Author: Shekhar Algundgi
From Surface to the Soul
Dr. Shekhar Algundgi
Consultant and faculty, ‘the other song: International Academy of Advanced Homoeopathy’
(Dr. Shekhar Algundgi presents a concise and clear discussion of the key points of the Sensation approach.)
In my introduction, I wanted to offer you all my dear colleagues, sentimental narration about Homoeopathy to show the song and harmony of an individual’s inner being. You were witnesses of how the inner world of the patient is revealed during sincere and cordial conversations, not only to the physician but to the patient himself. All of this considered together gives me the possibility to propose that the secret of Homoeopathy, on which the antagonists’ every sensible notion breaks itself apart, exists in each one of us. This secret is holy and the ultimate truth. It warms the soul of the physician and revives the sick. Over two decades of tidal experience hooking and pitching in this wonderful science, allows me to reevaluate the possibilities and prospects of health in one’s life. This is simply the influence of my beloved teachers who have been my mentors all through these years.
I would take the liberty to express my gratitude towards them in bringing forth this article and one of the cases from all those that have been enjoying the freedom of health as they would want it to be in their very own way. People have been exposed to deprivation, through sickness that very freedom of enjoying human health. It inspires fear not only in those who happen to witness life’s catastrophe, but also in the physician’s mind who bitterly acknowledges the helplessness of medicine.
We have voyaged together in the midst of treating the sick for decades. Tremendous developments have precipitated in our specialty and considerable new information has cascaded down the academic and professional homoeopathic world. We have seen changes in the way we view the individual, with the understanding of the mind-body relation, understanding nature’s innermost essence which gives the summary of its healing power, the way in which we approach towards treating it over the years since the time of Hahnemannian days.
Homoeopathy is a science that has the power to heal an individual. We often have patients coming to us and telling us, “Doctor, after starting Homoeopathy, my life has changed radically. I find myself better not only physically, but the things which used to affect me a lot mentally do not affect me as much now. I have grown as a person”. This is what ultimately every homoeopath is looking for, what gives him true satisfaction, because as true practitioners of the healing art we know that when healing occurs, it occurs at all planes simultaneously.
Dr. Hahnemann writes in Organon of Medicine in §6, ‘The unprejudiced observer…..takes note of nothing in every individual disease, except the changes at the level of the body and the mind (morbid phenomena, accidents, symptoms) which can be perceived externally by the means of senses; that is to say, he notices only the deviations from the former healthy state of the now diseased individual, which are felt by the patient himself, remarked by those around him and observed by the physician. All these perceptible signs represent the disease in its whole extent, that is, together they form the true and only conceivable portrait of the disease.
So when the master has clearly outlined for us, what is to be looked for in every case, what remains for us is to clearly follow his instructions by using sound senses, having freedom from prejudice and having fidelity in tracing the picture of the disease. Every case is individual, each expression varying – some may express only their physical symptoms, while some may talk of what their disease feels like to them, and how it affects them, while a few others are very emotionally disturbed from it. For example, consider how arthritis patients express themselves; one may say ‘I have arthritis and lot of pain due to it’, the other may say ‘I am extremely frustrated from this pain’, someone else may say ‘Dr. this condition is just not leaving me and I am harassed due to it. It is just latched on to me’, whereas someone else may say ‘The pain is as if my parts have become very stiff, as if they are bound and I have no space to move at all’.
The key to understanding their problems is to understand these expressions. And the expressions can be well understood if we have an idea about the level at which the person is speaking at. Once these expressions are understood, it is the physician’s skill in taking the case that helps elicit the expressions of disease at various levels – the body and the mind and helps to form a totality which reflects the disease in its whole extent – the portrait of the disease.
Experience, the interpreter between creative nature and the human race, teaches the action of nature among mortals: how under the constraint of necessity she cannot act otherwise than as reason, which steers her helm, teaches her to act.
- LEONARDO DA VINCI, Thoughts on Art and Life
Let us take an example; a patient once came to me for the complaint of sleeplessness. She could not sleep every night until a certain time. On enquiring further, I came to know that this had all stemmed from an episode where she was shouted at in front of an audience with apparently no fault of hers. I ventured a bit further and asked her what was the effect that time and I was told that she was extremely affected, feeling insulted as to how she could be treated like that. She then went on to describe how she is very sensitive to such things and a small scolding produces a state of severe disturbance in her, which causes in her tremulousness and palpitations. Now, if I were to look at her case, I see symptoms manifesting at different levels. Her main complaint – sleeplessness, the causation which led to it – an incident, the emotions associated with it – insult and the experience to such tendency to be insulted – sensitivity which results in palpitations and trembling. So, is only sleeplessness her disease or is her tendency to being sensitive her disease, where she is reduced to a state from it? We all know it is the entire picture, with the disturbance at all levels elicited which is her true disease and this portrait when matched in total with the remedy will give you the simillimum.
To understand the expressions at various levels, we who use the Sensation Approach have classified the symptoms into various levels. Why do we need to do this? If we are to see the example above itself, the symptoms go from apparently the superficial level to a deeper level, which forms the core of the individual. So it is a great advantage to the physician who now knows how to get the patient to the deepest possible level for that individual. This then when expressed at the core levels is the true expression and helps characterize the individual, helping his complaint to be differentiated from a person with a similar complaint. As stated by Hahnemann in aphorism 153 of Organon of Medicine ‘… in order to find among these an artificial morbific agent corresponding by similarity to the disease to be cured, the more striking, singular, uncommon and peculiar (characteristic) signs and symptoms of the case of disease are chiefly and solely to be kept in view; for it is more particularly these that very similar ones in the list of symptoms of the selected medicine must correspond to, in order to constitute it the most suitable for effecting a cure.’
Let us go through what the levels of experience are:
Level 1 – Name
The first level is the experience of a situation as just
The experience of a situation at this level ends with the naming or classifying of a situation or person or thing.
‘This is a computer.’
In medicine this would equate to making a diagnosis like: “This is asthma” or “This is a case of depression”.
Level 2 – Fact
At a somewhat deeper level one can experience a situation as a set of facts (Level 2). For example, with a computer, one can experience it as a series of facts such as features, specifications, price, manufacturer, etc.
Regarding a situation, one can choose to look only at all the objective facts of the situation like the where, when, and what of it.
Level 3 – Emotions
The desire to know these facts about a person or situation arises from a deeper level, the emotional level. We want to know a person and facts about him because we feel emotions for him like love, suspicion, hatred, etc.
Human beings view problems at an emotional level; they feel sad or happy in relationships, angry about the prevailing global situation, scared about the future etc. They view the external world in terms of situations and each of these situations is associated with an emotion. Our speech, actions, reactions and fears, all reflect these emotions. Emotions are experienced through the mind. Also they are individual specific.
Level 4 – Delusion
On looking deeper, we see that emotions stem from a delusion or imagination which is beyond likes and dislikes, happiness and sorrow. These imaginations or associations tend to evoke images which in turn give rise to certain emotions in us. So although our eyes see a certain thing, our mind may imagine it to be something else (i.e. a distorted perception of reality).
For example, we experience fear when we perceive danger, especially from some situation or object or person that we are sensitive to. No matter how safe an object may be in reality, if the eyes see it and the mind decodes it as dangerous, a complete chain reaction of feelings, sensations and reactions arises. The imagination evokes this fearful response. Our distortion of reality, our false perception will be exactly the same each time it happens throughout our lives.
Level 5 – Sensation
Although the delusion is manifest in the mind, it is not intellectual; it does not arise out of thought process, nor does it stem from emotions like fear, anxiety, hatred and joy. Examined deeper, delusion is a part of a much deeper experience, the sensation that encompasses the mind and the body. This is the general level and as the delusion arises from this deeper level, the experience of it can be “felt in our very bones”.
Let’s take an example. A person with a back problem continually says: “I need some support to my back. That is the only thing that gives me relief”. Regarding his emotional needs he says: “My friend’s give me support, I can lean on them.” He refers to his religion, god, or guru as his source of “moral support.” His experience of needing support resonates at every level within him. It is experienced not only in his body but has a deeper basis within his entire being, manifesting itself as a need for support emotionally, mentally, and spiritually. His basic sensation of “I need support” is felt at a level deeper than, but common to, both mind and physique. This is the level of sensation, Level 5.
Often for patients, their symptoms, their chief complaint, may be primarily in the physical or mental sphere. Whatever their chief complaint, their core sensation will always be clearly and most vividly expressed in their main symptoms. The way the patient describes the chief complaint, often his physical ailment - is an exact description of the deepest sensation that he experiences all over, in general and in his mind state, a sensation that lies at the core of his being. When I explore the mind state of a patient, I find the same sensation expressed there as in the physical symptoms, and vice versa. Since the sensation is felt or experienced at both the levels, the level of sensation is deeper than that of delusion. This sensation that links the mind and body must exist prior to its appearance in both these localities. It is therefore central or vital. Hence the term Vital Sensation. We also term it as the experience, as it is the experience running common in mind and body.
Level 6 – Energy
Finally, let us explore the origin of this vital sensation that is at a still deeper level. We cannot explore this deep level of Sensation by thinking about it intellectually. Rather, we must allow ourselves to experience it within our own body, and to observe the ways in which others express their experience of it (usually with their body language). Once we start exploring this level of sensation, we begin to notice certain recurrent body gestures. A gesture is a specific movement in a specific direction with a specific energy (force). For example, when we want to describe a pain in our abdomen which is of a twisting and stretching type, our hands will start moving in a specific direction in a specific gesture which is characteristic of our personal (individualistic) energy pattern. This Energy pattern is one of our deepest experiences, and it is from this level that the vital sensation arises.
Energy is represented by:
Level 7 – The Seventh
We explore the origin of Energy itself, or more accurately the fundamental origin or basis of all the levels, that deepest level which forms the background of all the other levels. Even deeper than the energy is the experience that provides the base of a given energy pattern. This is the Seventh level. The Seventh, or deepest level, can be compared to a blank canvas on which some pattern or picture can take form. Though it has no energy in itself, it still is individual and specific to the energy pattern that is going to manifest itself on the canvas. Probably this Seventh level is spontaneously experienced at the moment of birth and death as a blankness from which the form arises and into which it dissolves.
To experience an experience is the ultimate training. We are not alive and open to the experience.
We are more of a thinker and a dreamer. We miss the poetry of the experience.
One’s thinking can go round and round forever and still not experience the truth of the moment.
Most of life’s problems are rooted in dreams and expectations.
It is only in this comparison that one tends to be unhappy.
This comparison happens in a mind that is filled with expectations.
If one learns to be more of an experiencer rather than a thinker or a dreamer the truth of the moment will bless.
Truth is hidden in the experiencer and one has to be silent to see it, feel it, and merge with it.
Dreaming keeps one occupied and missing the moment.
How is the mind to be stilled?
Look at the subject who is looking at a world of objects. See the seer and not just the seen.
Let us see now how the concept of levels helps us understand our cases better. I will demonstrate it through a case:
A 29-year-old patient first consulted us on 30th June 2012, with complaint of cough coming every year between July and November.
The cough is dry, spasmodic and severe. During the cough, he feels pressure in the head and abdomen, feels pain in his ribs, and sweats on his palms and soles. It generally increases after midnight, especially from about 2:30 to 3:00 AM. Regarding the pressure in his head, he said he feels that the nerves in the temporal region get stretched. Each forceful cough makes him feel as if his breath is blocked near the heart, and he feels as if he has to take a sip of water to relieve it. He also perspires on his palms and soles when looking down from heights. He has some black moles on his face which are slowly increasing in number.
(This is all information at the level of name and facts. I have a few peculiar symptoms here, which I will consider and repertorize. However this information in itself at this stage is not enough to give me the characteristic, which will help me find the similimum. So I venture further in order to complete the portrait).
At the other song clinic, the patients are asked to fill out a case record form before they come in for the first consultation. Interestingly, we found that in this case record form, the section on dreams was the most prominently filled out. In the interview, the case did not seem to move ahead further along the lines of the chief complaint, so I then asked about his dreams.
(For me, this was a hot spot, I had direct opening at the level 4, level of Delusions and Dreams, I knew if I explored this a bit further, many more characteristic symptoms would be revealed).
He said that once he was in Bangalore, staying in a bungalow with two of his friends. While they were napping in the afternoon he dreamt of a dead body on a stretcher. The same night he dreamt that he was sleeping next to a window and someone was pulling his hair. When asked to describe the dream further, he said that he was lying on his back near a window, and he felt someone pulling at his hair. He was terrified and began shouting, and then he heard the sound of a lizard. He was shrieking in his sleep and was awakened by his friend. He said that he felt that he was being pulled away in the dream and he was very afraid. He was sweating, while experiencing an overwhelming fear that someone was pulling him away and would do something to him. In the dream he was shrieking, ‘Leave me!’ and crying out for someone to help him. He felt that he needed to find a way to release himself from this suffering as soon as possible. When asked about the word ‘released’, he says, “It is like completing a task as soon as possible, so that there is no tension later.”
He describes another dream, in which he is standing in a church with a friend, and wherever he looks there are dead bodies. He sees there is even a dead body lying between him and his friend. The priest at the church asks them, “Who is with this dead body?” He asks them to take it away with them. His friend then has to leave to go to work, so the patient asks the priest to send someone to help him to carry the coffin. Someone comes to help him, they are carrying the coffin, and on their way the helper slows down. Then the patient sees that the grass surrounding them is full of coffins, which turn shiny, and suddenly from those coffins terrifying faces rise up in front of him, and he starts shouting and running in fear.
(This is very good, I get the delusion and through it, I am able to get the symptoms that he is afraid of coffins, terrifying faces. Through this, when asked how he felt, he said – it was fear, panic; ‘Leave me!’ and crying for help. The emotional level was also clear when asked about the feeling. This is good, but since I know I can take it a bit further and that will give me something which is very individual to this person, I persist and ask him to go into the experience within him in those moments of fear. Here I am trying to take him a level higher to Level 5, the level of Vital Sensation).
When asked about this experience, he says it was like a shock, something sudden, and he was very frightened. His heart rate increased and he felt as if he was suddenly being attacked, “as if something comes on you suddenly.” He was frightened that something would happen to him, that he would be injured.
He goes on to describe yet another dream: he was going to his aunt’s place late at night, when there was no one else on the road. A stranger stopped and warned him against going ahead as the road was bad, but he tried to gather courage and go ahead, as it was urgent that he reach his aunt’s place. In the midst of his journey a dog suddenly ran towards him and bit his hand. He started fighting off the dog and then some more dogs attacked him. He was terrified and woke up shouting for help. In that situation he was extremely frightened and felt defenseless, as if he could do nothing to survive. He said the worst part of the dream was when all the dogs were attacking him from different sides, one biting his hand, some biting his legs and some biting him from behind. He said it was an experience of intense pain and suffering.
He said that at times he also dreams of snakes. In those dreams he is walking and a snake crosses his path.
In another dream, he had gone with his family to a beach and they all drowned, and he was then all alone. He said that in the dream he was watching himself standing on the rocks, and watching them all drown. This was a very sad and frightening dream for him. He said that the experience is of a big, sudden danger. Then he feels very sad and alone, and hollow within, as he has no support. He feels there is no one with him now to give him moral support or encouragement. It happened suddenly, and the experience within him is feeling shocked and benumbed.
As his dreams all reflect frightening incidents, I asked him to tell about his fears. He says that he had great fear of darkness during childhood, especially when he was alone. He used to feel someone was around, as if that person would suddenly appear in front of him and something would happen to him. Even now when he has to walk alone in a dark street at night, he always feels that someone is behind, following him. The feeling is that he will be attacked from behind, that the person will catch him and strangle him. In this situation he experiences intense fear, his heartbeat races, his lower limbs tremble, and he starts to perspire. His sleep is often disturbed by frightful dreams.
(He gave a series of delusions and emotions, each one when explored further came to the same experience).
He wants covering when he sleeps, and he has trouble tolerating cold weather. Normally he does not perspire much except during physical exertion or when he is frightened.
In this case, I began by asking about the chief complaint, the case (level 1 and 2) which yielded a few characteristic symptoms, but when we then explored his dreams (Level 4), it was like hitting a gold mine. Not one but multiple dreams were narrated, one after another, all of which were frightening. The dreams gave us some direct rubrics, but also led us into the patient’s core experience (Level 5). One of the most remarkable things about Homoeopathy is that if you probe deeper into each phenomenon, you come ultimately to a core experience, and when multiple areas are explored in this way, you find one common theme, one experience running through all areas, which then becomes the most characteristic for a given case. This leads us to a simillimum as what can characterize a case better than a chain of symptoms at various levels, forming a totality, which in turn conveys the portrait. The totality thus formed is total – a certain situation creates a certain feeling and the patient’s experience, and this is something very individual and characteristic for this patient. Such strong expressions at every level make us more sure about the remedy.
For this patient, everything came to the common experience of a sudden fright, a sudden shock which comes when least expected, and leaves him benumbed. The experience in his body is sudden terror, with increased heart rate, sweating, and trembling in his lower limbs. This experience is common to all his dreams, be they of dead bodies, of frightening faces, of someone pulling him away, of snakes, of his family drowning or of dogs attacking. And we found that this core experience is not seen only in his dreams but also in his childhood, in which he had fear of darkness, and in his fear of being alone in the dark, where he feels the presence of someone behind him who might suddenly attack and strangle him.
His active reaction to this experience is shouting loudly, shrieking for help and running away. He gives us precisely the Sensation of the plant family, Solanaceae. The Solanaceae Sensation can be summed up as: violence, sudden, splitting, bursting, spasmodic, apoplexy, violent terror, pursued, life or death, killed, snakes, pulsating, constricting, choking. The active reaction of this family is: senses acute, hurried, shrieking, and startling in sleep, spasm, escape, panic, rage, fight or flight reactions, striking. (From Sankaran’s Schema. Mumbai, India: Homoeopathic Medical Publishers, 2006).
The miasm of this case is acute; the patient’s experience is of something sudden, to which he has to react as a ‘do or die’ situation; he has to escape, to get out of it immediately, and he feels shocked, terrified and benumbed. The remedy coming up highest in the graph is Stramonium, one of the acute miasm remedies in Solanaceae. Here I become all the surer of the remedy, as the system and the symptoms were coming to exactly the same point.
On considering the rubrics of the case, from the symptoms at Levels 1-4, we get:
Thorn-apple or Datura expends its force of action on the BRAIN, producing marked and persistent disorder of the mental faculty; hallucinations; fixed notions, terrifying delirium etc. Therefore it is a remedy of TERRORS; but it does not in its ordinary effect cause actual pain.
Trembling of limbs. Ill effects of shock, fright;
Awakes terrified, knows no one, screams with fright, and clings to those near him (child). DREAD OF DARKNESS, Fearful hallucinations which terrify the patient, sees ghosts, vividly brilliant or hideous phantoms, animals; jumping sideways out of ground or running to him. Wildly excited; as in night terrors.
Desires company; shy, hides himself or tries to escape.
Remedy given: Stramonium 1M, 1 dose
Levels of experience also help us decide the potency for a given case. The patient is at level 4, as his case is full of spontaneous dreams and delusions. The potency level corresponding to Level 4 in our experience is 1M.
Follow up after 6 months, 6th January, 2013:
The patient reports that his cough is gone. His sleep is very good, rarely disturbed, and he now feels refreshed after sleep. He says, “Now I don’t get any dreams in my sleep. Earlier I used to see frightful faces in my dreams, or my family drowning, or that I was being pulled away. I do not get any of these now.”
He says that he feels he is better by 90%. He has even noticed an improvement in his memory function. He says, “I feel very energetic these days. Now I am very happy, not afraid like earlier.”
Follow up on 22nd November, 2013:
D: Yeah tell me how are you doing.
P: I am doing very well doctor. Frequency of getting cold and cough has reduced to 90%. My sleep pattern has become good; I get sound and refreshing sleep.
D: How would it be previously?
P: Previously I used to get pain in my chest due to coughing. But now all those complaints are not there.
D: What about your dreams?
P: No; now I don’t get such dangerous dreams since then.
D: Which dreams did you used to get?
P: Previously I used to get dreams of dangerous faces; dead bodies; big dogs attacking on me.
D: What’s the feeling in that dream?
P: Feeling is such that that dangerous face would come and something bad would happen with me. Only thing in my mind that came is by any way I have to face the situation and save myself.
D: Physically what’s the experience at that time?
P: Like energy in my body has become less to fight with them.
D: So overall what’s the % of change that you feel?
P: 90% better.
(Excerpts from: the other song – by Dr. Rajan Sankaran)
(For further references refer: the other song – Chapter : The Levels – by Dr. Rajan Sankaran, Sensation Refined – Chapter: Potency and the Levels – by Dr. Rajan Sankaran)
Posted in Clinical Cases, Homeopathy