Diagnosis

9 DiagnosisCase takingCase taking is the process of coming to a diagnosis, meaning finding the cause, the essence of the disease. Case taking is the beginning of therapy. One must first have an understanding of what the problem is before one can successfully treat it. Case taking is an investigation.Compassionate inquiryThis can best be done with compassion. Gabor Maté describes it beautifully as compassionate inquiry. It is important not to add one's own ideas and opinions to the case, not to project one's own feelings and thoughts. The aspect of compassion helps the patient in his own inquiry so that he will not need to go into defence against being attacked and criticised.IncompleteOne problem with case taking is that patients does not understand their illness, otherwise they would not have it. There is always a part that the patient does not know, does not see and therefore cannot describe. The core of the disease, the essence, is hidden, as if the patient has a blindness to it.
But it can often be deduced from the symptoms, mostly from the illogical ones. And they appear illogical as long as the cause is not seen and understood. It can be deduced from hobbies, fears, dislikes, desires, needs and so on. Dreams can show the cause of the problem in a symbolic way. It can be triggered by favourite stories, films, art, music and songs.
The illness can be passed on from ancestors. Traumatic experiences in the family can be passed on to the children. A well-known example is the holocaust, where trauma is passed on to later generations. This principle is well known from family constellation therapy.
The cause can also lie in trauma in early childhood or even in pregnancy. Then the patient is also often not aware of what the cause is. Then strategies like hypnosis and regression, or drugs like ecstasy, ayahuasca, ibogaine or psilocybin can reveal the underlying trauma. This also applies to issues from past lives.
Intuition can also play a big role, as can synchronicity.StrategiesThere are several ways to do this.
The first strategy is to take all the signs and symptoms and see which disease has them. This is a kind of brute force analysis. The problem with this is that symptoms can be put together that come from different problems, from different personalities. This is a big problem.
It is similar to confusing two plants that are entangled: you can take 43the flower of one and the leaf of the other, which does not lead to a correct identification.
A second strategy is to look for particular symptoms, symptoms that are rare and peculiar. This analysis is similar to plant identification: a particular shape of the leaf or flower allows a plant to be identified. One can recognise a dandelion by its leaf shape, its flower or its seed balls.
A third strategy is to use a combination of common symptoms. An example in identifying plants is that Bignoniaceae are climbers and have pinnate leaves; it is the only family that has that.
The strategy highlighted in this book is to work from the general classification of objectives, strategies and affiliations; it is the classification into Kingdoms, Series, Stages and Phases.Diagnoses versus symptomsDiagnoses as treated here are very different from diagnoses in official medicine, where diagnoses are actually symptoms. For instance, depression is a symptom and not a diagnosis. In fact depression or depressive feelings can be part of any disease, and they often are. This can be understood from the fact that disease is linked to a goal, which can be unavailable or can be lost; in both cases it leads to depression. In this respect depression can be seen as an adaptation to failure. It is a strategy to stop doing the same thing, since it was leading to failure, and to start rethinking and reevaluating what one was doing. In that sense depression is a good symptom.What, where, whenThe entry point of case taking is mostly the problem, the symptom, complaint or pain. In essence each problem has three aspects: what, where and when. That is the case for both physical, emotional and mental problems. Another way of looking at it is as subject (the where), object (the when) and the relationship between the subject and object (the what). These 3 aspects are the basic components of every sentence, as Wittgenstein has pointed out.
The location, the where, is linked to the Series and the motive. The action, the what, is linked to the Stages. The when is linked to the Phases. The when is linked to what is mostly seen as the cause, but it is everything that influences the problem, making it better or worse.Events TriggersA complaint is a kind of event. Important is to find the cause: which event, situation, problem or worry preceded the complaint. In that event one can find all three aspects of a problem: what is happening, where and when or by what or by whom.
Let us look at an example: "I have a grudge toward my friend as he did
not respect my opinion as a doctor." The grudge is what is happening and what I am doing. This is the Stage. Not feeling respected as a doctor is where it is happening: in my desire to be respected as doctor. This is the Series, most probably the Silver series. My friend is the trigger, the cause. The theme of friends is connected to Phosphor, which is in the position of Phase 5.
After analysing this way one can often find similar events in life. This can be triggered by asking which situations in life have given rise to the same kind of feeling. Similar situations come to mind that can seem different at first, but actually have the same basic theme. This is a confirmation of the personality that was also triggered in other situations. One can then better see the similarity and leave out other less specific aspects of the situation. In general, the life story can be seen as an event. It can be analysed the same way.SpecificitySymptoms can be categorised in specific and nonspecific symptoms. Depression is a nonspecific symptom, as we have seen above. There are many such symptoms. One group are symptoms that are general for having a problem. The problem can make one irritated or can lead to giving up and so on.
Problem symptoms are: desire, aversion, fear, anxiety, depression, anger, irritability, rage, restlessness, impatience, sensitive to criticism, critical and so on.
A second group are distraction symptoms, that arise from being absorbed in the problem and not being present in the here and now. These kind of symptoms cannot be used for analysing the case. They will not lead to a diagnosis, but they are often the start of the inquiry. Distraction symptoms are: absentminded, forgetful, mistakes, memory problems, being out of the here and now.Levels of symptomsSymptoms can also be classified according to the level at which they arise. The start is often physical complaints like pain and physical limitations. These can be linked to the first level, the Hydrogen series. At the second level are sensations. The central sensation of a patient can be used as an entrance into the case. This is called the vital sensation. This entrance is linked to the Carbon series.
Another strategy is to focus on delusions, ways of thinking or seeing the world. It is often called the basic delusion. This entrance is linked to the Silver series or Gold series.
Each starting point is equally valid; each entrance can bring one to the same diagnosis. Personalities have their own expression on all these levels. Symptoms on each level can lead to a correct diagnosis.Symptoms and SeriesThe relations of symptoms levels and Series are:
1 Hydrogen series 2 Carbon series
3 Silicium series 4 Iron series
5 Silver series
6 Gold series
7 Uranium seriesRosa’s case continuedUsing the classifications condition of the patient with kidney cancer. Her aim is to occupy a good position in society and achieve prosperity. This is the theme of the Silver series, row 5 of the Periodic system. Her aspiration to uphold the good name of the family business fits the Silver Series. And it also fits the Silicium series, one’s image for friends and family.
She has a very good connection with her father, which is a manifestation of Phase 4: she has a central place with her father. She herself also has a central place in her family. The element of Silicium is in the centre of the Silicium series, which is Phase 4 (also Stage 10). Her path is one of a legal struggle. This is a manifestation of Stage 12, the Stage of full struggle. It is a state of too much of a good thing. This is also the state of cancer: growth is beautiful, but too much growth is fatal. Cadmium is at Stage 12 of the Silver series.
Cadmium and Silicium in a compound make cadmium silicate. In homeopathy it is called Cadmium silicatum.