[Philip M. Bailey]
In my experience, the mentals are still the least understood, and the most underdeveloped aspect of homeopathic prescribing. Yet the personality of the patient is at least
as important as the physical characteristics in individualising the case and finding the similimum. So often remedies are prescribed on the basis of a few physical symptoms, along with gross simplifications of the patient's personality, and fail to act. This gives the unfortunate impression that homeopathy is a vague and unreliable practice.
It also gives rise to the relatively common attitude amongst homeopaths that the patient
belongs to several constitutional types simultaneously, any of which will help at any given time. This is nothing more than an excuse for inaccuracy, and it results in the homeopath failing to persist with case taking and analysis to the point where the mentals are truly understood.
It is true that some patients have more than one layer of pathology, and that each layer corresponds to a different remedy, but the layers must be dealt with in the right sequence if progress is to be made, and the personality of the patient at any given time will correspond primarily to the most superficial layer, which represents the present frequency of the patient's vital force. By familiarising himself or herself thoroughly with the personalities of the major constitutional remedies, the homeopath can avoid endless hours of confusion and uncertainty in case taking, and can rapidly become an effective prescriber.
The profiles that are contained in this book are the result entirely of my own clinical experience. They are not derived from previous materia medicas, and they sometimes differ considerably from the classical profiles that have been handed down through the years. I believe that this is due to the tendency for the original remedy pictures to
be copied over the years from teacher to teacher, and from materia medica to materia medica, with the result that the most obvious characteristics remain, and tend to be magnified, whilst the more subtle tendencies are left out, since they are not regarded as reliable. Furthermore, the subtle understanding of personality is a relatively recent phenomenon, growing out of Freud's discoveries of the unconscious, and the subsequent developments of depth psychology. This is another reason for the crudeness that
we find in the mental profiles of the old materia medicas. Thus Natrum Muriaticum is generally portrayed as an introvert, yet I have come across many highly extrovert
cases of this type. Similarly, Thuja tends to be portrayed as a nasty character who is bordering on the psychotic, whereas the truth is far more normal and varied. (I have
never come across a Thuja patient who felt that his legs were made of glass!)
In portraying the mentals, I have tried to get across the 'essence' of each type, which is often perceivable in the absence of more localised specifics, and indeed may even
seem to contradict them.
Thus the essence of Lycopodium is a lack of self-confidence, and this must be recognised by the homeopath through the confident exterior that many Lycopodiums adopt.
An understanding of the essence of the mentals is just as important as an understanding of the specific symptoms of a remedy.
Men who try to give her orders or who neglect her.
Tub. and Lach. love freedom, and will not take kindly to being restricted in any way. Those patients who do flare up in a temper fairly regularly are likely to be one of the following volatile types;
Alum. Anac. Ign. Lach. Nux-v. Merc. Sep. Sulph. Stram. and Verat. Some Staph. people are also very prone to anger, though only the "wild" type is likely to express it.
In general, the more sophisticated a patient is, the less they will admit to weaknesses. Patients who have changed consciously through their own efforts, or with the help
of therapists, tend to deny negative traits that they possessed until quite recently. If you suspect that a person is a particular type, but they deny having the weaknesses
of that type, ask if they used to possess them. Very often the patient will willingly confirm this. Personal growth does not change the constitutional type, hence previous characteristics can be used in the homeopath's assessment. In this regard, I find that an enquiry into the personality of the patient during childhood is often very helpful.
As people get older, they learn to compensate for their weaknesses, to control their excesses, and to hide traits which are not socially acceptable. The personality is relatively unmodified by such adaptations, and often reveals the constitutional type very clearly. Only Pulsatilla and Calcarea children are likely to change types as they grow older.
Just as patients often possess the trait which they go to great lengths to deny, so patients who are determined not to be like their father or mother often share the same constitutional type with this parent. Thus I sometimes make enquiries about the personality of such parents. The person who showers her child with love and attention, determined not to be like her cold mother, is likely to be Nat-m., whilst the man who drops out from society, and professes to be indifferent to what others think of him, probably belongs to the same type as his Lyc. father, who tried hard to make it in the world, and always courted popularity.
A patient's profession can reveal a good deal of use full information, and should not be ignored.
Ars. and Nat-m. have good organisational skills, and are often to be found in administrative positions. Counsellors and therapists are often Natrums, being very good
at listening to others, but not so keen to talk about themselves. Calc. often to be found in jobs that are either practically oriented, such as a mechanic, or else in clerical
and secretarial roles. Calcarea tends to avoid taking on too much responsibility, and often accepts work well below his intellectual capabilities.
Lyc. often to be found in scientific and computing positions, in salesman jobs and also in businesses of their own. They are also common in the teaching professions.
Artistic skills are seen most commonly in Lach. Nat-m. Phos. Sep. Ign. Sil. and Med.
Sulph. and Nux-v.: natural leaders, and are unlikely to remain in subordinate positions for long. If they are not at the top of an institution, are likely to be self-employed.
Sep.: often attracted to the healing professions, particularly to nursing, physiotherapy, and other 'hands-on' therapies.
Puls., if she works at all outside the home, often chooses one of the caring professions, whilst Tub. seeks either mental stimulation from his work, or adventure.
There is a saying amongst homeopaths that one should never believe what the patient says. Whilst this is deliberately provocative, and overstates the case, there is some
truth behind it. Not only do many patients try to hide their weaknesses from the homeopath, many more succeed in hiding them from themselves. Hence one should
not expect patients to give accurate accounts of themselves. Often the way a patient says something is more important than what they say. I remember an interview with
a young campus religious minister who was seeking treatment for post-viral malaise. He appeared open and friendly, and professed to being relatively liberal and
progressive as ministers go. There were few helpful mental features, and the physicals were also rather non-specific. It eventually became clear that the most noticeable aspect of his personality was a certain formality and politeness that was more commonly seen in his grandparents' generation than in his own. Furthermore, his very position as a religious minister on a university campus, surrounded by predominantly boisterous and hedonistic students (who were of the same age as he, or only slightly younger)
served to emphasise his formality and 'squareness'. It was this stiffness of character that led to the prescription of Kali Carbonicum, rather than the words he chose to
describe himself. Very often the impression that patient gives is more useful than the content of his speech.
Thus the patient who is very matter of fact, and is visibly impatient at having to discuss his emotions, when all he wants is treatment for his backache, may well be Nux-v. Similarly, the patient who denies being fastidious or prone to anxiety, but who observes the homeopath throughout the interview with an air of wariness or suspicion, and wants to know exactly what side-effects to expect, is likely to be Ars. With experience, the homeopath learns to give as much importance to the non-verbal cues as to the verbal ones.
Sex is a subject that many patients and homeopaths avoid, yet it can reveal a lot of helpful information, and is worth inquiring into when the remedy is not clear.
Again, the attitude with which the patient responds is as important as the words they use, or more so. An obvious reluctance to talk about sex is common with Nat-m.
and Thuja, both of whom are prone to guilt feelings. On the other hand, an easy and even enthusiastic approach to the subject is often seen in Caust., some Ignatias,
Lach. Med. Merc. Phos. Sulph. and Arg-met. The rest tend to be in-between.
Lyc. men often have issues about virility, which can lead to one of several approaches to talking about sex. If they are aware that they doubt their virility, they may brush
over the subject, saying simply,
"There's no problem there." Alternately, they may boast of their sexual prowess, either directly, or using their tone of voice in the manner of a men's locker-room exchange, "Well, there's CERTAINLY no problem on THAT account." An honest and direct third approach is also seen quite often.
Some types are rather shy but still relatively straightforward when talking about sex. These include Alum. Bar-c. Calc. Chin. the Kalis, Phos. Sil. and Staph. Will probably exhibit some embarrassment when asked about their sex life, but this will not usually stop them from speaking about it.
I like to get some idea of the strength of the patient's libido. One way of doing this is to simply ask, "Would you say your sex-drive is high, low or average?" Most people reply average, but those with a particularly high sex-drive usually say so (Arg-met. Hyos. Lach. Lyc. Med. Nux-v. Plat. and Sulph. A low sex-drive is reported by worn-out Sepias, and also by Chin. and by those Natriums who are having difficulties in relating emotionally to their partner. If, for some reason, I doubt the accuracy of a patient's reply,
I may enquire further, asking, "In a good relationship, how often would you ideally like to have intercourse?"
Often during a difficult case I find it helpful to narrow the personality of the patient down to one that is primarily mental, emotional, intuitive or practical. Once the case has been narrowed down to a few remedies, selective questioning can be used to rule out all but the correct remedy. Thus, if the choice is between Caust. Med. Lach. and Phos.
an enquiry into the patient's sense of social justice may help to support or eliminate Causticum, whilst a specific question about "spacing out" may help to identify Med.
Sometimes it happens that the physicals seem to favour one remedy whilst the mentals favour another.
In my experience, in chronic conditions the mentals tend to be more reliable in helping to find the correct remedy when the two don't agree. Partly due to the enormous
overlap in physical characteristics between the remedy types, and also to the fact that the list of possible physicals for each polychrest is so vast that it cannot be comprehensively learned, or even covered thoroughly by the repertory. There will always be physical symptoms of any given remedy that are not familiar to the homeopath. Obviously, if the physicals of the case are keynotes of one remedy, and the mentals only vaguely fit a different remedy, the physicals should be given more weight.
There are atypical cases of just about every type from the mental point of view, which can mislead the homeopath. In such cases, the essence of the personality, if it can be divined, may be more useful than the particulars. The essence is a theme that runs through every aspect of the personality, such as the physical insecurity of Arsenicum.
In other cases, a single strange, rare or peculiar mental trait can reveal the correct remedy. The hand-washing compulsion of Syphilinum is a good example. Every homeopath must realise that information that is volunteered by the patient is far more reliable than that which is given as a response to a specific question, especially if it is a leading question (one that can only be answered by "yes" or "no"). For example, I have found that patients who volunteer that they get the feeling that someone is behind them
when out walking at night are almost always Med., whereas those that say "yes" when asked if they get this experience may belong to any of the constitutional types.
As a compromise, if the patient does not volunteer a particular keynote, an open question can be asked to try to flush it out. For example, one might ask the patient if she
is prone to sixth-sense feelings when out alone at night or whether her imagination tends to be very active when alone at night. If she says yes, asking her to elaborate will usually reveal Medorrhinum's characteristic symptom if it is present.
It is extremely important to begin the interview with as much of an open mind as possible. Although a remedy or two will usually occur to the homeopath early on in the interview, he must be flexible enough to abandon it at a moment's notice if new information changes the picture.
There is another saying that during a good homeopathic interview the patient will laugh and cry at least once. Although not literally true, it expresses an important point; that the interview should be of sufficient breadth and depth to reach the heart of the patient. All too often homeopaths obtain a superficial and misleading impression of the patient's personality by failing to delve beyond the immediate replies that are given. This may be due to laziness on the part of the homeopath, but it is just as often due to
fear of embarrassing not the patient, but himself, and to feeling uncomfortable with the expression of painful emotions. The more a homeopath is in touch with and comfortable with his own self, the more easily he will win the confidence of his patients, and discover the real person that lies beneath the appearance.