Psychiatric Patients I

Review

This book review is reprinted with permission from Homeopathic Links.

Reviewed by Andries Keizer, psychiatrist


Composition
The editors of this book are: Edith Meinders, Ilse Bos and Rene Otter. They have attended the seminars held in the Netherlands in 1991, lectured by Saine and wrote the verbatim documentation. Saine is not a psychiatrist but a naturopathic physician working with psychiatric patients. Since 1976 he practises homoeopathy and has later founded the Kentesian Academy of Homoeopathy in Canada.

Ideas
During the past ten years Saine has devoted a couple of months a year to the research of articles written in old homoeopathic magazines. He has the special wish that the homoeopaths don't forget the 'old masters' while they are undertaking the current provings. Also he thinks that the homoeopathic schooling should be more focused on carrying on the old tradition. The present homoeopathic practitioners don't spend enough time getting more in depth knowledge compared to other medical specialists. Saine makes the analogy of the first generation of homoeopaths after Hahnemann - they devoted most of their time to study and thereby probably became the best in understanding homoeopathy. Today we only have access to a fraction of that old knowledge, as much is lost in the past years - as we all are trained by homoeopaths that weren't educated by the 'old masters'. He thinks that a large part of 'the heart of homoeopathy' is lost. One of Saine's favourites is Lippe. About Lippe is written some months ago in Homoeopathic Links in connection to a publication of a biography. Saine writes that it is a fatal mistake to prescribe a remedy about which very little is known and hereby he agrees with Lippe, who he quotes on the matter. He makes an exception for patients who are terminally ill when the suitable remedy cannot be found. Unfortunately Saine doesn't comment much on the current provings which are taking place everywhere today. It is fair to assume that he would make some critical comments on this subject.

Content
The book contains many subjects, which should be interesting to the second year homoeopathic student. Saine describes the case-taking just like Hahnemann taught us from the Organon and he thinks that nothing needs to be added to this classic method. He comments the neuroses according to the sections of the repertorium, i.e. the difference between anxiety and fear and the obsessive-compulsive neurosis. As the symptoms of these ailments are difficult to repertorise, he suggests the rubric: 'Thoughts persistent'.

Saine describes also the lesser-known remedies for psychiatric disorders: Asafoeditida, Moschus, Thea, Valeriana, Melilotus, Derris pinnata, Lecithin and Kalium phosphoricum.

Much attention is devoted to Argentum nitricum. He describes a dozen of cases where several members of a family were positively reacting to this remedy or to Silicea or Aurum. This part could have been shorter as it now consists of more than fifty pages.

Hering's law
Hering wrote about his 'law' in the English introduction to 'Chronic Diseases' in 1848. He mentions that pain -.no other symptoms are mentioned - usually disappears from upward to downwards and from the most import organs to less important organs. To Hering this was meant as a practical rule. To the next generation of homoeopaths however, it was treated as a Law and it still treated as such in contemporary homoeopathic training.

At the same time it is also interesting to read how Saine during his research discovered that the famous 'fear of pointed objects' - attributed to Silicea - originated from a single case in 1835. Nevertheless all the following authors repeated this and in this way it eventually has required a solid place in the Repertoria.

Psychiatry
In the homoeopathic literature very little is written about treatment of psychiatric patients. This is probably caused by the fact that patients with mainly physical complaints do consult a homoeopathic physician.

With the introduction of neuroleptica in 1950, psychiatry took a major step forwards.

The use of neuroleptic medication by chronic psychiatric patients poses a problem during the homoeopathic case-taking, as the original complaints are hardly felt any more due to the use of the medication. How can the remedy's effect then be inferred?

Saine compares this to the drinking of much coffee by some patients. The capacity to respond is numbed, the duration of the reaction is shortlived and the medicine has to be repeated more frequently.

If a patient fears a strong reaction after intake of the homoeopathic medicine you can offer him the opportunity to smell it. Saine tells us that Hahnemann around 1833 gave medication in this way as a standard procedure.

Psychotherapy
Many patients who consults my practice undergo often psychotherapy elsewhere or consider combining homoeopathic treatment with psychotherapy. Besides homoeopathy I also work as a psychotherapist on-analytical-lines. It was very interesting for me to read about Saine's comments on this combination.

He describes that Whitmont - a psychoanalyst and homoeopathic physician - combined his homoeopathic treatment with psychotherapy when homoeopathic remedies didn't help. Saine advises psychotherapy to homoeopathic patients after a successful ending of the homoeopathic treatment when they don't have any significant relationships or friends. By this he compares psychotherapy with merely having some confidential conversations with a trustworthy person, and thereby doesn't acknowledge the potential benefits of psychotherapy. I can recommend the reader Rajan Sankaran on the subject of 'homoeopsychotherapy'.

Saine argues that during a psychotherapeutic treatment a patient relives all his old pain and trauma's whereas this could easily be avoided by the proper use of homoeopathic medication.

Is it possible to grow or be cured without any anxiety or suffering?

In my opinion this is hardly possible but it is neither necessary to endure too much pain. Prior to any psychotherapy it is important to determine the strengths and weaknesses of the patient. The amount of this ego-strength determines to what extent a psychotherapist can help the patient either rationalise or mobilise old emotions. If this balance is not struck, the patient might be unable to endure the reliving of old pains and will consequently deteriorate. In other words, a patient has to be able to go home to family, friends and work after every session.

Contrary to Saine I find it hard to believe that chronic psychic problems can be treated well - in the long run - without achieving a certain amount of personal insight.

Hypnotherapists use the same arguments like Saine and also don't acknowledge the positive effect of becoming conscious of a psychic conflict (in psychoanalytic terminology). One could ask as to what extent the homoeopathic treatment can counter the so-called repetitive compulsion - the tendency of the 'cured' patient to repeat former self-destructive behaviour like continuing seeking traumatising relationships, get re-abused etc.

In other words I mean that Saine underestimates the possibilities of psychotherapy. I have had various experiences with patients where the homoeopathic medicine worked more efficiently together with psychotherapy, and the psychotherapy process was speeding up, however working differently. This might possibly be due to the fact that hereby both the conscious and the subconscious levels were treated - but who knows?

Unfortunately the book is lacking much of a system. Materia medica, case studies and psychiatric lessons are scattered around the book. Without indexes the subject search is rather tedious. It looks as if the work of the editors was done in a great hurry to meet the deadline requirements for publication. Words are misspelled and every now and then you can read that a certain sentence wasn't clear to understand while transcribing the tape. I am not interested in reading that. Even though it has some charm to read the book like you were present at the lectures yourself, it gets irritating in the long run when reading the same sentences in other words, for example.

Somewhere I once read: 'Writing (is) a very different medium and art than teaching. While books last forever, much endeavour should be spend on the format or the way it is written'. If the editors consider to publish a second edition I hope they will revise the text to make it more readable. Finally I suggest to use a different type of font while naming the remedies to make them are easier to find in the text.

The book offers a variety of subjects that possibly appeal to homoeopaths at different levels. Some subjects are especially interesting for the homoeopathic student whereas the case-studies might be inspiring for the practising homoeopath.

Homoeopathic Links
Summer 1999 - Volume 12, Number 2

This book review is reprinted from The Homoeopath with permission from Nick Churchill of The Society of Homoeopaths.

Reviewed by Nick Churchill

This book is the verbatim text of a seminar on the homeopathic treatment of psychiatric illness, held in 1991 in Amersfoort, the Netherlands, by the aptly-named Canadian homeopath, Andre Saine, ND. As such it has the raw feel of the spoken word transcribed into an altogether different medium - that of writing - and in its plain binding it is not in the slightest hit 'over-produced' as so many of today's books are. This volume may lack a glossy cover but it definitely isn't short on content: the depth of Dr. Saine's experience in this most difficult area of homeopathy comes out on every page in a very direct and accessible way.

It seems that it was these qualities that led to the book's publication by popular demand from those who attended the seminar back in 1991, and that this is only part of the material that was presented. A second volume may appear at some point in the future.

Unfortunately however the horse's mouth approach extends to the actual translation of the work. The journey from the Canadian French of the speaker to the Dutch of the audience and the editor, and finally to the non-mother tongue English of the written text has led to a serious outbreak of Chinese whispers, often with unintentionally amusing results. At one point we hear about the case of a schizohrenic man seen in 1959 by the celebrated homeopath Dr. Edward 'Withmond'. According to the translator:

'In spite of what at that time were considered neurotic trades, he serviced his term in the army and saw action in French'.

Trying to make sense of the language can lead to a fair degree of mental unhingement in the reader too, and while we would never value a guru who communicated in perfect English, this laxness quickly became an annoying impediment to my reading pleasure. In the end however I could always grasp what the author meant. This sole shortcoming should not deter anyone interested in the homeopathic treatment of psychiatric illness, or indeed in classical homeopathy in general, from studying this book.

Dr. Saine's clinical experience is evidently significant, and he applies himself to his subject with the same rigorous, no-nonsense, classical attitude that seems to have waned in popularity as the millenium draws near and other approaches to homeopathy are in vogue. This book is full of base-line homeopathy, the fruits of hard work and careful observation; it's practical, it's effective and you can't argue with it.

The bedrock of Andre Saine's skill in homeopathy is his unique knowledge of the classical sources of the last century, particularly of all the old journals packed with cases and round-table discussions by such figures as Dunham, Hering, Lippe, Kent, Farrington and Allen. He tells us that since 1983 he has spent 'on average, ten weeks a year (a week means seven days, of twelve to sixteen hours) in the library'. And you know what, I believe him. 'We have been cut off from our roots', says Andre Saine, 'We have no sense of a great part of the heart of homeopathy today; this is what I have discovered... If I can only stimulate you to go to the earlier writings and start that process again of mastering the subject from the root, you will develop a much broader, much deeper understanding of homeopathy'.

Saine illustrates his teachings with many small gems of cases drawn from his own practice and from the old journals. He holds in special esteem a number of the old masters, Adolph Lippe, for instance, known as the Ajax of prescribers because he was so fast. He was the man who after fifty years of practice had read the Organon over a hundred times and said he was just beginning to comprehend it, and whose lesser writings, if ever published, would come to over three thousand pages. This is the school of homeopathy that rejected all speculation in favour of pure observation.

Psychiatric Patients I begins with a digressive but compelling examination of Hering's 'Law' of Cure (not really a law, says Saine, as it doesn't hold true at all times). It moves on to an exposition of Hahnemann's ground-breaking attitude to the treatment of the 'insane'. Essentially this book is based on the premise that we are heirs to that attitude of Hahnemann's and modern homeopaths who treat psychiatric patients offer the only real hope of cure for those people trapped in the strait-jacket of mental illness or of medication to counter it.

Coming at the subject on the same plane of intellectual regard as Hahnemann and the great masters - and they keep appearing throughout - with the same degree of moral honesty and a blinding gift for telling it like it is, Saine runs through and across the practical issues, the philosophy, the rubrics, the cases, the remedies and the questions from the floor. There is no over-arching order or grand design to this book, but each page seems to have at least a couple of lessons of great importance which you want to embrace and take into your inner sanctum of homeopathic knowledge.

The material is loosely grouped into chapters but the basic elements are bitesized subsections covering dozens and dozens of such diverse subjects as choice of potency, ECT, Julia Green, Arthur Grimmer, cases on medication, manic depression in the climacteric, the history of the repertory, how Hering says you should study materia medica, treating acute disease to unlock psora, and more, much more. These pieces are all well-informed, relevant and highly insightful, whether Saine is making observations of his own or tapping into his reading of the great masters of the first century of homeopathy.

It is a deeply humbling experience to come into the range of someone with this kind of knowledge and experience, and to perceive that real healing is going on here, that the author has understood the full extent of a highly difficult problem such as the treatment of mental illness, and yet has set his mind to try and help his patients overcome it. There is no self-deception or wish-fulfillment in this book. In Saine's arena, if you get it wrong you'll probably know why you were wrong.

It is also extremely empowering to recognise the existence of a homeopathic discourse at this level, and one, moreover, that stretches back to the beginning of homeopathy itself. I very much hope that Dr. Saine will publish more material and come to give seminars in this country.

The Homoeopath
Summer 1998
No. 70