It may be a sensitivity or an irritation, an aversion or disgust.

A little reminder here: when the patient says: ‘I’m sensitive to’, does not automatically indicate the Plant kingdom, everybody is sensitive to a particular thing, that is the definition of their problem. Mineral or Animal or Nosode patients are also sensitive; it is what they are sensitive to that points to their remedy!

Sometimes it is in the last part of the consultation that everything falls into place and it is only then that we have the ‘aha’ feeling of ‘now I understand’, rather than it confirming what we already knew. This is just as well. Some cases evolve in a step by step manner, where one statement builds on another, while other cases seem to be only unconnected bits and pieces of information that the homeopath can’t bring together. It may be compared to working on a puzzle. If the homeopath has the main picture with pieces fitting together, he is able to see the picture quite early in the consultation. However, sometimes the homeopath has a piece here and a few pieces there and it is only at the end of the consultation that the missing piece that links all the others together is revealed. It can be more uncomfortable for the homeopath since he must stay in the ‘not knowing’ mode for a longer, but the end result is the same.

If at the end of the consultation things are still not clear, we can ask the patient what events, people, times, situations or circumstances in his life had the biggest impact. Often this leads to some conclusive statement from the patient.

To finalize the case we can talk about the things the patients likes to do best. Does he have any hobbies? Where or what does he likes best? What were the moments in his life he had a really good time? What would he like to do if he had the time and money? Normally if the vital sensation is understood at this point, the homeopath is not surprised to see it expressed in everything the patient says and does, even in his hobbies or fascinations and in his likes and dislikes. It is also advantageous to end the consultation on a lighter topic. To send the patient home once the fears and worries or deepest disgust has been investigated seems a rather odd thing to do. To discuss positive aspects of the patient’s life makes the atmosphere more natural and eases the transition to common conversation (Level 1, 2 or 3).

When an anamnesis is well done, the vital sensation is clear and two possibilities present themselves: the similimum (the remedy with a similar vital sensation) is known, or we know what remedy we need to look for. If this is a remedy that is unknown to us, we have software at our disposal to help us find it.

The bibliography which goes with this book is all but complete, it is to be understood as a mere hint to the wealth of information there is available.

Over a thousand provings can be found at Jörg Wichmanns’ website: Over a thousand provings can be found at Jörg Wichmanns’ website: http://www.provings.info/en/index.html.

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