Keywords – Retake, change, case taking in teenagers, in women, case taking in retakes
Following is a retake case of a school going girl aged 15years, she complaints of adenoids. During the retake she gave a clue, a hint to us which helped us unfold the whole case and come to the centre of the case.
Case summary of the Retake during Thursday live case sessions
Passive Case witnessing process
D: want to talk to you as if meeting you for the first time, all what speaks about you, writing your own writing, like story
- We went to aunt’s place to help her to plan for trip to Singapore and I was jealous of my sister, she went before me
- 6th grade, 2 yrs ago, boy named Om, I use to like him, we were friends, it was just attraction, whole school got to know, everyone started teasing, just get irritated, he is my class
- feel bad when teacher shouts at me, feel sad when she insulted me
- personality wise I am not that great, if I hurt someone emotionally and physically I keep seeing sorry till they say okay or say I am fine
- I am not good at English, I fumble a lot
- Feel like going in the past and changing all my things.
- Like get angry with my mother, if she is in good mood then she will talk, if she is in foul mood she will shout at me, if she does something I can’t shout, but she shouts at me, I feel this is wrong
Since this came up naturally about things she wants to change in the past we take her to that area, as she is already in touch with this aspect it will be easy for her to open up this way, and also this is an another open ended area for us to explore. So we keep her on what she wants to change from the past
D: what you want to go in the past and change?
- all my mistakes, if I had insulted someone, friends and family who I have hurt would change them
- go back to childhood I would enjoy all my life again
- Meet my grandfather who is not there...
- We have speech competitions, I got second prize, I was having full scope of first prize, didn’t practise did it at last moment, these things I would like to change...
D: even if they are imaginary things does not mater, see what else you want to change
- we adopted a dog when I was in 5th grade, a foster dog, we kept him for a month and see if we could manage him, that time I didn’t care, if that time I would have taken care then I would have had a dog right now, that I would be willing to change
- I would like relive 6th grade, lot of fun, good friend circle,
- 7th grade my best friend started to fight with me for no reason, I don’t know why she was angry, she would ignore me
- Now she is got into bad company, she is getting worse, gets shouted by teacher, I am feeling bad for her
- She has a friend now, and that girl is bad natured, she is fooling my best friend. The other girl makes her do all her work.
(We keep her at this change and take her a step further, as we see she is giving us more and more peculiar information about her)
D: what other things you want to change, relive, add
- wanted a big brother or small brother
- live in a country out of India
- Australia where would be having big house and a dog
- when I was small, I use to feel I was Mother Teresa in earlier life, use to help so many people
- like to add more confidence
- I use play basketball, use to get scared it will hit me, use to be fearful about something hurting me
- I like politics, whenever there is a discussion about politics in the house, I am fighting…
- I tell my mom government is bad, there are bad roads
- My sister does kathak (an indian dance form), I also do kathak, but I would like to add grace, my sister has grace it enhances her dance. I know it technically but no grace
- I have phobia of heights, I am scared, I will fall down, something will happen.
D: if given a chance if everything in your wish, what you want to add or change or bring in your life? Like a fairy tale, what would you like to put or add...
- want to change the Indian government, 29 states, every state has religions, different culture in different states, different dishes, India will prosper
- big bungalow in America, big house, big dog
- like straight hair, fond of straight hair, straight teeth
- biggest thing want to have small foot, they asked me use men’s shoes, as my foot size increases with my height
- Like to have cell phone, which mom is not giving me...
Active-active case witnessing process exploring the PQRS in Passive
D: one thing you said you want to change all those moments where you hurt or insulted someone
- If I had said something or spoke something wrong, if my talk has insulted someone's feelings, want to go back and change all my mistakes.
- lots of time I have insulted my mother
D: want to change politics?
- We have all corrupted people; countries outside of India have more control on people. Here they have no control on people what they wear, on population etc.
- Basically people don’t follow rules, our constitution says people have all power.
- Indian people are too impatient, people don’t care about others, he is in rush break traffic rules, for them there is no one important person than himself
- IAS officer they take bribes
D: height and foot?
- Yes because of my increasing height foot size is 8, there are no ladies shoes in my footsize, I will make ladies shoes and sandals with 8 foot size
D: you thought you were Mother Teresa, what you use to imagine?
- I had helped many people... when I use to see her photos, I am taking prize from Jawaharlal Nehru, use to imagine myself in place of her. I helped many people, I was great, so I am getting nice things in this life.
D: 6th grade you had a big circle
- Many friends, teacher also didn’t shout on us
D: friend went into bad company?
- Yes the other girl handles like her doll, something she said wrong about me, and pulled my friend to her side, she told her how bad I was and how good she is.
- she was making face, and telling my friend how I was favoured by teacher and that I would never accept my mistakes.
- Feel bad because now she is in bad company, she has even started copying and cheating in exams.
D: about your cousin, you felt jealous?
- Yes, because when we had been to their house, they hadn’t done any shopping, we helped them with all the shopping, and they were going before we could go, so I use to feel like crying. I was not wanting to help them to go for the travel, I was feeling jealous of her...about travelling, she is going and i am not going...about travelling...
D: you want to go to big country...
- All this because I want to have a dog, no other reason, married big house and big dog...
D: fascination for dog?
- companion, love pets from very small, too small first second standard, if I had been doing good with dogs at that time, I would have had a dog today (bangs hand on book)
D: sister has lot of grace in dancing
- when she was very small, she had that grace, put her to kathak, also went to Italy, all over India, I like to be like her, when I was small use to be jealous, everyone praises her not me...
Active-active advice – Designer’s Diary
- keep your own diary, and once a week write, where you think about what you want to be, do in your life... what inside you what you should do, how will know this....find by yourself
- How will you find by yourself? By putting your thoughts on journal or diary, which will last with you for long time
In that diary make some sections,
- one section note every dream that comes, initially it may be disturbing but then the diary will speak to you
- second section what I want to change whatever comes naturally
- what I want to add in my life, if given a chance, if everything according to my wish
- write one story about yourself
- Some spontaneous thought write that also...
Keep writing every 15-20 days without forgetting; when you will reread help you in your thought process and slowly make sense to you, automatically thought process will be channelized...
Centre of the case –
During her first interview she had been prescribed Calc Phos, then Calc Sulph, Calc Sil, Lac Felinum without significant improvement. So this time during the retake we had to be very sure of the centre of the case, being more passive and exploring areas which had not been explored during previous history. So in this retake -
The main feeling revolved around the need to be better, better than her sister, better than what she was before, more graceful, better looks, physical appearance, better hair, and wanting to change her past, like if she has been rude, or hurtful to anyone. Her sensitivity to being insulted and hurt, scolded, she doesn’t like being forced. Her dislike for corruption, and her imagination of being Mother Teresa, Her jealousy with her sister, and the classmate who she feels has taken away her friend; needing a sibling, good friends, needing a big house only for the sake of having a big dog; all this point to animal remedy Lac Caninum.
Materia Medica reference – Dr. Rajan Sankaran (Soul of Remedies)
- The main theme in Lac caninum is dominance (the bigger dominating the smaller) and who is going to be on top. Lac caninum persons can be irritable and ferocious, but if someone is more irritable and ferocious, they give up, they submit.
- Then arises the conflict within them: "Do I want to be what I am?" They develop a feeling of low self-worth: "I am not good enough.
- I feel dirty and horrible", and become contemptuous of themselves. This dirty feeling is also common to animal remedies, "I am not good enough, I am despised and looked down upon"
- Lac caninum patients suffer by comparison with others. They try hard to please, to be liked, cared for and accepted because they feel left out and rejected. They can develop malice and hatred because they hold somebody else responsible for their condition
- The Lac caninum situation is that of a dark-skinned girl child in an Indian home. Her sisters are fairer than her. She tries hard to get fair-skinned, but knows she will never be fair- skinned. She is constantly being compared to her "better looking" sisters, and she soon begins to hate herself. People bring clothes only for her sisters. Nobody listens to her; she is just not clever enough - everything she says is stupid and foolish.
- She feels she is uncared for and neglected because her body looks bad. She starts feeling dirty, and washes herself frequently.
Discussions during the case
- Q) Understanding retakes – how to do reassessment? What should we focus on? How would we know we are not going wrong this time?
- Your role as a retaker - you have to completely shatter your path and their path...as if you are meeting for first time, fool your own self what you know about her, because you have failed once; so you could use a question like: - As if we are meeting for the first time, as if talking to your own self, express yourself…
- An environment where you don’t want to understand the routine, so your questions would also be such that to enquire into areas which the patient hasn’t spoken about earlier, hence the long passive step (like in this case, we used the area of what she wants to change in her life and we kept exploring it and every time we got a new
- In the case, her fears were not very peculiar, neither her dreams were very peculiar, but she herself spoke of change, and we used it as a tool to go into an unexplored area and she kept opening up and giving us more peculiarities. So we kept asking her about change, what she wants to add or change
- Understand in detail about retakes in upcoming book on advanced case witnessing process
Hence 7 cardinal principles to understand during retakes/reassessments are
- Longer passive case witnessing step
- Longer guided passive (areas which you have not explored in first case) (chances of going wrong in understanding the focus, so check and recheck ask more 2 areas before concluding on the focus)
- Explore subconscious areas more than conscious areas
- If in first interview more mind areas covered during the case taking this time make sure you have to ask physical generals and physical particulars have to be explored minutely. Put conscious energy in understanding physical symptoms completely
- At the end of the retake interview reread previous histories ask about those data which came in patient spontaneously and not by your probing, which now does not fit in todays history explore it (for example, in previous history a unique fear or unique dream those point explore again, fitting into new history or no, any modality which didn’t fit, data from physical general, physical particular which is not fitting ask them now
- In previous history the centre of the case / focus without you becoming active or active-active which came naturally without the physicians interpretation, that focus explore it (dont keep remedy in mind in passive)
- Use a method which you have not used earlier, like right brain methods
- Q) Todays case also shows us glimpses about case taking in Teenagers, how can we enhance our case taking at this age?
Understanding case taking in teenagers
- Teenager is an age where now they start to have their own personal thought, ideas for having their own personal journey
- This is the age where they start to exercise their own personal choice, other than just following elder’s advice
- This is the age where most of the teenagers are not willing to go to the doctor where their parents take them…they generally start questioning their parents about all their instructions or choices. They prefer to spend time with their friends and open up and talk about themselves
- So here we create an environment where teenager feels as if they are conversing with his or her friends. Hence the passive case witnessing questions should be like – “as if sitting with your best friend and sharing all about you; as if you are writing your own story, once upon a time....
- Exploring their interest areas helps to build up a rapport and helps open up the case. Questions about their areas of interests and hobbies, about vision of their future, what they would want to do in life.
- What is your vision of life, study etc…
- Questions about fears, illness would be boring for them. Create an environment so they develop your trust.
- Teenager diary - different questions
- Advice to parents - upto age of 7 just learn from the kid, 7 to 14 individuality starts come so create that environment where you see the individuality while growing. After 14 again become the friend, then only will the child share.
- Q) Case Taking in women
Women go through a lot of changes according to their menstrual cycle and especially in traditional indian society marriage is also a big change for girls. The periods of menarche, marriage, childbirth, family, children, menopause, marriage of children etc are events in a women’s life which have a physical as well as mental impact in a womans life. Every change the women experience a shift in herself. And utilising these natural changes as a different areas and exploring these areas helps us get an idea of a holistic focus.
- menarche as a guided passive area (esp. cases where menarche has played a big role, where parents also see lot of shift) (not just as ailments/from menarche, but use that as case taking area)
- Since menses started around that period what changes have come in you mentally, physically, emotionally
- Especially in those females when they talk feminine, talks about female stuff - then use areas - menarche- shift more in women, marriage, child bearing, menopause)
COMPILED BY DR. RINA DEDHIYA