Meditative Approach in Chronic Skin Complaints

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Author: Dr. Jayesh Shah, Consultant and Senior Faculty, the other song – International Academy of Advanced Homoeopathy 

Chronic skin complaints like psoriasis, eczema, lichen planus virtually constitute the bane of a person’s life. The anxiety and the social embarrassment due to the complaints is often more agonizing than the suffering itself. This becomes a perpetual concern for the patient and the family. Often we get cases where every mode of treatment is tried before they finally approach us. The chronicity and the direct body- mind connection in such complaints necessitate the need for a systematic holistic understanding.

Despite a good totality, there are many relapses in such complaints. The patient loses hope and sinks into a state of despair. The duty of the homoeopath in such cases is to be a silent facilitator and to bring forth from the patient’s subconscious, the state of agony and despair that he has been living as a routine. The homoeopath plays the role of a passive observer to encourage the patient to observe and report the contours of his own experience. When the experience emerges to the foreground, it provides a proper grip on the patient’s inner song. The very crystallization of the patient’s experience itself initiates the healing process. The physician here has to go with the flow of the case and has to help the patient disconnect from his complaints. This is often possible by the use of meditative approaches.

Dr. Jayesh Shah, a Senior Consultant and Faculty at ‘the other song – International Academy of Advanced Homoeopathy’  is a renowned homeopath from the Bombay School of Classical Homeopathy and specializes in the use of meditative approaches combined with the Sensation Approach for treating and healing such chronic cases. Practicing for almost twenty-five years, he has gained a reputation as a skilled teacher and a keen homeopathic prescriber. He is much sought after as an educator and has conducted numerous seminars around the world. He developed a unique method of case-taking wherein he uses meditative and other intensive techniques to explore the patients’ deepest and core issues, leading to a very deep level of understanding, awareness and healing in any given case.

Given below are few cases of chronic skin conditions seen by Dr. Jayesh Shah at the other song, with his Resident Doctor, Dr. Devang Shah. The cases have been edited for brevity. The index for short forms is P: Patient, D: Doctor, HG – Hand Gesture. The doctor’s understanding has been highlighted in italics.

This is a case of 63-year-old female who had been diagnosed with oral lichen planus. She was first seen by Dr. Jayesh Shah on 4th July, 2012. She is a public relationship officer at a very big hospitalhospital in Mumbai. She had been to various doctors for the same with hardly any relief. She entered the cabin and said that she was feeling anxious about what questions might be asked to her. She could not describe this anxiety further.

A human being has two minds. One is the thinking mind and the other is the experiencing mind. These days I work a lot in giving the experiencing mind a chance to experience whatever the life force or the vital force has to experience. This is done by simply asking the patient to focus on the experience. So I ask her to give attention to this anxiety.

The patient said that the anxiety was of the unknown as to what questions would be asked.

While the patient is in an experiencing mode, the best way to facilitate this is by suggesting to him/her to close eyes and take some deep breaths and follow the directions. Asking them to take deep breath helps to connect us with the experience. In a way, it is like a guided meditation.

As she focused further on the anxiety about the unknown she felt alone, like there was no one. Not even feeling her body parts. Just few minutes into this meditative state and she started experiencing relaxation.

Now we see that the life force initially feels anxious and the anxiety is as if what questions are going to be asked. And as she gives attention to this anxiety, it abates and relaxation sets in. This is the beauty of the meditative approach that the patient starts to feel at ease during the consultation itself. Our job is to just facilitate the vital force.

D: Give this relaxation all your attention.

P: It feels light. Like body is travelling somewhere. Someone is asking me something and nothing is felt in body. Feels like I am flying somewhere.

D: Give this flying full attention and experience it.

P: My brain and my mind feel very free like I am getting sleep. Everything has become silent. Brain and body have vanished. It is just like vacuum. Nothing is there. I am floating somewhere but I don’t know where I am going. Just like an empty space. I am getting lost in this space.

D: Give this experience all your attention.

P: Now I feel I have stopped. Now I am going backwards. Feels like I am going backwards and backwards, down and down. I don’t know where I will go, again I have started going up. I am floating upwards. I am swaying like pendulum.

D: Just experience this swaying like pendulum.

P: I am in the sky, there is no ground below my feet. I am just going ahead and sometimes behind.

D: Environment of sky, no ground below your feet, going up and down… Give this your entire attention.

P: I am going high up; I am seeing a bright light. There is bright light in front of my eyes. As I am going higher and higher, I see a white light and there is no darkness. The light is spreading everywhere and I am travelling. My speed is reducing, I have become slower and slower. I feel I am going in right direction and I feel hot and there is power in my body. It is like a wave of energy running in my body. It is like a circle and there are rides in which you sit and go round and round. There is numbness in the body. It is a nice experience. I am enjoying this journey.

This is the point where the patient sees light and this light has a lot of potential to heal. If the patient is able to experience this light then a sense of ease starts to set in. At this point I ask them to take few deep breaths, ask them to feel the chair they are sitting, feel the floor, feel the place they are meditating and ask them to open their eyes when they are ready.  

The meditation ended there. From there, we began our classical case-taking process. The patient said that she dreamt of going somewhere, walking somewhere but not getting that thing and she just kept walking and walking. To her, it felt as if she was going by a bus and the bus was not moving, so she did not reach the destination. She was constantly trying to see and search her destination.

The patient recalled one more dream that she was going by a bus with her brothers and sisters. Midway the bus stopped and they all got down and waited for another bus. However, the bus did not come and they were not even aware of where they were going. The only thing she remembered about the dream was that she was travelling.

This was very interesting. At the beginning she said that she has this lichen planus and that she has been to so many doctors without result. Then in the meditation, we see that she is going back and forth but not reaching anywhere. The experience in the meditation is of enjoyment. When we asked about the dreams the same phenomena of trying is seen. This is the commonality of the case. Now our job was to find the experience of this trying and struggle. This would lead us to sensation. This trying was nothing but her coping mechanism which is ringworm miasm.

In Sensation Approach, depending on the pace, the rapidity and the level of desperation, the states of disease and remedies are identified and classified  into 10 miasms, ranging from Psoric which is the least and Syphilitic which is the most desperate. The other miasms include Acute, Sycotic, Typhoid, Malaria, Ringworm, Cancer, Tubercular and Leprosy, each having a distinct character. The situation of the ringworm miasm seems to be one at the borderline of the person’s capacity. There is hope of possible success and so a lot of effort, but each failure makes her give up and accept his limitations.

I then try to ask her the experience of this but she is unable to go into the experience. Hence we ask her to describe the chief complaint.

The patient said that she was on an outing in Jaipur with her family. During breakfast, the snacks felt too spicy, as if full of chillies. Her mouth started to burn and continued into the next day. She noticed multiple cracks in the mucosa of her mouth. The inside of her cheek had become rough. Her brother-in-law, a physician, prescribed some medicines along with milk and probiotic yoghurt. There was no relief at all. Then she was given B complex shots; got admitted and underwent all possible investigations. Finally, one physician diagnosed her condition as oral lichen planus. He opined that there was no treatment in modern medicine except steroids. However, the patient refused to take steroids. Then she tried Homoeopathy for 6 months without relief too, followed by all possible home remedies without success.

Her main complaint with this lichen was difficulty in eating. Any food felt too spicy to her. Her mouth was always dry and burning. She could not eat hot food at all. Cold ameliorated, so she retained some cold water in her mouth for 2-3 minutes after having any food, which provided some relief. Due to this condition, she was deprived of eating food items like samosa, kachori and chaat (spicy and fried Indian snacks). She loved to eat and drink, but could have only curd, while everyone had tasty food. She was interested in travelling and seeing new places as she was of the opinion that God has made so many things in the world and seeing them gave a good feeling. Apart from travelling, she loved to be in water, getting wet in the rains. She preferred travelling over buying jewelry and sarees.  She likes to remain active and she was a member of many clubs, she loved watching the dramas, going to the hospital then the club and would reach home by 11p.m. She did not like to sit idle or in front of television what she calls it as an idiot box, and to her it was a waste of time to sit watching the TV. It made her restless. It felt like a helpless situation, as if she was tied. The main experience for her to sit in front of television was of boredom.

Let us understand this case in parts. First we understand what comes up in the meditation. The most prominent thing that came was going up and down, back and forth and not being able to reach the destination. The experience of this is enjoyment. So we see that she is going somewhere, not reaching that place and this is an enjoyable experience. Then we move on to her dreams and in one dream that she narrates, she is going with her brothers and sisters in a bus and they don’t know where they are going and the bus stops in the middle and they are waiting for the next bus to come. Here again we see that they are travelling to a certain place but the bus stops and they are not able to reach the destination again. So the important thing that runs in these two subconscious areas is trying, not able to reach the destination and trying for the same.

The same phenomena of trying is evident where she is going from one doctor to another to another but there is no relief. Then she gives up, and then she tries Homoeopathy and then home remedies, and then she gives up again. So this trying and giving up is a pattern we see running through and through in the case. This is how she is coping; this is the miasm of the case which is nothing but ringworm. Next, our aim is to understand the sensation, that commonality, or theme which runs through the case.

We see that she loves enjoyment, travelling and she is fond of eating. She is a very active person; she likes to see the dramas, see the world, going to new places, and getting wet in the rain all of which make her happy. The other side is to be idle which she hates, especially to sit in front of television and waste time, which would be the last thing to do. This makes her feel bored. These are the two polarities of the case. On one side is the enjoyment and the other side is the boredom.

Last but not the least, we see that her disease is making her deprived of food or spicy things like chaat, kachori etc. She is forced to have bland food. So the main sensation in the case is:

  • Enjoyment by travelling, getting wet in the rains
  • Entertainment by watching drama
  • Seeing new places, travelling

The other polarity of the above is:

  • Boredom; sitting in one place in front of the idiot box (the television)
  • Pain
  • Blandness

Once we arrive at the sensation, our next job is to finalize the kingdom. We see here that the problem is not experienced as if there is something lacking or as a victim aggressor phenomenon. Here we see an issue of sensitivity and reactivity. So this sensation falls under plant kingdom. A systematic and prolonged study of cases led to a definitive understanding, that when classified at the level of experience, the patients’ experience could be classified into three kingdoms – the Plant, the Mineral and the Animal kingdom. The main experience or the Vital Sensation of the Plants is to do with sensitivity, of being affected and reacting. The main sensation of the Mineral kingdom is all to do with structure, whether I am lacking, if I have to complete myself, or if I am losing my structure; while the main experience of the Animal kingdom is survival.2

Further understanding of plant families led to knowing that the core experience of the vital sensation in them are expressed as two opposite polarities. Here in this case, the next step is to understand which plant family has pain, boredom, blandness, and enjoyment and entertainment as its central issue or core experience. This is seen in Piperaceae family. Unfortunately there is no remedy in Piperaceae family which belongs to ringworm miasm. So we studied all the remedies in Piperaceae family and the closest was the remedy Piper nigrum which was classified in a sycotic remedy.3

After a year of treatment, the lesions healed completely. In her follow up on 31st July, 2013, she said that there is no more pain and burning, no more deprivation of food. She is now able to eat spicy food with no aggravation. She was given Piper nigrum 200 for four months which was then stepped up to 1M. She was given approximately 1 dose every month, till her complaint settled completely. She is very happy as she can enjoy all food. Everyone asks her how the ulcers disappeared when the modern medicine doctors had given up on her case. She enjoys good health and feels very happy and grateful to Homoeopathy. She refers many patients to the clinic, being more than highly satisfied her own recovery.

Another case seen was of a 44-year-old man, suffering from palmer psoriasis since many years, first seen on 25th January, 2012. He had been prescribed many remedies by his wife who is a homoeopath. The remedy that had maximum effect was Staphysagria. He had many small eruptions on the palms, with cracks and occasional itching. When he entered our consulting room, we observed that he was averagely built. When he sat down, he was asked how he was feeling in the moment, to which he replied he was thinking that his consultation should go well.

Here, I again try to encourage the experiencing mind to the fore allowing it to experience whatever the life force has to experience.

As this is explained to him, he spontaneously resonates with the experience of being calm.

The moment he says calm I am happy, this means he is plugged into an experiencing mode from the thought mode. So, I ask him to close the eyes and experience his calm, to sink into this calm and trust his experience. While the patient is in an experiencing mode, the best way to facilitate his experience is by suggesting him to close his eyes and take few deep breaths and follow the directions which we gently give, which is in a way like guided meditation.

As the attention is focused on calm, he started experiencing stillness, peace and relaxed state of mind. He started to feel lighter. As the meditation continued further, he started getting some thoughts, where he was again directed to take deep breaths so as to facilitate the experiencing mind.

He started experiencing some sort of heaviness in the head and a sensation of heat in the face. The expression of heat was bright like sunlight.  As the meditative process intensified, he started to feel restless. The state of inactivity started disturbing him. At this point he resonated with the experience of the distress of this disease. It made him feel restricted. He said that the psoriasis robbed him of his freedom. He could not do what he wanted to do, like there was a restriction in touching things like soap, moisturizer etc. This restriction produced irritation and helplessness. While he was saying this, his hands became tight, folded.

His consciousness had plugged into what his vital force had to resonate with. Since his life force had identified this distressful experience, our role here is of a facilitator, a guide, providing him assistance to go further into this journey of life force.

As he came in contact with moisturizers the skin started to react, initially in the form of itch, which was an uncontrollable urge, then there were blisters followed by peeling and breaking off of the skin. This was not a nice feeling for him as it made him feel dirty. The use of his hands became restricted.

D: So what is the experience to have this dirty skin, which itches, cracks, peels off?

P: This produces lot of anger.

D: What is in the center of that anger? Anger is what you become. What is that feeling that makes you angry?

P: The pain in my helplessness. All those restrictions, all your movements are restricted, at home, at office and everywhere. It hampers my movements. My freedom is curtailed.

Here he spontaneously goes to another aspect of his life and said that his desire was to ride a bike or drive a car. The feeling was again of restriction that you cannot drive. He liked to move, be active and this state of inactivity either produced boredom or sleepiness.

Since he has spontaneously shifted to his love for driving it would be appropriate to ask him about his hobbies. When asked he expressed his passion about travelling. He also liked reading, solving challenging problems, music. But the most intense passion for him was travelling. It was interesting how he perceived the love for travelling. For him travelling was about seeing new places, new cultures, how people are being brought up especially how children are being brought up. He further elaborated saying that we had to ensure that children don’t cross limits, when they should be allowed to do a certain thing and when they should not be allowed to get carried away. He was the same way with his children.

He becomes very angry and violent when his children cross their limits. He would scream and shout at them. However, this reaction would then make him feel helpless. He feels that he should have handled the situation in a better way. And then he starts scratching his back again.

This is the general sensation in the case. His skin allows him to do and not do certain things and he as a parent allows and restricts his children from doing certain things. This is his other song.

We then move on to his dreams. He dreams of missing trains and passing stools. In childhood he had dreams of snakes. However, this dream did not carry enough energy. So we moved on to his nature. He likes doing things, likes to be active always. When he is free doing nothing he becomes restless. He says this with closed eyes. He has two major fears; one was the fear of cardiac arrest and the other was for his children’s education. He is constantly worried about these two things. The case ends here.

In the past he had joint pains with great difficulty in walking.  He has also suffered from jaundice and measles. During the whole case, it was observed that his legs were constantly restless.

On analyzing the case, we have to see what is the common to the case, what is it that runs through different aspects of his life, whether it is the skin complaint, the joint pains, his hobbies or his nature per se. A homoeopath must be skilled to trace out the commonality running through various aspects of an individual’s life. So, when we look at his case, his skin problems, his nature, his hobbies and his past history we see that the case revolves around the polarities of freedom, movement on one side and limitations, restrictions on the other. We see that he is sensitive to being restricted and wants to be free and on the move. The state of inactivity affects him, irritates, and frustrates him. This enables us to understand his experience as plant sensitivity. There is a sensation and there is a reaction.

This kind of sensitivity to restriction, limitation and the opposite of which is freedom, movement are classical of Anacardiaceae family4. Once the kingdom and subkingdom are clear, our next job is to understand the miasm.  This disease or eruptions come from time to time, they are not constant. They come up acutely and this makes him feel helpless, his work is hampered or hindered. This is malarial miasm. We see the same in his anger he gets angry acutely then repents about the same. This pattern of acuteness and acceptance is malarial miasm.5

The remedy from Anacardiaceae family with malarial miasm is Rhus radicans.

Also, when we read up our literature, we find the following references which match the symptoms of the patient.

Murphy’s materia medica6

SKIN – Itching, pricking, stinging. Dermatitis. Poison ivy and poison oak rashes. Hard, red eruptions. Inflamed tubercles, elevations, hard pimples. Pustules, blisters, watery pimples. Vesicular eruption, some disappear without rupture of the cuticle, others burst. Yellow, acrid fluid from eruptions. Erysipelas, especially in hot weather. Small boils. Ulcers. Swelling of the lymphatic glands.2

Here, we see the two sides coming together, the system on one side and the symptoms on the other. This is the perfect coming together of the new and the old school of thoughts, the Synergy. This gives us confirmation about the choice of the medicine.

After a year and half’s treatment, on 20th July, 2013, the patient said that the change has been remarkable. He says he is feeling good, more calm and patient. Physically he feels energetic. The skin is much better. Occasionally he has episodes of throat pain. The acute episodes subsided with the administration of the constitutional remedy i.e. Rhus rad. Blisters even if they come, heal on their own. It is not bothersome now. They vanish within a day. He received Rhus rad 200 to begin with, which was given once every month for 6 months. He has no more skin issues and he is off treatment and enjoying good healthy life.

In patients with deep seated pathologies and chronic suffering, it is important to create space and allow the experiencing mind to play its vital role. The journey from the thinking to the experiencing mind may be spontaneous or often facilitated. The patient has to be given encouragement to be in the moment and to trust whatever comes up, to have faith in his experience. The patient’s life force will lead the experiencing mind to where the energy of the case lies. Once the patient has connected to a resonating phenomenon then my role is to facilitate this process and take it as deep as the life force wishes to experience it. One of the ways to facilitate this process is by giving gentle suggestions to the patient to just give attention to this phenomenon. What comes when taken without any prejudice, combined with the understanding of the Sensation Approach, is a journey of awareness and healing.

References:

1,4 – Rajan Sankaran, The Sensation in Homoeopathy, Miasms, Second Edition, 2005, Homoeopathic Medical Publishers

2 – Rajan Sankaran, The Sensation in Homoeopathy, Vital Sensation and Kingdoms, Second Edition, 2005, Homoeopathic Medical Publishers.

3 –  Rajan Sankaran, Piperaceae,  An Insight into Plants – Vol 3, First Edition, 2007, Homoeopathic Medical Publishers, Mumbai

4 – Rajan Sankaran, An Insight into Plants, Volume 1, Second Revised Edition, 2005, Homoeopathic Medical Publishers.

6 – ReferenceWorks Pro, 4.2.1.1, Michael Hourigan and David Kent Warkentin, Kent Homoeopathic Associates.

About Dr Jayesh Shah:

Dr. Jayesh Shah is a renowned homeopath from the Bombay School of Classical Homeopathy. Practicing for almost twenty-five years, he has gained a reputation as a skilled teacher and a keen homeopathic prescriber. He is much sought after as an educator and has conducted numerous seminars around the world. He developed a unique method of case-taking wherein he uses meditative and other intensive techniques to explore the patients’ deepest and core issues, leading to a very deep level of understanding, awareness and healing in any given case.

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