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Lithium muriaticum
Year 2019, Issue 5, Article 6CaseAuthor: Mahesh Gandhi
Case of Lithium muriaticumBy Dr. Mahesh Gandhi, M.D. (Psychiatry), Senior Consultant and Faculty, the other song
Co-authors:
Dr. Sneha Vyas, Resident Doctor, the other song
Dr. Devang Shah, Resident Doctor, the other songDr. Gandhi then narrated another case of a 39-year-old lady who came to his clinic and the first sentence she uttered was ‘I don’t know where to start.’ Everything seemed catastrophic for her. She worried about everything; about relationships, finance, studies and almost everything under the sun. She found it very difficult to trust people. Physically, she was diagnosed with cholecystitis and has recurrent migraines. Migraines are better in dark and with the pain she needs open air and wraps up in warm clothes. She cannot sleep with closed windows. Her nature is very reactive; she has sudden bursts of anger, after which she calms down quickly. She complains of leucorrhoea with a foul odor.The patient was very erratic about her routine and is clueless about what her plans were, even in next 30 minutes. She was unable to choose or distinguish between things. She felt dizzy and sick on looking at moving objects.When asked about catastrophe, which was how she began her case, she related to this word with an example that if her boyfriend wanted to be alone, she thought that he does not love her, a thought which was like the end of the world for her. In childhood, if the teacher did not like her work, she would be so devastated that she would want to give up studies. Everything felt like the end of world to her. End of the world means loss, as if she is a burden on someone and feels worthless. She cannot separate from someone who she is close to her. She wants a lot of attention from people around her. Attention for her is warmth. Warmth is to be hugged, like the warmth of mother’s hug and she feels very safe when hugged. She experiences safety from the external world where one has to prove oneself.Suddenly out of the blue, the patient said “I always feel that I have to change myself to deserve things. I try to be perfect, there is someone inside who demands perfection. I want to be independent; to stand on my own feet and not depend on the support from outside. I once saw a toy which was like a closed system of living creatures, it didn’t need support from outside, and I want to be like that.”This spontaneous association with toy is called free association. The toy was the most surprising feature that surfaced. So we investigate it and see where it leads us.This toy is like a glass, closed and it has some creatures in it which are not dependent on the outside for support, e.g. food. The experience here is of independence. To be in the glass is to be away from the risk of humiliation or being away from the situation where you may be thrown out of the house. She recollected a childhood incident when her mother sent to her grandparents’ home as she did not obey her. The patient felt very hurt and humiliated and to her it was like being thrown out of the house. She felt that she did not want come to her home and if she had a bag, she would be off to a forest and never come back again. Then again, she felt that it would be very dark and scary away from home in the forest. So, she tried to perfect all the time, so that she would be never sent away again. She could not exist without her mother’s help all her childhood and always desired that her mother should respect her the way she was.Further describing the toy, she said that it was like a glass bubble, like an aquarium which is closed. (Here, she makes a hand gesture of a circle). It is a safe place for a baby, (starts weeping at this point) it is like a hug. You experience protection, care, tenderness and attention there. It is like an unborn baby; it is like something that the baby has before delivery but is missing after it is delivered.Here, she connected to a story which she had read in magazine, which featured a baby who was not safe, having being thrown out onto a street in China like a piece of garbage. She felt that the baby would be feeling vulnerable, unprotected, with all things being lethal around it. The patient related that she too had a thrown out feeling when she discovered that her husband was involved in an extramarital affair.There are two important aspects in the case one is of the womb and the other is of trust, humiliation and respect. On one side she is totally dependent where she feels like she is in a glass bubble which is safe tender loving caring and protecting. On the other hand, is the feeling of being disappointed by partner or mother throwing her out of this safe protective womb which is humiliating and disrespectful. This total dependency as if being in a womb is Lithium and the disappointment, mistrust, humiliation, no respect are themes of Muriaticum (Chlorine element)7. Remedy she received was Lithium muriaticum 200, which was shifted to 1M later.After 6 months of treatment, her panic attacks were much better. Her cholecystitis was completely cured. Her migraines have disappeared. Her dependence is much better, but she needs someone to support her. She was able to take a decision to separate from her partner. This shows that the need for dependence is markedly better.
Co-authors:
Dr. Sneha Vyas, Resident Doctor, the other song
Dr. Devang Shah, Resident Doctor, the other songDr. Gandhi then narrated another case of a 39-year-old lady who came to his clinic and the first sentence she uttered was ‘I don’t know where to start.’ Everything seemed catastrophic for her. She worried about everything; about relationships, finance, studies and almost everything under the sun. She found it very difficult to trust people. Physically, she was diagnosed with cholecystitis and has recurrent migraines. Migraines are better in dark and with the pain she needs open air and wraps up in warm clothes. She cannot sleep with closed windows. Her nature is very reactive; she has sudden bursts of anger, after which she calms down quickly. She complains of leucorrhoea with a foul odor.The patient was very erratic about her routine and is clueless about what her plans were, even in next 30 minutes. She was unable to choose or distinguish between things. She felt dizzy and sick on looking at moving objects.When asked about catastrophe, which was how she began her case, she related to this word with an example that if her boyfriend wanted to be alone, she thought that he does not love her, a thought which was like the end of the world for her. In childhood, if the teacher did not like her work, she would be so devastated that she would want to give up studies. Everything felt like the end of world to her. End of the world means loss, as if she is a burden on someone and feels worthless. She cannot separate from someone who she is close to her. She wants a lot of attention from people around her. Attention for her is warmth. Warmth is to be hugged, like the warmth of mother’s hug and she feels very safe when hugged. She experiences safety from the external world where one has to prove oneself.Suddenly out of the blue, the patient said “I always feel that I have to change myself to deserve things. I try to be perfect, there is someone inside who demands perfection. I want to be independent; to stand on my own feet and not depend on the support from outside. I once saw a toy which was like a closed system of living creatures, it didn’t need support from outside, and I want to be like that.”This spontaneous association with toy is called free association. The toy was the most surprising feature that surfaced. So we investigate it and see where it leads us.This toy is like a glass, closed and it has some creatures in it which are not dependent on the outside for support, e.g. food. The experience here is of independence. To be in the glass is to be away from the risk of humiliation or being away from the situation where you may be thrown out of the house. She recollected a childhood incident when her mother sent to her grandparents’ home as she did not obey her. The patient felt very hurt and humiliated and to her it was like being thrown out of the house. She felt that she did not want come to her home and if she had a bag, she would be off to a forest and never come back again. Then again, she felt that it would be very dark and scary away from home in the forest. So, she tried to perfect all the time, so that she would be never sent away again. She could not exist without her mother’s help all her childhood and always desired that her mother should respect her the way she was.Further describing the toy, she said that it was like a glass bubble, like an aquarium which is closed. (Here, she makes a hand gesture of a circle). It is a safe place for a baby, (starts weeping at this point) it is like a hug. You experience protection, care, tenderness and attention there. It is like an unborn baby; it is like something that the baby has before delivery but is missing after it is delivered.Here, she connected to a story which she had read in magazine, which featured a baby who was not safe, having being thrown out onto a street in China like a piece of garbage. She felt that the baby would be feeling vulnerable, unprotected, with all things being lethal around it. The patient related that she too had a thrown out feeling when she discovered that her husband was involved in an extramarital affair.There are two important aspects in the case one is of the womb and the other is of trust, humiliation and respect. On one side she is totally dependent where she feels like she is in a glass bubble which is safe tender loving caring and protecting. On the other hand, is the feeling of being disappointed by partner or mother throwing her out of this safe protective womb which is humiliating and disrespectful. This total dependency as if being in a womb is Lithium and the disappointment, mistrust, humiliation, no respect are themes of Muriaticum (Chlorine element)7. Remedy she received was Lithium muriaticum 200, which was shifted to 1M later.After 6 months of treatment, her panic attacks were much better. Her cholecystitis was completely cured. Her migraines have disappeared. Her dependence is much better, but she needs someone to support her. She was able to take a decision to separate from her partner. This shows that the need for dependence is markedly better.