September 18, 2012
MB – Welcome to the Hpathy Hot Seat Dr. Dinesh. It is a pleasure to have you with us. I was recently reading your new book – The Scientifically Intuitive Case Witnessing Process – The Journey of Three Steps. I must say it is a wonderful work that you have done and I really enjoyed reading your book.
Let me begin with a basic question. From the very early college days we used to hear about ‘case taking’. Then a few years ago, a new term, ‘case receiving,’ was introduced. And now you have introduced another term – ‘case witnessing’. What is the difference between case-taking, case-receiving and case-witnessing?
DC: When I started doing case taking, during that time I was reading Buddhism. I came across this term ‘witnessing’ where they use this word for their meditation.
A witness is someone who has a first-hand experience of something; he neither adds anything, nor receives anything. Most of the time when we take a case, we either ‘take’ or ‘receive’; we do not witness as is. Often we receive the case according to our perception or ‘take’ the case according to our pre-existing knowledge of case taking. I wanted a technique where we are witnessing the whole pattern as it is. And the whole aim of ‘witnessing as it is’ is according to that patient. That is why ‘case witnessing’, where you witness the cases without adding or subtracting any data. And you keep witnessing till the remedy arises by itself.
MB: So how does that differ from case-taking and case-receiving in practice?
DC: Earlier a question in my mind was –why are two homeopaths unable to come to the same remedy? Why are two homeopaths unable to come to the same understanding of a human being? And the reason I found was that most of the time case taking is done mostly according to our pre-existing knowledge of case taking, which we have learned in the books or which has been taught by our teachers. But it was never done according to human individuality. If we believe in individualization, then the whole method of bringing out individualistic features of a patient has to be individualistic. And that would only happen if we “witness” the case in a passively alert way, rather than taking the case according to our knowledge of homeopathy. For me it was subtracting all the knowledge of homeopathy that we have, and witnessing the case as is. Like in court we have a witness, the person who gives you a first-hand account of what he has seen, without adding or subtracting anything from it.
MB: But when Dr. Sankaran introduced the term ‘case receiving’, wasn’t it a very similar concept – that you don’t interfere and let the patient flow to his natural conclusion, that you let the patient move in the direction that she wants without interfering and without interpreting the data? So how does the technique of case witnessing differ from case receiving?
DC: I was with that technique for almost five years. What I found was that despite using that technique, most of the time we were not able to come to the real center of the patient, according to the patient. Most of the time I felt that the case taking we were doing was according to the existing knowledge of the system that we had created. A method that was according to the center of that human being was required. I wanted a case receiving process which is scientific, simple, according to the center of the human being and easily reproducible. So what I asked was – can I, in each and every case, reach the center of the patient and use an individualised approach according to the need of an individual patient?
MB: So the question is, can you?
DC: It is a good question. This is what I was trying to do since the last ten years. I will tell how I came to this method. I was watching the universal phenomenon and I came to the conclusion that everything in the Universe happens in a three-step process. Initially we are putting together information scientifically, but the things are not connected and coordinated. Then gradually things start connecting. Then a time comes when things connect and coordinate to come together in a single pattern. Let me give you an example. Let us say you are learning to drive a car. Initially you know everything, where is clutch, where is brake, where is accelerator. But when you start driving, your mind and hands and legs are not coordinated. Then a time comes when things start connecting and you can drive with effort. Finally comes a time when everything is so coordinated that you can drive effortlessly.
So I wanted a system where the PQRS symptoms, which are not connected, gradually start connecting in a single pattern. We initially put in scientific effort, but gradually the whole process becomes intuitive, effortless. So if you look at my case witnessing process, which is in three steps, these three steps are actually that. Initially you give free-floating attention to your patient where, with all your knowledge of case taking, you are just listening to the patient. And you are getting PQRS symptoms, maybe at the local level or mental level or general level or holistic level. But they are not connected. Then you keep giving them space till you see that out of these, there is one thing that is coming up again and again at the local, general and holistic levels. Now that becomes the center for me. It becomes the key to open the door of the subconscious and beyond (subconscious).
Then I start the second step, that is active case taking. Now I know that this is the right key, this is the PQRS symptom that will open the door of the subconscious and beyond. Then the other PQRS symptoms start getting connected to it. I know I am at the right path, when the verbal and non-verbal language starts becoming connected. And the moment it starts connecting, I know it is time to begin the Active-Active case witnessing process. You keep on doing the case taking till every PQRS symptom gets connected as a whole.
I wanted a method where everything in a case happened according to the patient and not according to my knowledge. Where I give him space, then I understand what is the real center of him that is a appearing in many areas. Then you make sure that this is it. Once you are sure of it, then go on till all PQRS get connected in a single pattern. Then you give a remedy where everything is connected like this.
MB: So, can you elaborate these three steps for the homeopaths who have not read your book or who are not initiated into the case receiving and case witnessing process?
DC: I would like to tell you the whole story. The question that was bothering me was – why couldn’t two homeopaths come to the same remedy and same understanding of a human being? Why two homeopaths belonging to classical homeopathy and modern classical homeopathy, never come to the same understanding of a human being. If we believe in laws that are simple, then naturally each and every homeopath should come to the same conclusion.
The first thing that I did in 2003-2004 was to understand this problem. Then when I read Hahnemann’s books again, I found that Hahnemann speaks about the PQRS symptoms at the local level, PQRS symptoms at the general level, and PQRS symptoms at the mental level. Then definitely there must be a PQRS symptom which is coming up at the local level, physical general level and mental general level. Naturally, then this is the PQRS symptom at the holistic level.
So in order to do a successful classical homeopathy I need to find out the PQRS symptoms or the individualised symptoms at the holistic level. Those expressions that are there in each and every area that the patient talks about – is what I call individualization at the holistic level. I feel that individualization at the holistic level is most important.
And what is a simillimum? I believe that a simillimum is where the PQRS symptoms of the patient at the holistic level, match the PQRS symptoms of the remedy at a holistic level.
Once I understood this, then I thought, let us understand the Sensation method again. What we call the ‘sensation’ is where the mind and body come together, where the PQRS symptoms come at the holistic level. Once I understood this, I realised what Dr. Vithoulkas calls ‘the essence’, Dr. Dhawle called ‘the core’, what Dr. Sankaran called in the early 90’s – the core delusion, and what he now calls the sensation -all these are nothing but the PQRS or the individualization found at the holistic level!
So now the scene is, we have many stalwarts who help us to understand patients at deeper level, holistic level; we have stalwarts who are doing successful case taking themselves as per their understanding of (or as per their system) “Holistic” patient. But the problem was, many of us (sometimes) including me could not reproduce the case taking that our stalwarts could follow – in various of our cases. The stalwarts could do a successful case taking most of the time but we often failed (whichever system we followed!)
So, the next question for me was – Can we have a method that is ageless, timeless and beyond any personality? A case taking method, which is also simple, scientific and reproducible? Can we develop a method of case-taking which is Human-centric – where we do not do case taking according to any system, but we do case taking according to the center of that human being? (And that’s the reason why my second step was to find the PQRS at the holistic level.)
Now the question was, how to develop this method – where you (as a homeopath) are out of the picture and you do case taking according to the center of the patient. So I understood that the PQRS symptom at the holistic level is most important. So the aim of the case taking is to bring out the PQRS symptom at the holistic level. Different people call it differently – some call it the sensation, some call it the core, some call it the essence, some call it the core delusion and some are calling it the genetic core.
So I felt the need of such a case-taking method, which was simple, scientific, intuitive and reproducible and according to the patient’s center so that I don’t bring out what I know, but actually it (the core/essence/ etc.,) comes on the surface the way it is. And that is the reason I use the term witnessing.
So that answers the question “why was there need to bring in Case Witnessing Method?”
Now, let me share why this method is the way it is (having three steps).
I wanted to know what kind of case witnessing should be there, to really make it simple and scientific, which everybody could do, from old classical homeopaths to modern classical homeopaths, or belonging to any school.
I told you I was observing all phenomenon of the universe. From Bushmen to car driving to the philosopher who gave the law of three – he said that everything in this universe happens in three steps. The way I understood it, is that initially when you put in any activity, you put in scientific effort, but still the end result is not connected, not coordinated and not in tune with the effort you put. Then a time comes when the results start coming according to the effort put out. The thing starts getting coordinated and connected. And then a time comes where everything starts coming together in a beautiful pattern, where you put little effort in, but the outcome is much more. And it is almost intuitive.
Let me give you an example. Newton was sitting under the tree, an apple fell down and he discovered the law of gravitation. It was intuitive. Buddha was sitting under a tree and he got enlightened. It looks as if it happened suddenly, but actually both of them had put several years into this effort. Newton put in several years and Buddha also put in six years. And one day the result was intuitive.
I gave you an example of car driving. That initially in spite of all my scientific effort the outcome is not coordinated. But later on everything is coordinated. I can drive at the speed of 150kmph without thinking of my eye and hand coordination. It’s the same way I wanted my case taking to be. Initially I put in scientific effort and later on, according to the center of that human being, the whole journey becomes effortless and intuitive, going towards the center of this patient – And that’s why the case witnessing has been divided in these three steps – Passive, Active and Active-Active.
The passive is universal to all the patients – from the age when a child can speak to old age, and for all pathologies – every patient goes through the passive case taking, where you give just free floating attention to the patient, and space where the patient can say whatever he wants to. This is passive case taking, where you are not altering the flow of the case. But why am I doing it? I want to see what PQRS symptoms he is giving and at what level. Some patients will give me local symptoms only, some will give generals, some will give mentals, and some would give feelings, delusions or dreams. I will note down everything as it is. This is my first aim in passive case taking.
Then while noting down, I’ll try to find out which is that symptom which is holistic – which is coming in general, particular and mental general and all the areas that patient is talking about. That which is coming in two or three different areas, not related to each other, I would call it the “focus” of the case, the key of the case or what Dr. Sankaran now-a-days calls as ‘the anchor of the case’…because I know this is the key towards this holistic remedy, or this is the key to his subconscious. Till then I’ll allow the patient to go in any area he wants to. And all the questions I’ll design will be open-ended. The aim of those questions would be to make the patient move in the direction he wants to. Some would go in the chief complaint, some in generalities, some in emotions – allow them to go and see what is coming up again and again. This is passive case taking.
Once I know I have got the key, I move on to the second step. But the second or the third step is according to the center of that human being. Because now I have got the theme or symptom which is coming up again and again, I have got this key and I ask – could there be chances that this key is wrong? So how do I make sure that this key is right? I told you earlier that as the case taking advances, the symptoms and themes start appearing coordinated. The moment I see that the other PQRS symptoms start connecting with this key, I know I am on the right track.
The moment the verbal and non-verbal language starts getting connected, I know this is definitely coming from the holistic level. And there are many other things that we won’t mention in the beginning. But these two things will give me the surety that this is the key. The moment I am sure of the key, I start the third step, Active-Active case taking. Now I know this is the key to open his complete subconscious. This is the key where every part of his remedy would come in front of me. This is the key where every PQRS symptom would get connected beautifully. And I keep asking about it till every PQRS symptom gets connected, till I get the whole holistic expression of that patient. The remedy should have that pattern in that fashion.
So these three steps help me in case taking. Initially you wait till the right action comes, make sure that this is the right key and once you make sure, go till the remedy. And once I start the third step, I know I have to go towards the remedy. There are patients, who will connect all the PQRS symptoms, then there are patients who will slowly start going towards the source or the remedy itself and there are some patients who would directly go the healing level, which we will talk about later.
MB: Dinesh, the last time I saw Dr. Sankaran in a seminar was in November 2010. The cases that I saw then were also very similar to those that I read in your book. All the cases were such that in the end, the verbal language of the patient and the gestures all come into alignment and start pointing towards the source. So my question to you again is – how is your case-taking, or case-receiving, or case-witnessing different from what other practitioners of the sensation method are doing? Because I do feel that there is a novelty in your approach in that you have divided the process into three clear steps, but the broad pattern in practice is similar to what I see Dr. Sanakaran doing, or other sensation method practitioners doing. You start from some key aspects of the case at the general or particular level, let the patient speak, move to a core area of the patient, what you label as PQRS, and then take the patient to the core where the physical language and verbal language and the cues, all come into alignment and start pointing towards a definite source. So how does your approach differ or innovate over the existing method?
DC: initially when I started teaching, the students used to say that the sensation method is too good. Students appreciate it till date, however they find it is very difficult to reach there. Second, if you see in sensation method, all my teachers including Dr. Sankaran, Dr. Jayesh, Dr. Sujeet, Dr. Divya, D. Sudheer – each one of us has a method to reach to the center of the patient. Now the question was that, definitely all of us are right, but if we do the case taking according to the center of the case, then in application each patient would need a different technique to go to his center or sensation.
I’ll give you an example. A patient is suffering from constipation and I, as a sensation method practitioner, ask him ‘what is the sensation?’ But that patient is at the physical level and there is a paucity of symptoms. So you are talking in a language, which is right according to you, but you are asking it to the wrong person at the wrong time. So all which was existing – the passive, active and active-active parts were already there. What I did was, I made a system which can be reproduced by any practitioner in any case, and depending upon the case, you use a different technique. The case witnessing method is not a method belonging to any one school of thought. Traditional and new homeopaths can identify with this method. This is a system which is reproducible.
Now the feedback I get from the countries where I give seminars, is that ‘now, we are able to practice sensation method’. The review of my pediatric book (Wander with a Little Wonder), which was published by Narayana Publishers, says that this is the method which can be practiced by anyone. It’s not that you need to be part of the Sensation school in order to do this kind of case taking.
MB: How will you address the difference in our understanding of what constitutes the PQRS? Different schools consider different types of symptoms as PQRS. A conventional classical homeopath will take anything that is rare, unusual or intense – at any level- as the PQRS symptom. In your method, it is the unusual expression or gesture which is out of place or intense or occurring at two or more different levels, that is taken as the PQRS. Your PQRS at that point of time becomes different from the one used by a classical practitioner. What is characteristic to the patient does not differ in reality, but the information that a classical practitioner and a sensation method practitioner take, does differ at the outset. So how will those two practitioners reach the same remedy, when the information being used is different?
DC: Again you are talking about a system which varies from practitioner to practitioner. Now see what I mean by PQRS symptom – when you are listening to the patient, take any expression that is out of place, out of order or out of proportion – whether at the local level, general level or mental general level. Whatever is coming up (a local symptom or fear or delusion or dream, or a physical general) you just make a note of it. In that I am just doing what a classical practitioner would do, whether belonging to Sehgal school, Dhawle school, Vijayakar school, Vithoulkas school and Sanakaran school. I am paying attention to all PQRS symptoms, which can be a modality, a word, a concomitant or anything. Now out of these PQRS symptoms, I’ll see which one is coming from the holistic level – what we call the grand generalization of Boenninghausen. But here the patient gives you a sensation that is present in his local symptom, in his modalities, in his fears, delusions, dreams also. Now I would take that as the PQRS symptom at the holistic level.
MB: SO what you are saying is that instead of just focusing on PQRS symptoms within individual symptoms, you find a symptom that is reflecting at all levels.
DC: Exactly
MB: And you take that as the general PQRS. And with that PQRS you move to the Active-Active case taking?
DC: No. First I make sure that this is it, because if it is wrong, then my whole journey is wrong. So first I make sure.
MB: So how do you make sure?
DC: Suppose I get ten terms (PQRS or out of place, out of order expressions). Out of this, one was appearing at the local level, physical general level and mental general level. Now I take that symptom and start asking about it. When I ask about it, the patient starts connecting three more symptoms from the remaining nine with this particular PQRS symptom. This will only happen if you are moving towards the holistic PQRS. I know that we are on the right track as these symptoms are all connected and not separate. The moment I ask about that, the verbal and non-verbal language starts getting in tune with it.
There are many other things, like the patients often start throwing defences at this point. Like if you ask about something from your deeper conscious, then automatically a defence comes up. Like the chief complaint gets aggravated. Suddenly the patient will ask to go to pass urine or would start perspiring or would become restless or body language starts coming up. I know this is coming from the whole. That’s where everything starts getting connected.
So active case taking is the part where I make sure that this symptom which has come up is actually the PQRS symptom at the holistic level. Once the other symptoms start connecting, once the verbal and non-verbal language start getting connected, I know I am on a right track. These will definitely lead me to the full expression of this PQRS symptom where the whole is connected.
MB: You talked about defences coming up when the core is touched. I was reading some of your cases and saw that in many of them the defence that came up was that patient would either ask for a glass of water or the patient would cough. If you are taking an hour long case, or a two hour long case, wouldn’t it be physiologically normal for a patient who has talked for half an hour to have a dry throat and ask for a glass of water?
DC: Naturally if the AC is not working then obviously the patient might ask me to start the AC or may ask for a glass of water. But what I am trying to tell you here is – the moment you touch the core, at that particular time only the defences are thrown. Every time you touch the core, the periphery is aggravated. It actually happens according to the concept of homeopathic aggravation, where you touch the center and the periphery gets aggravated. So I am not talking about random acts where the patient asks for a glass of water, or wants a break to pass urine. I watch closely that every time I touch the core, either the chief complaint gets aggravated or a reaction comes up again and again. For eg. I touch the core and yawning comes. I can miss it once and feel it could be a coincidence. But every time I touch the core the same reaction comes up and gets deeper.
MB: So that is how you confirm the PQRS in the active process.
DC: Yes. When the defence starts coming, the moment he goes in, the chief complaint gets aggravated – till the whole remedy is out. The moment the remedy is out, automatically the chief complaint becomes complacent and nothing happens. So you are watching again and again, if it is happening two three times, then you know that this is it.
This case taking is like if you are watching a castle from outside. So the first step is watching the castle from outside, where you see the domes, the pillars, the walls – everything. There are multiple keys lying there. Now you need that one key which is for the main door, which goes directly to the king’s room. If you pick the wrong key, inside the castle the defences are already ready. The more wrong you pick up, the more aware they will be. So once you get the key, make sure that key is right and you try to open the door. If it is the master key then the door will open and you will have way to go to the king’s room. But the defences are already ready, and if you touch the main door, the defences will attack. And now for the first time you see inside what is in there. Same way when the subconscious is touched, it throws a defence.
MB: so you are saying that we need a key to open the door. But I have seen many sensation practitioners taking a log of wood and hammer at the door with it.
DC: That’s why we say we are ‘therapists’. You divide that word in two and we become ‘the rapist’. And the rapist is one who does everything without consent. So naturally there would be a problem. You are penetrating into the patient’s core without consent. I am talking about a case taking were the patient subconsciously gives you his consent. You wait, wait and wait till the patient is ready to go to his subconscious level. That’s the time you use the master key and smoothly open it. Then there is least resistance.
That is the reason why we need three steps. Many people ask me, “Why not do the active-active directly?” It is like waiting for the golden egg. You wait and wait till the golden egg comes out. You are ready to witness and then respond.
MB: So we have seen what happens in passive case witnessing and also in active case witnessing process. So how do you move into the Active-Active case witnessing process? And what is the objective of that process?
DC: By the time I reach the active-active process, I am 200% sure that this is the master key, this PQRS symptom will open the remedy – what in our (sensation) system we now call ‘the other song’ or the remedy or simillimum. So now I will not go into any superficial area. My whole focus in on that key. Everywhere the patient diverts, I’ll get him on track. The more he speaks about what is the feeling, what is the experience, I’ll allow him to talk. It is like editing a film. The film is ready and now you want to edit it to the point where the patient is focused right at the center only, and not wasting time in asking where, why and how. That you have already done in the first part. So the active-active is like zooming in with the help of that key. So my questions will be designed to bring out what is it, what is the feeling, what is the experience he keeps talking about it. And I’ll wait and see, that gradually every PQRS symptom starts getting connected.
The more he is connecting, the more I know that I am on the right track. From a word now he is giving me the qualified experience of the whole phenomenon. It’s like a patient tells me that the fear of being alone is the key. And now I am exploring it till the level where the patient tells me it is like the fear of being all alone on an island. And only one remedy is there for this – phosphorus. So in active-active process, the effort is to bring the remedy out in front of you where all PQRS symptoms get connected. And the moment they start getting connected I want to see where the patient is moving. Because now he is talking about not human but the remedy which may belong to plant, mineral, animal, nosode, sarcode or imponderables. I keep going with him and keep seeing in this whole PQRS phenomenon, what other rubrics get joined.
I make note of which is the kingdom and sub-kingdom that starts coming up. If the patient’s level of experience is high, it might lead to his remedy itself, the source itself. So you design questions in such a way that it goes towards the language of the substance. Some can go if their level is good. But those at a very low level of experience like the one who just stays with constipation, won’t go. And then there are some patients who can even go to the healing level. When the patient becomes aware of this whole altered pattern within him, which of course in many cases are temporary – So this is my aim in the active-active case taking, to bring the whole process out. So later on when I search the remedy, I should be able to see it in that remedy. So if the level of awareness is good, take him to the source and if it is really very good, take him to the healing. That was the meaning of the phrase that old homeopaths used – “a good case taking is half the cure”. And good case taking can take the patient to the healing level. That is why we say that the whole case taking is an alchemical reaction. And the presence of both – you and the patient – transform the patient to the higher level.
MB: We will talk about both the cases – where the patient is at the fact level and where the patient experiences healing. So my question is, what if the patient remains at the fact level? There are a lot of patients in clinical practice who won’t move beyond their chief complaint…who show resistance – “I just want to be treated for this particular problem” (say constipation). “Give me something for my constipation”. How do you reach to the core of the person in such cases?
DC: 60% of our patients, maybe more, are on the lower level of experience, where they either remain with the chief complaints, that is local or move to the generals at best. They don’t go beyond that. In my case taking when I do passive case taking, I understand what is his level of experience? That is my first aim of understanding the patient. When we see that the patient is at the local level, it means that he will give me PQRS symptoms only at the local level or the fact level. Here I am not going to get the focus, so I can’t start the active process.
In such cases you go into other subconscious areas like dreams, fears, interest and hobbies, incidents that had a deep impact on him, a present predominant situation that is bothering them. And I see in these multiple subconscious areas what is coming up again and again in two or three different areas. I go with the idea that this patient is at the lower level of experience, he would take his time. So I wait for him, but I am very sure if I give him enough time, things will come out. So out of those 70% of patients, in 55% this may give me the focus. Explore each subconscious area slowly, giving them time.
I’ll give you an example. If I ask such a patient – “Tell me about your dreams”, I am sure the first five times he will say I don’t remember. I have a headache and you are asking me this thing about dreams. But you give them time and out of 10 such patients, five to six will open up. When you give them time, the subconscious gradually starts throwing up things that are present deep in there.
MB: What about the remaining four or five?
DC: Yes, 50% of the patients are still stuck to the chief complaint. So he will give me either a location, sensation, modality or concomitant of the chief complaint. I treat them as one-sided disease patients; it means they have become localized. They can only talk about the local. So now in such cases I will start my active case taking with the chief complaint. Now here I take a long process that Dr. Sankaran suggested in his book Sensation of Homeopathy. We explore the chief complaint and the case would be out. But only in those cases where the patient is stuck at the chief complaint. I know that his energy is in the chief complaint, so keep aside the generalities, dreams, delusions, sensation etc. for the moment and just talk about the chief complaint. So I will get local symptoms, local modalities, local sensation and local feeling. Now out of such 10 patients, 5 to 6, when you explore locals gradually, the local becomes general. And then from local to general and then in the subconscious areas. So first You confirm the location, sensation, modality, and concomitant. then gradually it takes you to generalities, and make sure that your PQRS is present in other areas. And if it is there in two other areas, I know this is it.
Now you will ask me, what about the remaining four or five? Definitely there are patients in our practice, who despite our trying hard will not go to their center. They will keep talking about the chief complaint.
MB: True
DC: In such cases, first I’ll use all my knowledge of case taking to explore them. If it still does not happen, then I’ll tell the patient that this is not the time for both of us. But if I do get the location, sensation, modality and concomitant of the local; I start with a local remedy. This is not a simillimum at the holistic level. With such cases, I will be very careful in the follow-up. Every follow-up could be long; I’ll explore at least one area in the follow-up. And will explore if the same thing is there or something different comes up. You have given a local remedy; now make sure whether this local remedy is the simillimum or a partial simillimum.
Now there must still be 2-3 patients out of every 20 who still do not talk. To them I say this is not the time. I do another case taking again because right now either my energy is blocked and I am not able to go further or your energy is blocked. Mostly it is the physician’s energy that is blocked, otherwise the physician can do it. It’s not the patient. He comes a second time and still nothing happens, which is possible in one out of 20 cases. Then I say I am not the right person for you. And you will see such a patient goes to a junior or another homeopath and they in the very first interview crack the case. Because their energy is magic. That is why we say that the two of us have come together for a purpose and the purpose is to bring an alchemical reaction in both of us. I say to them, you go to someone else.
MB: Now let’s move on to the patients who experience a healing response, just as a result of the case taking. Why do those patients need a remedy?
DC: Very good question! Because if the healing has come, why do they need a remedy? What is happening in the case taking, I would like to compare with a person sitting in front of a mirror. The whole case taking moves from passive, to active, to active-active – you are taking a journey from his superficial self to his deepest self, towards the holistic self. And at every stage I am showing him a mirror – this is who you are. He is actually going deeper and seeing his other pattern, the remedy pattern. And a time comes when he sees that complete pattern. Now that is the first time in his life, that he is getting a complete glimpse of his whole self. This itself is awareness – Oh, this is who I am at every stage of my life! This is happening because of the presence of a catalyst. I as a homeopath act as a catalyst. In my presence this is happening. It is like I am holding a mirror, and after some time I remove the mirror. So this healing awareness, most of the time, is temporary.
MB: But why? I remember reading in the very first book of Dr. Sankaran that disease is delusion and awareness is cure. If the patient has become aware, then why is the cure not permanent?
DC: Yes disease is delusion and awareness is cure. This whole method is making you aware of your whole altered pattern, till maybe in some cases, to your source level. But who is bringing this awareness? Is it the homeopath or is it the vital force? It is because of the help of the homeopath as a catalyst that this awareness is coming. It is like we say that the highest ideal of cure is where your vital force heals you. Here your vital force is not doing anything; it is with the help of the homeopath that the whole pattern is coming out. The moment the homeopath or the mirror is out, automatically you will come in contact with your reality. So that’s why the Patient feels temporarily better, which can occur for a few days to a few months, depending upon how deep that awareness is.
In some cases, where awareness has come at every level and it is so deep that the transformation is there, the vital force starts taking care. It happens in very rare cases. Maybe till now in my practice I have seen this in two or three cases, where the case taking itself has become the simillimum. So most of the time it is temporary, but when the vital force starts healing itself and the process continues, the cure can happen. But in very rare cases.
MB: So you remain the therapist and the healer is the vital force.
DC: Yes, you show the window that’s all.
MB: Now let us discuss this case witnessing process in some special circumstances and some special classes of patients. One patient group I am particularly interested in, are the pediatric cases, especially in relation to your earlier book,A wander with a Little Wonder. How do you use this case witnessing approach in pediatric cases?
DC: Naturally, the rule says that what is true for one part of the system is often true for the other parts of the same system. So if we have a method to explore which is working in one age group, it has to work in other age groups too. That was my reasoning, so I thought that this scientifically intuitive case witnessing process should work in pediatric cases also. In fact much better! Why? First, the children are in touch with their higher energy; they are more in tune with their higher level of experience. So they should be able to talk. But then the question was that their verbal language is not that developed, not that good to tell you the PQRS symptoms at the holistic level, but their energy level is very high, they can definitely give the PQRS symptoms at the holistic level, through their little activities. So I can do the same case taking – passive, active and active-active. But here my focus would be 90% on observing what the child is doing, 9% what the child is saying and 1% what the parents are saying.
In pediatric cases the energy is more, so we focus more on the energy level. When I do passive case taking in a case whose verbal language is developed, I use the same three steps. The only difference is that often the passive case taking is less, especially in the younger age group where they themselves won’t go to different areas. So you have to become active and take them to those areas which children are in tune with, for e.g., fears, art, dreams, interests and hobbies. These are the four areas children are usually in tune with. Then explore every area, give them space here. Earlier what we used to do – we would ask the child about his fears, the child will tell about two fears and we will put them in the repertory. But here I wait and wait till all the fears are out, and then I look for the fear that is coming from the center. The same way with dreams and other areas. Most of the time they give you the focus of the case. In fact children go to their center much better than the adult group.
MB: So in the children’s case witnessing process, you focus on these four areas in the passive case taking process?
DC: In passive case taking, first allow him to talk freely. Most of the time they will talk. If they are not talking, then guide them towards these four areas open-endedly. And stay in one area for a long time, so that every fear, every dream is out. Then from all this, find that which is in the center.
MB: And while you are doing this, do you take the child’s case in front of the parents, or do you interview the child alone?
DC: Most of the time it is alone with the children, because children can express their inner pattern by themselves. Earlier, we would only talk to the parents, as we believed they know much better about their children. But a parent gives his/her opinion about the child, which may not be true. And nobody knows what lies in the depth of the child. Only the child knows. The child is the director, producer and storyteller of his own other song.
MB: Please share with us how you take cases in the following situations. Firstly, infants and toddlers who are not able to tell you anything about those four areas. Secondly, patients who are deaf and mute. Lastly, patients who are in coma.
DC: With children below one and half years of age, where the verbal language is not developed, and with children who are grown up but the verbal language is not well developed like autistic, dyslexic and cerebral palsy patients, I divide the case taking into four or five steps.
First is my observation. When the parents are sitting and talking about the child, I am watching the child and observing what he is doing, what is happening in the consulting room.
Second is the parent’s observation. My questions are such that I ask the parents to just tell me what they have observed – as it is. The moment they tell their interpretation, I cut that short.
Third is my examination. Head to toe you examine and you see a sclera which is blue or you see a crack in the tongue or you see perspiration on the nose or you see perspiration on the head or an ear that is red.
Fourth, and most important, is the mother’s history during pregnancy. The most important thing that I understand after taking the mother’s history during pregnancy is that it is actually the child’s energy that is expressing itself through the mother, during those nine months. So every change the mother goes through – physical, general, mental, dreams – every change is because of the child’s energy within her. And if mother can recollect that change at the physical, general, mental, emotional and dream level – then we know that all this was part of the child’s energy. So you Make note of all changes that she went through, from thermal modality to perspiration to sleep pattern, to cravings-aversions, interest and hobbies, fears, dreams, etc.
Now I have four areas
Mother’s history during pregnancy
My observation
Parent’s observation
My examination
Now I’ll give a remedy where at least three of these points are covered in the remedy. If I just select one area, I might go wrong, but if the remedy covers at least three areas then the chance of going wrong decreases. and chances of getting the right simillimum at the holistic level increases.
MB: How about the patient who is an adult, but deaf and mute and cannot speak and hear? In the sensation method the verbal and the non-verbal clues have to match. what if there are no verbal clues in an adult?
DC: The more your senses are not developed, the more you are in tune with your higher energy. That is why you see in autistic and dyslexic children, their one faculty is often highly developed. So we find out which is that faculty that is developed in this person, by observing for some time. And it actually takes time. Let’s say the drawing is developed. Then you put a paper there and let them do what they want to. Keep giving paper after paper till you know nothing new is coming. Then see in all the drawings which is the pattern that is emerging. This is the way I have done it in many cases, where this drawing area is developed. You don’t take just one drawing; you take 5-6 drawings and see what is the focus that is coming up. Knowingly or unknowingly, the patient puts that in the center. Then you find the remedy with help of other observations and examinations.
I recently saw an autistic child who came from Australia. The eleven year old child was not talking, just moving in the room. No communication, and all typical signs of autism. No eye contact, constant moving, moving in a circle. The only thing I could do was watch. Now one sense that I saw was developed was that he was touching everything. And he would make a sound (tap-tap) while touching everything, be it wood or glass or pen. Then I started playing the sound game with him. I’ll make similar sounds. The moment I would do that he would be calm and sitting in place. And every time he wanted a different sound. This was my observation about him. I was there for 2 hours and this happened continuously. And this came up in the mother’s history too. During pregnancy she will communicate as if she is communicating with sound and not words. And she of course got a dream of dolphins or whales dancing and communicating in her dream. The child was given Ambra grisea, which also has this communication with sound waves. The mother had also developed symptoms of that during pregnancy – shyness and embarrassment, which was coming in the center of her case.
MB: And now what about the patient who has a head injury, he is in a coma and you have to treat him.
DC: when the patient is in coma, so what choice do I have? My observation and history by the relatives. So first I go to the patient to observe everything, including checking the reports and examination. Then I take a deep history from relatives and try to see what is that which is original and not their interpretation. The third very important thing I do is – before the patient went into coma, his body must have thrown that intense state out. It could be a few hours or few days before that, some change according to the state must have come out. So I ask relatives to focus on that. Tell me in two days around this time, what happened to him. Definitely you will see that symptoms related to his inner state must have come out. Because that is the highest intensity, the peak of the state, and after that he has slipped into coma.
MB: But in such cases you can’t take the sensation.
DC: I am taking PQRS symptoms which I observe, which they (relatives ) observed and which happened before and after he slipped into coma. One which matches in these three must be coming from the holistic level. And that PQRS symptom is actually the sensation. Sensation is one where the mind and body are connected, where my entire PQRS symptom are connected and is present in all levels, be it local, general or mental general. That PQRS symptom is the sensation.
MB: I have two final situations for you. First, how do you do an acute case with this method? A mother comes with a child who has fever and diarrhoea. The mother just says that the child has had fever or diarrhoea since the morning. Now what do you do? They have not come to you for any chronic complaint. How do you treat such cases?
DC: I will stick to my principle that what is true for one part must be true for the whole. What is acute? Acute is nothing but the intensification of the symptoms. Intense symptoms are there in front of me. So if something of interest is there, the whole state must be intense with that. In a Bryonia patient with 105 fever, he will bring out every symptom of the Bryonia state. So acute is nothing but crystallization of the whole state at this point in time. Naturally in such cases I cannot do open passive case taking. But I do case taking focusing on the present predominant picture. So right now what is happening to you. Suppose he has come with diarrhoea. So he will give me symptoms of diarrhoea, the PQRS symptoms at the local level. Along with this his, his whole generals are also disturbed. So he might give me some general symptoms. He might give me some fears or dreams since it started. I try to see that PQRS symptom in the present, predominant complaint that is coming up at every level. I will use them for the prescription, rather than just taking location, sensation, modality and concomitant. Watch the whole state. What is that which is holistic at a given point in time? Take those PQRS expressions for the prescription. Naturally, I am treating the local according to the whole at this given point in time.
MB: It seems there are times when you fall back on the classical homeopathy prescriptions.
DC: Yes. But I can focus all my energies in bringing out the PQRS symptoms in the present predominant state. And I am definitely going to prescribe on the location, sensation, modality and the concomitant of the local. But since it is acute, the chances are that the whole state is aggravated, that in a few minutes I can get the whole state out. Not only that I can get PQRS symptoms at the present predominant state, but I can also get persistent symptoms. Sometimes it can happen that the patient tells me that this symptom was not just in his diarrhoea, but also in his headache two years back. It was also there in dreams.
MB: Agreed, but senior homeopaths have always said – don’t mix the acute and chronic symptoms. So when the acute patient is in front of you, do you take the symptoms of the diarrhea or fever, or do you take the general symptoms too?
DC: What I was saying is that I am picking local generals, mentals and locals which have changed with that diarrhoea.
MB: I absolutely agree on this Dinesh. I see that your work is very useful for those practicing sensation method, because for the first time I see there is a clear division regarding how to approach different types of cases and how to deal with patients at different levels, and to reach the same core. So definitely your book is very useful for sensation method practitioners and in general also, other homeopaths can learn a lot from it.
One practical problem I see with all the neo-classical methods, is that in the Western world where the homeopath sees just two or three cases in a day, it is perfectly feasible to do such case taking, where you are taking a case for two hours and trying to reach the core. But here in India, the doctor-patient ratio is very dismal. There are government doctors who don’t have any option – if there are 50 patients in the queue, they have to see them. In most of the smaller towns and cities in India the doctor still charges 100 to 300 rs for a case (2 to 6$), even for a new case. They can’t charge 2000Rs. And so they have to see a large volume of patients to make their ends meet. It is a practical problem. What would advise such practitioners who see a large number of cases in a day, either because they are too successful or because of financial constraints or for any other necessary reason. Within their restricted time frame, how do they reach the center of the case?
DC: that group of people have no choice right now. Keep doing what you are doing. Your first aim right now is to make your ends meet. But also you keep in mind the true classical homeopathy. Think that one day I want to do individualization at the holistic level and searching for a remedy based on that. Either I don’t have time now, or don’t have money now. But I am sure a time will come where you gradually create a system where you are more in command. Then you can spare 2-3 hours in a week and just take one or two cases in a classical manner. First you create your name and space and then follow your heart. But ultimately you have to do true classical homeopathy. Not just for your patients, but also for yourself, where in the end you also want to transform yourself a little bit.
Many teachers advise their students that this is the only right method and you should do it. But most of the young students can’t do it successfully and they leave homeopathy because they can’t make ends meet.
Your second point was, when you are doing this, seeing 20-30 patients in a day, then how can you reach the simillimum. You can take one PQRS at the local level, one at the physical general level and one at the mental general level and that is all three. And start searching for a remedy where PQRS symptoms are present in that way. You are taking four symptoms, but at least you are following the principles of true classical homeopathy.
MB: Great advice Dinesh. Imagine a homeopath who sees many patients in a day and takes the case in the traditional classical way. Say the patient’s thermal is chilly, he has profuse perspiration, is timid, is plethoric and the homeopath prescribes Calcarea carb, without going through the whole case witnessing process and without exploring the core. Here the case taking is not in-depth, but probably the remedy is right. Even after a thorough case taking, you might reach the same remedy. if there is no detailed case taking, but the remedy is still right, will the result be as profound?
DC: Yes the result would be the same, even if he gets the simillimum unknowingly. But the time for transformation that he would take would be longer, because the transformation that occurs during case taking won’t occur.
Also, when the case taking is done thoroughly, it is an alchemical reaction and the homeopath also gets transformed in this process. Both the homeopath and the patient get transformed at a higher level.
MB: You say that the case witnessing process brings alteration in the Homeopath also. The patient goes through the process once and reaps the benefits once, but the homeopath will get the alteration every day, with every new patient. So what would become of him after a few months or years? You cannot get cured beyond a limit. So if you are getting a therapy yourself with every case, what is the end result of that for the therapist?
DC: What is happening is that with every case, there is some part of the patient that touches you, some part that makes an impression on you. And if you are aware of that, it gives you some glimpse of yourself. Because his simillimum is not your simillimum, but some part of him, somewhere it is touching you. So every case brings me closer to my awareness. But I am sure there must be one case which I am still waiting for, where head to toe, the sensation to sensation matches me. That is where I believe the complete transformation would happen. Before that, day in and day out I will get a partial simillimum. I am convinced now that maybe the case witnessing process is my simillimum.
MB: I totally concur with you on that. I have posed too many questions to you and your answers were wonderful, and they just brought out more questions from me. This interview gave me a learning opportunity from you, through you. it has been a wonderful opportunity. I am sure our readers are going to benefit a lot from this discussion. I will recommend both of your books highly. Both the books are excellent for sensation method practitioners as well as other practitioners. I would like to thank you for your beautiful answers and the time you have given me.
DC: I would also like to tell you that we have launched a new website www.casewitnessing.com The aim of the website is to bring together from all over the world, people who are doing case taking, case receiving or case witnessing according to true classical homeopathy. Bring all of them together. Articles and cases about the case witnessing process are already there.
MB: I am sure it would prove to be a very useful resource. I will urge my readers to visit casewitnessing.com. Thank you once again Dinesh!
About the author
Dr. Manish Bhatia
- BHMS, BCA, M.Sc Homeopathy (UK), CICH (Greece)
- Ass. Professor, Organon & Homeopathic Philosophy, SKH Medical College, Jaipur
- Founder Director of Hpathy.com
- Editor, Homeopathy 4 Everyone
- Member, Advisory Board, Homeopathic Links
- Co-author - Homeopathy and Mental Health Care: Integrative Practice, Principles and Research
- Author - Lectures on Organon of Medicine vol 1 & 2. CCH Approved. (English, German, Bulgarian)
- Awardee - Raja Pajwan Dev Award for Excellence in the Field of Medicine; APJ Abdul Kalam Award for Excellence in Homeopathy Education
- For consultation, seminars or clinical training, write to This email address is being protected from spambots. You need JavaScript enabled to view it.